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Archive for Sunday, June 28, 2009

‘Fix’ may make health care worse

June 28, 2009

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— “In the beginning,” says a character in a Peter De Vries novel, “the earth was without form and void. Why didn’t they leave well enough alone?” When Washington is finished improving health care, Americans may be asking the same thing. Certainly the debate will compel them to think more clearly about this subject.

Most Americans do want different health care: They want 2009 medicine at 1960 prices. Americans spent much less on health care in 1960 (5 percent of GDP as opposed to 18 percent now). They also spent much less — nothing, in fact — on computers, cell phones and cable and satellite television.

Your next car can cost less if you forgo GPS, satellite radio, antilock brakes, power steering, power windows and air conditioning. You can shop for such a car at your local Studebaker, Hudson, Nash, Packard and DeSoto dealers.

The president says his health plan is responsive “to all those families who now spend more on health care than housing or food.” Well. The Hudson Institute’s Betsy McCaughey, writing in The American Spectator, says that in 1960 the average American household spent 53 percent of its disposable income on food, housing, energy and health care. Today the portion of income consumed by those four has barely changed — 55 percent. But the health care component has increased while the other three combined have decreased. This is partly because as societies become richer, they spend more on health care — and symphonies, universities, museums, etc.

It is also because health care is increasingly competent. When the first baby boomers, whose aging is driving health care spending, were born in 1946, many American hospitals’ principal expense was clean linen. This was long before MRIs, CAT scans and the rest of the diagnostic and therapeutic arsenal that modern medicine deploys.

In a survey released in April by NPR, the Kaiser Family Foundation and Harvard, only 6 percent of Americans said they were willing to spend more than $200 a month on health care, and the price must fall to $100 a month before a majority are willing to pay it. But according to Grace-Marie Turner of the Galen Institute, Americans already are paying an average of $400 a month.

Most Americans do not know this because the cost of their care is hidden. Only 9 percent buy health coverage individually, and $84 of every $100 spent on health care is spent by someone (an employer, insurance company or government) other than recipients of the care. Those who get insurance as untaxed compensation from employers have no occasion to compute or confront the size of that benefit. But it is part of the price their employers pay for their work.

The president says the health care market “has not worked perfectly.” Indeed. Only God, supposedly, and Wrigley Field, actually, are perfect. Anyway, given the heavy presence of government dollars (46 percent of health care dollars) and regulations, the market, such as it is, is hardly free to work.

As market enthusiasts, conservatives should stop warning that the president’s reforms will result in health care “rationing.” Every product, from a jelly doughnut to a jumbo jet, is rationed — by price or by politics. The conservative’s task is to explain why price is preferable. The answer is that prices produce a rational allocation of scarce resources.

Regarding reform, conservatives are accused of being a party of “no.” Fine. That is an indispensable word in politics because most new ideas are false and mischievous. Furthermore, the First Amendment’s lovely first five words (“Congress shall make no law”) set the negative tone of the Bill of Rights, which is a list of government behaviors, from establishing religion to conducting unreasonable searches, to which the Constitution says: No.

The president may have been too clever when he decided, during an economic crisis that was sending federal expenditures soaring and revenues plummeting, to push the entire liberal agenda on the premise that every item on it is essential to combating the crisis.

Now the health care debate is coming to a boil just as public anxiety about the deficit is, too. As cost estimates pass the $1 trillion mark, the administration is reduced to talking about financing its reforms with mini-measures such as a 3 cent tax on sugary sodas. The public, its attention riveted by the fiscal train wreck of trillion-dollar deficits for the foreseeable future, may be coming to the conclusion that we should leave bad enough alone.

Comments

kansasmutt 5 years, 1 month ago

Greed is what has done our health care system in.Insurance companies need to make shareholders money, so we pay the price.Hospitals charge $3.00 for 1 single Tylynol. I paid $4.09 for a 250 count pack last time at Target.My premium has gone from $64.00 in 2006 to $172.40 a month in 2009 .Less coverage , but costing me more per month.Blue Cross has the answer.Aforda Blue. 5 visits, higher copays and its only $430.00 a month, Now that is pure greed. I am all for a goverment plan and to pay for it is simple. Every working person can give 3% of every check to the fund. No person gets out of paying. You make a check, you pay. The poor pay and the wealthy pay. If your income is $700.00 a month you pay 3% - If your income is $7.000.00 a month you pay 3% .You can keep your insurance you now have or join the goverment group plan. That simple.

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Bob Harvey 5 years, 1 month ago

LJReader...now that is downright scary.

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notajayhawk 5 years, 1 month ago

kansasmutt (Anonymous) says…

"Every working person can give 3% of every check to the fund. No person gets out of paying. You make a check, you pay. The poor pay and the wealthy pay. If your income is $700.00 a month you pay 3% - If your income is $7.000.00 a month you pay 3% .You can keep your insurance you now have or join the goverment group plan. That simple."

Yep. Simple. Oh, except:

Total income for individuals in 2006 was just over $8 trillion. 3% of that would be $240 billion dollars. You really think you could pay for all the healthcare needs of every man, woman, and child in this country for about $800/year? Really?

And, um - how is your plan going to change the fact that your hospital charges $3 for a Tylenol?

But at least, with your plan, we can afford to buy everyone a Tylenol 3 out of 4 days. Good plan.

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gl0ck0wn3r 5 years, 1 month ago

This comment was removed by the site staff for violation of the usage agreement.

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Flap Doodle 5 years, 1 month ago

The Porkulus bill has made unemployment worse. The cap & trade disaster bill will make the economy worse. Why wouldn't Barry's mad health care scheme make the current system worse?

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pace 5 years, 1 month ago

Will must have not of been screwed over by his health industry provider when he or a member of his family developed a life threatening illness. He must be able to afford his cobra when he is laid off. His employer probably takes care of it. Why not leave your family health care coverage to corporate America to design and control? It ties people to corporate jobs, robs small businesses of employees, and can result in the average family facing death and homelessness. Gee, we just don't get it, how great the current system is. Those whiners who aren't covered, just don't have the gumption to work full time at a large corporation and the qualities to not get laid off. More and more part time jobs out there, no benefits. Leaving it to businesses and Insurance companies to plan your cancer screening, just isn't paying.

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Aguilar 5 years, 1 month ago

I don't trust the government. Very few people do. The only thing I trust less than the government are corporations who are willing to make a profit off of my health. I did the math, and last year Humana made over a $9,000 profit from me. That includes a trip to the E.R., in which they paid absolutely nothing, while I PAID $870.

Health insurance companies are scum and I cannot believe there are people out there who are so lacking in sense that they defend these people exploiting our health. Pure blind capitalism at its worst.

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Corey Williams 5 years, 1 month ago

Liberty_One (Anonymous) says… "why is it that this same greed brings us cheaper cell phones, DVD players, furniture, laptops, blue jeans, etc.? This “blame greedy companies” doesn't make sense if you can't explain why products in other areas get cheaper as technology improves, yet health care gets more expensive as technology improves."

Government intervention? No, it's because they haven't figured out how to get your healthcare taken care of by workers in China.

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camper 5 years, 1 month ago

George, I'd say most of us want basic health care and don't believe an ambulance ride, setting a broken arm, or having a baby should cost us thousands of dollars. For the most part, basic health care is not rocket science.

One thing I believe that should be pointed out is that the Obama plan is focusing on coverage. I understand arguments about fearing the socialization of health care coverage, but at least append it with the word coverage. Doctors, nurses, drug companies, hospitals etc. will remain in the private realm.

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notajayhawk 5 years, 1 month ago

Aguilar (Anonymous) says…

"The only thing I trust less than the government are corporations who are willing to make a profit off of my health."

I hope you don't go to the hospital when you're sick, then, aguilar. Or a doctor's office, for that matter.

"I did the math, and last year Humana made over a $9,000 profit from me. That includes a trip to the E.R., in which they paid absolutely nothing, while I PAID $870."

And if you'd had that broken leg, burst appendix, or head injury from a car accident last year, aggie, how much 'profit' would Humana have made then?

Um - you DO understand how insurance works, don't you?

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Leslie Swearingen 5 years, 1 month ago

I now fully understand the argument that a lot of money for health care goes for things that could have been prevented in the first place. I am 63, I understand this fully for the first time, and I am just praying it is not to late for me to turn things around. I am watching my diet, and exercising regularly. For one week I have done this and I am taking it one day at a time. On the 1st I will begin my swimming lessons. Self indulgence today will come back to bite you tomorrow.

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SettingTheRecordStraight 5 years, 1 month ago

Free market advocates like me would never claim that capitalism is perfect. It's simply the best economic model of those that exist. We need market-based solutions to health care challenges.

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Flap Doodle 5 years, 1 month ago

Considering how Barry sticks to doing things the Chicago-way, we could wind up with someone like Monica Conyers being the new health czar. For those who've not been following the news, she is the wife of Democratic Representative John Conyers (a bud of Barry's). She recently plead guilty to bribery charges that could send her to prison for 5 years.

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Corey Williams 5 years, 1 month ago

Liberty_One (Anonymous) says… "mancity, oh really? So that must explain the prices of airline fares and food as well. Try a thought-out response please."

Actually, yes. You can't produce services like health care or airline trips in countries where one dollar an hour is a good salary.

Can you understand the difference between goods and services? Goods are things that you can touch and feel like clothes and electronics. Those things are mostly produced in overseas markets where the prevailing wage is much lower than it is here. As the technology for some goods (i.e.: lcd televisions) becomes more widespread, the cost of their production drops. Services are things that you can't physically grasp. Healthcare and airline flights would be a good example. If you fly somewhere, the only proof you have of that trip is your ticket stub. If you go to the doctor, the only proof of your visit is paperwork. And as technology in healthcare increases, so does the need for more highly trained technicians to operate these new machines. These are things that can't be outsourced for production in foreign countries.

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Leslie Swearingen 5 years, 1 month ago

Corey, you made the most sensible comment yet. If you want to be correctly diagnosed someone has to do it. It takes years of training and that takes a lot of money. People don't often think of the medical community as performing a service, but they are. Also as mundane as it may sound, someone has to pay the rent on the office space, the salaries of those who work at the doctors office, utilities, supplies, think of how many needles and urine bottles they go though. And, let us not forget medical malpractice insurance.

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TheYetiSpeaks 5 years, 1 month ago

A major stepping stone in my maturation process as a young man was they day I realized that I was entitled or owed nothing. What happened to the days of our grandfathers' when if you wanted something, you just had to work hard until you could have it? The only thing I demand from my country is a reasonable attempt at keeping me safe...the rest is up to me.

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BrianR 5 years, 1 month ago

Yeti, You never had to eat popcorn for dinner so your kids could have the "real' food, did you? You're statement speaks loudly to your privilege and place in society. The world you are fantasizing about never reallyexisted. It didn't exist for everyone, just like health care. Hmmmmm.

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notajayhawk 5 years, 1 month ago

BrianR (Anonymous) says…

"Yeti, You never had to eat popcorn for dinner so your kids could have the “real' food, did you?"

Waaah.

I'm far from "privileged," Brian, and there have been times when I've gone hungry to feed my kids. I still don't expect someone else to take care of me.

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BrianR 5 years, 1 month ago

Your idea that the uninsured expect someone else to take care of them is your first mistake. Where do members of the bed wetting right like you get this wack idea?

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Aguilar 5 years, 1 month ago

notajayhawk (Anonymous) says…

I hope you don't go to the hospital when you're sick, then, aguilar. Or a doctor's office, for that matter.

I actually need to go to the dr. right now. I'm pretty sure I have strep. I'll have to suffer through the night and wait for an office appt as the only place I can see a dr. right now would charge $1,000. My insurance would cover none of this.
I don't mind dr.'s and hospitals getting theirs. It's the insurance companies that inserted themselves into this mix I have a problem with. Yes, I do "understand" how insurance works. If I had quadruple bypass and had my severed limbs reattached, Humana's profit that winter would still be well over THE $243 MILLION DOLLAR PROFIT THEY MADE DURING THAT QUARTER!!! Again, I ask you directly notajayhawk: How do you defend what these insurance companies do? How can you defence insurance companies making this kind of profit. Do you understand how insurance companies work?

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BrianR 5 years, 1 month ago

He can't, he's just being a troll. He couldn't possibly know how the system works and defend it unless he somehow profits from it.

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Richard Heckler 5 years, 1 month ago

Health care costs and facts:

        Paying More, Getting Less/ How much is the sick  U.S. health care system  costing you?

http://www.dollarsandsense.org/archives/2008/0508harrison.html

• 5 common fears about health insurance reform http://www.consumerreports.org/cro/magazine-archive/august-2009/viewpoint/5-common-fears-about-health-reform/reform-5-common-fears.htm

    * Senate Report Finds Insurers Wrongfully Charged Consumers Billions

http://www.washingtonpost.com/wp-dyn/content/article/2009/06/24/AR2009062401636.html

      *Special Interest Funds,Lack of Disclosure & Legislative Conflicts of Interest

http://www.washingtonpost.com/wp-dyn/content/article/2009/06/12/AR2009061204075.html

Polls favor medical insurance reform with impressive numbers : http://www.huffingtonpost.com/sarah-van-gelder/what-americans-want-natio_b_110830.html

6/22/09 A poll by the New York Times and CBS News has found that 72 percent of Americans support the government creating a public healthcare plan, similar to Medicare.

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notajayhawk 5 years, 1 month ago

BrianR (Anonymous) says…

"Your idea that the uninsured expect someone else to take care of them is your first mistake. Where do members of the bed wetting right like you get this wack idea?"

Gee, you're right - I don't know where anyone could get the idea you believe someone else should be taking care of you, solely from your whining about Yeti's suggestion people take some personal responsibility. Silly me.

And it wasn't "the uninsured" I was talking about - that was your first mistake. And it wasn't the "members" of anything that responded to your post, just me - that was your second. But please, when you're done sniffling, feel free to go on with your rant about how the "privileged" live in a fantasy land where people should take care of their own problems.

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notajayhawk 5 years, 1 month ago

merrill (Automoton) says…

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notajayhawk 5 years, 1 month ago

merrill-bot (automoton) says ...

"A poll by the New York Times and CBS News has found that 72 percent of Americans support the government creating a public healthcare plan, similar to Medicare."

From the polls linked to in the story the merrill-bot linked to:

Which of these statements do you think best describes the Medicare system: it is in a state of crisis, it has major problems, it has minor problems, or it does not have any problems?

63% said Medicare is in crisis or has major problems. Only 2% said no problems. So hey, yeah, let's put them in charge of the whole thing, merrill.

Also from the links merrill-bot provided:

In a CNN News poll, 55 percent preferred a system "administered by the government and paid for by taxpayers" -- just 29 wanted to hold on to the current private insurance system that leaves some without coverage.

When asked: "Do you think the government should provide a national health insurance program for all Americans, even if this would require higher taxes?" 64 percent said yes.

However, the same polling site linked to also reported that if the plan "would require residents with higher incomes to pay for coverage and state funding that would be used to help cover residents with lower incomes," support dropped to 48%. (Although 55% supported such a plan provided everyone was required to pay something.)

And here's an interesting tidbit: More people think that insurance companies can do a better job at administering Medicare's prescription drug benefit than the government can (47% to 43%).

Sounds like even your own numbers are a little bit mixed, merrill.

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notajayhawk 5 years, 1 month ago

Aguilar (Anonymous) says…

"I don't mind dr.'s and hospitals getting theirs. It's the insurance companies that inserted themselves into this mix I have a problem with."

Congratulations. Although it clearly was not your intention, you have hit on both the problem and why a tax-payer funded universal-coverage system is most definitely not the answer.

You "don't mind dr.'s and hospitals getting theirs" - it's perfectly acceptable to you that an ER visit can cost $10,000 or more, plus shelling out a couple of hundred bucks each for a radiologist to glance at the x-rays for 30 seconds, a hematologist to glance at the blood workup, etc., etc., etc.

You just object to that big, evil insurance company "that inserted themselves into this mix." Um - aggie - they didn't "insert" themselves anywhere. YOU put them there. If you object to their making a profit, feel free to remove them from that "mix" any time you want. Then, when you find out that quadruple bypass or limb re-attachment cost you several hundred thousand dollars, we'll see if you still "don't mind dr.'s and hospitals getting theirs."

"How do you defend what these insurance companies do? How can you defence insurance companies making this kind of profit. Do you understand how insurance companies work?"

And how do you defend what hospitals do, aggie? How much is being tacked onto every single bill for every patient at KU med to pay for that new $73 million office expansion? How much was tacked onto every bill to pay for Tom Skerritt pimping them on TV, for the sole purpose of convincing people to go there instead of Shawnee Mission or Olathe, so they can make more money?

THAT is where the problem lies, but you don't have a problem with that. You think doctors and hospitals should be able to charge ungodly fees, and make outrageous profits, and the insurance company should somehow be a non-profit charitable agency and assume the risk of your quadruple bypass for nothing?

Brilliant.


BrianR (Anonymous) says…

"He couldn't possibly know how the system works and defend it unless he somehow profits from it."

Unlike the whiny, entitled trolls of Larryville like yourself, I not only know how healthcare financing works, I know why government funded healthcare is such a disaster.

I actually work in the healthcare field. Where does your expertise come from, again?

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Stain 5 years, 1 month ago

I have yet to hear a single Republican suggest a single thing that could possibly make our broken health care system better.

Brownback writes me bragging that he supports health savings accounts. I am insulted that he assumes a constituent is so stupid as to think that represents any kind of reform.

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notajayhawk 5 years, 1 month ago

Stain (Anonymous) says…

"I have yet to hear a single Republican suggest a single thing that could possibly make our broken health care system better."

Then you have been pretty selective in your reading.

First and foremost, the cost of healthcare must be addressed. Not the cost of insurance, the cost of service delivery. There are ways of doing this, starting with tort reform, but it would have to go much further. Something needs to be done to reduce the huge waste within the system - unneccessary duplication and repetition of services, over-use of specialist referrals, patients picking up the tab for beautification projects to medical facilities, etc.

And the fact that YOU don't like the idea of HSA's or tax credits for health insurance of the taxpayers' choice doesn't mean that alternatives haven't been proposed. It just means that no alternatives YOU like have been proposed.

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average 5 years, 1 month ago

Health care is not an insurable matter. It doesn't work like car or home insurance.

You can build a house tomorrow in Greensburg, KS. You'll get home insurance. Because it's no more likely to be hit by a tornado than any other Western Kansas town. Thus, statistically, you're profitable the first month you send in a premium.

Car insurance is the same. Your rates are adjusted a bit to your driving record, but you are profitable the first installment.

Health insurance does not work on disconnected events. Everything is connected to previous events (and age, etc). You get leukemia. Unless your premium can go to $8000 a month or more, you are, statistically, never going to be profitable again. You will be, from the perspective of the insurer or any 'competition', better off dead. Ask people who have been there... the insurance company will assuredly treat you exactly like someone they'd rather would die.

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TheYetiSpeaks 5 years, 1 month ago

posted by BrianR- "Yeti, You never had to eat popcorn for dinner so your kids could have the “real' food, did you? You're statement speaks loudly to your privilege and place in society. The world you are fantasizing about never reallyexisted. It didn't exist for everyone, just like health care. Hmmmmm."

Wow. Actually, I have never had this "place" in society you speak of. The only privilege I have ever had, was the privilege of eating bread (not popcorn) for dinner. My comment only referred to my personal history with, perhaps, a moral for others to digest as they choose. As for your contention that this world I fantasize about (that of personal responsibility and hard work) not existing, I think your "messiah" , President Obama would disagree with that notion. After all, a black man from a poor background IS president is he not? The majority of folks around the world would agree that the US has the best healthcare. Is it perfect? Of course not. But you don't spend trillions to overhaul something that is already the best when you have the largest deficit in history, anywhere. You (and this is so surreal to say) spend millions to "tweak" it.

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average 5 years, 1 month ago

@TheYetiSpeaks -

Um, no. Most people around the world don't agree with that statement. You'd think, if that were the case, that there would be at least some popular movement to go toward an American-style system in those other countries, then, don't you? When, in reality, there isn't a single member of the Canadian, UK, French, German, Japanese, etc parliaments, who would even think of suggesting such a thing.

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average 5 years, 1 month ago

Got any stats on that, Pilgrim?

Because I know theoretically-insured Americans who have gone to doctors in Tijuana for medical care that their insurance company refused to cover.

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jafs 5 years, 1 month ago

I agree with notajayhawk and others who point out that current health care costs are much too high, especially for the level of care delivered.

However, it's not clear how to fix it.

Tort reform usually seems to mean that patients whose doctors/hospitals/etc. screw up have less recourse, thus making health care professionals less accountable.

Part of the problem is that we're all paying for things we might not want to if we were aware of the fact, eg. expensive new facilities/buildings/etc.

What about making all health care services operate as non-profit businesses? They would still compete and employ people, and if they provided good value for cost, they'd do just fine.

This would include insurance companies as well.

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skinny 5 years, 1 month ago

You know, eveyone always wants something for nothing.

If you want something, you have to pay for it just like everyone else. Nothing is free.

Dr. Adrian Rogers pretty well sume it up here with this statement!

"You cannot legislate the poor into freedom by legislating the wealthy out of freedom. What one person receives without working for, another person must work for without receiving. The government cannot give to anybody anything that the government does not first take from somebody else. When half of the people get the idea that they do not have to work because the other half is going to take care of them, and when the other half gets the idea that it does no good to work because somebody else is going to get what they work for, that my dear friend, is about the end of any nation. You cannot multiply wealth by dividing it."

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TheYetiSpeaks 5 years, 1 month ago

average says- "When, in reality, there isn't a single member of the Canadian, UK, French, German, Japanese, etc parliaments, who would even think of suggesting such a thing."

Which is why I said most people would agree, not most politician/ bereaucrats. I have very little interest in what most politicians think. As for your claim of Americans going to Tijuana for procedures, I find it hard to believe they are going for appendectomies, getting broken bones set, or having their tonsils out, etc. I'm no expert, but most of the people I have heard of going to Mexico are interested in still experimental procedures that are possibly dangerous or physical procedures that are unnecessary.

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kansanbygrace 5 years, 1 month ago

Concerning qualiy of care delivered: Of 19 European and American nations whose medical care systems are compared, US rates 19th best. In total global comparisons, US system is somewhere between 30th and 40th best.
Ours is, however, the most expensive. Ours is also the only system in which insurance company functionaries possess the power to overrule physicians, effectively practicing medicine without a license and interfering in the decisions and practices of licensed medical professionals.
Treatments all too often consist of creating dependencies on drugs and other treatments that do not remedy the disease or deficiency, rather mask the symptoms at great expense.

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notajayhawk 5 years, 1 month ago

kansanbygrace (Anonymous) says…

"Concerning qualiy of care delivered: Of 19 European and American nations whose medical care systems are compared, US rates 19th best. In total global comparisons, US system is somewhere between 30th and 40th best."

Which is a complete and total load of cr*pola. There is absolutely no objective measure that can compare the 'output' (what we get for healthcare dollars) between systems.

One measure often thrown around is mortality rates. You can't compare them. Infant mortality rates may be higher in Sweden, for example - how many crack babies are born in Sweden every year? There are a multitude of factors that affect mortality that have nothing to do with healthcare delivery (let alone insurance).

Another factor nationalized medicine proponents use to say their systems are 'better' is that everyone's covered by insurance. This link was originally posted by jmadison:

http://www.thespec.com/News/Local/article/590540

An interesting article illustrating the difference between coverage and care. The people in this story had coverage - they still had to leave the country to get care. You can get care without insurance - but insurance is pointless if you can't get care.

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kansanbygrace 5 years, 1 month ago

The comparisons of medical care between systems evaluate prenatal care, infant mortality, adult mortality, days unavailable for work, cost of comparable treatments, recurrence of illness, and a raft of other qualified and quantified objective measures. Some countries spend quite a bit to help people stay healthy, improve nutrition, reduce risks in their home and work environments, etc.
Various governmental, healthcare, UN, organizations do these studies routinely, US practioners' professional organizations participate and publish the results. Maybe you can't compare them, but a person with the motivation to read what's published most certainly can.

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MyName 5 years, 1 month ago

As cost estimates pass the $1 trillion mark, the administration is reduced to talking about financing its reforms with mini-measures such as a 3 cent tax on sugary sodas.

And this is why people think conservative columnists are dumb. Let's ignore the real suggestion for paying for the plan, removing the tax breaks companies get for insurance, and focus on the oddball suggestion that may not have been seriously considered, just to attempt to score a cheap point.

But my problem with George Will's response is the same problem I have with every other pro-insurance company response in this area. Even if the money doesn't come from our taxes, we are still going to have to pay for our healthcare in this country. You can't pretend that just because our money is going to Blue Cross instead of the U.S. Government that it's somehow now magically pure and has been blessed by the ghost of Adam Smith.

The bottom line is our current healthcare system is a failure. In terms of cost versus results, in terms of overall coverage, and in terms of future viability it is bankrupting the country while failing to meet the basic needs of millions of Americans. The only area where it is a success is in lining the profits of the insurance corporations, which is why the market hasn't come up with something better, and why it won't without some sort of intervention.

People in government aren't trying to step into the market because they're socialists, or believe that the government magically makes things better. They're stepping in because the current system stinks and government intervention is becoming the only option left.

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Aguilar 5 years, 1 month ago

Notajayhawk: Yes, KUMED expanded their offices to accomodate more patients. Right, that's straight up wrong.
And while KUMED making 72 million in one year is too much (I'll give you that), it is still a fraction of what healthcare companies are making. Most hospitals do not make any profit close to this.

Again, Notajayhawker, how do you defend Health Insurance Co'.s making this kind of money. Last year, 7 CEO's of these companies earned over $14 milllion. That's a bigger problem. Please don't reply with another fact that does not relate.

http://kansascity.bizjournals.com/kansascity/stories/2008/06/09/daily16.html

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salad 5 years, 1 month ago

The only way we could make the current system worse, is to FORBID healthcare completely.

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TheYetiSpeaks 5 years, 1 month ago

Do you feel like you NEED to eat? Do you feel like you need water? Do you feel like you need shelter? What about transportation? Electricity? Why is it that nobody ever mentions that companies get rich off of these necessities as well? Why do you pay for these things but want your healthcare for free? It's a capitalist society and this is just how it works. I find it astonishing that some of you think the answer is to spend hundreds of trillions of dollars to overhaul a system thats "bankrupting" the country. This philosophy makes no sense even IF your claims were right.

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notajayhawk 5 years, 1 month ago

kansanbygrace (Anonymous) says…

"The comparisons of medical care between systems evaluate prenatal care, infant mortality, adult mortality, days unavailable for work, cost of comparable treatments, recurrence of illness, and a raft of other qualified and quantified objective measures."

As for mortality rates, one more time (for the slow folks), there are numerous other factors that have nothing to do with healthcare that affect mortality. The percentage who smoke or drink; diet; exercise; rates of obesity; environmental factors; and a host of others. As for cost, is that in absolute or relative terms? By that, I don't mean in relation to GDP, I mean as a percentage of individual disposable income?

I have read, and continue to read, the research, kbg. All of it, not just the sound bites. Every bit of responsible research I've read on the subject qualifies its findings by mentioning the limitations to genralizing the results. Try reading the fine print sometime, or do something radical and use your brain to analyze the claims being made. Or just continue to read the soundbites and follow the rest of the lemmings over the cliff.

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notajayhawk 5 years, 1 month ago

Aguilar (Anonymous) says…

"Yes, KUMED expanded their offices to accomodate more patients."

How many beds were added? What? None? How is this expansion going to cut down on waiting time for an appointment? What? It won't?

They didn't spend $73 million to accomodate more patients, but to consolidate office space. Supposedly this is to better serve the patients. 'Cause it's so much easier to find your doctor in a huge six-story building with over 400 other doctors than it is in one of several smaller buildings. Right.

"And while KUMED making 72 million in one year is too much (I'll give you that), it is still a fraction of what healthcare companies are making. Most hospitals do not make any profit close to this."

In 2004, hospitals' average profit margin was over 5% - about what the insurance companies make. And that was with $100 billion in capital spending in the preceding 5 years. About 1/3 of healthcare spending in this country goes to hospitals - so they made about $33B in profits, even with 1/4 of them operating in the red. They accomplished this by negotiating higher payments from insurers and by performing more high-dollar procedures. Oh, and by cutting the length of hospital stays.

But I forgot - you don't have a problem with any of that.

"Again, Notajayhawker, how do you defend Health Insurance Co'.s making this kind of money."

I have no need to defend it. What is your basis for objecting to it? If you don't want the insurance company to make money off you, cancel your insurance. Assume the risk yourself.

Just what in the he** makes you think that insurance companies should be any different than any other business that provides any other service that you purchase? My insurance company provides me with a service. They assume the risk for catastrophic medical bills due to exhorbitent hospital and other provider charges. I pay them to do that - just like I pay my car insurance company (despite not having an accident in many years), my life insurance company (they haven't paid anything out yet, either), or any other insirance company I deal with.

And when my insurance rates go up, I look at why. I think it's outrageous that an ER visit for several hours of 'observation' can cost over $12,000, that a family member can be referred for two separate visits to a specialist for no other reason but to evaluate whether the swelling from a small animal bite responded to the antibiotics, that the same family member can go to the ER several times in a month and have the same expensive tests repeated, sometimes in less than 24 hours, as if they're going to show something new. And since hospitals and other providers can't seem to get their charges under control, I don't have the unrealistic expectations that you seem to have that the insurance companies should eat the additional cost.

And again I'll ask you - as I see others have - just what makes you think they should provide this service to you for free?

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notajayhawk 5 years, 1 month ago

jafs (Anonymous) says…

"What about making all health care services operate as non-profit businesses?"

Not sure we need to be that drastic. There are simpler yet still effective ways.

As I mentioned, tort reform wouldn't be the final solution. And while I see your point about injured patients having recourse, there have to be some limits put in place for minor issues. If a doctor kills a patient because he showed up drunk for surgery and took out the heart instead of a kidney, he**, sue the bejezus out of him. But large awards (or any award) for more frivolous suits have got to be controlled.

How about if patients could be countersued? If they file a frivolous suit and lose, they have to pay a huge settlement - and the attorney who was in line to collect 1/3 (or more) of the patient's settlement now has to pay 1/3 (or more) of their cost?

In any event, one thing that could make a significant impact would be true portability of medical records. It might cut down on the amount of waste going to unneccessarily repeated and duplicated tests, the over use of referrals to specialists, etc.

But that could also be regulated. I'm not usually a fan of over-regulation either, but it's the lesser of evils.

When I was growing up, the state where I lived had a hospital commission. They decided whether hospital A could spend that $2 million on a new piece of diagnostic equipment, and would refuse the request if hospital B, a block away, already had one. They also got to approve (or deny) requests to add additional services, like offering a particular operation. The reason for this was to ensure that a hospital surgery team had enough procedures per year to remain proficient, but it also cut down on duplication.

I'm not saying we have to go all the way back to the old days - the hospital in the city where I lived was denied permission to buy a CAT scanner because 2 other hospitals within 30 miles had one, and we don't need so much control that it interferes with the quality of care. But there must be a balance point somewhere, something that could prevent two hospitals within sight of one another both building huge facilities for multiple-organ transplants and then spending millions on advertising to take away each others' business.

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kansanbygrace 5 years, 1 month ago

KBG voices an opinion on a subject of his interest, Notajayhawk thumps his chest, spits out something about “I’ve read it all”, makes a cute reference to “Sound bites”.. Curiously, I’ve read an enormous quantity of articles, reports, monographs, and books, since the mid-seventies. Your perspective has very little support from professional literature.
Here are a few select citations from sources you may recognize, which pertain directly to my initial statements:
Per the Institute of Medicine: “The messages of this statement are that (1) that the quality of health care can be measured and improved and (2) that quality of care should be measured with continued and increased vigor”…. “Pursuing this objective means identifying and assessing the risks and opportunities posed by the changes in health care in the United States. It also means describing how health care organizations and clinicians should be accountable to patients and society and, conversely, how individuals can take appropriate responsibility for their own health.”…The IOM stated in 1990 in Medicare: A Strategy for Quality Assurance that "quality of care is the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge" (IOM, 1990, p. 21). This definition has been widely accepted and has proven to be a robust and useful reference in the formulation of practical approaches to quality assessment and improvement. The international comparison in which the US placed 19th of the 19 European and American nations analyzed the available care according to these categories: Preventable mortality; Activity limitations; Effective care; Coordinated care; Safe care; Patient-centered, timely care; Insurance and access; Affordable care; Inappropriate, wasteful, or fragmented care; Avoidable hospitalizations; Variation in quality and costs; Administrative costs; Information systems; and Disparities. Continued next post...

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kansanbygrace 5 years, 1 month ago

The Commonwealth Fund's National Scorecard on U.S. Health System Performance, 2008, qualifies objectively as follows, and offers detailed quantification.
1. Mortality amenable to healthcare, 2. Infant mortality, 3. Healthy life expectancy at age 60, 4. Adults under 65 limited in activities, 5. Children missed 11 or more school days due to illness or injury, 6. Adults received recommended screening and preventative care, 8. Needed mental health care and received treatment, 9. Chronic disease under control, 10. Hospitalized patients received recommended care for heart attack, heart failure, and pneumonia. 11. Adults under 65 with accessible primary care provider, 12. Children with a medical home, 13. Care coordination at hospital discharge. 14. Nursing homes: hospital admissions and readmissions. 15. Home health hospital admissions. 16. Patient reported medical, medication, or lab test error. 17. Unsafe drug use 18. Nursing home residents with pressure sores, 19. Hospital-standardized mortality ratios, 20. Ability to see doctor same/next day when need medical care 21. Very/somewhat easy to get care after hours without going to the emergency room. 22. Doctor-patient communication: always listened, explained, showed respect, spent enough time. 23. Adults with chronic conditions given self-management plan. 24. Patient-centered care. 25. Adults under 65 insured all year, 26. Adults with no access problem due to costs, 27. Family spending on out-of-pocket medical costs and premiums 28. Premiums for employer-sponsored coverage less than 15 % of median household income. 29 Adults under 65 with no medical bill problems or medical debt. 30. Potential overuse or waste. 31. Emergency room for condition that could have been treated by regular doctor, 32. Hospital admissions for ambulatory care – sensitive conditions 33. Medicare hospital 30-day readmission rates. 34. Medicare annual costs for chronic diseases. Diabetes, heart failure, COPD 36. Health insurance administration as percent of national health expenditures. 37. Physicians using electronic medical records. The World Health Organization listed their qualifications as: Health, Responsiveness, Fairness in Financial Contribution, Overall gain attainment, Expenditure per capita, Performance on level of health, and Overall system performance. (US ranked 37th of 191 nations)

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kansanbygrace 5 years, 1 month ago

And- from the advocacy group “Connecticut Coalition for Universal Health Care” the contribution by John R. Battista, M.D. and Justine McCabe, Ph.D., cite with references: • Fact One: The United States ranks 23rd in infant mortality, down from 12th in 1960 and 21st in 1990 • Fact Two: The United States ranks 20th in life expectancy for women down from 1st in 1945 and 13th in 1960 • Fact Three: The United States ranks 21st in life expectancy for men down from 1st in 1945 and 17th in 1960. • Fact Four: The United States ranks between 50th and 100th in immunizations depending on the immunization. Overall US is 67th, right behind Botswana • Fact Five: Outcome studies on a variety of diseases, such as coronary artery disease, and renal failure show the United States to rank below Canada and a wide variety of industrialized nations. • Conclusion: The United States ranks poorly relative to other industrialized nations in health care despite having the best trained health care providers and the best medical infrastructure of any industrialized nation Also useful, particularly to examine effect per cost, the American College of Physicians, The Henry J. Kaiser Foundation, and the Organization for Economic Cooperation and Development offer volumes regarding money spent, where it goes and relative effectiveness. If you’d like, I can refer you to scores of comparable professional publications, but I’d prefer you do your own homework. And now, NAJ, disagree, with references, if you like, but when you talk with the grownups, leave your childish insults out of it if you’d like to be taken seriously.

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notajayhawk 5 years, 1 month ago

"The Commonwealth Fund is a private foundation that aims to promote a high performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society's most vulnerable, including low-income people, the uninsured, minority Americans, young children, and elderly adults." [from their website]

The Connecticut Coalition for Universal Health Care's list of "supporting organizations":

Physicians for a National Health Program Connecticut Society for Clinical Social Work Connecticut Small Business Coalition Connecticut Caucus of Democrats Green Party of Connecticut Labor Party of Connecticut Connecticut Call to Action Health Care for All [from their website]

Nice unbiased sources you've been reading, kbg. That explains a lot.

"Conclusion: The United States ranks poorly relative to other industrialized nations in health care despite having the best trained health care providers and the best medical infrastructure of any industrialized nation"

Four out of five of your "facts" have to do with mortality. Has it occurred to you that infants have the least exposure to the healthcare system, and there just might be other reasons why their mortality rate is higher? Did the 'studies' happen to compare such factors as whether those infants had been drug-exposed during gestation? Or the poverty levels of the mothers (which affects several other critical factors in the mortality rate of the infant besides healthcare)?

Is the diet of an American similar enough to that of a Canadian that you can accurately compare survival rates for coronary heart disease? Or the amount of exercise, or environmental factors?

If average height in Germany is two inches over what it is in America, would a nationalized healthcare plan make me taller?

It doesn't bother you that we can have the "best trained health care providers and the best medical infrastructure" and yet rank at the bottom for healthcare overall? Again, that explains a lot.

When you start factoring in cost and accessibility, and the responsibility of the healthcare system for changing peoples' lifestyle choices, those are essentially political, not quality-of-care issues. Some people believe that better doctors and better hospitals are appropriate indicators of quality care. The fact that you and your sources believe those factors to be trivial side issues suggests your complaints are based more on a social change agenda than on quality of care.

Could our system be improved? Yes. (Surveys show that the overwhelming portion of Canadians believe theirs could be, too.) Could we allocate resources better to reach more people? Again, yes. Would adapting the system of these other countries result in having the same healthcare outcomes as they have? There is absolutely no evidence that can support that.

And before you say anything about talking with grownups, child, why don't you try showing me some reason to believe that you are one?

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BrianR 5 years, 1 month ago

You profit from it then, moron.

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notajayhawk 5 years, 1 month ago

Yes, dipsh**, I 'profit' from it, just as, in your own job - which undoubtedly involves the words "paper or plastic" - you profit from the hunger of others. As for me, I work in an agency that serves mostly indigent patients and just took a pay cut to keep us at full staff levels.

I would 'profit' a lot more with a taxpayer funded system, BR. I happen to be in one of the fields that Medicaid pays better than private insurers do. But it would be a disaster for the country I live in and for my patients.

Once again - your own expertise on healthcare financing comes from where, again? Oh, yeah - out of the area you're sitting on.

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