Looking at the posts/comments on this blog is fantastic, I always get a real visceral response.
So, I'm going to throw this out there......
Is it possible that there is no way to fix the escalating cost of health care?
I believe you get what you pay for, plain and simple. Health care is expensive. That's probably not going to change. You may squeak out some 10% efficiency here and there.You may eek out some cost savings from reducing administrative costs, but in general health care is expensive. There is a whole lot of investment and research tied into everything. Who would guess that the people who invested in and did the research would like to earn money for there effort?
So the question is pretty simple. Do we want health care to be more affordable? And if so what is the cost of more affordable health care?
I hate to say it, but most likely if you have cheaper insurance your end of life care will be given at a cheaper cost. If you pay less for something you will probably get less...
Let's scrap health care reform. Let's just get insurance companies to provide the service they claim. We need to reform insurance companies, not health care. The US has the best health care in the world, and by the way it's expensive.
Subscribe to:
Post Comments (Atom)
28 comments:
I'll let Rich or Bruce go first...
How about this...
Spending money on prevention measures, and giving incentives for Americans to join exercise programs.This will help with health care costs from epidemics such as cancer and obesity. Unfortunately, any politician who brings this up will be killed publicly for "telling Americans how to live".
incentives= tax credits to join health clubs etc...
"US has the best health care in the world" is a Fox News talking point. Can we at least agree that is unlikely considering the uninsured, pre-existing conditions, dropped coverage, % of overhead costs versus the cost of care. WHO has us ranked 37th. Its probably somewhere in between depending on how you weight individual statistics.
The fact that people are losing their health insurance and/or their salaries are going up 30% while insurance premiums go up 3-4 times that rate suggest something big must be done. It is hard to propose a solution when neither side presents the facts in a fair manner.
"Telling Americans how to live"...isn't that politics?
I actually agree with Mike's suggestion; it's similar to most conservative plans, which suggest a high-deductible catastrophic plan with help for those who can't afford it.
This is a question about who should bear the costs of health care: the individual, the individual's employer or the government? Those on the right favor shifting as much cost as possible onto the individual; those on the left favor shifting the burden to the gov't.
I favor shifting the short-term individual costs onto the individual; I don't find it particularly awful that an individual (close to regardless of income) would be asked to save a certain level of their income for health costs of their retirement.
I have a problem with the American version of long-term care, where Medicare seemingly will pay for everything and anything. I find that it (and even more, the overall wealth of the US) has shifted older generations out of the home and into gov't-funded long term care. But, like many other areas, I find myself outvoted on this point.
@Vince: Most studies that I've seen from the left and right do not show significant cost savings from preventative care -- you'll have to find it somewhere else.
I'll take this opportunity to slag one of the President's more recent press conference statements:
"people who, because they don't have a primary care physician, show up at the ER. If we can get those people insured, instead of having a foot amputation because of advanced diabetes, they're getting a nutritionist who's working with them to get their diet where it needs to be, that's going to save us all money in the long term." [JCT's transcription; errors are his, and not BHO's.]
This is just wishful thinking on the President's part. I am unconvinced that diabetic folks who have contracted some of the serious long-term problems that are more related to lack of consistency can be conquered by consulting a dietitian or getting insurance. (You need to keep your sugar under control to stave off peripheral neuropathy, you must do proper foot care to prevent infections, amputation, etc.)
Rich, I think you missed the point. Health care in the US, when received, is far superior to any other country.
The uninsured and cost of care is a completely different issue.
As far as prevention, I think it's a mixed bag. Some preventative measures cost more some save money. There is no quick fix with prevention. The number to treat gets really high with preventative care anf usually drives the cost up.
So back to my point. Isn't health insurance the problem? I think so.
I would also say that comparing different cultures / countries on a whole to say the US healthcare system is 37th really doesn't hold water. It's a thousand variable equation and we are looking at holding country constant and then looking at a couple of outputs.... I hate those rankings, but that's just me.
N.B. Vince - when I said "you'll have to find it somewhere else", I meant the cost savings, not the studies.
I don't know if I would consider our health care to be "far superior" to other systems. There is really no way to quantify just how good our health care is. A lot of people will bring up specific examples of people who have had tremendous experiences. But I guarantee for every person with a great experience there is someone who had a syringe left inside them.
The real problem with our system are the soulless bloodsucking vampires who profit off of human misery; Insurance companies. It is sickening to know that out of insured Americans 25% of them do not use their insurance because they cannot afford health care costs.
It is also sickening to know that someone working at Wal-Mart may not qualify for Medicaid (it is actually very hard for one to qualify for Medicaid. Being shit house poor is only one qualifier) and may be too poor to afford health care from a private insurer.
The system in this sense is broken.
Like many things in the US versus the rest of the world, the distribution of quality health care is probably shifted towards the middle and upper classes, i.e. those with jobs that can purchase relatively high quality insurance. I am guessing that the quality of care available to the upper quintile of income in the US is better than than which can be obtained by similar cohorts in the rest of the world. I'm curious to know if Mike would disagree with the above statementa.
I also note that in a 2003 NEJM study, it was estimated that there are 1500 retained foreign objects a year. Vince, I would argue that there are likely >>1500 patients given high quality health care by the system.
It is unclear to me why you, Vince, are against insurance companies. Presumably, you should be against the medical-industrial complex where costs keep rising and rising. It is insurance companies that only pass along those costs. Also, I suggest you point more of your ire towards the government that attempts to saddle insurance companies with vast regulatory complexities. In addition, I suggest that your ire should be pointed at the government and the voting public, which (according to you) should lower the barriers to Medicaid.
I find the likelihood that the government will do a better job pretty unlikely. That being said, I suspect that we will find out in our lifetimes. Insurance companies are politically extraordinarily unpopular (we see it on this blog) and will likely be killed by the government in the coming decades. Whether that's a good thing (I think it is bad), remains to be seen.
Jim,
I was just bringing up the most extreme example for the sake of a cheap laugh. But you are probably right; If you are rich enough to buy great health care, then your experience will be great. However, if you have Notre Dame Student insurance you will wind up $2000 in the hole despite having the insurance.
And yes I do think the barriers for medicaid should be lowered. This is called a public option. I think Obama would have been better off from the beginning had he just called the public option "Medicare for All".
And I guess my ire with insurance companies(and the medical-industrial complex)can be the fact that they are comparable to war profiteers.
...the US pays twice as much yet lags other wealthy nations in such measures as infant mortality (33rd) and life expectancy (50th), which are among the most widely collected, hence useful, international comparative statistics...from Wiki but supported by many unrelated sources.
Intelligent discussion should at the very least start with some things we agree on. If you don't agree we spend too much for too little there is no reason to keep discussing it.
If you don't agree we spend too much for too little there is no reason to keep discussing it.
Rich, is this a serious comment, or just a statement of a certain level of discouragement with the discussion as it's been progressing?
I (obviously) quite respect your opinion on many things, but I ultimately find attempted correlation between these sociological measurements (life expectancy, infant mortality) and medical expenditure to be flawed at best. I'd like to hear why you think they are on point.
Does health care correlate with life expectancy? Does it correlate with infant mortality?
It's a part of the number, but it's not the reason we lag in these numbers. The US has the fatest population and a culture of excess. Couple it with a car based population that won't walk a block to save their lives.
As far as infant mortality, we have the highest percentage of teenage mothers. Low intelligent mothers and fathers and people who take no responsability for themselves let alone there children.
The numbers are meaningless. The culture drives those numbers. You could argue that it's amazing with our culture that the numbers are as good as they are. It must be that the health care is really good to compensate for the unhealthy lifestyles we have.
Sorry.
fattest
their
Also, I agree we pay a lot. I'm not sure it's too much. Where do we cut costs?
Cut doctor's salary?
Cut the cost of items, like saline bags? Syringes?
All these things have high costs but why are they high?
Do we increase nursing ratios?
Do we not provide extrodinary care to the terminally ill?
Let's face it, if the thing was so scary broke as this administration would have you believe where are all the casualties? I guess Obama plays the scare game too. Not just Bush and the terrorists.
http://www.realclearpolitics.com/articles/2009/08/25/the_great_escape_98015.html
I have to post an article from T. Sowell. It's makes the point I'm saying, the media and polititians all want to fix things that can only be fixed on an individual basis.
I just don't want to argue with Sean Hannity. America has the best healthcare in the world or America is the greatest nation ever are examples of flag-waving currently followed by BUT if THIS administration has its way the "fabric of our society" will be destroyed.
Mike has ever right to send Vince, Bruce and I to RealClearPolitics whenever he makes a point and I have every right to ignore websites that promote commentary O'Reilly, Beck, Hannity and Coulter.
I agree if we look at only people who take good care of themselves or get cancer through no fault of their own, they have a good job and it provides a good health plan (which many do not), and we remove all the lazy poor people who have babies though they can't afford it, then may be we have the best healthcare in the world, but to be honest I don't know if thats true...at least I am willing to admit that.
Rich, far be it from me to ask you to stop wrestling with Sean Hannity and Ann Coulter... (wouldn't that be a sight? -- who would you like as your tag team partner? Krugman? Franken?)
But we haven't heard from you on how you think we should stop the rise in healthcare costs. I think Vince favors gutting the for-profit medical/insurance/industrial complex. Mike's solution (probably?) involves forcing the market to change by asking the consumer to bear the true costs of medical care; I tend to agree with Mike, although I probably favor more gov't intervention than Mike does.
What's the Taylor plan?
"I guess Obama plays the scare game too. Not just Bush and the terrorists."
Are you seriously comparing this to Bush's use of terrorism to help pass his agenda? Bush used the terror alert system (Tom Ridge's book discusses how he was pressured into raising the terror alert system) to scare people into voting for him. Obama is using "fear" to help people obtain affordable health care.
Jim, all I was asking was that we should be able to agree that there is a problem that needs to solved soon. Mike has made it clear that he believes there isn't one. Therefore, any plan you or I propose is a waste from the start.
Poverty, poor health, unemployment, poor education scores, violence can all be attributed to individual responsibility and therefore everything is solved, yeah us!
Tom Ridge's book discusses how he was pressured into raising the terror alert system
Er, no. Ultimately, Ridge never raised the alert level, although he discusses pressure from Rumsfeld and Ashcroft.
That being said, when is Obama going to roll back the stupidity of TSA?
http://city-journal.org/2009/19_3_work-ethic.html
Good article.
I am not going to give any rep to a website that has as many pop-ups as Bangbros.com.
There's a health-care comment I'd like to make about Sen. Kennedy's 1980 convention speech that's inappropriate for right now. I will wait until Sunday to add it.
Post a Comment