Wed 10 Mar, 2010 08:43 pm
Here's how:
Full credit:
1. Forming insurance exchanges
2. Reforming Medicare Advantage
3. Value-based payment for Medicare
4. Creating an independent Medicare advisory board
5. Fighting Medicare fraud
6. Investing in IT
Partial credit:
7. Prevention programs
8. A tax on high-value insurance plans
9. Malpractice reform
According to this article in the far-left wing Socialist Wall Street Journal:
David M. Cutler: Health Reform Passes the Cost Test - WSJ.com
And he left one out:
10. Price transparency (making public the precise charges for items and services charged by hospitals)
@jpn of Seattle,
In general government administered programs of all kind end up quickly costing much more than would comparable services in the free market.
The best way to reduce the costs of health care and to reduce the deficit is to end all government involvement in the health care market.
I suggest you look at administrative costs of single-payer health plans around the world, georgeob. There are now on the order of twenty plus of them, most now operating for at least forty or fifty years, (and Germany's for a century and a half now),and they ALL have administrative costs (which include costs to doctors and hospitals too)that are a fraction, usually around a quarter to a third, of private American health care. You might compare American "socialized" medicine--Medicare-- with American private medicine as well. Its administrative costs too are a fraction of the private market.
There are several reasons. In the American system, doctors and hospitals have to deal with a multiplicity of different health plans and plan providers, each of which has its own forms, its own rules about what's covered and what's not, and the procedures that must be followed, and then its own rules for refusing to pay for procedures, which means you need large financial departments just to try to collect for the services you provide. Amd then you have to spend more time and money arguing about why the patient SHOULD have that treatment, no matter why they think not. Single-payer has typically one system--medical necessity, not forty.
Salaries paid to administrators in single-payer systems are government level, which means no-one is making multi-million dollar salaries and bonuses. Ed Markey, the Mass. congressman who deals with health and human services, , had one American health industry witness who was making $80,000..... (wait for it)...... a day. That's ten times the yearly health costs of a single individual that he gets PER DAY. That's on the order of 3,500 clients whose yearly premiums are doing nothing but paying ONE executive's pay package. Not to mention all the other private company executives feeding at the trough. If we had a rational health care system, with the proven costs of such systems around the world, there's nothing like that. That one guy would have 7,000 people doing nothing but paying for his lifestyle, based on world healthcare costs.Doesn't happen in single-payer.
@MontereyJack,
Government accounting is nothing like that in business and it consistently fails to account for most of the support costs associated with its various programs. This is because wage, pension and office costs associated with various government programs are found in the budgets and accounts of the various government departments; leagal and liability costs in the Justice department; and because the government can't be sued for damages unless it chooses to do do, there are no risks in the tort court. The so-called statistice to which you refer prove nothing.
A little critical thinking about various government programs to "regulate" industry reveals they almost always raise costs for someone in the private sector. Government subsidies for student loans haver reduced cost pressure on university tuitions and burdened a generation of young peoplle with enbormous debts, much of which will not likely be repaid. Government regulation aof import quotas raise the price of commodities for consumers but provide guaranteed markets for organized producers who in turn pay off their congressmen. Government support of ethanol production and mmandates for its use raise the price of fuel and arguably do nothing to reduce GHG emissions.
Government single payer health care systems cost the people their freedom and increase their slavish dependence on politicians. That's a high price to pay for anything.
re georgeob ("United States National Health Care Act", Wikipedia)
Quote: A study by Harvard University and the Canadian Institute for Health Information estimated the 1999 costs of U.S. health care administration at nearly $300 billion, accounting for 30.1% of health care expenses, versus 16.7% in Canada. This study estimated the U.S. per-person administrative cost at $1,059.[10] One organization that advocates nationalized health care estimated this savings could be as high as $350 billion per year in "...overhead, underwriting, billing, sales and marketing departments as well as huge profits and exorbitant executive pay."[11]
and Canada is on the high end of world single-payer health care plans costs.
geogeob says:
Quote: Government single payer health care systems cost the people their freedom and increase their slavish dependence on politicians
Tell people that in single-payer countries and they'll look at you as if you're insane. With reason. Health care systems are among the most demanded services worldwide, and the most popular. That's what democracy is all about--government BY the people, FOR the people. The general opinion seems to be pity for the unfortunate citizens of the US stuck with our Tyrannoxaurus Rex of a system, rather than one that insures everybody, that costs half as much as ours, that delivers better health care metrics, that delivers longer lives (we're somewhere in the forties in worldwide ranking of longevity by country), that satisfies their clients more, that doesn't cut off anybody for pre-existing conditions or try to find some way to kick them out when their treatment starts getting too expensive, that doesn't lead to personal bankruptcy (60% of personal banruptcies in the US are due to catastrophic health expenses, and 60% of those are of people who had health insurance. Doesn't happen in single-payer countries. Of course you could just let Mom die). Somehow that doesn't sound much like a loss of freedom to me.
@MontereyJack,
In the single payer systems, such as those in Canada and the UK, which you so uncritically tout as models of perfection, it is government bureaucrats, who make the statistical cost benefit decisions, who in effect make the decision to "just let mom die" as you described it. In a top down, administratively-controlled, health care system, the best way to reduce cost and maximize statistical benefit, as in life expectancy statistics and the like, is to deny or delay care to sick people. For such groups of people, the cost of the "benefit" of extended life or improved quality of life, his far higher per unit of benefit than others. That's why mortality for those afflicted with cancer is higher in these countries than here. That's why access to specialists and advanced care is so limited in both the UK and Canada.
This is government by the leaders for the people - not our tradition at all.
Europeans across the continent are discovering that the "social protections" provided to them by their oh-so-protective governments cannot be sustained. Afrter a few generations of illusions carefully fostered by self-serving elites in power, the people find they have lost their tasste for self-reliance and the ability to escape the coming catastrophe. Why, with the unfolding spectacle in Europe before us, would we wish to imitate their ruin?
@georgeob1,
I'm curious what you were trolling for that had you responding to this question two years after it was asked.
@georgeob1,
georgeob1 wrote:The best way to reduce the costs of health care and to reduce the deficit is to end all government involvement in the health care market.
you do know that this isn't the real-world result
come over here - I'll show you some comparable invoices for treatment in the U.S. and Canada - and I'll also tell you what people tell me about the care they received for the $ that were spent
@georgeob1,
georgeob1 wrote:Government single payer health care systems cost the people their freedom and increase their slavish dependence on politicians.
nah - we've got much freer choice of docs and hospitals - we don't have to go where our insurer happens to have an "arrangement"
@MontereyJack,
MontereyJack wrote:
geogeob says:
Quote: Government single payer health care systems cost the people their freedom and increase their slavish dependence on politicians
Tell people that in single-payer countries and they'll look at you as if you're insane.
forget the "as if". We'll know he's insane with a comment like that.
@georgeob1,
georgeob1 wrote: the best way to reduce cost and maximize statistical benefit, as in life expectancy statistics and the like,
oooh you want the statistics? you'll love them
http://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy
Canada # 12 80.7 yrs
U.S. # 38 78.2 yrs
http://en.wikipedia.org/wiki/Comparison_of_the_health_care_systems_in_Canada_and_the_United_States
and from an interesting opinion piece
http://alainsaffel.com/canada-us-health-care/
seems we're getting much better bang for our buck up here (which is why people from the U.S. come here for treatment, when they're not travelling to Mexico for dental care, and Asia for surgery)
@georgeob1,
Quote:In a top down, administratively-controlled, health care system, the best way to reduce cost and maximize statistical benefit, as in life expectancy statistics and the like, is to deny or delay care to sick people.
Are you saying what I think you are saying? Are you saying people live longer if they are denied health care?
It's kind of amazing how this has become the Holy Grail of those wanting to claim how much better the US system is than others.
http://www.ncpa.org/pub/ba649#_edn1
But when you start to get into the details, it starts to raise questions about it's accuracy.
For instance, when they claim the wait times are longer in Canada and the UK than the US, they list sources for wait times in both of those countries but have no such statistic for the US. Comparing actual numbers to no number results in what they want it to be. Where are the US numbers?
The Cancer survival rate is another fuzzy thing. They list their source for that as the Concord study found here
http://www.ncbi.nlm.nih.gov/pubmed/18639491
Yet, the Concord study states they adjust the survival rate based on the life expectancy of the population. All that means is those treated in the US live longer compared to those that aren't treated. Comparing that to the life expectancy in a country where everyone is treated leads to a conclusion one shouldn't make when comparing them.
@parados,
parados wrote:
Quote:In a top down, administratively-controlled, health care system, the best way to reduce cost and maximize statistical benefit, as in life expectancy statistics and the like, is to deny or delay care to sick people.
Are you saying what I think you are saying? Are you saying people live longer if they are denied health care?
No, not at all. Perhaps you should read it again and think while you do so.
However, to help I'll state the same proposition another way.
The best way to reduce total system cost, while having the least net effect on total population life expectancy is to reduce care and cost devoted to those who have the least remining life expectancy.
The problem with this "justice" is that it is based on the collective good, as determined by yhose in charge, and not that of individuals. Moreover individual wants and needs are not considered at all.
@georgeob1,
yes, George, our system is damn near perfect.
unless you are poor.
or unemployed.
or have a pre-existing illness.
and if you are all of the above, hurry up and die already...
georgeob says:
Quote: The best way to reduce total system cost, while having the least net effect on total population life expectancy is to reduce care and cost devoted to those who have the least remining life expectancy.
The thing is, george, that's not the way single payer systems work. it's the right wing's fantasy of how they work. It is, however, how the US private system tends to work. Don't insure the poor and those who can't afford anything and have to rely on emergency room care. Don't even touch end stage renal care, which tends to be just about the most expensive care--only the feds will do it since private care refused. Don't insure anybody with pre-existing conditions. Find a reason to cut off clients when their care threatens to get too expensive (recission, remember that? private care at it's most heartless). Lifetime caps on care.
@MontereyJack,
You are confusing means and ends. Our "system" is simply that most people pay for their own health care. Most of them choose to do so through insurance that they either buy or get through their employer on a cost-sharing basis. Just as one can buy and get health care services above what is paid by insurance schemes, and just as he or she can buy more expensive car repair than may be provided for by his/her auto insurer; or buy his or her own food in whatever quality or quantity he or she likes even without food stamps. Any insurance policy, whether for automobiles, life or health care, involves a cost & risk sharing agreement between insurer and buyer under stated conditions. If you want cheap auto insurance, you will get limited coverage and a high deductable. If you want more coverage, you will pay more. If yo want to insure an old car you will have to establish the initial condition of the vehicle. Same goes for health care insurance.
People aren't sheep. They can make their own decisions for themselves, and in this, and other areas of life, they must live with the consequences of the choices they make.
There are, of course large exceptions to the above "system". People with incomes below certain government set standards have access to Federal/State provided care under Medicaid. Government employees and Military service members have government paid or provided care. Some veterans have access (generally very limited) government provided health care.
@georgeob1,
georgeob1 wrote:The problem with this "justice" is that it is based on the collective good, as determined by yhose in charge, and not that of individuals.
I'd rather go with the Canadian system - where the doctor determines appropriate treatment. Trusting insurance companies to make the treatment decision doesn't work for me.
When the 'collective good' is about dividends earned, I get uneasy.
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