MANDATORY health insurance - Page 6 - U2 Feedback

Go Back   U2 Feedback > Lypton Village > Free Your Mind > Free Your Mind Archive
Click Here to Login
 
 
Thread Tools Search this Thread Display Modes
 
Old 06-29-2009, 07:06 PM   #101
Forum Moderator
 
yolland's Avatar
 
Join Date: Aug 2004
Posts: 7,471
Local Time: 02:01 PM
I took that quote as a somewhat-of-an-aside corollary re: the "perverse incentives" for doctors to prescribe wastefully unnecessary 'treatments,' and for insurers to keep covering them, already mentioned. In other words, if you're someone with "good" insurance, then--depending on both your current health and your doctor's integrity (and to be fair, his/her awareness of your medical history)--you might wind up in the position of getting all kinds of wastefully unnecessary treatments, basically for free. And yes, that's ultimately the doctor's responsibility, but if you were footing a bit more of the bill, then you'd probably start asking more questions like, "Hold on a minute--Dr. ____ already recently tested me for that, and everything came back negative; why do we need to do it again now?"

You're right though about the absurdity of expecting patients to take much responsibility for "overconsumption"; medical care isn't just another 'product,' where any layperson can easily make him/herself a 'highly informed consumer.'
__________________

__________________
yolland [at] interference.com


μελετώ αποτυγχάνειν. -- Διογένης της Σινώπης
yolland is offline  
Old 06-29-2009, 07:45 PM   #102
ONE
love, blood, life
 
melon's Avatar
 
Join Date: Oct 2000
Location: Ásgarðr
Posts: 11,782
Local Time: 09:01 AM
Quote:
Originally Posted by yolland View Post
You're right though about the absurdity of expecting patients to take much responsibility for "overconsumption"; medical care isn't just another 'product,' where any layperson can easily make him/herself a 'highly informed consumer.'
And, frankly, we've seen what happens when HMOs take charge of what's "medically necessary" too. Patients who need procedures that are deemed medically necessary by their doctors are sometimes rejected likely just because they're "too expensive."
__________________

melon is offline  
Old 07-07-2009, 12:13 PM   #103
The Fly
 
Join Date: Feb 2009
Posts: 57
Local Time: 09:01 AM
The best countries to live in all have universal, communist healthcare...it's cheaper and more equitable.

Why would America want to emulate Denmark, Sweden, Canada...?
jimyjazz is offline  
Old 07-16-2009, 01:41 PM   #104
Refugee
 
AliEnvy's Avatar
 
Join Date: Jan 2001
Location: Toronto, Canada
Posts: 2,320
Local Time: 01:01 PM
Quote:
Originally Posted by deep View Post
more likely the blood sucking health profiteers,
will suck it dry,

much like the blood sucking wall street, finance, derivative profiteers did

then it will implode,

there won't any money in the system

then there will be a re-imagining of how we perceive health services, how they are delivered and how they are paid for.
Yep. Not sure if this latest faux pas has made into any thread around here.

'The Select Few' Are Cashing in: Shocking Corruption at the Washington Post

by Bill Moyers and Michael Winship
.
Global Research, July 15, 2009

If you want to know what really matters in Washington, don't go to Capitol Hill for one of those hearings, or pay attention to those staged White House "town meetings." They're just for show. What really happens -- the serious business of Washington -- happens in the shadows, out of sight, off the record. Only occasionally -- and usually only because someone high up stumbles -- do we get a glimpse of just how pervasive the corruption has become.

Case in point: Katharine Weymouth, the publisher of The Washington Post -- one of the most powerful people in DC -- invited top officials from the White House, the Cabinet and Congress to her home for an intimate, off-the-record dinner to discuss health care reform with some of her reporters and editors covering the story.

But CEOs and lobbyists from the health care industry were invited, too, provided they forked over $25,000 a head -- or up to a quarter of a million if they want to sponsor a whole series of these cozy get-togethers. And what is the inducement offered? Nothing less, the invitation read, than "an exclusive opportunity to participate in the health-care reform debate among the select few who will get it done."

The invitation reminds the CEO's and lobbyists that they will be buying access to "those powerful few in business and policy making who are forwarding, legislating and reporting on the issues...

"Spirited? Yes. Confrontational? No." The invitation promises this private, intimate and off-the-record dinner is an extension "of The Washington Post brand of journalistic inquiry into the issues, a unique opportunity for stakeholders to hear and be heard."

Let that sink in. In this case, the "stakeholders" in health care reform do not include the rabble -- the folks across the country who actually need quality health care but can't afford it.
If any of them showed up at the kitchen door on the night of this little soiree, the bouncer would drop kick them beyond the Beltway.

Now, before you can cross the threshold to reach "the select few who will actually get it done," you must first cross the palm of some outstretched hand. The Washington Post dinner was canceled after a copy of the invite was leaked to the web site Politico.com, by a health care lobbyist, of all people. The paper said it was a misunderstanding -- the document was a draft that had been mailed out prematurely by its marketing department. There's noblesse oblige for you -- blame it on the hired help.

In any case, it was enough to give us a glimpse into how things really work in Washington -- a clear insight into why there is such a great disconnect between democracy and government today, between Washington and the rest of the country.

According to one poll after another, a majority of Americans not only want a public option in health care, they also think that growing inequality is bad for the country, that corporations have too much power over policy, that money in politics is the root of all evil, that working families and poor communities need and deserve public support if the market system fails to generate shared prosperity.

But when the insiders in Washington have finished tearing worthy intentions apart and devouring flesh from bone, none of these reforms happen. "Oh," they say, "it's all about compromise. All in the nature of the give-and-take-negotiating of a representative democracy."

That, people, is bull -- the basic nutrient of Washington's high and mighty.

It's not about compromise. It's not about what the public wants. It's about money -- the golden ticket to "the select few who actually get it done."

When Congress passed the Helping Families Save Their Homes Act, "the select few" made sure it no longer contained the cramdown provision that would have allowed judges to readjust mortgages. The one provision that would have helped homeowners the most was removed in favor of an industry that pours hundreds of millions into political campaigns.

So, too, with a bill designed to protect us from terrorist attacks on chemical plants. With "the select few" dictating marching orders, hundreds of factories are being exempted from measures that would make them spend money to prevent the release of toxic clouds that could kill hundreds of thousands.

Everyone knows the credit ratings agencies were co-conspirators with Wall Street in the shameful wilding that brought on the financial meltdown. But when the Obama administration came up with new reforms to prevent another crisis, the credit ratings agencies were given a pass. They'd been excused by "the select few who actually get it done."

And by the time an energy bill emerged from the House of Representatives the other day, "the select few who actually get it done" had given away billions of dollars worth of emission permits and offsets. As The New York Times reported, while the legislation worked its way to the House floor, "It grew fat with compromises, carve-outs, concessions and out-and-out gifts," expanding from 648 pages to 1400 as it spread its largesse among big oil and gas, utility companies and agribusiness.

This week, the public interest groups Common Cause and the Center for Responsive Politics reported that, "According to lobby disclosure reports, 34 energy companies registered in the first quarter of 2009 to lobby Congress around the American Clean Energy and Security Act of 2009. This group of companies spent a total of $23.7 million -- or $260,000 a day -- lobbying members of Congress in January, February and March.

"Many of these same companies also made large contributions to the members of the Senate Environment and Public Works Committee, which has jurisdiction over the legislation and held a hearing this week on the proposed 'cap and trade' system energy companies are fighting. Data shows oil and gas companies, mining companies and electric utilities combined have given more than $2 million just to the 19 members of the Senate Environment and Public Works Committee since 2007, the start of the last full election cycle."

It's happening to health care as well. Even the pro-business magazine The Economist says America has the worst system in the developed world, controlled by executives who are not held to account and investors whose primary goal is raising share price and increasing profit -- while wasting $450 billion dollars in redundant administrative costs and leaving nearly 50 million uninsured.

Enter "the select few who actually get it done." Three out of four of the big health care firms lobbying on Capitol Hill have former members of Congress or government staff members on the payroll -- more than 350 of them -- and they're all fighting hard to prevent a public option, at a rate in excess of $1.4 million a day.

Health care policy has become insider heaven. Even Nancy-Ann DeParle, the White House health reform director, served on the boards of several major health care corporations.

President Obama has pushed hard for a public option but many fear he's wavering, and just this week his chief of staff Rahm Emanuel -- the insider di tutti insiders -- indicated that a public plan just might be negotiable, ready for reengineering, no doubt, by "the select few who actually get it done."

That's how it works. And it works that way because we let it. The game goes on and the insiders keep dealing themselves winning hands. Nothing will change -- nothing -- until the money lenders are tossed out of the temple, the ATM's are wrested from the marble halls, and we tear down the sign they've placed on government -- the one that reads, "For Sale."
AliEnvy is offline  
Old 07-16-2009, 09:58 PM   #105
Forum Moderator
 
yolland's Avatar
 
Join Date: Aug 2004
Posts: 7,471
Local Time: 02:01 PM
^ I thought about that story when I posted the David Brooks clip, actually. He was considering Washington's 'loss of dignity' on a different front, but to a point I think there's a common theme there, corruption resulting from relentless self-marketing and self-commodification.
__________________
yolland [at] interference.com


μελετώ αποτυγχάνειν. -- Διογένης της Σινώπης
yolland is offline  
Old 07-16-2009, 10:08 PM   #106
Forum Moderator
 
yolland's Avatar
 
Join Date: Aug 2004
Posts: 7,471
Local Time: 02:01 PM
^ And having said that, I shall now have the chutzpah to post an article from the Post on health care reform.


Quote:
CBO: Democrats' Proposals Lack Necessary Controls on Spending

by Lori Montgomery and Shailagh Murray
Washington Post, July 17


Congress's chief budget analyst delivered a devastating assessment yesterday of the health-care proposals drafted by congressional Democrats, fueling an insurrection among fiscal conservatives in the House and pushing negotiators in the Senate to redouble efforts to draw up a new plan that more effectively restrains federal spending. Under questioning by members of the Senate Budget Committee, Douglas Elmendorf, director of the nonpartisan Congressional Budget Office, said bills crafted by House leaders and the Senate health committee do not propose "the sort of fundamental changes" necessary to rein in the skyrocketing cost of government health programs, particularly Medicare. On the contrary, Elmendorf said, the measures would pile on an expensive new program to cover the uninsured.

Elmendorf's blunt language startled lawmakers racing to meet Obama's deadline for approving a bill by the August break. The CBO is the official arbiter of the cost of legislation. Fiscal conservatives in the House said Elmendorf's testimony would galvanize the growing number of Democrats agitating for changes in the more than $1.2 trillion House bill, which aims to cover 97% of Americans by 2015. A lot of Democrats want to see more savings, said Rep. Mike Ross (D-AR), who is leading an effort to amend the bill before next week's vote in the Energy and Commerce Committee. "There's no way they can pass this bill on the House floor. Not even close." Republicans also seized on Elmendorf's remarks, with House Minority Leader John A. Boehner (R-OH) saying they prove "that one of the Democrats' chief talking points is pure fiction."

Senate Minority Leader Mitch McConnell (R-KY) said Elmendorf's testimony should serve as a "wake-up call" to Obama and Democratic leaders to heed requests from lawmakers in both parties to slow down the process. Sen. Olympia Snowe (R-ME) said she delivered that message directly to Obama at the White House yesterday, and strongly urged him to give up his August deadline so bipartisan negotiators in the Senate Finance Committee can craft a new reform plan that does more to control costs. "I think it would be prudent for the president to be patient," said Snowe, whom Obama is courting aggressively. Bipartisan approval of a finance bill "can provide huge impetus for the success of this legislation and achieving broader support as it goes through the legislative process."

Talks in the Senate broke late yesterday, with plans to resume next week. Senate Finance Committee Chairman Max Baucus (D-MT) said the group is considering about a dozen options to cover the estimated $1 trillion cost of its package, including reductions in Medicare spending and additional tax increases. The chairman of the Senate Budget Committee, Sen. Kent Conrad (D-ND), also has taken a leading role in the Finance Committee negotiations. Yesterday, when Elmendorf appeared before Conrad's committee to testify about the nation's long-term budget problems, Conrad focused his questions on the House and Senate committee measures, which were drafted without Republican input. "I'm going to really put you on the spot," Conrad said. "From what you have seen from the products of the committees that have reported, do you see a successful effort being mounted to bend the long-term cost curve?"

Elmendorf responded: "No, Mr. Chairman." Although the House plan to cover the uninsured, for example, would add more than $1 trillion to federal health spending over the next decade, according to the CBO, it would trim about $500 billion from existing programs--increasing federal health spending overall. Some provisions of the bill have the potential to trim spending further, Elmendorf said, but "the changes that we have looked at so far do not represent the sort of fundamental change, the order of magnitude that would be necessary, to offset the direct increase in federal health costs that would result from the insurance coverage proposals."

Asked what provisions should be added, Elmendorf suggested changing the way Medicare reimburses providers to create incentives for reducing costs. He also suggested ending or limiting the tax-free treatment of employer-provided health benefits, calling it a federal "subsidy" that encourages spending on ever-more-expensive health packages. Key senators, including Conrad, have been pressing to tax employer-provided benefits, but Senate leaders last week objected, saying that the idea, which Obama opposed on the campaign trail, does not have enough support to win passage. Yesterday, Baucus said White House opposition had hindered acceptance of the tax, which critics said would target police and firefighters who receive generous benefits packages.

...The benefits tax is also hugely unpopular in the House, which has instead proposed a surtax of as much as 5.4% on income exceeding $350,000 a year to pay for health reform. "You're not going to get a tax on health benefits," said Rep. George Miller (D-CA), chairman of the House Committee on Education and Labor.

But House Speaker Nancy Pelosi (D-CA) said she welcomes other efforts to improve the bill, including demands for additional savings. "Can there be more? I think so," Pelosi said. "And that is what the legislative process is about. You don't write the whole bill, introduce it and then go to the floor. This is the time now for an open process of bipartisan review of the bill in the committees."
__________________
yolland [at] interference.com


μελετώ αποτυγχάνειν. -- Διογένης της Σινώπης
yolland is offline  
Old 07-31-2009, 09:17 PM   #107
Forum Moderator
 
yolland's Avatar
 
Join Date: Aug 2004
Posts: 7,471
Local Time: 02:01 PM
Did Warren Burger Create the Health Care Mess?
The 1975 antitrust decision that gave you physician-owned hospitals.


By Timothy Noah
Slate, July 29, 2009



...Doctor-owned hospitals are the most conspicuous manifestation of a culture of entrepreneurship that's gone a long way toward creating today's health care crisis. Although traditional economic theory holds that competition drives prices down, in medicine competition had tended to drive prices up as doctors explored new avenues for profit, most typically through fee-for-service overuse of expensive technologies and procedures.

It's easy to shrug at such things and say, "That's capitalism." But, in fact, market-driven medicine didn't exist a generation ago, because the American Medical Association didn't allow it.
"I saw it happen before my own eyes," says Dr. Arnold Relman, 86, emeritus professor at Harvard Medical School and former editor of the New England Journal of Medicine. Relman has written extensively (most recently in the New York Review of Books) about what he terms "the medical-industrial complex." Much of the blame for its creation, Relman believes, lies with the Supreme Court's 1975 decision in Goldfarb v. Virginia State Bar.

Goldfarb doesn't get a lot of attention from the health-reform crowd, partly because (as its name suggests) it was a case involving lawyers, not doctors, and partly because it extended the reach of antitrust law, something usually favored by the same sort of Democrats who want to make health insurance universal. Lewis H. Goldfarb was a homebuyer in Fairfax County, VA, who got mad when he couldn't find a title-search lawyer willing to charge less than 1% of the purchase price, the minimum recommended by the county's bar association and enforced by the state bar. Goldfarb maintained that the bar's imposition of a minimum fee constituted price fixing and violated the Sherman Antitrust Act. The Supreme Court agreed, and in a unanimous opinion (minus Justice Lewis Powell, who recused himself), Chief Justice Warren Burger concluded that law and other "learned professions" participated in "trade or commerce" as defined by the Sherman Act and therefore could not engage in "anticompetitive conduct."

Nowhere in the opinion did the words "medicine" or "doctor" appear, but the implications for health care were immediately obvious. Prior to Goldfarb, Relman explains, any notion that doctors or hospitals might seek to maximize profits was deemed a violation of professional ethics. AMA guidelines forbade doctors to advertise, to sell drugs, or to own a financial interest in any lab or machinery they used to perform tests. Medical doctors' sole source of income in the health arena was supposed to be the care of patients (or supervising the care of patients). "For the most part," Relman says, "those guidelines were followed." After Goldfarb, the AMA's lawyers warned that such prohibitions risked being struck down in court as anti-competitive. So the AMA altered its message. Doctors could now have other sources of health care-related income, provided these money-making activities weren't harmful to patients and that patients knew about them. In 1982, the Supreme Court followed up on Goldfarb by striking down not a minimum fee but a maximum fee imposed by Arizona's Maricopa County Medical Society. Federal regulations were imposed to ban a few particularly egregious types of physician self-dealing.

But in general, especially after Ronald Reagan became president, there was a paradigm shift. Where once government had sought to police the health care sector mainly to protect patients, now it sought to police it mainly to protect a competitive health care marketplace. A thriving health care bazaar, it was assumed, would serve patients' interests. This is the theory that bequeathed us doctor-owned hospitals, the endless churning of marginally valuable medical tests, and dermatologists' waiting rooms where patients are bombarded with video infomercials in which their very own doctors market skin creams and facelifts. "The same investors who started Kentucky Fried Chicken," Relman complains, "started the Hospital Corporation of America!" (The common link is Jack Massey.)

The failure of market-driven medicine was foretold by Nobel Prize-winning economist Kenneth Arrow in a 1963 paper, "Uncertainty and the Welfare Economics of Medical Care," that is widely credited with inventing the discipline of health care economics. (In 1963, the health care sector was so sleepy financially and so dominated by nonprofit do-gooders that economists saw little reason to study it.) There were several factors making it difficult to impose a market model on medicine, Arrow wrote. Demand for services was "irregular and unpredictable," and the buyer was physically vulnerable. Judging the value of the product (i.e., medical treatment) entailed a degree of uncertainty "perhaps more intense…than in any other important commodity," which was compounded by the presumption of an extreme asymmetry between the doctor's knowledge and the patient's. Complicating matters even further, the patient didn't pay; his insurance company did. The doctor "acts as a controlling agent on behalf of the insurance companies," making sure the patient didn't overuse his services, but only up to a point; "the physicians themselves are not under any control and it may be convenient for them or pleasing to their patients to prescribe more expensive medication, private nurses, more frequent treatments, and other marginal variations of care."

In an online interview last week with Conor Clarke of the Atlantic, Arrow, now 87, said that "the basic analysis hasn't changed," but "[s]ome specifics have changed." Arrow explained that in his 1963 paper he emphasized that market forces were supplemented by "professional commitments to provide a service, to engage in services that aren't self-serving. Standards of caring decided by non-economic actors. And one problem we have now is an erosion of professional standards. In a way there is more emphasis on markets and self-aggrandizement in the context of health care, and that has led to some of the problems we have today."

...Relman believes that the health reform bill, if it passes, won't do much to solve the problem, because it does almost nothing to inhibit medical entrepreneurship. "The idea that health care is a legitimate arena for investment is monstrous," Relman says. "Things are going to have to get a lot worse and the costs are going to have to become absolutely intolerable, and then people will finally begin to realize that the system we have doesn't work right." Part of that change, Relman says, should come from the Supreme Court. If Congress outlawed for-profit medicine, perhaps "the Supreme Court would be willing to take another look at this." The Supreme Court? Where the Chicago school is king? Relman's answer skirts thrillingly close to violating the Hippocratic oath. "Where there's death, my friend, there's always hope."

[Update, July 30: In today's New York Times, Kevin Sack and David Herszenhorn report on an energetic lobbying effort by the doctor-owned Doctors Hospital at Renaissance in Edinburg, Texas, that helps explain why existing doctor-owned hospitals (as opposed to future ones) would be permitted to continue participating in Medicare under the House and Senate bills. Suffice it to say that traditional market economics, while not easily applied to health care (a point explored further by Alec MacGillis in today's Washington Post), apply all too well to the legislative process. The Doctors Hospital at Renaissance is not a specialty hospital, but it was criticized for wasteful spending in Atul Gawande's much-cited New Yorker piece about excessive Medicare spending in McAllen, Texas, which is next door to Edinburg. ("It has a reputation," Gawande wrote, "for aggressively recruiting high-volume physicians to become investors and send patients there. Physicians who do so receive not only their fee for whatever service they provide but also a percentage of the hospital's profits from the tests, surgery, or other care patients are given.") Overall, the Washington Post (citing figures from the Center For Responsive Politics) reports that the health care sector is spending close to $1.5 million a day to influence health reform.]
__________________
yolland [at] interference.com


μελετώ αποτυγχάνειν. -- Διογένης της Σινώπης
yolland is offline  
Old 08-04-2009, 07:34 AM   #108
Refugee
 
adrball's Avatar
 
Join Date: Feb 2005
Location: Nightclub in Tripoli
Posts: 1,733
Local Time: 02:01 PM
Just adopt the Singapore model.

Firstly...Provide health insurance free-of-charge to cover those once/non in a lifetime events such as road-traffic accidents, fires, personal attacks, terminable deseases. There's some strong economic theory that supports the fact that nobody will take out insurance against these events unless they know they are likely to claim for it (eg cancer runs in the family), and therefore the sky high premiums make it unattractive to the rest of us.

Secondly...Give money to the population (individually) and give them further tax breaks for investing this money into other medical plans (covering non-seriousl conditions, and preventative care such as annual check ups). Competition between hospitals for these funds creates an efficient industry where the individual gets the benefit of lower cost which in turns makes the proposition to the individual attractive. For the folks that don't take out the insurance - well they have to pay for the treatment but they did make a concious decision to opt out.

Something like this anyway
adrball is offline  
Old 08-04-2009, 09:11 PM   #109
Refugee
 
AliEnvy's Avatar
 
Join Date: Jan 2001
Location: Toronto, Canada
Posts: 2,320
Local Time: 01:01 PM
A Canadian doctor diagnoses U.S. healthcare - Los Angeles Times

The caricature of 'socialized medicine' is used by corporate interests to confuse Americans and maintain their bottom lines instead of patients' health.

By Michael M. Rachlis
August 3, 2009

Universal health insurance is on the American policy agenda for the fifth time since World War II. In the 1960s, the U.S. chose public coverage for only the elderly and the very poor, while Canada opted for a universal program for hospitals and physicians' services. As a policy analyst, I know there are lessons to be learned from studying the effect of different approaches in similar jurisdictions. But, as a Canadian with lots of American friends and relatives, I am saddened that Americans seem incapable of learning them.

Our countries are joined at the hip. We peacefully share a continent, a British heritage of representative government and now ownership of GM. And, until 50 years ago, we had similar health systems, healthcare costs and vital statistics.

The U.S.' and Canada's different health insurance decisions make up the world's largest health policy experiment. And the results?

On coverage, all Canadians have insurance for hospital and physician services. There are no deductibles or co-pays. Most provinces also provide coverage for programs for home care, long-term care, pharmaceuticals and durable medical equipment, although there are co-pays.

On the U.S. side, 46 million people have no insurance, millions are underinsured and healthcare bills bankrupt more than 1 million Americans every year.

Lesson No. 1: A single-payer system would eliminate most U.S. coverage problems.

On costs, Canada spends 10% of its economy on healthcare; the U.S. spends 16%. The extra 6% of GDP amounts to more than $800 billion per year. The spending gap between the two nations is almost entirely because of higher overhead. Canadians don't need thousands of actuaries to set premiums or thousands of lawyers to deny care. Even the U.S. Medicare program has 80% to 90% lower administrative costs than private Medicare Advantage policies. And providers and suppliers can't charge as much when they have to deal with a single payer.

Lessons No. 2 and 3: Single-payer systems reduce duplicative administrative costs and can negotiate lower prices.

Because most of the difference in spending is for non-patient care, Canadians actually get more of most services. We see the doctor more often and take more drugs. We even have more lung transplant surgery. We do get less heart surgery, but not so much less that we are any more likely to die of heart attacks. And we now live nearly three years longer, and our infant mortality is 20% lower.

Lesson No. 4: Single-payer plans can deliver the goods because their funding goes to services, not overhead.

The Canadian system does have its problems, and these also provide important lessons. Notwithstanding a few well-publicized and misleading cases, Canadians needing urgent care get immediate treatment. But we do wait too long for much elective care, including appointments with family doctors and specialists and selected surgical procedures. We also do a poor job managing chronic disease.

However, according to the New York-based Commonwealth Fund, both the American and the Canadian systems fare badly in these areas. In fact, an April U.S. Government Accountability Office report noted that U.S. emergency room wait times have increased, and patients who should be seen immediately are now waiting an average of 28 minutes. The GAO has also raised concerns about two- to four-month waiting times for mammograms.

On closer examination, most of these problems have little to do with public insurance or even overall resources. Despite the delays, the GAO said there is enough mammogram capacity.

These problems are largely caused by our shared politico-cultural barriers to quality of care. In 19th century North America, doctors waged a campaign against quacks and snake-oil salesmen and attained a legislative monopoly on medical practice. In return, they promised to set and enforce standards of practice. By and large, it didn't happen. And perverse incentives like fee-for-service make things even worse.

Using techniques like those championed by the Boston-based Institute for Healthcare Improvement, providers can eliminate most delays. In Hamilton, Ontario, 17 psychiatrists have linked up with 100 family doctors and 80 social workers to offer some of the world's best access to mental health services. And in Toronto, simple process improvements mean you can now get your hip assessed in one week and get a new one, if you need it, within a month.

Lesson No. 5: Canadian healthcare delivery problems have nothing to do with our single-payer system and can be fixed by re-engineering for quality.

U.S. health policy would be miles ahead if policymakers could learn these lessons. But they seem less interested in Canada's, or any other nation's, experience than ever. Why?

American democracy runs on money. Pharmaceutical and insurance companies have the fuel. Analysts see hundreds of billions of premiums wasted on overhead that could fund care for the uninsured. But industry executives and shareholders see bonuses and dividends.

Compounding the confusion is traditional American ignorance of what happens north of the border, which makes it easy to mislead people. Boilerplate anti-government rhetoric does the same. The U.S. media, legislators and even presidents have claimed that our "socialized" system doesn't let us choose our own doctors. In fact, Canadians have free choice of physicians. It's Americans these days who are restricted to "in-plan" doctors.

Unfortunately, many Americans won't get to hear the straight goods because vested interests are promoting a caricature of the Canadian experience.
AliEnvy is offline  
Old 08-07-2009, 01:45 AM   #110
Forum Moderator
 
yolland's Avatar
 
Join Date: Aug 2004
Posts: 7,471
Local Time: 02:01 PM
Republicans Propagating Falsehoods in Attacks on Health-Care Reform

by Steven Pearlstein (business columnist)
Washington Post, August 7



As a columnist who regularly dishes out sharp criticism, I try not to question the motives of people with whom I don't agree. Today, I'm going to step over that line.

...There are lots of valid criticisms that can be made against the health reform plans moving through Congress--I've made a few myself. But there is no credible way to look at what has been proposed by the president or any congressional committee and conclude that these will result in a government takeover of the health-care system. That is a flat-out lie whose only purpose is to scare the public and stop political conversation. Under any plan likely to emerge from Congress, the vast majority of Americans who are not old or poor will continue to buy health insurance from private companies, continue to get their health care from doctors in private practice and continue to be treated at privately owned hospitals.

The centerpiece of all the plans is a new health insurance exchange set up by the government where individuals, small businesses and eventually larger businesses will be able to purchase insurance from private insurers at lower rates than are now generally available under rules that require insurers to offer coverage to anyone regardless of health condition. Low-income workers buying insurance through the exchange--along with their employers--would be eligible for government subsidies. While the government will take a more active role in regulating the insurance market and increase its spending for health care, that hardly amounts to the kind of government-run system that critics conjure up when they trot out that oh-so-clever line about the Department of Motor Vehicles being in charge of your colonoscopy.

There is still a vigorous debate as to whether one of the insurance options offered through those exchanges would be a government-run insurance company of some sort. There are now less-than-even odds that such a public option will survive in the Senate, while even House leaders have agreed that the public plan won't be able to piggy-back on Medicare. So the probability that a public-run insurance plan is about to drive every private insurer out of business--the Republican nightmare scenario--is approximately zero.

By now, you've probably also heard that health reform will cost taxpayers at least a trillion dollars. Another lie. First of all, that's not a trillion every year, as most people assume--it's a trillion over 10 years, which is the silly way that people in Washington talk about federal budgets. On an annual basis, that translates to about $140 billion, when things are up and running. Even that, however, grossly overstates the net cost to the government of providing universal coverage. Other parts of the reform plan would result in offsetting savings for Medicare: reductions in unnecessary subsidies to private insurers, in annual increases in payments rates for doctors and in payments to hospitals for providing free care to the uninsured. The net increase in government spending for health care would likely be about $100 billion a year, a one-time increase equal to less than 1% of a national income that grows at an average rate of 2.5% every year.

The Republican lies about the economics of health reform are also heavily laced with hypocrisy. While holding themselves out as paragons of fiscal rectitude, Republicans grandstand against just about every idea to reduce the amount of health care people consume or the prices paid to health-care providers--the only two ways I can think of to credibly bring health spending under control. When Democrats, for example, propose to fund research to give doctors, patients and health plans better information on what works and what doesn't, Republicans sense a sinister plot to have the government decide what treatments you will get. By the same wacko-logic, a proposal that Medicare pay for counseling on end-of-life care is transformed into a secret plan for mass euthanasia of the elderly. Government negotiation on drug prices? The end of medical innovation as we know it, according to the GOP's Dr. No. Reduce Medicare payments to overpriced specialists and inefficient hospitals? The first step on the slippery slope toward rationing. Can there be anyone more two-faced than the Republican leaders who in one breath rail against the evils of government-run health care and in another propose a government-subsidized high-risk pool for people with chronic illness, government-subsidized community health centers for the uninsured, and opening up Medicare to people at age 55?

Health reform is a test of whether this country can function once again as a civil society--whether we can trust ourselves to embrace the big, important changes that require everyone to give up something in order to make everyone better off. Republican leaders are eager to see us fail that test. We need to show them that no matter how many lies they tell or how many scare tactics they concoct, Americans will come together and get this done. If health reform is to be anyone's Waterloo, let it be theirs.
__________________
yolland [at] interference.com


μελετώ αποτυγχάνειν. -- Διογένης της Σινώπης
yolland is offline  
Old 08-07-2009, 07:07 PM   #111
The Fly
 
Join Date: Jul 2009
Posts: 108
Local Time: 08:01 AM
If anything, Americans should want a state run health care system because it is a lot cheaper. It probably won't happen because of the efforts by the insurance companies to scare people into keeping an expensive system that penalizes the middle and lower class.

If all people are equal under the eyes of god or whatever the constitution says, then everyone should have the same access to healthcare.

So: it's cheaper and will help the lower and middle classes maintain their health. What's the problem?

And no, the government will not euthanize anyones grandparents or abort fetuses.
torn vinyl is offline  
Old 08-07-2009, 07:22 PM   #112
Refugee
 
AliEnvy's Avatar
 
Join Date: Jan 2001
Location: Toronto, Canada
Posts: 2,320
Local Time: 01:01 PM
Quote:
Originally Posted by yolland View Post
Health reform is a test of whether this country can function once again as a civil society--whether we can trust ourselves to embrace the big, important changes that require everyone to give up something in order to make everyone better off. Republican leaders are eager to see us fail that test. We need to show them that no matter how many lies they tell or how many scare tactics they concoct, Americans will come together and get this done. If health reform is to be anyone's Waterloo, let it be theirs.
AliEnvy is offline  
Old 08-07-2009, 07:45 PM   #113
Refugee
 
Bluer White's Avatar
 
Join Date: Jul 2005
Location: Maine
Posts: 2,186
Local Time: 08:01 AM
Quote:
Originally Posted by torn vinyl View Post
And no, the government will not euthanize anyones grandparents or abort fetuses.
The president's public option would not cover abortion?
Bluer White is offline  
Old 08-07-2009, 08:47 PM   #114
The Fly
 
Join Date: Jul 2009
Posts: 108
Local Time: 08:01 AM
Quote:
Originally Posted by Bluer White View Post
The president's public option would not cover abortion?
I meant that they wouldn't force people to abort their parents or fetuses.
torn vinyl is offline  
Old 08-09-2009, 11:42 PM   #115
Blue Crack Supplier
 
Irvine511's Avatar
 
Join Date: Dec 2003
Location: Washington, DC
Posts: 33,476
Local Time: 09:01 AM
Quote:
What if We Win the Healthcare Fight?
August 7th, 2009 at 4:04 pm by DAVID FRUM | 122 Comments |
Share
What would it mean to “win” the healthcare fight?

For some, the answer is obvious: beat back the president’s proposals, defeat the House bill, stand back and wait for 1994 to repeat itself.

The problem is that if we do that… we’ll still have the present healthcare system. Meaning that we’ll have (1) flat-lining wages, (2) exploding Medicaid and Medicare costs and thus immense pressure for future tax increases, (3) small businesses and self-employed individuals priced out of the insurance market, and (4) a lot of uninsured or underinsured people imposing costs on hospitals and local governments.

We’ll have entrenched and perpetuated some of the most irrational features of a hugely costly and under-performing system, at the expense of entrepreneurs and risk-takers, exactly the people the Republican party exists to champion.

Not a good outcome.

Even worse will be the way this fight is won: basically by convincing older Americans already covered by a government health program, Medicare, that Obama’s reform plans will reduce their coverage. In other words, we’ll have sent a powerful message to the entire political system to avoid at all hazards any tinkering with Medicare except to make it more generous for the already covered.

If we win, we’ll trumpet the success as a great triumph for liberty and individualism. Really though it will be a triumph for inertia. To the extent that anybody in the conservative world still aspires to any kind of future reform and improvement of America’s ossified government, that should be a very ashy victory indeed.



any serious person knows that the present system is fiscally unsustainable. we have to address that if we are to have any hope of climbing out of debt.
Irvine511 is offline  
Old 08-10-2009, 12:32 AM   #116
War Child
 
Join Date: Aug 2002
Location: Carlisle PA
Posts: 818
Local Time: 08:01 AM
Quote:
Originally Posted by torn vinyl View Post
I meant that they wouldn't force people to abort their parents or fetuses.
Bummer.
HyperU2 is offline  
Old 08-10-2009, 07:46 AM   #117
Rock n' Roll Doggie
Band-aid
 
maycocksean's Avatar
 
Join Date: Jan 2006
Location: The Most Important State in the Union
Posts: 4,892
Local Time: 08:01 AM
Quote:
Originally Posted by Irvine511 View Post
any serious person knows that the present system is fiscally unsustainable. we have to address that if we are to have any hope of climbing out of debt.

Yes! Thank you for that! That article NEEDS to be the starting point for any reasonable opposition to the current efforts at health care reform.
maycocksean is offline  
Old 08-10-2009, 11:41 AM   #118
Blue Crack Supplier
 
Irvine511's Avatar
 
Join Date: Dec 2003
Location: Washington, DC
Posts: 33,476
Local Time: 09:01 AM
Quote:
Originally Posted by maycocksean View Post
Yes! Thank you for that! That article NEEDS to be the starting point for any reasonable opposition to the current efforts at health care reform.


i think what you said before is fascinating. you're obviously an educated person, you have a good job, you've lived abroad, you have a wife and a child ... and yet you told us that having to pay $5000 in medical care would absolutely break you. and that's what should shock us. you're hardly working at McDonalds or a day laborer without a steady source of income, you've "made it," so to speak, and even still, you could very easily be broken by health care costs.

this is what we need to address. i've paid well over $10,000 with my health issue, and i'm lucky because i have a generally well paid job job, no kids, and i co-habitate a relatively cheap apartment with Memphis. could i afford to suddenly cough up $5K, yes, it would hurt but it could be done, but i realize that this is actually a very rare thing.

and that's something that "market forces" can't do a damn thing about.

there has to be a public option. there simply has to be. and, yes, we are all going to pay for it, but it will save us in the long term.
Irvine511 is offline  
Old 08-10-2009, 12:44 PM   #119
Rock n' Roll Doggie
Band-aid
 
Join Date: Jun 2005
Location: The American Resistance
Posts: 4,754
Local Time: 07:01 AM
I'm sorry for your misfortune. Unfortunately what you experienced is what is both right and what is wrong with our current system. First you enjoyed technology and therapies that may well have saved your life, but they are expensive. What is wrong with our systems is that cash customers are often the patsy that hospitals and providers recoup their third party and uncompensated care losses from. In other words, you were paying for more than just your care.

Not fair I know. But neither are expectations that healthcare should be paid for by someone else (the poor and catastrophic care aside). If healthcare is a right does one also have the right to force someone else to purchase it for them? I know it's hard to look at the economics of healthcare but we need to get away from our current system of third party payers and returned it to the domain of personal choice and responsibility like buying car insurance, food, clothes and our homes. If 75% of patients requiring your care were paying out of pocket I promise you prices would fall to an affordable price through a consumer-driven marketplace. If not the providers would have to close up shop. In addition, tax credits encouraging savings accounts would allow families to save for the day they had larger bills and paychecks would be larger if employers weren't purchasing health insurance.

But now you know how a public system will control costs. Lower fees paid for services will shift costs from taxpayers and patients to healthcare providers. With no way to recoup losses if the government set price is too low, providers will fall out of the system. In other words, De facto rationing.
INDY500 is offline  
Old 08-10-2009, 01:20 PM   #120
Blue Crack Supplier
 
Irvine511's Avatar
 
Join Date: Dec 2003
Location: Washington, DC
Posts: 33,476
Local Time: 09:01 AM
Quote:
Originally Posted by INDY500 View Post
I'm sorry for your misfortune. Unfortunately what you experienced is what is both right and what is wrong with our current system. First you enjoyed technology and therapies that may well have saved your life, but they are expensive. What is wrong with our systems is that cash customers are often the patsy that hospitals and providers recoup their third party and uncompensated care losses from. In other words, you were paying for more than just your care.

Not fair I know.


no, i think it is fair. we live in a country where everyone will be treated if you show up at the ER. my bills probably in some small part helped cover them. i don't resent other people for that. i resent a system where these people cannot afford coverage or had coverage denied to them.

we do not want people with a GSW to go untreated. i don't care if Joe Crackhead doesn't have health insurance -- if he's gunned down and rushed to the ER, we shouldn't deny him care simply because, god forbid, someone else (like the government) is paying for it. i don't think that health care is a commodity like food or even car insurance -- it's much more akin to education, where we force everyone to go to school up until the age of 16. why not bring Joe Crackhead into the system, find a way to pay for him, and maybe we can not get hung up on our free-market-saves-all ideology. Joe Crackhead is a person, no matter what stupid decisions he has made, and i don't understand the ideology that would let him bleed to death in the streets simply because he's made a series of bad decisions.

if that comes out of my pocket book in part, so be it. i'd rather pay for Joe Crackhead to have his GSW stitched up than for G.I. Joe to go kill Tommy Al Quaeda in Baghdad.
__________________

Irvine511 is offline  
 

Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off



All times are GMT -5. The time now is 08:01 AM.


Powered by vBulletin® Version 3.8.8 Beta 1
Copyright ©2000 - 2021, vBulletin Solutions, Inc.
Design, images and all things inclusive copyright © Interference.com
×