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The mirage of U.S. healthcare

August 26, 2009

On healthcare, the White House is struggling with a political riptide that threatens to drag it into deep water.

Americans, as they contemplate change, have suffered a weakness of nerve. The main reason is that nearly two thirds of Americans are apparently happy with their healthcare coverage, for all its deficiencies. Repeated reassurances from President Obama that those who like the existing set-up will not be forced to change, have had little effect.

A change of tactics may be in order. The administration must do a better job of underlining the glaring defects of the existing system. The genius of the U.S. healthcare is in providing the illusion of value and security. For their own sake, Americans must be encouraged to set aside jingoistic claims about having the best care system in the world and look more honestly at its short-comings.

Let’s start with value. Most Americans are blissfully unaware that their healthcare system provides appallingly little value for their money. This is because when it comes to costs, they see only the tip of the iceberg. While companies typically pay about three-quarters of an employee’s family premium — on average $12,680 a year — individuals ultimately bear the burden. In a free market, companies do not hand over to their workers more than they absolutely have to. Money spent on healthcare is carved out of take-home pay or other benefits.

“We pay for healthcare in considerably lower salaries,” Uwe Reinhardt, a Princeton University economics professor, said in a telephone interview. “The system seduces people into thinking care is pretty cheap. We are kidding ourselves if we think that the shareholder pays.”

One measure of this financial sacrifice is that employer premiums are now 17 percent of median household income — up from 15 percent in 2003. From 1999 to 2008, family health insurance premiums rose by 119 percent.

With healthcare costs rising fast, it is small wonder that middle-class Americans have failed to wring real pay increases out of employers. The drag on pay will increase further, according to research by the Commonwealth Fund. The foundation estimates that without reform, the cost of premiums could double again by 2020 — gobbling up still more take home pay.

The second big healthcare mirage is security. If the current downturn has demonstrated one thing, it is the fragility of an employer-based healthcare system. Lose your job — as more than 6.5 million have in this downturn — and your insurance can disappear with it. (COBRA provides only a temporary patch and can be expensive.)

It also means that you can lose your coverage if you get very sick. “Get so sick you can’t work, you can also forfeit coverage,” Gary Caxton, an analyst with Kaiser Family Foundation, said in an interview. The very idea of insurance is to protect you during a crisis. Instead Americans are getting insurance that works only when the sun shines. “The American system is least good at the worst times,” as David Cutler, a Harvard healthcare economist, puts it.

The final illusion is that the healthcare system can be relied on in the longer term. In reality it is taking on water fast. This is most obvious in small companies. Less than half of companies with fewer than 10 employees now offer insurance, down from 57 percent in 2000, according to the Kaiser Family Foundation. For all companies, the percentage is down from 69 percent to 63 over the past 8 years. Companies are also starting to unload a growing share of costs onto employees anyway.

Deductibles for most employees have more than trebled since 2000 — a trend that looks almost certain to continue. This is all before you take into account the prodigious quantity of tax dollars soaked up by healthcare.

As the private sector has faltered, the state has been forced to step in. The result is that America is stumbling toward nationalization.

A recent Gallup poll found the share of Americans dependent on the state for healthcare — including Medicare, Medicaid and VA benefits — had climbed to 29 percent from 26.5 since the start of 2008. If you include the 17 percent of U.S. workers employed by the state, then closer to 40 percent are covered by the government.

Americans need to take a good look at their existing healthcare system, warts and all. It is the administration’s job to hold up a mirror to U.S. healthcare. If they fail to do so, the U.S. will pass up an opportunity to build a system that’s fair, sustainable and offers better value.

Comments

“Americans need to take a good look at their existing health care system, warts and all.”

But, as a whole, they won’t. Even in today’s highly stressed economy, 2/3 are apparently happy with their health care. Add to this the money-cowards in Congress, the medical-industrial complex’s big money lobby, reform is impossible. Obama leadership notwithstanding.

Reform may be possible when 2/3 are NOT happy, and 1/3 ready to revolt. Society ready to blow up. Big money lobby no longer can contain street violence. That’s how America works.

Posted by The Real Deal | Report as abusive
 

I don’t understand why the drop in small businesses providing insurance is called “fast.” It fell 7% in a decade. At that rate, it’ll take 40 years to reach 25%, and 70 years (a lifetime, literally) to reach zero. It’s definately a problem, but not one I’d call a pressing concern.

 

We should also be taking a good look at the statistics and polls that say people are happy with their coverage. Who are they polling and how was the question asked? Anecdotal evidence suggests to the contrary: People are constantly having to review insurance issues, wait for months to get appointments (particularly when changing providers) and complain that the doctors do not provide sufficient time or personalized attention. It seems like it is a convenient poll to stave off a government option, although the same noise was made 40 years ago when Medicaid was first introduced.

Posted by Kira | Report as abusive
 

hows this for a possible future. since the people (rightwingers) are ultimately concerned about gov. take over then how about we embrase the reality tv crowd to answer this delima? seriously, those who adore reality tv present a much larger pop. base than those who are poled. so, let the gov. create its big bad public healthcare plan while in parallel holding a national reality tv show like the apprentice to find young new talent out of college and off the street to create say, 50% of the future board to this monster of a business? what do you think. this way the gov. can show that it has no stake in the ultimate control over healthcare and can take credit for the possible creation of our future healthcare system.

 

The really hope Daniel was being sarcastic, otherwise those with more than a couple marbles bouncing around up there should be scared out of our minds.

Also, love the use of jingoistic… haven’t seen that word in years – I think it was used by Chomsky. Pretty good (literary) company, he being the foremost current scholar of linguistics.

Posted by the Shah | Report as abusive
 

Gee whiz. What manner of delicate phraseology in loaded polling does it take to even *use* the word “happy” in conjunction with America’s terminal case of health insurance shenanigans?

Only the terminally stupid could conceivably rank today’s American public infrastructure – health care in particular – as anything better than a gigantic disaster waiting to happen. Command-level insurance finagling only makes it worse.

How little must it really take to make an American “happy” these days? The pollsters will have you believe, precious little, with some ritual abuse and TV ads for erectile dysfunction medication thrown in for good measure.

How uneducated must people be to remain passive while paying $1000.00 a year for dental insurance which literally, and only if you’re lucky, caps out at $1000.00 per annum? The pollsters will no doubt find redemption in this ongoing practice of licensed usury as well.

How passive must Americans be to sweat out this blatant fiasco without so much as a soupçon of revolt? The same pollsters will have you believe Americans are not, as they appear, incurably comatose. Only sleeping?

Nay, say said pollsters, Americans are actively “happy” in their bipartisan-induced apathy and in the widespread delusion of consumer satisfaction, yea though failure – even total collapse – be staring them in the face, gloating at their impotence.

Long ere this nation’s politics became, undeniably, a miasma of meta-quotation (who’s saying what about whomever supposedly said anything in the first place) laundered through myriad pollsters for generic popularity testing – which means, the language having been taken hostage (ref: Victor Klemperer’s masterwork, “LTI”) the American education system had already been undermined.

Before they were deprived of health care and meanwhile charged up the colon for a load of hot air, generations of Americans had already been robbed not only of a decent education, but also of their natural voice and vocabulary.

The main reason so many people in America still pay as much as they possibly can for as little as possible in return, case in point being any aspect of health insurance, would appear to be this: they no longer have the basic education, let alone sense of community spirit or social orientation to recognize an institutional scam-job when they see one.

So here it is in plain lingo, Americans: Just Say No to health industry BS.

Posted by The Bell | Report as abusive
 

You must realize that outside of Massachusetts and the beltway, Teddy is reviled everywhere else as a drunken lout and a “lady killer” in the most literal sense. He was a laughing stock. This is a great day for the Irish – we no longer have to make excuses for this bastard’s bad acting. National health be damned.

Posted by Margaret C | Report as abusive
 

I wonder how “happy” Americans will be with their health insurance policies when it costs them $36,000 to cover a family of four (just a couple of years away). As for stagnant wages, health care costs are not the only foe, globalization has also played a role. There is no way a worker in the US can compete with a worker in China, who has the skill set, when the Chinese worker makes 1/10 the salary. People have lost their ability to think critically about the issues in this country, that along with being able to see the big picture. Not really a suprise when only 25% of the population has a college degree.

Posted by BB | Report as abusive
 

What this article fails to point out is our famus Senator from MA, did not nor ever would participate in national healthcare. He received premerie care only because Congress has gold plated healthcare. If this national healthcare ever passes, I can almost be certain, that Congress will exempt themselves. JUST as they have done with every other “program”. So we have a body of fat cats writing laws which they really never intend to be subject to.

Posted by scott | Report as abusive
 

Where to even start? I do like to Commentary; if anything, it is too kind.

I’m not sure 2/3 of American’s are happy w/ their health care. Is that 2/3 of the 40% on a government plan? Or 2/3 of those who have no coverage like it that way? Or, what?!?

Or, is it that 2/3 of the folks that supported or voted for Obama have this sinking feeling that in health care, like financial matters more generally, he’ll just continue to go down the corporate path? i.e., we got suckered into thinking there would be real change, but now, … After all, Ben gave trillions to Goldman Sachs and other on Wall Street, and O just re-up’ed him for another term!

What is clear is that well more than 2/3s of the few, big companies in the “health” industry continue to make giga dollars. What is clear is that well more than 2/3 of the Congress seem to be bought by their lobbyist — this is THE perfect example of: all the government money can buy!

What is clear is that if even 2/3 of the American voters that could vote did, and if 2/3 of them voted one way, it would still not change one hell of a lot — the U.S. quietly became a fascist some time back now …

What is clear is that more than 2/3 of the Senators think they are party of a ruling, privileged elite that frankly don’t give a damn about their constituents!

What is clear is that more than 2/3 of the Birther’s and Deather’s are profoundly stupid people who must have resulted from too much inbreeding, or too much listening to Rush — the ultimate bastion of intelligence, knowledge, compassion, correctness, and all good qualities!!

Barney Frank is right — and what we ought to do about it is drop all medical coverage, of all forms, for all Birther’s and Deather’s!!

And, if you think all this is bad, just wait till O tries to do ANYTHING on global warming that amount to anything whatsoever!

We’ll have more wind-bags blustering BS, we’ll have more outrage from idiots, egged on by the corporate greed-heads who don’t gave a F about anybody but themselves!

We’ll have more of Rahm putting the label of “success” on literally anything Congress and O manage to do, no matter how weak, ineffective, or how much a sell-out it is!!

We are ALL — both in the U.S. and everybody else in the world — quite literally F’d!!!

Posted by MadAsHell | Report as abusive
 

Baloney. Most people realize there are problems but we wanted healthcare remodeling, not demolition. Fix what is broken, don’t break what is working.
- Attack fraud in Medicare; the government already runs that mess
- Provide access to private insurance for all legal citizens who what insurance
– No mandates
- Tackle Tort Reform
- Leave decisions between the patient/doctor
- Encourage efficiency and cost reduction.
- Try for a patient payment system instead of third party payer system
There is no Constitutional authority for a government owned and operated health insurance system. No to a public plan which is calculated to morph into a ‘single payer system’ which is a code word for government monopoly of healthcare which is socialized medicine. NO to socialism!

Posted by Allen S. | Report as abusive
 

“With healthcare costs rising fast, it is small wonder that middle-class Americans have failed to wring real pay increases out of employers. The drag on pay will increase further, according to research by the Commonwealth Fund. The foundation estimates that without reform, the cost of premiums could double again by 2020 — gobbling up still more take home pay.”

Single best point of the argument…the admin should be driving this home, but they won’t.

Why? b/c they don’t want to shake the house too much. Obama isn’t steadfast in his initiative…One quality I wish he could mirror Bush in.

Posted by LVR | Report as abusive
 

Allen S. is right on.
I’m a conservative Republican, and virtually all of the right-of-center people that I know _want_ changes to the healthcare system. We want it more affordable, and we want it to extend to more of the population.

What we object to is the way the proposed program is being rammed through, that it is not well thought out, and that is too far reaching in giving the feds additional power in areas beyond health care.

The white house mantra that anyone who opposes the plan is misinformed or is a selfish dolt manipulated by the insurance companies, only serves to insult those of us who are legitimately concerned and trying to practice good citizenship.

Posted by Pete C. | Report as abusive
 

My question to Allen S – How is a governement option going to break the working private sector? Unless you are aware that the private sector isn’t really working. This is like a small town business crying foul when they hear a Walmart will be opening soon. This is an opportunity for us to explore all our options. We will only choose the government plan if its better.

Posted by Emmanuel | Report as abusive
 

The author of this article is unbelievably misguided. “Lttle value” in the health care received? Seriously? By every single measure, outcomes for serious medical conditions are better in the U. S. system than the NHS and Canadian systems. That’s a fact. Yes, more money is spent, but more (and better) care is given. That’s not “jingoistic” (what a stupid label), that’s also a fact. This is another falsely manufactured “crisis” by the statists. Just say “no” to socialized medicine.

Posted by Robert | Report as abusive
 

Let’s start reform by requiring many more autopsies, run by qualified, thorough, and independent doctors. Let’s see if the medical establishment knows what they are doing.

Posted by Linda | Report as abusive
 

The government needs to start by cleaning up house – its own share of medicare, medical + many other government sponsored expenses. As soon as the house is in order, they would be in position to claim more money for extending their programs (e.g. the new healthcare initiative). Chances are, the pruning will de-allocate so much funds, there will be no need for additional revenue from the population.

The way Obama administration wants it (today) is throwing good money after bad…

Posted by Cris | Report as abusive
 

Allen S. is correct. As for Emmanuel…are you really serious? You’re comparing apples to oranges. A large private business vs. a small private business are the same except for scale. They BOTH must make a profit to survive. The government does not…it can print more money to continue on, whilst the private insurer cannot. Get a clue. Obama made the same mistake as you when he compared the govt Postal Service to FedEx and UPS. Guess which ones are more efficient and provide better service? Guess which one goes billions in the red each year, yet continues to suck money from taxpayers to stay in operation? I hope you guessed correctly. No one in their right mind would want the government to run health care in this country.

Posted by Robert L. | Report as abusive
 

As a Canadian, and being on both sides of the doctor patient relationship, I would like to give Americans a neighbours perspective of this issue.

As a patient, a universal healthcare insurance plan is supposed to offer you portablility and the peace of mind that when you are unemployed, you can still get care for your family and yourself. It does mean having to wait in lines. It does mean that newer technology is slow in coming online and that it’s adoption or use is severely limited by bureaucratics who usually do not know what is being talked about. You can get your sore throat assessed, and you can usually get your cancer treated very well. Our plan in Canada does not cover medications. Thus, you can get a diagnosis, but sometimes you cannot get treatment.

From the physician side, I see governments who play political games with healthcare. Decisions are made from a political bias and not necessarily from a needs or best practice bias. We are left arguing with hospital administrators who try to make decisions for your patients based on cost. I have never worked in the U.S. so I do not know if the same can be said for hospitals there.

My suggestion to you neighbours are that you have a long discussion about what it is that you are trying to do. You need to be able to incorporate coverage for the poor and those that cannot get coverage. Leaving someone or their family to fend for themselves when some tragedy befalls them will not help you build and maintain a stable society. As a people, you have to have a say in this. You have to informed and interested. Do not let politicians grab hold of any system you create for they will surely run it as they see fit. Politicians will certainly get great care and at taxpayers expense if they control your system. Politicians will get to the head of any line before you or your family. If it needs control, then the people need to control it.

Good Luck
I wish you develop a system that is the envy of the rest of the world.

Posted by Docotr Canuck | Report as abusive
 

The Swiss approach has much to be said for it that could translate to the American landscape if only Americans were as sensible yet truly believed in limited government as the Americans claim to do:

Require all to have health insurance.

Provide vouchers and/or scaled subsidies appropriate for those with truly low incomes.

Let private insurance companies compete for the business, but have the government regulate cost ceilings.

Pretending there’s no need to ‘ration’ health care is delusional. Resources are finite. The only question is whether it’s left to the self-interest of private entities in the name of the ‘marketplace’ when in fact there is in most cases no real market competition and the process is manipulable, or whether a form of appropriate regulation of pricing is necessary while allowing competition within that framework.

The Swiss can make it work.

The Americans can only whine while waving their fists in the air and proclaiming themselves ‘Number One!’

At what, precisely, other than internecine warfare and paralysis is another question . . .

Posted by Super Atomik Dog Fred | Report as abusive
 

This health care reform will change nothing as long as Americans continue to rely on doctors to take care of their health. A doctor is no different than plumber, electrician, software engineer, lawyer, etc: the more people who go to doctors, the more their rates will go up. An emphasis must be put on prevention. Aside from eating low fat foods and exercising, little else is taught to Americans of how to take care of their own health. American’s pride themselves in independence, so they should be taught to take control of their own health.

Posted by Fred | Report as abusive
 

We do not need Healthcare reform, what we need is insurance company reform. IF insurance companies were all non profit, could not deny coverage for pre-existing conditions or recent illness, and permitted purchasing pools to get group rates — the overwhelming majority of americans would be covered. Medicare and private insurance work just fine. IF you are not insured you can go to any ER and get the same treatment as Sen Kennedy would get. If you want to limit defensive medicine, then have federal malpractice reform where lawyers fees are capped, informed and educated judge panels decide the cases, and settlements are determined by merit not threat. Let me see any legislator take on either the Lawyers lobby or the insurance company lobby then we would have real reform.

Posted by Jim U | Report as abusive
 

I always wonder who these ‘happy’ people are – perhaps they mixup their maintenance health care with the whole point of insurance – for catastrophic coverage. I was diagnosed with a genetic cancer syndrome 9 years ago. My employer keeps changing private insurance provider so the rules keep changing with each new provider. Perhaps the reason they are so sloppy with processing claims is that it benefits their bottom line. I’m fortunate to be well enough and too mean to let them get away with it. Lost? miscoded? denied? not approved properly? Don’t get seriously ill in this country.

Posted by Val G | Report as abusive
 

Mr. Swann, although you write well your argument is flawed. First, Americans do have great value in healthcare. We have maginal tax rates of 15 to 36%. In many European countries with “cradle to grave” healthcare the tax rate is 70% at least and for all income classes. We are getting off cheap and have first tier access and treatment available to just about everybody. Second, please recall that Cobra was recently changed to permit coverage for up to 2 years with the federal government/employer covering 80% of the premium for the employee. By the way, healthcare insurance, paid time off, paid lunch, paid holidays, life insurance, 401Ks are optional employer paid benefits – they ar not employee rights or entitlements.

Posted by Jim U | Report as abusive
 

Tort Reform before Health Care Reform

The US government predicts an 11% rise in the number of lawyers between 2006 and 2016 (www.bls.gov/oco/ocos053). Why is this a consideration in health care reform? The costs of medicine are not stand-alone costs. A great percentage goes to lawyers.

The American Tort Reform Assn. notes: “America’s… civil justice system is the most expensive in the industrialized world. Aggressive personal injury lawyers… systematically recruit clients who may never have suffered a real illness or injury and use scare tactics, combined with the promise of awards, to bring these people into massive class action suits. They effectively tap the media to rally sentiment for multi-million-dollar punitive damage awards.” (www.www.atra.org/about).

Health Care Reform Steps:
Step 1: Delineate the factors present in health care costs including all lawyer costs and malpractice insurance.
Step 2: Draft a comprehensive plan that considers the results of step 1.

Having a health care reform without tort reform is like putting make-up over skin cancer and stating, “It looks better, therefore it must be better.”

Posted by Elaina | Report as abusive
 

I don’t understand why we think a public option or any other coop arrangement would change the final results. The services have to be paid for either directly via the insured or their employer or via tax dollars. Increased government involvement has never solved any problems in the long-term. The real problem is skyrocketing costs due to the presence of medical malpractice and looming litigation. Put caps on recoveries and implement other meaningful tort reform and you will get much better results.

Posted by Erik | Report as abusive
 

QUOTE: “Mr. Swann, although you write well your argument is flawed. First, Americans do have great value in healthcare. We have maginal tax rates of 15 to 36%. In many European countries with “cradle to grave” healthcare the tax rate is 70% at least and for all income classes. We are getting off cheap and have first tier access and treatment available to just about everybody.”

Hahahahah! Hahahahaha! Hahahaha! Where did you pull this load of misinformation?

I pay more on taxes than my contemporary coworkers in the UK who make the economy based equivalent of what I make! Then, after that — I pay $480 a month in health care!

Perhaps you should go and research tax rates, and don’t forget the cost you are paying for social security that many of us likely won’t receive much of. Because regardless what you think, that is a tax. The NHS fee (Equivalent to SSI but including health care) in England isn’t much different than what we pay in OASDI/SS.

FAIL!

Posted by Kevin Morgan | Report as abusive
 

i overheard that on page 19 of the proprosal, it made it illegal for a citizen that either lost their job, changed jobs, or changed status (marriage divorce etc.) to attempt to switch their healthcare plan
i was however unable to track down a copy of the actual proposal, can anyone confirm or deny this?

Posted by question | Report as abusive
 

More of the liberal health card garbage. There is NOTHING wrong with our health care system.

Posted by One_Mad Taxpayer | Report as abusive
 

“the U.S. will pass up an opportunity to build a system that’s fair, sustainable and offers better value”

If someone would propose a system that is fair, sustainable, and offers better value the vast majority of Americans would jump at it. It’s not that we don’t see the flaws in our system, it’s that the proposed system doesn’t do anything to fix the flaws. Having the government run a broken system won’t fix it, just ask GM or Chrysler.

Posted by Mark | Report as abusive
 

The first problem (of employee provided insurance) is easily fixed by changing the tax code in two ways: individuals get a tax break for providing their own insurance, and second, providing the tax benefit for companies only for the amount provided to the employee who can use it to make his own choice among many plans and these plans must be available to individuals at the same rate as if they were employeed. If the individual chooses a catastrophic plan that costs less than the amount provided by the company, he should be free to put excess into a tax-free account that can be used for medical expenses.

Notice that this plan also takes care of what happens to the individual that is laid off. Since the insurance cannot be purchased from the company unless it is also offereed to the individual on the same terms as if he were employed, he will be free to continue it using his savings from the health account. The company and the union will be free to negotiate an amount (not a level of benefits) that are provided.

The coverage of “pre-existing conditions” cannot be mandated without encouraging people to not purchase health insurance. By not erasing debts of those who do not provide any insurance people will be encouraged to purchase major medical insurance which can be at much lower costs. In addition, this would discourage overuse of medical facilities, especially of relying on emergency room care.

Posted by Cliff Alexander | Report as abusive
 

The administration is missing the main point. Why is health care so expensive in America?
Liability, a patient come into the hospital and the standard of care is based on the law suit that should be avoided. Obama administration is not willing to handle the male practice cap because of interest group. The reform will drive more dr out of the filed that already is missing thousands of dr.

The reform should be on fixing the system, and not overload it with another 50 million clients

Posted by dr | Report as abusive
 

“It’s not that we don’t see the flaws in our system”

Sorry, I was too hasty to jump to a conclusion; One_Mad Taxpayer obviously doesn’t see the flaws.

Seriously, one doesn’t have to be liberal or conservative to see that there are problems. It’s just that each side (not like there are only 2 sides on this issue) believes that a different issue is the problem. It’s hard to agree on a solution when you don’t even agree on the problem.

Posted by Mark | Report as abusive
 

Less value – For $13000 a year, an average American gets health-care that is inferior to all industrial nations.
No security – You get very sick or you lose your job and you lose your health insurance.

Posted by Sam S. | Report as abusive
 

Fear-spreading by far right-wing media, i.e., Obama’s plan is a Nazi plan, etc. The irony is that so many of the American people are being manipulated “nazi-style” by propaganda spread by large corporations. Meanwhile hundreds of thousands of good Americans either can’t afford private health insurance or can’t qualify due to a pre-existing condition. Nothing can be accomplished if the hard-core spin continues.

Posted by Sygma | Report as abusive
 

I’m 73. My wife is 64. She has diabetes II but is not insulin dependent. No insurace company will insure her other than the one we have from my employer. I pay $13,000 per year plus co-pays and 10$ overage on hospital bills (even tho’ I have Medicare and Secondary Health). My wife lost our doctor’s coverage and either goes without medical care OR takes a doctor who looks at his watch after 10′. We need some new approach. The $13,000 ($17,000 with all other medical expenses) is 33% of my retirement.

Posted by Dick Diamond | Report as abusive
 

The point about stagnant wages as a reflection of hyperinflative health care costs rings so true. There are a whole host of people who have a vested interest in maintaining the status quo (insurance companies and the doctor’s union, better known as the AMA most notably). If health care hyperinflation continues at the current rate, the most likely scenario will be companies continuing to shift the cost burden to employees. MORE cost transparency is needed, MORE competition (including government options), MORE accountability for cost, and most importantly, BENCHMARKING care standards (referred to as rationing by the doctor’s union). Don’t confuse QUALITY of care with QUANTITY of care. Ask my father, who’s had pneumonia FOUR times over the last five years because his (old) doctor has insisted that his psoriasis medication hasn’t compromised his immune system…..

Posted by Joe Bonomasses | Report as abusive
 

no matter what change takes place–enormous amounts of people are going to really get pissed off–there is no way to provide 50 million with health care without extorting dollars from who ever has them–medicare clients will pay thru the nose for medicaid–i am glad i am retired from the health care field

Posted by peter lener | Report as abusive
 

Re: – Posted by Pete C.
Which is it? Are you a conservative or a Republican? They are almost mutually exclusive in light of the Medicaid drug benefit the Republicans voted in.

Posted by e065702 | Report as abusive
 

Just another case taking from one group of people in order to give to another. The government should be getting out of health care instead of forcing companies farther down the socialist path. The main reason for the cost of meds is the governments refusal to grant long term patents to the companies who develop the meds. It forces companies to jack up the prices to recover the large sums of money spent to develop the meds in the short period of time they have sole rights. This is just one example of how government forcing its way into the health care field raises the cost. Can anyone give one example of where government involvement makes anything better? Public schools, housing, or air travel???? HAHA!!! Stay out of health care big government before you destroy that to.

Posted by Daniel Mckay | Report as abusive
 

Because the government has had so much success in running any business, I guess we should let them run healthcare as well. King Obama said it best, “Fedex and UPS aren’t in trouble. It’s always the USPS”. Anybody that agrees that the gov. should be in healthcare is a moron.

Posted by Clemdog | Report as abusive
 

# “Americans are blissfully unaware that their
# healthcare system provides appallingly little value”

Worse by far is that they are unaware (blissfully or not) that their healthcare system is fictitious. Yes, that’s right: there is no healthcare “system” in America. Americans have the dubious distinction (among many others) of living in the only industrialised nation without a healthcare system. The natural question for any rational person to ask (“why is that??”) does not seem to occur to Americans. They seem to be content with, even proud of, their ignorance. Why is that??

Posted by Moe Badderman | Report as abusive
 

I have coverage from Kaiser. I have a sore foot. I emailed my doctor with a detailed description of my symptoms and what caused it and she promptly emailed me back telling me to continue the cost effective care I was already administering myself.

CoPay = $0.00
No XRay needed
Consultation = $0.00
Time spent in waiting room: O:00 min
Distance travelled in car: 0 miles

How does this work? My doctor works for an HMO that has standards of care and, gasp!, benchmarks. She doesn’t make more money by ordering more procedures. They don’t fire up the MRI just for a sore foot. I benefit because I can consult the expertise of a doctor about a minor issue from the comfort of my own home. The members of Kaiser benefit from lower premiums.

People need to show some willingness to accept that the most responsible treatment for a damaged knee may be a brace and some ibuprofen for six months, not an MRI and expensive orthopedic surgery.

I kind of like managed care run by technocrats and actuaries. I think it is the most equitable and cost effective way of delivering healthcare.

Added bonus? When I see the doctor, I walk into the clinic, show the nice lady my Kaiser card, pay my 10 dollar copay, and go wait for the doctor. No billing, no reimbursement forms, none of that in or out of network hassle, it’s all taken care of.

Posted by Josef | Report as abusive
 

It seems to me many of the people in the U.S opposed to healthcare reform are the same people filling pews on sundays. Dont you think jesus would want everyone to have healthcare? I’m not a christian simply because I believe in being kind to everyone, not just stale white bread.

Posted by Chris D | Report as abusive
 

It is just the kind of comments like the one Clemdog made that convince me that America is the new Nazi nation. Spewing hate, and innuendo and lies is the order of the day…..
Healthcare in America needs reforming…. but I haven’t heard anybody say the government would be running the healthcare business…..

Posted by edgy | Report as abusive
 

The only to solve the HC issues mentioned in your article is the single payer healthcare program. Specifically, H.R. 676, John Conyers bill.
If not now, when?

Posted by Christine, RN | Report as abusive
 

If you haven’t worked in health care as a provider at a system level, please don’t comment on how good our “health system” is; we don’t have one here. We have several hundred, profit-centric systems that do not have any motivation to coordinate care, in fact there are tremendous competitive disadvantages to cooperation for the pieces of the system that offer the same or similar services.

That is exactly the point, there is no incentive large enough from a business perspective to meaningfully cooperate and attempt to actually improve health in this country. Tort reform would be nice, but is not a huge contributor to health care costs. Insurance reform is a good start, but there is too much greed on that front for anything useful to come from insurers. The AMA represents approx 10-15% of us. The rest out intentionally don’t belong because they are no less corporate than Cigna et al.

To actually improve health and save my kids’ future, we have to imitate Kaiser , Geisinger etc. on a massive (yes, Government!) level, employ physicians (sign me up!) hold us to quality standards rather than volume targets and have the government hold the malpractice riders for all participants (its tough to sue the Government and make any money at it) and put all government programs (Medicare, Medicaid, VA care and this new one)into one US CARE program. Eliminate any new contributions to Medicare, etc and take all the funds from those programs to help finance US CARE. Anybody that wants private care or insurance can keep right on paying exorbitant fees for highly variable quality. There will undoubtedly be fewer health insurance companies, but a few less zillionaires in this country is ok with me.

Posted by Michael Williams, MD | Report as abusive
 

It only makes sense the more the federal government CUTS Medicare payments to health care providers, the more health care and insurance costs with RISE for the rest of us.

In typical big government fashion, the Obama Administration is rushing to throw money at the problem – without first performing and publishing for the public a detailed analysis of “What works and what doesn’t” within our current healthcare delivery and insurance industries. For each item that needs to be “fixed”, the report should list the possible options and costs to implement solutions, then outline which option the government wants to implement.

The government should first focus on reducing the costs of health care and insurance through the aggressive identification and elimination of FRAUD and over billing.

The government should offer tax credits to healthcare providers and insurance companies who implement computerized Electronic Medical Record (EMR) systems.

Lastly, if the government really wants to through money at the problem, let’s offer a Federal Tax Credit to each and every U.S. citizen who is currently paying out-of-pocket more than $200 per month for healthcare services, insurance, and prescriptions.

Government intervention simply does not increase efficiency or cut costs. Our government has no business in the health care industry.

(By the way, I am a life long Democrat but on this issue I must side with the Republicans.)

Posted by Jodi Boyd in L.A. | Report as abusive
 

Beware the ‘Industrial Medical Complex’! It’s $400 hammers all over again. We’ve been frogs stewing in a slowly heated pot. Costs just go up and up. I had a co-worker with a very sick child. Our small company saw its premiums double each and every time we tried to renew based on the costs of that poor little girl. it was the biggest lose lose situation ever. Management absorbed the costs as long as they could, then we began paying more and more out of our own pockets. But ,when dealing with a dying child money is not really an issue you speak of. I don’t care what side of the political isle you stand on … the system has appalling flaws … and its the wrong issue to try and use as political cannon fodder. I am not saying that I agree with Obmamacare. Actually I think that Obamacare doesn’t go far enough. It just bandages the system … while what we really need to do is transform it.

http://docs.google.com/View?id=dfz22bg6_ 1554wgh8xhn

Posted by Juls | Report as abusive
 

Yes, we need to reform and improve our system !
As a conservative, I whole-heartedly agree !
But let’s be honest: the retards in congress are not
concerned with healthcare ! It’s all about CONTROL !!
Solution: Term Limits!
Get rid of all the dinosaur legislators!
Elect people with new ideas that are willing to
work for the good of the country !
Keep doing the same every time vote!

Posted by Max Lehmann | Report as abusive
 

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