Well, of COURSE it takes more out of the economy.The AVERAGE American doesn’t NEED any health care RIGHT NOW. So why should he WASTE money on Insurance that could be so much more economically used to fund Investment Banker Bonuses?But no. The Heritage Foundation, Mitt Romney, and Barack Obama (But not the GOP) want you to take some personal responsibility and BUY Health Insurance from a Private Company like a Good Little Socialist, instead of getting free taxpayer funded medical care at the Emergency Room like a Money Gouging Capitalist.
Health care counts should count as inelastic demand; that is, some things (such as a new yacht) you can choose to buy or not, that’s elastic demand, but some things (such as basic food or basic health care) you pretty much have to buy, or else you’re in trouble. Basic economics would say that not all goods belong in the same demand/supply equation.
Why are American health care costs so high compared to other countries? It’s not because of the AHC. It’s not because of the high cost of malpractice insurance or defensive medicine. Economists have determined the total malpractice suits and defensive medicine bill adds about 1% to costs. .It is because:1. For-profit health care insurance. All other countries have either eliminated the for-profit insurance companies in favor of government sponsored single-payer plans, or have decided that health care insurance must be non-profit plans.2. Highly paid health care workers, particularly doctors and administrators. These healthcare workers earn consideraably more than their counterparts in other countries.3. Complexity and resulting administrative inefficiency. All other countries have settled on one health care system for everyone and there’s one set of rules governing treatment and payment. The U.S. in contrast is a dog’s breakfast of different payment systems – Medicare for over 65, Medicaid for the poor, one for the military, different one for veterans, one for Members of Congress, one for Native Americans, and on and on. There are hundreds of different private insurance plans, each with its own set of rules. Americans like to think private enterprise and competition brings efficiencies and drives down costs. It doesn’t seem to work that way with health care. Some developed countries have administrative costs of 3%-5% of total health care costs. Most are around the 10% mark (Canada for example). The U.S. is about double that at 17%. The system is so complex that one operation in the same hospital on the same day can have ten different prices, depending on who is paying. A growing business is “compilers” – middlemen who compile the bills that doctors submit and then shuttle them through the payment system.
Yes, My BC/BS went up 80 or 90 cents a month starting this month. That is the least I can remember in the recent past. I guess back in the 60’s I did get refunds.
Here’s an interesting passage from Hayek’s “The Road to Serfdom”, which many regard as the founding document of modern neo-liberalism/conservatism:
“To prohibit the use of certain poisonous substances or to require special precautions in their use, to limit working hours or to require certain sanitary arrangements, is fully compatible with the preservation of competition. The only question is whether in the particular instance the advantages gained are greater than the social costs which they impose. Nor is the preservation of competition incompatible with an extensive system of social services — so long as the organization of these services is not designed in such a way as to make competition ineffective over wide fields.” pp. 86-87.
Hayek, F. A. 2007. The Road to Serfdom: Text and Documents: The Definitive Edition. Edited by Bruce Caldwell. Chicago: University of Chicago Press.
Excellent post!Most of the people here commenting about insurance don’t even have a basic understanding of what is required to run an insurance company or appreciate the benefits they provide, they are all just evil.I’m agree with a previous poster as well regarding the ability of the government to run a complex system such as health care with any degree of efficiency. There are just to many examples of government bureaucracies that have been money pits, far to many.In order for the government to do a better job, it would require fundamental changes that government leaders do not have the strength or stomach to make.
Gypsy8, Wratihkin and Bruce are very close to the truth. As a practicing optometrist, I can agree with most of what they say.
Gypsy is incorrect in that doctors no longer make money. For example, the state of Virginia wanted to reduce its Medicaid costs, so they asked for bids from subcontractors (private insurance). There was no shortage of bids, and the state signed contracts. That year, on September 30, I made $X on an eye exam. On October 1, I made $1/2 X. This is how money was saved. Not in administrative costs, not in better coverage, not in greater efficiency. Just cut doctors’ pay. I submit this fits in along with the idea that you shouldn’t insult the cook before he makes your dinner.
Bruce is right, even if he’s trying to make a different point. Universal health care is the only answer, and it is only a matter of time before every other idea collapses.
Wraithkin is right that there are too many systems. It’s way too complicated. For example, I never get paid anything from Worker’s Comp. Why? Because I can’t bill worker’s comp. The patient’s boss has to bill worker’s comp, and he/she won’t forward the paperwork because then his/her premiums will go up. So all emergency work I do for worker’s comp is paid for by yours truly. Go figure.
Medicare spends 3% of its money on administrative costs. Private insurers are now limited to 20%, and many of us have received refunds because they were using MORE than 20% for marketing, salaries, “expenses”, etc. Comparing to the USPS is apples and oranges, since USPS is now an independent agency. People don’t write letters anymore, which was where the USPS used to make money. Now it’s junk mail and political advertising, which is just junk mail. Also, since the USPS is dependent on transportation, and gas prices and vehicle prices have skyrocketed, it’s a wonder it continues to exist. There will never be a lack of demand for health care.
Private insurance companies take in money from premiums, INVEST that money to provide returns, and pay off claims from actuarial tables intended to assure that claims are LESS than premiums collected. The profits insurance companies make go to “investors”, and employees, like bonuses for CEOs. The government doesn’t have to pay off “investors”, or give CEOs bonuses, and btw, the average insurance company, or bank president makes FAR MORE than the President of the United States, which is $4000,000 per annum. (It jumped from $200k for Clinton, to $400 K for “W”, as approved by Congress.)
While short-term projects, like building one new section of road for example, might be cheaper under contract, because you don’t have to buy equipment, expensive, for a short-term event that doesn’t recur. However, in every study done regarding contracting by government agencies, only about 1-2% of all permanent jobs performed by government employees could be done for less cost under contractors. While seasonal fire fighting has gone to many contractors, and the wages and benefits for the firefighters have gone down, the overall cost to the government has NOT gone down, and those running the contracts, who didn’t exist before, are making huge profits. Safety has also gone down!
Simply put, in real-word terms, “single payer”, using private hospitals and doctors, not “socialized medicine”, would save hugely, if done properly, like doing away with the “no bid” policy on pharmaceuticals the REPUBLICANS pushed through. Which two highly advertised on TV drugs I know of, cost folks WITH insurance, $5 per pill! Yet, counting all costs of development, and advertising, and manufacture of those drugs, the cost per pill to the company is less than TEN CENTS per pill!! Right there’s no reason for Medicare to negotiate like VA does. Which, drugs NOT on formularies for either insurance companies, or VA are largely those still under patent protection, which, thanks to the founding fathers and that Constitution, corporations are given a license to steal called : patent.
Individual doctors pay a hefty malpractice insurance premium. I’ve heard $140,000 is not uncommon and each doctor might be expected to be sued two or three times during their lifetime. In contrast, European doctors pay around $1,400, and expect never to be sued. But, it still remains that, although significant to the doctor, it is still only around 1% of total health care costs, according to economists..I’m not going to get into actuarial issues of insurance companies, because I don’t know much about it. The big picture is that other countries have determined that to provide affordable health care, they either go to single payer or make insurance coverage non-profit. (Insurance companies will still compete for business but the profits will be from ancillary coverages.) That is the big difference between the U.S. and the rest of the world – the U.S. treats health care as a business opportunity. The rest of the world takes the position that the purpose of health care is to cure disease and make people well, which has many spin-off benefits for the country..Although health care workers make considerably less in other countries than in the U.S., it has not resulted in inferior care. Quite the opposite – despite spending about double any other country, the U.S. still rank mediocre by world standards. (although possibly the best in innovative technology, quality of best hospitals, and medical teaching) I could give you a half dozen or so health care metrics where the U.S. is dead last or near last..You mention that the government is the most inefficient operating mechanism. Why then does the most socialistic system on the planet, the U.S. VA medical system have only 3% administration expenses – about one fifth that of the mainstream private insurance system?
“……..But we are America, we do not have to learn from foreigners…….”.You put your finger on a very good point. The Chinese have a saying, “When lost on a foggy night, follow the trail of the ox cart ahead.”.Which is what Taiwan did in 1994, the year the Republicans shot down Hillarycare in the U.S.. The Taiwanese asked Chinese American Professor William Hsiao, a health care economist from Harvard to lead the way. .Hsiao studied systems in Canada, Japan, Germany, Britain, and the U.S. Hsiao recommended a plan borrowed from several countries. At the core was Canada’s single-payer National Health Care system. He added the smart card for records and billings pioneered by the French. Rather than a tax to pay for the system he recommended a premium with contributions from employer, employee, the user, the government, and an approximately $7 per office visit co-pay. Approximately two years later Taiwan had a world class, universal health care system. Administration costs run at 2% of total costs, a tenth that of the U.S., total health care spending is about 6% of GDP, compared to 17% for the U.S...Anecdote:In 2002, Professor Hsiao was touring some newly constructed hospitals. At one remote hospital, Mrs. Lee Ching-li was doing volunteer blood pressure work. Decades earlier her mother had died from breast cancer. Then when Mrs. Lee also got breast cancer, she feared the worst. But thanks to the new health care system she was given a complete cure. She was so grateful she volunteers several days a week at the hospital. Someone pointed out Hsiao to her as the man who designed the system that saved her life. This shy peasant woman hesitantly walked up to him with tears in her eyes, hugged him and thanked him for saving her life. Then she went back to her volunteer work thankful for Professor Hsiao, thankful for living in a country than can afford universal health care, and thankful for a government that puts people ahead of politics.
And all these flamethrowers are why I stopped posting here before. Jesus people, grow up. Throwing names around does not further your cause, nor reinforce your opinion. That goes to both sides.Gypsy: In response to your post, you make fair arguments. I just disagree that a single-payer system is what’s best for this country. If for no other reason than for the option of choice. This country was founded, and I still hope today, that people can choose. It’s our right. And a single-payer or socialized medicine takes away that choice. In Canada, if you aren’t getting the care you need at the pace you need it, what do you do? Come to America. Is it covered? Nope. But people do it anyway. If America was so crappy, why is that?American medicine is the source of many, if not most, of the world’s medical innovations. That can only be done with money… money that wouldn’t exist in a single-payer or socialized medicine. Why? Because hospitals wouldn’t have the funds to push the advance. We just had a hospital in my area take their for-profit funds and build a new wing onto the hospital. That improves the amount and quality of the care available to our community. I consider that a good thing.As to the rankings across the world as to our health care, I’m going to venture a guess there’s an underlying factor that is being ignored on those analyses: societal norms. By that I mean in America, we are the most obese country in the world. We have a high (though declining) rate of smoking. We have a workforce that is stressed. A lot. We have a large portion of the population that doesn’t come in until it’s an emergency, sometimes too late. You have people who are more self-absorbed to do what they want instead of taking care of their unborn child. While we have a lower per-capita violent crime rate, we still have 330 million people. That means we’re going to have more people going to the hospital for violent crime, because hospitals are static.When you have all these factors pushing up the mortality rate in hospitals, it’s going to push our rankings down. I’m willing to bet those rankings don’t take that into effect, and are simply pushing those numbers out. And that, I’m sure, doesn’t paint our health care in a flattering light. As to the cost of the care, I know that when I was talking to my orthopedic surgeon (who I only had to wait 1 week to see, by the way) for my shoulders, he told me that his direct costs, not counting what he paid to the clinic and hospital, was approximately 46 cents per dollar he charges. That, to me, says that your economists are wrong on that 1%. If the doctors are paying that much expense, how can that only make up 1% of the costs of care? He also said that government reimbursement (via medicaid, medicaire, and the VA) is about 42 cents on the dollar. So that means that when he was treating me, he was actually losing money. But he did it because I’m a veteran. He lamented that if the PPACA continued the way it was, he wouldn’t be able to afford to practice medicine. I think there are a lot of things that we can do to help shrink the costs of care, but forcing a single-payer or socialized medicine model on the American people is not one of them. We aren’t Europe. We don’t want to be Europe. Health Care is not a right. It’s a service provided by other human beings. A service for which you must pay. I take offense at the notion that I should be forced to subsidize someone else’s medicine because they are too damn lazy to work. I don’t mind paying my premiums because I know that all the other people in the insurance plan to which I subscribe also pay an equivalent portion. This is about fairness. I don’t want to pay another $6000 a year in taxes to pay for an illegal’s health care, or non-working teen single-mother who couldn’t be bothered to keep her legs closed. Or that 40-something guy who just can’t be bothered to take a job that pays $11 per hour, because he “deserves” better. I bust my rump to make the money I make, and if I have insurance for myself and my family, it’s because I pay for it. So should everyone else, because that’s what’s truly fair.
Actually, yes. You may think I’m crazy, but here’s why: I have, between my surgeries, my wife’s surgeries (note plural for both), and my children’s surgeries, I have had a great positive experience with it. I have had dual shoulder surgeries. My total time for each surgery from complaint to going under the knife of an orthopedic surgeon was probably 3-4 weeks for each shoulder (years apart), and that was only because it had to get cleared through the military medical complex. My wife has had to have both gastric bypass and an hysterectomy. Gastric Bypass was pre-approved through the insurance (private insurance through my employer), which took about 4 weeks, and then surgery was scheduled approximately a week later. Her hysterectomy took even less time. Now compare this to our neighbors to the north. Assuming either of these would be approved, how long would the wait time to see a specialist be? I’ve heard stories about people with a need for a hip replacement waiting months to just go for the initial consult, and then another few months to actually go under the knife. Or heart specialists. Or whatever. To me the issue is the wait times. Now, I will give our upstairs neighbors a lot of props: Their PCP/GP’s are great and it’s a great system they have. But when it comes to specialists, they are about as rare as unicorns, from what I’ve heard. So perhaps a hybrid system may be appropriate? General, in-office care be universal, where surgical services would be contracted through private insurance. That way those with sniffles, need a toenail excised, or need a medication refill would be covered by the universal care, but it wouldn’t stifle the desire to be surgeons. But one thing absolutely has to be dissolved is this price control nonsense from the government. Reimbursing doctors at below-market rates will drive doctors away, not encourage them to work with you. You have to provide competitive wages if you want the best doctors working in the system.
Single payer, and completing he Affordable Care Act, with additions, and restrictions on profiteering, would be a good thing. While the Act provides some oxygen as in the ‘toon, Lisa’s been huffing too much nitrous.
@WraithkinThe paradox is that America ranks high in medical innovation but low in quality health care delivery to the masses. Profits incentivize innovation, but the record shows it doesn’t do likewise to health care. It should be possible to split the two. Incentivize innovation through profits, but don’t do it on the backs of the sick..You blame social factors such as widespread obesity. By casual observation, you are probably right. But America is not the only nation that has its segment of the population who abuse themselves nor do not take responsibility for their health. One difference is that all national health care plans in the world include health care education. The American conservative wing seems to resent any advice or involvement from government. Note the conservative outrage over Mayor Bloomberg’s concern for the harmful effects of large container sugar drinks. Damn the health of the children, we want our freedoms. .The fallacy of your argument is that by maintaining the status quo you are keeping a system where costs will continue to escalate and health care will continue to suffer. .You are defending a system that allows 20-22,000 to die annually from treatable diseases because they lack the capacity to pay for treatment (seven 9/11s). You are accepting that 700,000 medical bankruptcies annually is okay. That’s an incalculable amount of pain and hardship you are accepting to defend a questionable, if not phantom, principle..You don’t want to be like Europe, but Europe has more favourable treatment outcomes and a higher life expectancy than America at half the cost. .This is the status quo you are prepared to defend. What is Einstein’s definition of insanity? Wasn’t it doing something over and over and expecting different results?
Well, here’s a personal example. A couple of years ago I began to notice what could have been the symptoms of a serious but non-life threatening medical condition. I look it up on the web and I got a little freaked out, so I ran over to the emergency department, about six at night. At triage I explained what I was experiencing — they took it seriously, but there were people with more immediate concerns ahead of me, so I did have to wait about four hours to see a doctor. He listened to me and he did a pretty thorough work-up. Then he said, “So far as I can see, you’re okay, and there’s another explanation for what you’re experiencing. But I’m not a specialist in that particular condition. As it happens the specialist has gone home. I could call him back in, and if you were experiencing X rather than Y, I would. But as it is, I am quite confident that nothing serious is going to happen, and we can wait until tomorrow. So I am making you an appointment to see the specialist tomorrow afternoon. Meanwhile, if X should happen, and I am sure it won’t, you get right back here and we will deal with it.” So I saw the specialist the next afternoon, and as the emergency room doctor said, there was nothing seriously wrong. That’s one example of medicine in Ontario.
ConserveGov about 11 years ago
Hold up Yo!I’s thought we’s waz gon see prices cheapa?
Nebulous Premium Member about 11 years ago
Well, of COURSE it takes more out of the economy.The AVERAGE American doesn’t NEED any health care RIGHT NOW. So why should he WASTE money on Insurance that could be so much more economically used to fund Investment Banker Bonuses?But no. The Heritage Foundation, Mitt Romney, and Barack Obama (But not the GOP) want you to take some personal responsibility and BUY Health Insurance from a Private Company like a Good Little Socialist, instead of getting free taxpayer funded medical care at the Emergency Room like a Money Gouging Capitalist.
Stormrider2112 about 11 years ago
I still think it’s humorous that Republicans are complaing (again) about a Democrat who proposed an idea they’ve had for decades.
Bandusia15 about 11 years ago
No, Lisa Benson sucks. Her pettiness and ignorance is apparent in all her cartoons.
mnsmkd about 11 years ago
Good one
lonecat about 11 years ago
Health care counts should count as inelastic demand; that is, some things (such as a new yacht) you can choose to buy or not, that’s elastic demand, but some things (such as basic food or basic health care) you pretty much have to buy, or else you’re in trouble. Basic economics would say that not all goods belong in the same demand/supply equation.
Gypsy8 about 11 years ago
Why are American health care costs so high compared to other countries? It’s not because of the AHC. It’s not because of the high cost of malpractice insurance or defensive medicine. Economists have determined the total malpractice suits and defensive medicine bill adds about 1% to costs. .It is because:1. For-profit health care insurance. All other countries have either eliminated the for-profit insurance companies in favor of government sponsored single-payer plans, or have decided that health care insurance must be non-profit plans.2. Highly paid health care workers, particularly doctors and administrators. These healthcare workers earn consideraably more than their counterparts in other countries.3. Complexity and resulting administrative inefficiency. All other countries have settled on one health care system for everyone and there’s one set of rules governing treatment and payment. The U.S. in contrast is a dog’s breakfast of different payment systems – Medicare for over 65, Medicaid for the poor, one for the military, different one for veterans, one for Members of Congress, one for Native Americans, and on and on. There are hundreds of different private insurance plans, each with its own set of rules. Americans like to think private enterprise and competition brings efficiencies and drives down costs. It doesn’t seem to work that way with health care. Some developed countries have administrative costs of 3%-5% of total health care costs. Most are around the 10% mark (Canada for example). The U.S. is about double that at 17%. The system is so complex that one operation in the same hospital on the same day can have ten different prices, depending on who is paying. A growing business is “compilers” – middlemen who compile the bills that doctors submit and then shuttle them through the payment system.
Justice22 about 11 years ago
Yes, My BC/BS went up 80 or 90 cents a month starting this month. That is the least I can remember in the recent past. I guess back in the 60’s I did get refunds.
lonecat about 11 years ago
Here’s an interesting passage from Hayek’s “The Road to Serfdom”, which many regard as the founding document of modern neo-liberalism/conservatism:
“To prohibit the use of certain poisonous substances or to require special precautions in their use, to limit working hours or to require certain sanitary arrangements, is fully compatible with the preservation of competition. The only question is whether in the particular instance the advantages gained are greater than the social costs which they impose. Nor is the preservation of competition incompatible with an extensive system of social services — so long as the organization of these services is not designed in such a way as to make competition ineffective over wide fields.” pp. 86-87.
Hayek, F. A. 2007. The Road to Serfdom: Text and Documents: The Definitive Edition. Edited by Bruce Caldwell. Chicago: University of Chicago Press.
dpbriley about 11 years ago
Excellent post!Most of the people here commenting about insurance don’t even have a basic understanding of what is required to run an insurance company or appreciate the benefits they provide, they are all just evil.I’m agree with a previous poster as well regarding the ability of the government to run a complex system such as health care with any degree of efficiency. There are just to many examples of government bureaucracies that have been money pits, far to many.In order for the government to do a better job, it would require fundamental changes that government leaders do not have the strength or stomach to make.
I Play One On TV about 11 years ago
Gypsy8, Wratihkin and Bruce are very close to the truth. As a practicing optometrist, I can agree with most of what they say.
Gypsy is incorrect in that doctors no longer make money. For example, the state of Virginia wanted to reduce its Medicaid costs, so they asked for bids from subcontractors (private insurance). There was no shortage of bids, and the state signed contracts. That year, on September 30, I made $X on an eye exam. On October 1, I made $1/2 X. This is how money was saved. Not in administrative costs, not in better coverage, not in greater efficiency. Just cut doctors’ pay. I submit this fits in along with the idea that you shouldn’t insult the cook before he makes your dinner.
Bruce is right, even if he’s trying to make a different point. Universal health care is the only answer, and it is only a matter of time before every other idea collapses.
Wraithkin is right that there are too many systems. It’s way too complicated. For example, I never get paid anything from Worker’s Comp. Why? Because I can’t bill worker’s comp. The patient’s boss has to bill worker’s comp, and he/she won’t forward the paperwork because then his/her premiums will go up. So all emergency work I do for worker’s comp is paid for by yours truly. Go figure.
Medicare spends 3% of its money on administrative costs. Private insurers are now limited to 20%, and many of us have received refunds because they were using MORE than 20% for marketing, salaries, “expenses”, etc. Comparing to the USPS is apples and oranges, since USPS is now an independent agency. People don’t write letters anymore, which was where the USPS used to make money. Now it’s junk mail and political advertising, which is just junk mail. Also, since the USPS is dependent on transportation, and gas prices and vehicle prices have skyrocketed, it’s a wonder it continues to exist. There will never be a lack of demand for health care.
Dtroutma about 11 years ago
Private insurance companies take in money from premiums, INVEST that money to provide returns, and pay off claims from actuarial tables intended to assure that claims are LESS than premiums collected. The profits insurance companies make go to “investors”, and employees, like bonuses for CEOs. The government doesn’t have to pay off “investors”, or give CEOs bonuses, and btw, the average insurance company, or bank president makes FAR MORE than the President of the United States, which is $4000,000 per annum. (It jumped from $200k for Clinton, to $400 K for “W”, as approved by Congress.)
While short-term projects, like building one new section of road for example, might be cheaper under contract, because you don’t have to buy equipment, expensive, for a short-term event that doesn’t recur. However, in every study done regarding contracting by government agencies, only about 1-2% of all permanent jobs performed by government employees could be done for less cost under contractors. While seasonal fire fighting has gone to many contractors, and the wages and benefits for the firefighters have gone down, the overall cost to the government has NOT gone down, and those running the contracts, who didn’t exist before, are making huge profits. Safety has also gone down!
Simply put, in real-word terms, “single payer”, using private hospitals and doctors, not “socialized medicine”, would save hugely, if done properly, like doing away with the “no bid” policy on pharmaceuticals the REPUBLICANS pushed through. Which two highly advertised on TV drugs I know of, cost folks WITH insurance, $5 per pill! Yet, counting all costs of development, and advertising, and manufacture of those drugs, the cost per pill to the company is less than TEN CENTS per pill!! Right there’s no reason for Medicare to negotiate like VA does. Which, drugs NOT on formularies for either insurance companies, or VA are largely those still under patent protection, which, thanks to the founding fathers and that Constitution, corporations are given a license to steal called : patent.
Gypsy8 about 11 years ago
Individual doctors pay a hefty malpractice insurance premium. I’ve heard $140,000 is not uncommon and each doctor might be expected to be sued two or three times during their lifetime. In contrast, European doctors pay around $1,400, and expect never to be sued. But, it still remains that, although significant to the doctor, it is still only around 1% of total health care costs, according to economists..I’m not going to get into actuarial issues of insurance companies, because I don’t know much about it. The big picture is that other countries have determined that to provide affordable health care, they either go to single payer or make insurance coverage non-profit. (Insurance companies will still compete for business but the profits will be from ancillary coverages.) That is the big difference between the U.S. and the rest of the world – the U.S. treats health care as a business opportunity. The rest of the world takes the position that the purpose of health care is to cure disease and make people well, which has many spin-off benefits for the country..Although health care workers make considerably less in other countries than in the U.S., it has not resulted in inferior care. Quite the opposite – despite spending about double any other country, the U.S. still rank mediocre by world standards. (although possibly the best in innovative technology, quality of best hospitals, and medical teaching) I could give you a half dozen or so health care metrics where the U.S. is dead last or near last..You mention that the government is the most inefficient operating mechanism. Why then does the most socialistic system on the planet, the U.S. VA medical system have only 3% administration expenses – about one fifth that of the mainstream private insurance system?
Gypsy8 about 11 years ago
“……..But we are America, we do not have to learn from foreigners…….”.You put your finger on a very good point. The Chinese have a saying, “When lost on a foggy night, follow the trail of the ox cart ahead.”.Which is what Taiwan did in 1994, the year the Republicans shot down Hillarycare in the U.S.. The Taiwanese asked Chinese American Professor William Hsiao, a health care economist from Harvard to lead the way. .Hsiao studied systems in Canada, Japan, Germany, Britain, and the U.S. Hsiao recommended a plan borrowed from several countries. At the core was Canada’s single-payer National Health Care system. He added the smart card for records and billings pioneered by the French. Rather than a tax to pay for the system he recommended a premium with contributions from employer, employee, the user, the government, and an approximately $7 per office visit co-pay. Approximately two years later Taiwan had a world class, universal health care system. Administration costs run at 2% of total costs, a tenth that of the U.S., total health care spending is about 6% of GDP, compared to 17% for the U.S...Anecdote:In 2002, Professor Hsiao was touring some newly constructed hospitals. At one remote hospital, Mrs. Lee Ching-li was doing volunteer blood pressure work. Decades earlier her mother had died from breast cancer. Then when Mrs. Lee also got breast cancer, she feared the worst. But thanks to the new health care system she was given a complete cure. She was so grateful she volunteers several days a week at the hospital. Someone pointed out Hsiao to her as the man who designed the system that saved her life. This shy peasant woman hesitantly walked up to him with tears in her eyes, hugged him and thanked him for saving her life. Then she went back to her volunteer work thankful for Professor Hsiao, thankful for living in a country than can afford universal health care, and thankful for a government that puts people ahead of politics.
Gypsy8 about 11 years ago
Thanks Ahab M.D.. I’m surprised.
Wraithkin about 11 years ago
And all these flamethrowers are why I stopped posting here before. Jesus people, grow up. Throwing names around does not further your cause, nor reinforce your opinion. That goes to both sides.Gypsy: In response to your post, you make fair arguments. I just disagree that a single-payer system is what’s best for this country. If for no other reason than for the option of choice. This country was founded, and I still hope today, that people can choose. It’s our right. And a single-payer or socialized medicine takes away that choice. In Canada, if you aren’t getting the care you need at the pace you need it, what do you do? Come to America. Is it covered? Nope. But people do it anyway. If America was so crappy, why is that?American medicine is the source of many, if not most, of the world’s medical innovations. That can only be done with money… money that wouldn’t exist in a single-payer or socialized medicine. Why? Because hospitals wouldn’t have the funds to push the advance. We just had a hospital in my area take their for-profit funds and build a new wing onto the hospital. That improves the amount and quality of the care available to our community. I consider that a good thing.As to the rankings across the world as to our health care, I’m going to venture a guess there’s an underlying factor that is being ignored on those analyses: societal norms. By that I mean in America, we are the most obese country in the world. We have a high (though declining) rate of smoking. We have a workforce that is stressed. A lot. We have a large portion of the population that doesn’t come in until it’s an emergency, sometimes too late. You have people who are more self-absorbed to do what they want instead of taking care of their unborn child. While we have a lower per-capita violent crime rate, we still have 330 million people. That means we’re going to have more people going to the hospital for violent crime, because hospitals are static.When you have all these factors pushing up the mortality rate in hospitals, it’s going to push our rankings down. I’m willing to bet those rankings don’t take that into effect, and are simply pushing those numbers out. And that, I’m sure, doesn’t paint our health care in a flattering light. As to the cost of the care, I know that when I was talking to my orthopedic surgeon (who I only had to wait 1 week to see, by the way) for my shoulders, he told me that his direct costs, not counting what he paid to the clinic and hospital, was approximately 46 cents per dollar he charges. That, to me, says that your economists are wrong on that 1%. If the doctors are paying that much expense, how can that only make up 1% of the costs of care? He also said that government reimbursement (via medicaid, medicaire, and the VA) is about 42 cents on the dollar. So that means that when he was treating me, he was actually losing money. But he did it because I’m a veteran. He lamented that if the PPACA continued the way it was, he wouldn’t be able to afford to practice medicine. I think there are a lot of things that we can do to help shrink the costs of care, but forcing a single-payer or socialized medicine model on the American people is not one of them. We aren’t Europe. We don’t want to be Europe. Health Care is not a right. It’s a service provided by other human beings. A service for which you must pay. I take offense at the notion that I should be forced to subsidize someone else’s medicine because they are too damn lazy to work. I don’t mind paying my premiums because I know that all the other people in the insurance plan to which I subscribe also pay an equivalent portion. This is about fairness. I don’t want to pay another $6000 a year in taxes to pay for an illegal’s health care, or non-working teen single-mother who couldn’t be bothered to keep her legs closed. Or that 40-something guy who just can’t be bothered to take a job that pays $11 per hour, because he “deserves” better. I bust my rump to make the money I make, and if I have insurance for myself and my family, it’s because I pay for it. So should everyone else, because that’s what’s truly fair.
Wraithkin about 11 years ago
Actually, yes. You may think I’m crazy, but here’s why: I have, between my surgeries, my wife’s surgeries (note plural for both), and my children’s surgeries, I have had a great positive experience with it. I have had dual shoulder surgeries. My total time for each surgery from complaint to going under the knife of an orthopedic surgeon was probably 3-4 weeks for each shoulder (years apart), and that was only because it had to get cleared through the military medical complex. My wife has had to have both gastric bypass and an hysterectomy. Gastric Bypass was pre-approved through the insurance (private insurance through my employer), which took about 4 weeks, and then surgery was scheduled approximately a week later. Her hysterectomy took even less time. Now compare this to our neighbors to the north. Assuming either of these would be approved, how long would the wait time to see a specialist be? I’ve heard stories about people with a need for a hip replacement waiting months to just go for the initial consult, and then another few months to actually go under the knife. Or heart specialists. Or whatever. To me the issue is the wait times. Now, I will give our upstairs neighbors a lot of props: Their PCP/GP’s are great and it’s a great system they have. But when it comes to specialists, they are about as rare as unicorns, from what I’ve heard. So perhaps a hybrid system may be appropriate? General, in-office care be universal, where surgical services would be contracted through private insurance. That way those with sniffles, need a toenail excised, or need a medication refill would be covered by the universal care, but it wouldn’t stifle the desire to be surgeons. But one thing absolutely has to be dissolved is this price control nonsense from the government. Reimbursing doctors at below-market rates will drive doctors away, not encourage them to work with you. You have to provide competitive wages if you want the best doctors working in the system.
Dtroutma about 11 years ago
Single payer, and completing he Affordable Care Act, with additions, and restrictions on profiteering, would be a good thing. While the Act provides some oxygen as in the ‘toon, Lisa’s been huffing too much nitrous.
Gypsy8 about 11 years ago
@WraithkinThe paradox is that America ranks high in medical innovation but low in quality health care delivery to the masses. Profits incentivize innovation, but the record shows it doesn’t do likewise to health care. It should be possible to split the two. Incentivize innovation through profits, but don’t do it on the backs of the sick..You blame social factors such as widespread obesity. By casual observation, you are probably right. But America is not the only nation that has its segment of the population who abuse themselves nor do not take responsibility for their health. One difference is that all national health care plans in the world include health care education. The American conservative wing seems to resent any advice or involvement from government. Note the conservative outrage over Mayor Bloomberg’s concern for the harmful effects of large container sugar drinks. Damn the health of the children, we want our freedoms. .The fallacy of your argument is that by maintaining the status quo you are keeping a system where costs will continue to escalate and health care will continue to suffer. .You are defending a system that allows 20-22,000 to die annually from treatable diseases because they lack the capacity to pay for treatment (seven 9/11s). You are accepting that 700,000 medical bankruptcies annually is okay. That’s an incalculable amount of pain and hardship you are accepting to defend a questionable, if not phantom, principle..You don’t want to be like Europe, but Europe has more favourable treatment outcomes and a higher life expectancy than America at half the cost. .This is the status quo you are prepared to defend. What is Einstein’s definition of insanity? Wasn’t it doing something over and over and expecting different results?
lonecat about 11 years ago
Well, here’s a personal example. A couple of years ago I began to notice what could have been the symptoms of a serious but non-life threatening medical condition. I look it up on the web and I got a little freaked out, so I ran over to the emergency department, about six at night. At triage I explained what I was experiencing — they took it seriously, but there were people with more immediate concerns ahead of me, so I did have to wait about four hours to see a doctor. He listened to me and he did a pretty thorough work-up. Then he said, “So far as I can see, you’re okay, and there’s another explanation for what you’re experiencing. But I’m not a specialist in that particular condition. As it happens the specialist has gone home. I could call him back in, and if you were experiencing X rather than Y, I would. But as it is, I am quite confident that nothing serious is going to happen, and we can wait until tomorrow. So I am making you an appointment to see the specialist tomorrow afternoon. Meanwhile, if X should happen, and I am sure it won’t, you get right back here and we will deal with it.” So I saw the specialist the next afternoon, and as the emergency room doctor said, there was nothing seriously wrong. That’s one example of medicine in Ontario.