Who wrote this? From what I have read for many years medical expenses have been one of the most consistent causes for bankruptcy in the U.S. I can say from my experience in the real estate industry for 18 years it has been the most consistent obstacle to families buying a home. Among the people I know it rates very high as well when it comes to the one thing that has cost them the most. In the United States we are way behind the rest of the world in dealing with this issue. We pay more for health care and more for prescriptions than any country I can think of. We are sold the line our system is the best by far but yet we rank so poorly amongst much less fortunate counties, much less wealthy countries...much less advanced countries when it comes to overall health. In fact we rate 37th in the world.

http://www.consumeraffairs.com/news04/2005/bankruptcy_study.html

http://www.photius.com/rankings/healthranks.html

I've been treated overseas and I can tell you I'd rather need treatment almost anyplace else on this planet. Our system is slow, expensive, redundant, prone to fraud, and wasteful. Doctors are not gods. They are just an individuals with a skill set the same as a mechanic, plumber, teacher, or anyone else on this board. Whoever wrote the garbage above ignores study after study and thinks we don't read. The person that wrote this must be a lobbyist in D.C. paid for in medical cost by you and me.

Figure might be a little questionable, the problem is not.

(and guess who pays for all these default medical bills?)

Obama lies!

What else is new...?

Read the article, Hydra...

"Various fact-checking services have said this figure is wrong. When senior White House officials or Obama appointees were asked about this figure and whether it was true, one said, “It really doesn’t matter..."

White House official ADMIT the stat is wrong but they know you don't care...

The liar leading the blind...

"OK, so to what degree is it OK for Barack Hussein Obama to lie?"

Same as all the other politicians, as much as they can get away with. That's why I don't listen to politicians, or pundits.

"When senior White House officials or Obama appointees were asked about this figure and whether it was true, one said, “It really doesn’t matter..."

and when caught, the democrat White House says that the truth really doesn't matter...

"That socialist systems are better in accordance with socialist ideals is hardly surprising and is definitely not a valid indicator of health care quality."

Of course, when you invalidate all of the other markers except for the single one that you deem relevent, the results are more or less the same, aren't they?

"There’s no question that Obama is using every means, if not to panic or scare the general citizenry..."

Who's trying to scare people? Obama or the LJW?

"Various fact-checking services have said this figure is wrong."

Great reporting. Various fact-checking services have said this figure is right. Just as convincing, don't you think?

The problem with Obama's statement, if you've just got to get your panties in a wad about it rather than getting your panties in a wad about the state of health care costs in the nation, is his use of outdated stats.

http://mediamatters.org/items/200903050026?lid=923498&rid=22604423

I really wish that if the LJW was going to write such inflammatory editorials, they'd back it up with some references and citations and stats they've twisted to fit whatever view they're trying to push. Sheesh, even Cal Thomas can manage that.

asleepinthechapel (Anonymous) says…

Exactly! Don' forget the LWJ endorsed hot head McCain.

This editorial is hilarious, in light of the new health care benefits adopted by the World Company. How much did the deductible increase, again?

full disclosure: I am not a world company employee.

Marion writes ...

"The article is about more of the lies of Barack Hussein Oabama. . . Rhetoric sells."

You're right. Rhetoric does sell. Just ask the Bushies. They sold the American people right into the worst financial crisis in 80 years, into a war that is morally unjustifiable, and into diminishing our rights as citizens.

And now you are trying a little bit of backhanded rhetoric yourself - Barack Hussein Obama. Phew, that stinks of a missed attempt at persuasion.

But hey maybe the Republican Party can dance its way back into power on the words of the de facto Republican voice of hatred, oppression, and duplicity that is Rush Limbaugh. After all he tells nothing but the truth. Hahahaha.

Rhetoric indeed.

I see that all of Richard Epsteind and Lew Rockwell's talking points represented. I'll borrow some from the other side of the fence.

1. This ignores the reality that patients and health care providers cannot acquire on their own the information they need to make rational choices about drugs. Without complete information, drug market failures, in the form of poor patient outcomes, are inevitable.

2.The Elixir Sulfanilamide disaster of 1937

1. This ignores or minimizes recent misbehavior on the part of some pharmaceutical companies in concealing unfavorable data (the examples of Vioxx, Ketek, and Trasylol spring to mind), proceeding instead as though drug information is immediately provided to physicians, patients, and health insurers by virtuous pharmaceutical executives.

There are areas within the FDA that need serious consideration and reform. For example, why does the FDA treat small and large pharmaceutical companies differently, creating barriers to market entry for the former that need to be addressed? Why don’t third-party payers have a market incentive to demand more complete information on drugs, a mechanism that could substitute for government regulation? But these are not solved by eliminating the agency entirely.

Anarcho-capitalists would gleefully have us consume tainted or dangerous pharmaceuticals, salmonella infected produce and sundries and open the market wide open to patent medicine nostrums, all with the flimsy protection of caveat emptor.

Awesome article XD40!

Notice the author?

Ms. Pipes is president and CEO of the Pacific Research Institute. The Pacific Research Institute (PRI) received funding from Pharmaceutical Research and Manufacturers of America, the Altria Group (formerly Philip Morris), Pfizer and a foundation set up by three members of the Lilly family -- J.K. Lilly Sr. and sons J.K. Jr. and Eli -- through gifts of stock in their pharmaceutical business, Eli Lilly and Company.

Pipes is a big pharma industry hack. Way to fight for the status quo and sell out your fellow Americans XD40!

Liberty: Quit copy pasting that ridiculous statement about the WHO, you ignore the other stats and yet you grossly distort the definition of "responsiveness".

Responsiveness: Responsiveness includes two major components. These are (a) respect for persons (including dignity, confidentiality and autonomy of individuals and families to decide about their own health); and (b) client orientation (including prompt attention, access to social support networks during care, quality of basic amenities and choice of provider).

While respect and prompt attention are desirable, this definitely does not mean that the US is #1 in satisfaction, quickness, and efficiency like you claim.

"Way to fight for the status quo and sell out your fellow Americans XD40!"

That's kind of his M.O.

Studies showing approx 1.06 million bankruptcies filed in 2008 divided by 365 days and 24 hours (not business days/hours) leaves 2.02 bankruptcies filed per minute. A Harvard study concludes that approximately 50% of bankruptcies are due to medical costs, leaving a more likely figure to be a little over 1 medical bankruptcy per minute instead of 1 per 30 seconds. Obviously, using business days/hours would lead to many more than 1 per 30 seconds.

The problem is serious, and I'm disappointed the LJW appears to be more concerned about a small difference in statistics than the INCREDIBLE breadth and depth of the real problem.

The real shocker is that an editorial page that supported the whacko neo-com tyranny of the Bush years would have the nerve to question Obama's integrity!!!!! Let's see..........complaining about the way a well known problem is quantified with statistics VS.........LYING ABOUT WEAPONS OF MASS DESTRUCTION resulting in the deaths of nearly 5000 Americans and countless Iraqis??? Not to mention to new rack of lies from Bush and his cronies that appear in the news almost every day now that people are no longer afraid of what will happen to them if they speak out!!!!!!!!

Clearly, this was written by someone who is lost on the River Denial!!!!!

Well here is a statistic from the National Coalition on Healthcare: "1.5 million families lose there homes to foreclosures every year due to unaffordable medical costs" Assuming the NHC is behind the cause, lets just assume that this number is grossly overstated, and health related bankruptcies are only 1/4 of this. Here is my calculation:

1,500,000 x 25% = 375,000 adjusted (and estimated) annual bankruptcies 375,000 / 365 days = 1,027 estimated bankruptcies per day 1,027 / 24 hrs = 43 estimated bankruptcies per hour 43 / 60 minutes = .713 estimated bankruptcies per minute

By my conservatively adjusted calculation, a health-related bankruptcy occurs about every minute and a half. If President Obama used a non-conservative estimate, the rate would be about 2.8 per minute. The problem with statistics though.....anyone can use them to prove there point on either side of the fence. Any way you slice it though, the numbers appear to be high.

Liberty_One (Anonymous) says… If you know so much how come you are completely forgetting that strict liability would be enforced creating FAR stricter regulation of the drug industry. ============================== Quis custodiet ipsos custodes?

Who's doing the enforcing, the kind folks a Pfizer? Deregulated industries certainly have self-enforced strict regulations, haven't they? Why, just look at AIG, Enron and Lehman Brothers! Maybe we can ask Bernie Madoff to run the whole enterprise, I hear he's available.

Our healthcare system spends nearly 30% on administrative fees. With so many pay sources with all differing rules and guidelines, attempting to understand all of this and keep up with it, especially when payers are more interested in making a profit instead of making it convenient for their clients, there is so much time and expense just trying to figure out who owes what. When one gets out of the hospital, one doesn't get a hospital bill anymore. One gets a bill for the x-rays, the tests, this doctor and that doctor, this service and that. Suddenly instead of one more bill, one has many bills to be paid and every one of them want to be paid ASAP and minimally will want money every month. Below is an article from The National Coalition on Health Care

The National Coalition on Health Care 1120 G Street, NW, Suite 810 Washington, DC 20005

202.638.7151

This document is also available as a printable .pdf file. Health Insurance Costs

"Facts on the Cost of Health Insurance and Health Care

Introduction

By several measures, health care spending continues to rise at a rapid rate and forcing businesses and families to cut back on operations and household expenses respectively.

In 2008, total national health expenditures were expected to rise 6.9 percent -- two times the rate of inflation.1 Total spending was $2.4 TRILLION in 2007, or $7900 per person1. Total health care spending represented 17 percent of the gross domestic product (GDP).

U.S. health care spending is expected to increase at similar levels for the next decade reaching $4.3 TRILLION in 2017, or 20 percent of GDP.1

In 2008, employer health insurance premiums increased by 5.0 percent – two times the rate of inflation. The annual premium for an employer health plan covering a family of four averaged nearly $12,700. The annual premium for single coverage averaged over $4,700.2

Experts agree that our health care system is riddled with inefficiencies, excessive administrative expenses, inflated prices, poor management, and inappropriate care, waste and fraud. These problems significantly increase the cost of medical care and health insurance for employers and workers and affect the security of families."

More from the National Coalition of Healthcare:

"The Impact of Rising Health Care Costs

National surveys show that the primary reason people are uninsured is the high cost of health insurance coverage.2 Economists have found that rising health care costs correlate to drops in health insurance coverage.8 A recent study by Harvard University researchers found that the average out-of-pocket medical debt for those who filed for bankruptcy was $12,000. The study noted that 68 percent of those who filed for bankruptcy had health insurance. In addition, the study found that 50 percent of all bankruptcy filings were partly the result of medical expenses.9 Every 30 seconds in the United States someone files for bankruptcy in the aftermath of a serious health problem. A new survey shows that more than 25 percent said that housing problems resulted from medical debt, including the inability to make rent or mortgage payments and the development of bad credit ratings.10 About 1.5 million families lose their homes to foreclosure every year due to unaffordable medical costs. 11 A survey of Iowa consumers found that in order to cope with rising health insurance costs, 86 percent said they had cut back on how much they could save, and 44 percent said that they have cut back on food and heating expenses.12 Retiring elderly couples will need $250,000 in savings just to pay for the most basic medical coverage.13 Many experts believe that this figure is conservative and that $300,000 may be a more realistic number. According to a recent report, the United States has $480 billion in excess spending each year in comparison to Western European nations that have universal health insurance coverage. The costs are mainly associated with excess administrative costs and poorer quality of care.14 The United States spends six times more per capita on the administration of the health care system than its peer Western European nations.14 "

Now, where do you think Obama got the idea that there is a bankruptcy every 30 seconds? Could it have been from this Harvard study? Could some in the press be continuing that nasty smear campaign against Obama?

max1 (Anonymous) says…

"A recent study by Harvard University researchers found that the average out-of-pocket medical debt for those who filed for bankruptcy was $12,000. The study noted that 68 percent of those who filed for bankruptcy had health insurance."

Gee, you mean that 2/3 of those who filed for bankruptcy had their healthcare costs covered, and still couldn't pay their bills? Imagine that.

"In addition, the study found that 50 percent of all bankruptcy filings were partly the result of medical expenses."

And this is the post hoc propter hoc fallacy of the argument that Obama and his fawning minions would have you swallow - that because the bankruptcies followed medical expenses, the medical expenses caused the bankruptcies.

The key word, for you slow folks, is "partly." Again, gee whiz, you mean that out of all those folks who overextended themselves on mortgages they couldn't afford, excessive student loans, and massive credit card debt, half of them weren't paying their hospital bills, either?

I'll bet the percentage is higher for those bankruptcies that were partly due to credit cards, max. Should we take your tax dollars to pay off their Visa bills?

'Every 30 seconds in the United States someone files for bankruptcy in the aftermath of a serious health problem."

No kiddin'. I'm amazed. You mean when someone has a catastrophic illness, and they can't WORK, they can't pay their bills? Go figure.

rshrink (Anonymous) says…

"We need a psych unit in Lawrence for the size of our population, but we don't have one anymore, because it isn't profitable."

Um - rshrink? LMH is a not-for-profit hospital. The lack of a psych unit isn't because of a lack of profits, it's because of a lack of economic viability.

"Our healthcare system spends nearly 30% on administrative fees."

[sigh]

Just keep rehashing the same old tired misleading figure, rshrink.

The NEJM study this number came from is outdated and riddled with problematic methodologies. Try reading it sometime. Funny thing, if you do read it, even they don't claim that moving to a single-payer system will result in a savings of anywhere near 30%.

"Licensing does not make you safe. Licensed doctors kill patients all the time, make all kinds of terrible mistakes, misdiagnos patients every day. The purpose of licensing is not to make you safe, it is to protect doctors from competition. It sets up an oligopoly (look it up if you don't know it) that allows doctors to charge higher fees. The free market answer is private accreditation."

Liberty, what are you 15? I think I need to remind you that people make mistakes, yes even doctors, but if they follow protocol and best practices, then they are protected to a great extent. Problems come up with people. People don't all respond to treatment the same. People are complex, so many different things can cause the same symptoms and only trained people are going to be able to be sophisticated enough to sort this out. The reason we have stuck with doctors for so long is because they have been doing a reasonably good job.

Regarding your point about how licensing prevents competition, that is total nonsense. Who isn't able to compete with the doctors, witches? Maybe you would like to be able to choose to go to a palm reader. Well, go on ahead and do that. I don't know where you are coming up with this stuff, but I think you really need to do more research. Yes I do know what an oligopoly is and as I have already said, it doesn't apply here. Doctors are quite able to compete adequately with each other. Don't worry about that. Insurance and managed care has also had a big impact on fees. Where we have had the least control on keeping fees down has not been with docs, it has been with drug companies, which is privatized and medical supplies and what hospitals charge for them. So, like I said, do a bit more research on this.

rshrink (Anonymous) says…

"By jove, not, I think you have got it."

That's right, rshrink, believe it or not (don't know why you were having difficulty), people file for bankruptcy all the time, due to many other reasons besides medical bills. Glad I could help you understand. It really wasn't that difficult after all, was it?

max1 (Anonymous) says…

"Or, imagine this: their insurance came nowhere near paying their medical bills. Read up on the subject."

Have read it, max. Have you?

Did you happen to notice that the NCHC says in their policy statement that addressing the cost of healthcare was a prerequisite to universal coverage - in other words, that a bigger problem than who pays is how much it costs in the first place? (Gee, wish I'd said that. Oh, wait, I did - many, many times.)

Or did you happen to read the Harvard study cited by the NCHC? The one that began "Even universal coverage could leave many Americans vulnerable to bankruptcy... ?"

Once more for the slow folks - nobody's saying our current system is perfect, or even the best system we could have. But government-funded single-payer universal healthcare is NOT the answer.

rshrink (Anonymous) says…

"Unlike you Liberty, age 15, I have worked in the healthcare field. I have had to deal with it daily and anyone who has will tell you it is not doctors that are the problem. It is the Insurance companies. If you don't know that, then you are either writing from another planet or as I said spending too much of your time reading from right wing oriented reading material. When you have worked for decades in a field then you can call me arrogant."

Okay - you're arrogant.

I do work in the healthcare field. And for long enough to recognize that whatever area of that field you worked in left you absolutely clueless about the administration/billing aspects of that line of work. Unlike liberty, it's you that's spouting the uninformed ideological drivel of the left, blindly believing that turning healthcare over to the government would somehow fix all the problems, that healthcare would suddenly cost no more than lunch at McDonald's and nobody would ever get sick or die. With each successive post it becomes more apparent you have no idea what you're talking about. liberty has suggested you do some research before you continue to spout off, and that's sage advice. But if you really want to continue embarassing yourself, hey, who am I to stop you? I can always use a good laugh on the weekend.

So, Liberty and Not, Here is some of the research that I didn't do:

U.S. health care spending is expected to increase at similar levels for the next decade reaching $4.3 trillion in 2017, or 20 percent of GDP.1

In 2008, employer health insurance premiums increased by 5.0 percent – two times the rate of inflation. The annual premium for an employer health plan covering a family of four averaged nearly $12,700. The annual premium for single coverage averaged over $4,700.2 From the National Coalition of Health Care, which used studies done at Harvard and was presided over by academicians, healthcare providers and politicians from both parties:

Experts agree that our health care system is riddled with inefficiencies, excessive administrative expenses, inflated prices, poor management, and inappropriate care, waste and fraud. These problems significantly increase the cost of medical care and health insurance for employers and workers and affect the security of families.”

Obama is destroying confidence in our financial system. Is it sheer ignorance, or malevolent intent?

Obama on Wednesday: "On the other hand, what you're now seeing is profit and earning ratios are starting to get to the point where buying stocks is a potentially good deal if you've got a long-term perspective on it."

Profit to earnings ratio????? Really, Mr. President? And, by the way, just how long is "long term," anyway? Got any specific companies you care to name, or is it all of them that have a good "profit to earnings ratio?"

And now this, from the NYT:

"In a 35-minute conversation with The New York Times aboard Air Force One on Friday, Mr. Obama reviewed the challenges to his young administration. The president said he could not assure Americans the economy would begin growing again this year. But he pledged that he would “get all the pillars in place for recovery this year” and urged Americans not to “stuff money in their mattresses.”

“I don’t think that people should be fearful about our future,” he said. “I don’t think that people should suddenly mistrust all of our financial institutions.”

This is on the heels of the announcement by the FDIC that it does not have enough funds on hand to fulfill its guarantee of banks that it knows are about to fail, not to mention the ones that might in the future, so it increased the fees banks pay to the FDIC, and asked Congress to authorize a $500 Billion cash infusion for the agency that insures banks,

Is Obama stupid, or is he trying to cause a run on the banks?

Why did Obama snub Prime Minister Gordon Brown of Great Britain during his visit to the Whitehouse this week? He avoided a photo op, did not hold a joint press conference, and did not even offer Brown a meal. The ultimate insult was Obama's gift to Brown. My guess is someone on Obama's staff dragged it out of the "re-gift" closet.

http://www.telegraph.co.uk/news/worldnews/northamerica/usa/barackobama/4953523/Barack-Obama-too-tired-to-give-proper-welcome-to-Gordon-Brown.html

" [British officials] concede that the mood music of the event was at times strained. Mr Brown handed over carefully selected gifts, including a pen holder made from the wood of a warship that helped stamp out the slave trade - a sister ship of the vessel from which timbers were taken to build Mr Obama's Oval Office desk. Mr Obama's gift in return, a collection of Hollywood film DVDs that could have been bought from any high street store, looked like the kind of thing the White House might hand out to the visiting head of a minor African state.".....

"The real views of many in Obama administration were laid bare by a State Department official involved in planning the Brown visit, who reacted with fury when questioned by The Sunday Telegraph about why the event was so low-key.

The official dismissed any notion of the special relationship, saying: "There's nothing special about Britain. You're just the same as the other 190 countries in the world. You shouldn't expect special treatment."

Great Britain, aside from being one of America's most loyal allies, is the second largest holder of US debt.

Obama claims he is too busy with the economy to concentrate on foreign relations. Yet he has had time to craft a plan to reach out to "Moderates" in the Taliban, and to see that Hamas gets a few billion for rebuilding.

Mr. Obama, the world is watching, and they see you for what you are.

rshrink (Anonymous) says…

"I am also left the realization that I don't know what you are talking about either."

Yeah, there's a shock.

"So, Liberty and Not, Here is some of the research that I didn't do:"

Wow, that's exhaustive 'research' - you quoted something that's already been quoted and/or linked to at least a half-dozen times on this board alone. Where do you ever find the time?

By the way, shrunk, in the sentence "Experts agree that our health care system is riddled with inefficiencies, excessive administrative expenses, inflated prices, poor management, and inappropriate care, waste and fraud," where did you see the words "insurance companies?" All those things are, unfortunately, endemic to the system; it's your ideological goggles that leads you to believe they're all due exclusively to the insurance companies.

"If NAJ has any experience in the health field... "

Whew, stop and breath once in a while, shrunk. What was that, an attempt to see how much blathering you could do in a single sentence?

For all intent and purposes, most of my field already has a one-payer, government funded system. Virtually every dime that comes into our agency comes from the state. If you knew half of what you pretend to know in your rants, you'd know that a 'single-payer' system is a myth. Just because it all comes from the state doesn't mean it all comes from the same account or the same program. It's evident you don't know anything so I won't bother to ask 'did you know that,' but there are at least a half-dozen kinds of Medicaid alone. Less than half my time at work this week was involved in provision of services - the rest was jumping through the hoops and barrels of authorizations, clinical justifications, program and/or level-of-care changes, contesting denials of payment, and all the crapola that you, in your ignorance, believe only happens at private insurance companies. The final straw was when a 'customer service' rep from the state called me to say my request had been denied because they hadn't been able to e-mail me. Yes, he called me to tell me he couldn't contact me, resulting in a client being denied services. That's how wonderful a taxpayer-funded 'single-payer' system works.

And no, the state doesn't have a profit motive. Then again, they also don't have control of their revenues. They get an annual budget amount approved by the legislature, and when that amount runs out, providers either stop providing services or they work for free. Even state-run facilties lay off staff and close down units, programs, or entire facilities when tax revenues fall short or when demand for services exceeds what was budgeted.

Keep on showing your ignorance, shrunk.

NAJ - I think you are saying you don't like what is going on. Then sometimes you say you do. I think you confuse yourself. I am really sure I have not defended what is going on in the healthcare world now. Perhaps you need to read my posts again instead of just jumping to the conclusion that we disagree and therefore you should go on the attack. You mention an agency, which means you are government funded, except due to privatization, there is another layer that the money has to flow through.

The sentence you attribute to me, is not my sentence. But unlike you, I do understand it. Your agency is different than others. An agency or clinic that takes insurance, copes with managed care and also with various government payers, is plagued with paperwork. Most clinics and hospitals are in this boat. So, it is apparent that you didn't know what I was talking about, but that doesn't mean I am not reporting what is going on in most of the healthcare delivery system. I have worked for several hospitals, having had privileges at a number of them, having also been in a teaching role and worked for church, school, government and private practice agencies and clinics. So, what do you think, I am just making stuff up for the fun of it? It is not that fun. Our healthcare system is fragmented, expensive and heavy on the administrative end. The more years I have been involved in it, the worse it has gotten. I do recall when we had a single payer and it was great. I had only one staff person who was not a clinician. Nowadays, it takes many for most clinics of any size. (Good post Hoots)

rshrink (Anonymous) says…

"NAJ - I think you are saying you don't like what is going on. Then sometimes you say you do. I think you confuse yourself. I am really sure I have not defended what is going on in the healthcare world now. Perhaps you need to read my posts again..."

I have never said or even implied that I believe the current system is perfect or the best it could be or that I 'like' it. The problem with ideologues is that they see things that way - you assume anyone who is not in favor of nationalizing the system must like it the way it is now.

And no, I don't think anyone here has gotten the impression that you're defending our current system.

The biggest and most urgent problem is the cost of services, not who pays for it. If you had bothered to read anything from the NCHC's website that you cited earlier, you'd know that they agree with this - they say that addressing the cost is a prerequisite to any type of universal coverage. (And the Harvard study that's been cited here repeatedly starts off by mentioning that even with a nationalized system, it still won't keep people from filing bankruptcy.)

Debating over insurance vs. taxpayer funded coverage is pointless without addressing those costs. It's like having coverage for towing your car from your auto insurance or motor club - if the cost of a tow jumps from $50 to $500, it makes absolutely no sense to complain about the unaffordable cost of car insurance or motor club memberships without addressing the cost of the service itself.

The real threat is that when you have coverage, you don't worry about the cost of the service. When a catastrophic illness or injury can cost several hundred thousand dollars in medical charges, it doesn't matter whether we, as a society, pay for those costs out of pocket, through insurance premiums, or through tax dollars - it costs too much, and we can't afford it, period. But whether we have private insurance or it's paid for through our tax dollars, we're insulated from the problem (those people with Medicaid don't even see the bill, they have no idea what the hospital billed for that ER visit). Government guarantees of payment would only serve to support those fee levels, and nobody would care that the doctor charged $1,000 for that five minute visit - there would be no incentive at all to control, let alone reduce costs.

Your problem seems to be that you think the inefficiencies and administrative costs involved in healthcare would suddenly disappear if we went to a 'single-payer' government-funded system. As I detailed above, they wouldn't. In my own experience the administrative BS is much, much worse dealing with a state or federal agency than with private insurers. Everybody knows the current system is, to say the least, problematic - nobody here has claimed otherwise. But there are better ways to fix it than to turn it all over to a monstrous bureaucracy with all the simplicity and efficiency of, say, the IRS.

max1 (Anonymous) says…

"The Supreme Court will hear a case Wednesday that goes to the heart of the current national furor over managed care: Can patients trust doctors who are paid bonuses by their health plans to cut medical costs?"

So your solution would be what, max - providers having no incentive to keep costs down? Brilliant..

One MORE time for the slow folks - it's the cost of services that's the problem, not who pays for it. Going to a government-funded system would remove any incentive to control (let alone reduce) those costs, and whether we're paying out of pocket, through insurance premiums, or through tax dollars, the cost of providing services has become unaffordable.

Thank you, Max1, for your diligence in fact checking. Actually, if you were to do a little more digging, I think you would find that the UK holds a great deal of US corporate and agency debt as well as US Treasuries. Neverthess, I now have a chance to make my point again:

Obama either purposefully insulted Great Britain, our most loyal ally, and the third largest holder of US debt, or he dissed Gordon Brown out of ineptitude, laziness and an embarrasing lack of manners.

If his insult was intentional, what did he hope to achieve?

If this is considered quality editorial, it is would not surprise me to see the LJW fold up like so many other small town publications struggling these days.

The feigned indignation over rhetorical elements of a speech is laughable. There are so many other important topics affecting the citizens of this community that deserve attention.I wish there was a way I could get back the 5 minutes I spent reading and responding to this.

rshrink (Anonymous) says…

"One more time for the slow folks, our administrative costs are 2-3 times higher than in other developed countries."

And one more time for the even slower folks - "administrative costs" includes much, much more than billing insurance companies, things that going to a 'single-payer' taxpayer-funded system would not reduce one bit. Do those other developed countries have HIPAA, rshrink? Or any of the other myriad regulatory nightmares that drain a huge amount of money for compliance procedures? How much does the average physician in, say, West Germany, spend on malpractice insurance compared to physicians here? How do the continuing education & training requirements compare? For the umpteenth time, yes, administrative costs in this country are an obscene waste of resources. But blaming that all on the insurance companies is misleading if not downright dishonest.

In addition, while public agencies typically have lower administrative costs, the end result is higher payments for the same services. In general, Medicaid and Medicare pay more for the same services than private insurers do, and by rejecting fewer claims, they end up paying for more unneccessary (if not outright fraudulent) claims. I'm sure you're aware that the federal government doesn't even negotiate prices on medications with the drug companies. Saves quite a bit on administrative costs, but they pay out a lot more for the product.

"Hospital stays for the mentally ill are usually so short that it is practically no help."

Again, agreed. I spent five and a half years working in acute-care psych before returning to agency work, and the amount of time patients spent in the hospital was, on average, much less than adequate.

Funny thing, though: It was a state-owned, state-operated, and taxpayer-funded facility.

Liberty, your clip from Independence Institute doesn't impact on what I said at all. First, what is Independence Institute? Even if it is legit, it largely doesn't change anything from my own observations and readings. Here is a better representation of the article you quote:

"Zuckerman and Shen of the Urban Institute summarize the general conclusion: “The uninsured do not use more [ER] visits than the insured population as is sometimes argued,” they write. In fact “the publicly insured are overrepresented among [ER] users.”

Are the publicly insured overrepresented because Medicare and Medicaid patients are sicker? No one knows. The problem with accepting this explanation at face value is there is evidence suggesting that the government run programs, organizational nightmares that deliver poorer care at higher cost, may also do a poorer job of healing people.

In a cancer treatment study, 65 percent of privately insured people received guideline treatment. Just 60 percent of Medicaid and Medicare patients did. Children with juvenile rheumatoid arthritis on Medicaid used the same amount of health care as those with private insurance. They had similar joint involvement. But they also had higher disability and a lower health-related quality of life, possibly because public programs are a lousy way to deliver health care. "

It says the uninsured don't use the ER more than the uninsured. So, that doesn't say anything about how often that is, if it is inappropriate care and how much more it costs. I know you say you love books. This isn't from a book. You could do better by going to an ER and talking to people who work there. It is also clear from the start of the article that the person has an axe to grind. You also left out the part that ends up not supporting the contention that the author first asserts. Nice cherry picking. If you lead someone to a cite, it should at least do a better job of supporting your contention. Also, go ahead and read some of the cites that don't agree with your assertions. Also, as usual you still ignore the other facts I wrote about and still haven't answered the question about panels. Do you know what they are?

NAJ writes, "And one more time for the even slower folks - “administrative costs” includes much, much more than billing insurance companies, things that going to a 'single-payer' taxpayer-funded system would not reduce one bit. Do those other developed countries have HIPAA, rshrink? Or any of the other myriad regulatory nightmares that drain a huge amount of money for compliance procedures? How much does the average physician in, say, West Germany, spend on malpractice insurance compared to physicians here? How do the continuing education & training requirements compare? For the umpteenth time, yes, administrative costs in this country are an obscene waste of resources. But blaming that all on the insurance companies is misleading if not downright dishonest."

While apparently thinking you disagree with me, I am struck with how much it appears that you do agree with me NAJ. I do think you need to ask yourself why we have HIPPA, however. I do agree that it was a huge costly deal and I am not really sure myself why it was necessary. A lot of it was already in place and a normal expectation of professionals. Politicians and Insurance companies are typically not aware of professional education and tend to act as if they know more.

Here is why I don't like insurance companies. They end up having too much control over how treatment goes and they are not the professionals. They are not the ones who provide the hands on care. You can say they pay, but no, we who have the insurance pay, for the premiums, the co-pays, the deductibles and in loss of income. They add a layer of expense to our healthcare. I am sure you know that the Insurance sector is the wealthiest in the world. I don't blame the insurance industry in total. In the end, it is the people who accept the status quo that are responsible. The government we elect has supported the insurance industry, so therefore, the government also cannot be blamed. They are only doing what we have asked them to do. Then when we need medical services and can't get them for various reasons, it is too late to go to the government or the insurance company. During the Bush years, the insurance companies had the upper hand. They could do no wrong and consequently, they did whatever they could to make profit, unrestrained. Now, they need to be regulated again. I don't know what Obama plans. I wouldn't even begin to imagine what can be done now. It looks like just another nightmare trying to figure out what to do. Change is never easy. I do think we need to be discussing this and the people need to be involved in the decisions being made.

max1 (Anonymous) says…

"So you believe doctors should be rewarded for denying patients critical medical attention?"

Why, max - do you believe they should be rewarded for padding their bills with unnecessary or even fraudulent claims?

There's no incentive to 'deny patients critical medical attention,' max. The few bucks you pick up from managed care aren't going to make up for the hefty lawsuit and the loss of your medical license. On the other hand, without the financial incentives to hold down costs, there's plenty of reason to inflate the bill - far fewer people are going to sue or complain to the board because you gave them too much care, especially if they didn't have to pay for it.

When I worked for the state, we had one of those gold-plated policies - the kind that had clinicians drooling and ordering every kind of test under the sun when someone in our family had a stomach ache or a sniffle. My wife has chronic medical issues, and frequent-flyer miles at most area ERs. When she goes to the same ER for the third time in a week for the same problem, a CAT scan on Thursday isn't going to tell them anything that the CAT scan from Tuesday and the CAT scan from Sunday didn't tell them.

When the hospital commission in the state where I grew up denied permission for the local hospital to buy a CAT scanner, a local neurologist bought one for himself. How many of the scans he performed in order to pay that thing off do you really believe were 'critical,' max?

Or, speaking of cats, there was the time she got bit by one. The ER sent her to see an orthopedic specialist the day after the ER visit, and all he could say was we had to schedule another visit after a week to see if the swelling responded to the antibiotics. In other words, the scheduling of the visit was pointless. And why is it that our family physician couldn't be the judge of whether the swelling went down? (If there had been a problem, she could always have been referred to the orthopod when it became necessary.)

The over-use of expensive testing and unnecessary referals to specialists drive up costs for everyone, max. Especially since, in these days of ridiculous over-specialization, an ER doc might order x-rays, blood tests, and an ultrasound when someone comes in for a stomach-ache, and that involves a radiologist to read the films, a hematologist to review the labs, and a GI to look at the ultrasound. It's completely appropriate for insurers to try to eliminate excessive services. And by the way, government agencies have their own incentive for denials of services - they get an annual appropriation once a year from the legislature, and when the money runs out, it runs out (in today's economic climate, the days of running back to the legislature crying 'we need more' are gone - the money just isn't there). Government agencies that pay for medical services can and do deny claims on a daily basis for no other reason than the money.

"this government-managed health-care program—socialized medicine on a small scale"

When you're done comparing apples and oranges, max, let us know. The VA isn't a 'government-managed' system, it's a government owned and operated system. There's a bit of a difference.

There are also some rather good explanations as to why they can do it cheaper. For one thing, the staff gets paid substantially less than they would in non-government-owned facilities.

As to whether they can do it 'better?'

http://www.washingtonpost.com/wp-dyn/content/article/2007/03/04/AR2007030401394.html

"Stories of neglect and substandard care have flooded in from soldiers, their family members, veterans, doctors and nurses working inside the system. They describe depressing living conditions for outpatients at other military bases around the country, from Fort Lewis in Washington state to Fort Dix in New Jersey."

"Across the country, some military quarters for wounded outpatients are in bad shape, according to interviews, Government Accountability Office reports and transcripts of congressional testimony. The mold, mice and rot of Walter Reed's Building 18 compose a familiar scenario for many soldiers back from Iraq or Afghanistan who were shipped to their home posts for treatment."

"Among the most aggrieved are veterans who have lived with the open secret of substandard, underfunded care in the 154 VA hospitals and hundreds of community health centers around the country."

(This story appeared in the Washington Post the year following the glowing Time article that max cited.)

"I can afford 1/4 of a heart bypass, thank you."

While I take your point, I think there are still a few other details to address.

I'll give you the SEC. I'll give you that a private sector employee called attention to it. It was something that the government would have to take up and they didn't. The private sector employee can't prosecute. I can't address what happened during Clinton times. The reports were clearly being made during the Bush years from the beginning of his terms and clearly nothing was done during his 8 year tenure. I know you don't like Bush. My point is a do nothing president comes the closest to your ideal model. We have never been without a president, so that is as close as it gets. Bush did not manipulate the market. He wouldn't be smart enough to do that. There were plenty of others who were able and did. Did you ever hear of insider trading? Did you here of the CEO's taking bonuses for failing corporations? Bush had nothing to do with this stuff. People don't have to be employed by the government to be crooked. Get over that idea. It is simplistic at best. And when people break the law, only the government has the authority to prosecute. We are not going to privatize the courts, not if we have a lick of sense.

Your ideas about government making banks loan is ridiculous. You will need to provide a reliable cite for me to even begin to entertain such a notion. Secondly, you make no mention of adjustable rate mortgages which is what got people into trouble. They borrowed at affordable low rates and when those rates went up, the were forced into foreclosures. That has driven the value of houses down considerably and made a lot of people homeless, which I think you would agree is not a good thing. Thirdly, did you as a young high schooler or early in college ever get approved for a credit card? Is that responsible? We have also witnessed banks pulling tricks to increase credit card interest rates by delaying registering payments and finding other ways to increase low interest loans into incredibly high interest loans. This was not forced by the government, but it was not stopped by the government who was allowing unrestrained dealings. Interesting how the fair debt laws were effectively dismantled by the government looking the other way. Notice how the Bush admin. shifted many policies away from benefiting consumers towards benefiting businesses. Unfettered business ran with it. Suddenly, consumers had to start watching for every little tricky detail.

You mention closing on a house. You need to ask who benefits from all the signatures? Who is protected and from what? Mostly it allows a lot of business people to get money thrown their way.

Too many issues to take up in one writing, so will use another space. You still haven't responded to panels. Give up on that?

max1 (Anonymous) says…

"Walter Reed Army Medical Center is run by the Army, not the VA"

No duh, max? Ya' suppose that's why it's called an 'Army Medical Center?'

As usual, max, nice attempt at misdirection when you don't have anything of substance to come back with. Even from the passage you requoted, it's apparent to anyone with a fourth grade reading comprehension level or above that the article I linked to was reporting on the abysmal conditions returning veterans are facing throughout the system, and comparing them to the more-publicized conditions at Walter Reed. Maybe you just 'missed' the part that said “Among the most aggrieved are veterans who have lived with the open secret of substandard, underfunded care in the 154 VA hospitals and hundreds of community health centers around the country.”

Oh, wait - did I say you came back without anything of substance? After all, you had a wonderful article that said the VA was the best at "measuring and reporting surgical quality and outcomes." Like any good bureaucrats, the VA may give lousy care, but at least they keep great records.

Here is a clip from an article that gives a much longer term explanation of the mortgage problems.

link for the whole article:

http://www.boston.com/news/globe/ideas/articles/2007/08/19/debt_again/

"As for deregulation of mortgage lending, it's too late to head off this debacle, but Congress should act now to prevent the next one. Banks and S&Ls are regulated because taxpayer money is at risk through deposit insurance. Though mortgage companies do not take deposits, they too need to be regulated because their antics put the entire economy at risk. Irresponsibly speculative lenders should be prohibited from selling mortgages in the secondary market, even if they can find a consenting adult foolish enough to buy them.

My former boss, Senator William Proxmire of Wisconsin, sponsored the 1968 Truth in Lending Act, to require that interest rates be disclosed to borrowers in clear, consistent terms. The senator, who died in 2005, must be whirling in his grave. Today's mortgages are often convoluted and opaque, explicitly designed to mislead the borrower. We need a new Proxmire Act, to limit the bait-and-switch character of mortgages, and to police the secondary market in mortgage securities.

We've now had an experiment in the claims made for mortgage deregulation, extending over three decades, and deregulation flunked. America needs to restore a system in which government supports home- ownership -- and makes sure that mortgage lenders serve as responsible creditors, not predators."

Article written in August, 2007

Robert Kuttner is co-editor of The American Prospect and a senior fellow at Demos, a New York-based think tank. From 1975 through 1977 he was chief investigator for the Senate Banking Committee.

So, admit it, you don't know what panels are.

Bush employed his friends. Its the easiest way to pay people off so that won't interfere with your agendas and it keeps the wealthy trash off of the street. In truth, I think Bush was getting his religious conservatives in positions to add to the religious right influence. He tried to make it so they would be there after he left, to continue his influence.

Glad you like Clinton. He was mostly good, except for the deregulation. And as you should have noticed, yes you did respond to some things, but you were wrong. Cherry picking again to get the outcome you want. Looking at the small picture instead of the bigger, longer term one. Yes, you are right, only the government can prosecute. You advocate having the wolf watch over the chicken coop. Your non buddy Bush proved that doesn't work. Cheney invited the polluters to make environmental policies and they virtually screwed everyone else in the process. A democracy relies on people negotiating out conflicts. It means tension between competing entities. What you advocate would not provide that. So, try again. And look up panels.

You let the lenders off scott free, like they were innocent in all of this. Wrong. Almost no one will agree with you on that. You obviously have biases against government and pro-business. So, again, I have to assert that people of good and negative qualities get into both. Just picking an institution is not enough. People need to be watched. They will try to cut corners and gain an advantage, some in sociopathic ways. Life won't be simple, so keep your eyes open and don't buy into ideologies and prejudices. They will only distract you. It is hard being objective. Sometimes you just have to suck it up and do it, and people will not like you all the time for doing it, so it takes courage and strength. If you get the time, I would recommend that you read Kevin Phillips, another disliker of Bush, but a business minded person who would share some of your views.

rshrink (Anonymous) says…

"I would expect that Obama will increase the funding."

And if wishes were horses, beggars would ride.

'Expect' what you want. Any idea where the money's gonna' come from, shrink?

"Also, didn't answer with all this defensiveness, what do you actually advocate for?"

I have answered that several times, shrink, sorry if your reading comprehension isn't any better than max's.

Nothing is going to make any difference at all unless the costs of delivering services is addressed. When ten hours of lying in a bed for "observation" in an emergency room, with no tests performed or treatment provided, can cost twelve thousand dollars, all this talk about whether Humana or Medicaid is more efficient at processing the claim is irrelevant; any talk about whether Humana or Medicaid is more likely to deny the claim is irrelevant; whether we, as a society, as a community, have to bear the expense of such procedures by paying them individually out of pocket, through insurance premiums, or through tax dollars, is irrelevant. It COSTS too damn much! And looking for a way to pay for everyone to be able to receive treatment at such ridiculously over-inflated prices is counterproductive - all a government guarantee of payment would accomplish would be to prop up those already inflated prices. Nobody cares - the consumer has no incentive to dispute the charges when they never see the bill; providers have no incentive to hold down costs when Uncle Sam is footing the bill; funding sources don't have to wonder where the money's coming from, they just go to the legislature and say "raise taxes, we need more." There is no incentive to hold the line on costs, let alone reduce them. UNLESS we end up with an oversight board that determines whether you should receive treatment based on cost-effectiveness - oh, wait, I forgot, since the 'stimulus' bill was passed, we already have one.

There are a lot of areas that can be looked at to bring down costs. People with insurance (private or public) have their bills ridiculously overinflated on a regular basis through duplication of services and/or unnecessary procedures. The overutilization of 'specialists' is beyond the ridiculous level. Tort reform is an absolute necessity - but it will never happen in a Democratic administration and legislature (why do you think lawyers contribute so much to the Democrats?).

I'm not totally against government regulations - but they have to make sense, and work towards solving the problems, not adding to them. If you really worked for the VA and also worked for an agency that accepted government-funded payments, you know one of the dirty little secrets: All the administrative BS that government auditors insist on is well beyond what they require of the staff at the facilities they operate themselves.

(continued)

(continued)

Some of the problem isn't going to go away. As our population ages, despite what fine upstanding Democrats like Tom Daschle would like to happen, more and more people are availing themselves of more and more expensive life-extending procedures. Yeah, we could cut costs significantly - all we have to do is just let them die. If you read Daschle's book, it's not the European system he wants, he wants Americans to be more like the European people - i.e., more willing to accept catastrophic diagnoses instead of exhausting every possible option for a cure.

I have no problem with our tax dollars being used to pay for those who really, really can't afford to pay for healthcare. But that number would be a lot smaller if we do something to bring the cost down. And turning all our healthcare over to Uncle Sam is about as smart as building a bicycle path to Australia.

Gee, max, even for you that's quite a bit of talking out of both sides of your mouth.

So you quote an article that says:

“For too long, the VA health-care system has had to struggle with budgets that were too little and too late,” Dempsey said. “Insufficient funding for veterans health care leads to rationed care, waiting lists and veterans being turned away from VA hospitals and clinics.”

And THEN a bunch more claiming they give the best care anywhere. Brilliant as always, max.

"The 154 hospitals and 875 clinics run by the Veterans Affairs Dept. have been ranked best-in-class by a number of independent groups on a broad range of measures..."

One notable group who disagrees, according to the Washington Post article I linked to: The poor schmoes who have to get their healthcare there.

All of which is pointless anyway, max, just like the rest of your posts - the VA isn't government-managed or government-funded healthcare, it's government-OWNED and operated healthcare. Is that your proposal, max? That the government should take over and own the whole system?

But, if you want to look at how generous and efficient the VA is at paying claims:

http://www.washingtonpost.com/wp-dyn/content/article/2007/04/07/AR2007040700938.html

And your not-to-be-missed opportunity for a BDS-oriented rant, max, only underscores another problem with turning our healthcare system over to the government - even if somebody managed to put together a workable system, there's no guarantee that an incoming administration or legislature won't gut the whole thing. Thanks for pointing that out. With every post you strengthen the argument against letting Uncle Sam run our healthcare.

I stand corrected, max.

I thought your last load of drivel was talking out of both sides of your mouth. Glad to see you keep striving to outdo yourself.

Hey, max - if the Bush administration did such horrible things to the VA, how is it you're claiming the VA is the best care anywhere?

Do you even bother to read the links you post to, or are you just stuck on automatic, posting anything you can google with "VA" and sorting it out in your tiny little pinhead later?

So which is it, max? Is the VA "the highest-quality healthcare provider in the United States," or an organization that "remains mired in crisis?" How is it possible, max, that the Bush administration destroyed the VA when all those glowing reviews of the VA healthcare system were written during the Bush years? When your own articles point out the wonderful advances they made during those years?

Good old maxie - never miss a chance to blather out of both sides of his diaper. And never one to let the facts - on either side - get in the way of a good ol' BDS-rant.

I really loved this one: "Bush and his lovers tried their damnedest to destroy the VA medical system by sending veterans from Walter Reed to private sector clinics..." Just after pointing out that “Walter Reed Army Medical Center is run by the Army, not the VA”

Brilliant as always, max. You must be the smartest mollusk on the block.

More facts that point out the need for regulation, the lack thereof causing this current economic crisis.

"BEN BERNANKE, Federal Reserve Chairman: It is imperative that policymakers address this issue by better supervising systemically critical firms to prevent excessive risk-taking and by strengthening the resilience of the financial system to minimize the consequences when a large firm must be unwound.

JEFFREY BROWN: In the question-and-answer session that followed, Bernanke went on to say there had been, quote, "shocking gaps" in the regulatory system up to now.

BEN BERNANKE: I mean, who was overseeing the subprime lenders, for example? Who was overseeing AIG? There simply wasn't enough adequate oversight in those cases.

And certainly one of the things that even a -- even if you have an oversight -- financial stability authority which has a relatively light mandate, really one just information-gathering and description rather than power, direct powers, an authority of that type could point out and identify such gaps and call them to the attention of the Congress, and Congress could then take the necessary steps."

p>Boston.com news

Veterans Affairs

$52.5 billion, up 10 percent

Obama takes a step toward expanding healthcare access to non-disabled veterans whose incomes exceed about $30,000 annually, and would provide extra funding for homeless veterans and those in rural areas.

"White-collar crimes cost the United States more than $300 billion annually according to the FBI.

White-collar crimes are fraud, bankruptcy fraud, bribery, insider trading, embezzlement, computer crime, medical crime, public corruption, identity theft, environmental crime, pension fund crime, RICO crimes, consumer fraud, occupational crime, securities fraud, financial fraud, and forgery. The tools of the trade are paperwork or through the computer. performed by using paperwork or computers .WHITE COLLAR CRIMES GO LARGELY UNDETECTED " "Kenny Boy," Ken Lay and Jeff Skilling of Enron notoriety, and friends of George W. Bush, were convicted of fraud and conspiracy on May 25, 2006.

Recent news of Bernie Maddoff, who made off with 65 billion dollars, possibly one of the largest cases of fraud ever, but not the only one. Here are some other entreprenuers of dubious distinction:

Jack Abramoff - fraud of (Indian Casinos for campaigns and personal welfare Kenneth Lay - fraud Enron (Died to get out of prison time) Jeffrey Skilling - fraud Enron Andrew Fastow - fraud Enron Joseph Nacchio - Qwest John Rigas - Adelphia Bernard Ebbers - World Com Dennis Kozlowski - Tyco Mark Swartz - Tyco Ivan Boesky - Stock Speculator Michael Milken - Junk Bonds (actual junk) Leona Helmsley - Hotelier or (Hotel Liar) Steve Madden - Founder of a Shoe Store Rush Limbaugh - fraudulent information and phony humor (Sold phony political junk rhetoric bonds)

Breaking News:

Bernie Maddoff just released a statement before being sentenced; ” I was just taking my bailout early.”

The judge was overheard responding with a Palin quote, “Thanks, but no thanks,” but we will give you lifetime, free room and board at the luxurious Lansing Federal Pen.”