Archive for Sunday, January 24, 2010

Health care reform a dismal failure

January 24, 2010

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As we begin a New Year, it’s natural to reflect on what transpired during 2009 and firm up our hopes for 2010. My biggest hope can be simply expressed: I’d like to get healthy.

While vacationing in Minnesota during mid-July, I was diagnosed with Burkitt’s lymphoma, a type of cancer that spreads very rapidly to the bone marrow, blood and central nervous system. Without treatment, Burkitt’s lymphoma is quickly fatal. Thanks to the swift and excellent cancer care I received at the University of Minnesota Medical Center (UMCC) and KU Med, I survived the initial onslaught of the disease and am now in complete remission.

This means that, according to medical science, the cancer that was detected in July has been eradicated and there is no immediate fear of a catastrophic health event. Nobody in the cancer business uses the word “cured,” but I’m looking at a 70-80 percent chance of dying from something unrelated to my cancer.

Sitting in a hospital bed for nearly six months gave me lots of time to think about pending “reforms” to our health care system, and raised some important questions:

  1. How do you measure the quality of health care? Patient satisfaction is the best way to measure product quality in health care, and I received excellent cancer care at the UMCC, KU Med, and from my primary care physician here in Lawrence. These nurses and doctors served me with a rare combination of competence and empathy; they literally saved my life. I want nothing to do with a new system that threatens the quality of health care and endangers future improvements.

  2. Are current health-care costs out of line? I don’t think so. Catastrophic cancer treatment is very expensive but worth it. The total cost of my cancer treatments will run in the neighborhood of $300,000. I use KU’s Blue Cross Blue Shield plan with an 80/20 percent match and an annual coinsurance cap of $2,200, so it will take about 20 years of insurance premiums at the current rate of roughly $10,500 per year to pay these costs. I’m happy to pay the bill.

  3. If you were really sick, would you prefer 1985 treatment at 1985 prices, or 2010 treatment at 2010 prices? If you’re really sick like I was, I think you’d want to pay up for state-of-the-art health-care treatment. The United States has a big lead in pharmaceutical research, medical device development, and medical treatment technology. If 1985 technology still ruled the medical world, I’d be a dead man by now.

  4. Does the government have the expertise to run the U.S. health-care system? I see no evidence to support an affirmative answer. Suppose you have an important message or package that has to get delivered to a friend or business associate as soon as possible. Most of us would send important time-sensitive messages using texting or e-mail (via the Internet), and ship vital packages using FedEx or UPS. Given that the U.S. Postal Service is notoriously inefficient and slow, why should the same folks be put in charge of the U.S. health care system?

  5. Will health care costs explode with further government involvement? History says yes. The government has not been able to prudently control Medicare, Medicaid, or Veterans Affairs health care costs, or any other costs for that matter. (Have you seen the federal budget deficit lately?) Since 1965, and following the start of the Medicare and Medicaid programs, health care spending in the United States has more than tripled from 5 percent to 16 percent of GDP. Inefficient government spending is a time-proven recipe for higher health-care costs.

Under the Bush and Obama administrations, exploding federal spending and skyrocketing federal deficits have become the norm. In the last half-century, federal outlays accounted for an average 22.2 percent of GDP. The fiscal 2010 Obama budget boosts that by about one-third to 27.2 percent. If our health care system were fully nationalized, federal outlays as a share of GDP would rise to 43.2 percent-or roughly double what it was in 2007. Taxpayers get what’s left over, and their share of GDP is rapidly shrinking.

The federal government has a record of dismal failure when it comes to health care “reform.” More government meddling is an unlikely solution. In the words of an old axiom, “If you want to get out of a hole, the first step is to stop digging.”

Mark Hirschey is the Anderson W. Chandler Professor of Business at Kansas University.

Comments

anon1958 5 years, 2 months ago

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dearman24 5 years, 2 months ago

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Richard Heckler 5 years, 2 months ago

Government run health care has never been on the table.

Cleaning up the medical insurance industry has been on the table. The insurance industry laid out $1.25 million health care dollars a day in special interest money for bribery and misinformation campaigns. Laundered primarily through the Chamber of Commerce.

Very few people have KU type medical insurance. While it is very good no doubt the students are picking up the tab and the cost will increase by about 20%-25%. The students probably realize the increase in cost by way of tuition. Yet so so many students cannot afford what they are supplying KU employees.

What is being considered on capitol hill still protects the insurance industry.

Something like Advanced Medicare for All insurance would create millions of jobs. It would also bring on complete CHOICE across the board for everyone plus bring on sweet competition. Yes choice inspires competition by way customer satisfaction. Yes consumers would have the ball in their park aka choice of doctor,clinic,hospitals and freedom to change at any given moment.

Advanced Medicare for All would reduce admin costs in all doctors offices,clinics and hospitals by a generous margin. Payments would likely be close to whatever current insurance pays. Doctors and hospitals will not go broke.

All consumers would receive the same level of healthcare because there would be no insurance company telling the doctor what can or cannot be done.

Advanced Medicare for All eliminates co-pays and deductibles.

Richard Heckler 5 years, 2 months ago

"tax dollars already pay for at least $1.2 trillion in annual U.S. health care expenses. Since federal, state, and local governments collected approximately $3.5 trillion in taxes of all kinds—income, sales, property, corporate—in 2006, that means that more than one third of the aggregate tax revenues collected in the United States that year went to pay for health care.

Recognizing these hidden costs that U.S. households pay for health care today makes it far easier to see how a universal single-payer system—with all of its obvious advantages—can cost most Americans less than the one we have today.

Medicare must exist in the fragmented world that is American health care—but no matter how creative the opponents of single-payer get, there is no way they can show convincingly how the administrative costs of a single-payer system could come close to the current level." More on this matter: http://www.dollarsandsense.org/archives/2008/0508harrison.html

Richard Heckler 5 years, 2 months ago

Who would Expanded Medicare For ALL Insurance cover 365 days a year 24/7?

*employed or not

*moving on to a new job or not

*single mom or not

*struck down with cancer or not

*senior citizens

What would Expanded Medicare Insurance for 365 days a year 24/7 cover?

EXPANDED MEDICARE

  • long term care such that cancer would require

  • prescription drugs

  • hospital

  • surgical

  • outpatient services

  • primary and preventive care

  • emergency services

  • dental

  • mental health

  • home health

  • physical therapy

  • rehabilitation (including for substance abuse)

  • vision care

  • hearing services including hearing aids

  • chiropractic

  • durable medical equipment

  • palliative care

Suggested cost:

A family of four making the median income of $56,200 might pay about $2,700 annually in payroll tax for all health care costs. About $225 per month.

Expanded Medicare Insurance ends deductibles and co-payments

For 2010 the cost for same above care will be about $18,310 a year.

While business could be responsible for taking the deduction business should not be responsible for any of the cost.

leedavid 5 years, 2 months ago

Anon this health care bill was a dismall failure because it was ill conceived, corrupt, and left 26 million of the 40 million uninsured without coverage. It was over 2,000 pages of crap written, for the most part, in secret. Democrats were not allowed to know what democrats were writting.

The republican party did what? Democrats had a veto proof congress with a democratic president. They did not need a single republican vote and could have pulled this off. But they could not, even with millions available for a buy a vote program, they could not do it. This is entirely on the democrats and I for one am happy they could not pull it off.

Back to the article, my wife died of cancer. LMH was stellar in their care for her and she was so lucky to receive care at that hospital. Her care came from a magnificant Doctor Stein and an outstanding cadre of medical people that celebrated her life and made her feel like a queen. The most modern technology available was used and my insurance covered just about every penny. Blue Cross and Tricare.

Flap Doodle 5 years, 2 months ago

If only somebody had made more copy/paste posts about HR 676.....

Mixolydian 5 years, 2 months ago

snap_pop_no_crackle (Anonymous) says…

If only somebody had made more copy/paste posts about HR 676…..

Agreed. That's exactly what Obama was referring to when he said democrats didn't do a good job getting the message out.

You gotta think Scott Brown is thankful there's no equivalent cut and paste commenter at the Boston Globe.

WilburM 5 years, 2 months ago

wow. This opinion piece is breathtaking in its ignorance. It argues from a particular example, it ignores the well-run (by all accounts) Veterans medical system. It ignores the experience of the rest of the industrialized world in delivering solid (not perfect) health care for far less than the U.S. system does. It extrapolates unrealistically about US costs, without any backup information. In short, this business school professor makes a private sector/business-oriented argument that quotes a few favorable figures and mixes them with his own experience (nice that you had good coverage -- what if you were among the 47 million with none?).

Where is the overhead and waste (yet, waste in the private sector) of insurance companies, often dedicated to denying coverage to boost profits?

If this is the best a named professor of business can do, the KU Business school is in a world of hurt.

just_another_bozo_on_this_bus 5 years, 2 months ago

" I received excellent cancer care at the UMCC, KU Med,"

Sounds like you got lots of government-provided healthcare to me.

This is nothing but an ideological screed. Sure, the " Anderson W. Chandler Professor of Business at Kansas University" is happy with his largely government-provided healthcare. Too bad he thinks he's the only one who should be so entitled.

camper 5 years, 2 months ago

I don't think anyone wants health care reform that threatens advancements in technology and care. But this does not mean that worsening problems should not be addressed. For instance, 1) As more people lose insurance or become uninsured, those who are covered will end up paying an increasing amount of deductibles and premiums to cover hospital overhead (ie. $30 aspirin or a $15 pair of gloves). 2) Employeres are being increasingly squeezed by rising benefit costs. This hurts the bottom line and may lead to more layoffs and outsourcing. All of this of course makes the things in #1 all the more concerning. 3) Pre-existing conditions. Insurance has been playing tough on this for many years. I'm sure there are many cancer survivors who fear that if they were to lose there job, it would be very dificult to get new coverage.

It sounds like the writer is glad that he got his and is not too concerned about everyone who is not fortunate enough to have such good coverage. But in a rather sophmoric example (for a college professor) he did bring up the one shining example that is so over-used these days.....you know the Post Office argument. Brilliant.

tomatogrower 5 years, 2 months ago

Mr. Hirschey, I am truly happy that our system has worked for you, but lets look at your situation more closely. You make more that the average wage earner and are provided with wonderful insurance, because you are a part of a huge insured group, state of Kansas employees. You appear to be paid through an endowed professorship, so you could say that you aren't paid with tax monies, except that the contributor was able to make that endowment, because they were educated at a state funded university, at least I'm assuming that Anderson W. Chandler was a KU alumnus.

What do you suppose that people making half of what you earn do? Especially when they work for a small company that can't get the smaller premiums? If they have any pride, they die, like my brother. He was a hard working, proud man who always took care of his 2 children, and he had health insurance. When he was diagnosed with renal cancer, often a death sentence, not unlike your type of cancer, he did not receive quick care. His insurance had a huge deductible. Being too proud to accept charity from anyone, he delayed his treatment while he tried to find the funds and get his situation in order. When they finally removed the most diseased kidney, the cancer had spread. When he had to stop working, he couldn't afford the Cobra, and was too proud to come to his sisters for help. He did have some wonderful doctors who agreed to continue to treat him for free, and he agreed to try out experimental treatments, but to no avail. Hopefully his willingness to be a guinea pig helped further the study of cancer, but of course, my nieces and nephew now have no father.
I realize that you, Mr. Hirschey, could care less about my brother, or anyone else who didn't have the foresight to work for the state and have good insurance. That's what most conservatives seem to have in common. Lack of compassion. But to actually write an opinion piece about what great insurance you have is a slap in the face of those who aren't as fortunate, and those numbers are growing rapidly. They will grow even more rapidly, since the government isn't willing to control the insurance companies. Hopefully you will hold on to your position, despite your illness, and continue getting the wonderful insurance you have. Good luck to you.

Richard Heckler 5 years, 2 months ago

Thursday, June 25, 2009

Health insurers have forced consumers to pay billions of dollars in medical bills that the insurers themselves should have paid, according to a report released yesterday by the staff of the Senate Commerce Committee. This Story

The report was part of a multi-pronged assault on the credibility of private insurers by Commerce Committee Chairman John D. Rockefeller IV (D-W.Va.). It came at a time when Rockefeller, President Obama and others are seeking to offer a public alternative to private health plans as part of broad health-care reform legislation. Health insurers are doing everything they can to block the public option.

At a committee hearing yesterday, three health-care specialists testified that insurers go to great lengths to avoid responsibility for sick people, use deliberately incomprehensible documents to mislead consumers about their benefits, and sell "junk" policies that do not cover needed care. Rockefeller said he was exploring "why consumers get such a raw deal from their insurance companies."

The star witness at the hearing was a former public relations executive for major health insurers whose testimony boiled down to this: Don't trust the insurers.

"The industry and its backers are using fear tactics, as they did in 1994, to tar a transparent and accountable -- publicly accountable -- health-care option," said Wendell Potter, who until early last year was vice president for corporate communications at the big insurer Cigna.

Potter said he worries "that the industry's charm offensive, which is the most visible part of duplicitous and well-financed PR and lobbying campaigns, may well shape reform in a way that benefits Wall Street far more than average Americans."

Insurers make paperwork confusing because "they realize that people will just simply give up and not pursue it" if they think they have been shortchanged, Potter said.

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

Richard Heckler 5 years, 2 months ago

CIGNA medical insurance CEO receives $73 million retirement bonus..... sounds like Wall Street bankers.

Denial of Care Profits: $73 million for CIGNA’s retiring CEO

By Donna Smith, National Nurses Movement January 7, 2010

It’s hard for most of us to imagine a lifestyle supported by a $73 million retirement bonus. It’s even harder to imagine a whole nation’s healthcare controlled by those who have benefited so wildly from denying healthcare to those who need it.

But Cigna’s Edward Hanway knows well what it feels like to rest in the lap of luxury thanks to all those profits he helped secure as he led one of the nation’s for-profit insurance giants through some very successful times. And as we lumber toward a new piece of healthcare legislation with new promises of expanded health insurance coverage and mandate for both individuals and employers to purchase private health insurance plans, insurance companies will have even more control over our healthcare – and the denials of care that make companies like Cigna pay out such obscene bonuses.

BEFORE you read further…National Nurses United, the new national union for RNs, is asking nurses and patients to demand Congress remove the mandates that would force Americans to purchase products from the CIGNA’s of the world. Call Rep. Pelosi (415-556-4862) and Sen. Reid (702-388-5020) and tell them to strip this bill of the CIGNA-mandates immediately!

Under Hanway’s leadership, Cigna also did what for-profit insurance companies do so very well to enhance the profits that become multi-million dollar bonuses. They denied care to thousands upon thousands of policyholders, and the company profits were protected.

KS 5 years, 2 months ago

Mr. Hirschey - Very well stated. Notice the first two comments had to be deleted and most of the balance was the typical cut and past that nobody reads anymore. Man, these folks are on the defensive.

just_another_bozo_on_this_bus 5 years, 2 months ago

"I don't know why anon's and dearman's posts were removed. I didn't think they crossed the line."

I didn't either. I had one removed in another thread. I don't recall exactly what I said, but I don't think I said anything that warranted its removal.

I think the vast majority of removals are done purely on the basis of someone clicking the "suggest removal" button.

tomatogrower 5 years, 2 months ago

KS (Anonymous) says… Mr. Hirschey - Very well stated. Notice the first two comments had to be deleted and most of the balance was the typical cut and past that nobody reads anymore. Man, these folks are on the defensive.

And I assume you have great insurance too, and could care less about those who don't. By the way, I have wonderful insurance and health care, but I see many who don't through no fault of their own. They aren't lazy or druggies. They work hard at jobs that are important to those of us who are professionals. But they are treated like second class citizens. Why is that?

kansasplains 5 years, 2 months ago

This is ridiculous. He is not in any way typical of the average Lawrence person, or people in so many other towns throughout Kansas. He probably has never met all the kinds of people which Lawrence has, to its great advantage. He is typical of the town-gown divide. Get down to earth and go out, go through Kansas, meet its great people who can not afford health insurance.

ilikestuff 5 years, 2 months ago

The problem with the Post Office argument is, unlike UPS, Fed Ex., etc. it is required to pu/deliver mail at every mailbox in the country ~6 days per week. The others only deliver when/where their customers pay them.

Similarly, private healthcare's priorities are to be profitable while providing coverage for its customers. By contrast, national healthcare's priorities should consist of covering all US citizen w/health insurance from cradle to grave seemingly regardless of profitability.

The monstrosity being jammed through Congress thus far isn't national healthcare rather its government controlled access to healthcare and all the usual suspects are on board with the President hoping to score ever-larger profits in the future.

camper 5 years, 2 months ago

"I want nothing to do with a new system that threatens the quality of health care and endangers future improvements" the writer states, yet did not provide a single example describing how reform is going to inhibit technology.

The bulk of the current reform (which by the way I don't think goes far enough) is addressing coverage. And while increased coverage will not do a thing to reduce aggregate health care cost, it will ease the burden on those who are by increasing the pool. Here is a sobering stat from Kaiser Family Foundation:

since 2001, premiums for family coverage have increased 78%, while wages have risen 19% and inflation has risen 17%, according to a 2007 study by the Kaiser Family Foundation.[53] Workers with employer-sponsored insurance also contribute; in 2007, the average percentage of premium paid by covered workers is 16% for single coverage and 28% for family coverage.

So now we have the current administration trying to compromise, and all we seem to see on the table is a massive bill (who knows how many pages long it is), and the other party and the professor are spreading this fear of the the big bad government that is on our backs, just look at the postal service see. But why is it ok for wage earners and employers to continually absorb higher costs, but it is not ok for the Feds to step in. Why is it ok (in the mind of some) to see a 78% rise in family premiums, but a modest tax increase (offset by higher wages and increased coverage I must add) so bad?

These stats are are only gonna get worse if nothing is done, and the Republicans are taking a big risk if this comes true.

Here is my solution. Medicare for all. Increase Medicare tax from 1.5% to 3%. Get rid of Health Insurance. Eliminate this burden from employers large and small, eliminate "job lock" which is the fear of starting a new business for fear of losing coverage, or transferring to a new job. How can this be bad for business? How can this be bad for employers? How can this be bad for wage earners? And most important and oft forgotten, how can this be bad for those who are sick?

This will never happen though. In the meantime, stay healthy everyone.

camper 5 years, 2 months ago

Penders, I usually blow over all your posts because they say the same thing.....Stimulus, Posecare, Darwin bless you all ( he was an ok pitcher but not that great ). Provide some reference point to those of us who need a clue.

But why should I care? I shouldn't? Aaaah the great falsity of modern man, we all try to change people and get upset when their ideas don't conform to ours. Instead of accepting, we find fault and quarrel with them. Likewise, instead of accepting ourselves as we are, we strive for acceptance and approval. Values and beliefs? We got em. Instead of seeking facts, we seek reinforcement in our beliefs. Find the news that supports this. Associate with people to confirm this. All false notions. In the end this makes us unhappy. So never mind Penders, it is my error to be in disagreement with you.

lucky_guy 5 years, 2 months ago

Reply 1. Patient satisfaction is bogus. The real measure is outcome i.e. did the patient survive? A business man wants satisifation, so you will buy hamburgers at the same place. Health outcome is a long term and complex issue. Patient satisfaction only measures one parameter, health outcomes is a complex measure of many things, culminating in either longer live or longer than expection survival.
2. Mr Hirschey's seems to have the wrong model in mind again. The bill was 300K, the insurance paid a whole lot less. Who made up the difference? Other plans and the health care worker who took less pay to have a job so Mr Hirschey could have his discount. 3.????????????????????????????? makes no sense. 4. Again Mr Hirschey is taking too many drugs. He doesn't know that the hospitals that he lauds as having great care derive 45 to 75% of their revenues from the government -Medicare, Medicaid. If he doesn't realize this then he is just ignorant, and shouldn't submit articles as if he knows anything. He sates he doesn't see that government can do anythig right because he doesn't want to. 5. ????? medicare is cheaper that private insurance how can he say that. I say the dear old gov is getting a bum rap.

puddleglum 5 years, 2 months ago

somebody please clear this up for me.

so if Obamacare is passed, is it true that it will be against the law to not have insurance?

If it is passed, it it supposedly only going to lower the monthly premiums to $347......

I think about 1/2 of the people I know can't afford that.

puddleglum 5 years, 2 months ago

Obambi made the same mistake Bill Clinton did. They both should have steamrolled the health care issue immediately after being elected-riding the wave of popularity while it lasts.

Obambi waited to long, and made the idiotic mistake of trying to ask what the republicans would think of health care-giving them the precious time that they needed to run countless claims-confusing everyone, and spreading fear, as they do so well...

single payer insurance. If the Europeans can do it, why can't we?

puddleglum 5 years, 2 months ago

U.S. Health care Quality: 50th best in the world (!) still the most expensive by 200% and here's my favorite: health care represents 1/6th of our economic spending in the U.S. but time and time again we hear how low the profit margin is, those poor insurance companies and pharmaceutical companies just scrapping to get by. poor guys-the government should give them a lot of money.

Or just put them out of their misery and go to a single payer system like the rest of the world.

works great for them, why not for us?

RedwoodCoast 5 years, 2 months ago

Current health care costs in this country are prohibitive at best. What the author of this heartening op-ed is neglecting to mention is socioeconomics.

Mark Hirschey: "Does the government have the expertise to run the U.S. health-care system? I see no evidence to support an affirmative answer. Suppose you have an important message or package that has to get delivered to a friend or business associate as soon as possible. Most of us would send important time-sensitive messages using texting or e-mail (via the Internet), and ship vital packages using FedEx or UPS. Given that the U.S. Postal Service is notoriously inefficient and slow, why should the same folks be put in charge of the U.S. health care system?"

I am incredibly heartened by your recovery, but a public option to health care would be nice. Then you could really prove that government can't handle health care as well as private industry. You're incredibly luck that you were able to get your KU insurance, dude. If I were to be diagnosed with Burkitt’s lymphoma at my current financial location, then I might as well just jump off of a cliff. I'm sure you wouldn't physically push me off that cliff, would you?

LloydDobbler 5 years, 2 months ago

I am glad that the writer was able to receive quality treatment and I wish him the best. But it seems a bit indignant not to support at least some sort of reform that extends a higher quality of care TO ALL having been the beneficiary of what most would consider a partially socialized insurance system. Anyone who receives catastrophic healthcare such as cancer treatment NEVER pays for it themselves, either directly or through insurance premiums. It's paid for as a collective pool of insured individuals. If the writer, now matter how rich or poor, had to pay for the entirety of care out of his own pocket, it would at worst bankrupt him and his family or at best put a pretty big dent in his nest egg. No, I don't think it's fair at all for someone who benefits from the system to question its extension to a broader population. And, by the way, the writer's assessment of Medicaid, Medicare, and VA health benefits is not accurate either. Those who receive those benefits are generally happy with them and their costs are substantially contained relative to the open market. There are healthcare administration researchers at KU who can provide that data.

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