89 replies to this topic

[niner]

It's not meant to be overly partisan. The democrats are mainly in power and there the ones pushing this reform. So it's just a statement of fact.

I don't think anyone is claiming that we don't have a serious problem with our present system, so why can't we all work together to fix the problems?

It's not that they lie necessarily. They just don't report what they don't need to. Your taking figures at face value niner without thinking as to whether they are comparable or not. Comparing the % overhead between medicare and private insurance may be like an apples to oranges comparison. Medicare covers the elderly and they cost more than people who are covered with private insurance. So the fact that there is only a 3% overhead may be due to the fact that administrative costs are a smaller percentage overall if you have more care.

What you say here makes sense, but I don't know if it's a significant effect or not; without data we can only speculate. The proper thing to do would be to compare equivalent populations. I'm assuming that someone out there has done that, and you are assuming that no one has. It would be pretty easy to compute an administrative cost per person, without relating it to cost of care.

Technically medicare has higher administrative cost per patient than private insurance, but it shows up as being a smaller percentage overall since they get more care. You can't really compare the two since they are not equivalent.

How can you possibly claim this? Medicare is one entity, with one set of forms. Private insurance is thousands of companies, with countless different forms which places a huge burden on the doctors that submit those forms. On top of that, these thousands of private companies advertise and run duplicative operations, AND they rake off a percentage in the form of profits. How in the world could they have a lower administrative cost per patient than Medicare?

These are a few potential costs not taken into account in medicare.

* Medicare has its own billing department. It's called the IRS.
* Medicare's negotiation with drug companies occurs between lobbyists and Congressmen, and are not done internally. An insurance company has to pay for their own billing.
* Medicare has more fraud due to a less aggressive pursuit of phoney claims (the flipside of insurance companies, which may be too aggressive about avoiding payment).
* Medicare represents a tax on employment, which is a cost externalized on society, which doesn't show up on its own budget.

*Medicare has no "billing department". That's one of many reasons why it's cheaper.
*Medicare has been forbidden from negotiating with drug companies. That was a political decision. It can be undone, and probably will be in the present political climate.
*Medicare may or may not have more fraud, I don't know. As you point out, one downside of aggressive fraud prevention is denial of care that is warranted. Without any data, we can't say whether fraud is significant or not.
*Private health insurance delivered through employers is a huge tax on employment. At the moment, American industry is trying to compete with industry in other countries that don't have to provide healthcare. That is a very unbalanced playing field, and is probably a significant contributor to the loss of American jobs to foreign competition.

[Futurist1000]

I don't think anyone is claiming that we don't have a serious problem with our present system, so why can't we all work together to fix the problems?

I just wish they could do some sort of computer simulation ahead of time to figure things out, personally. I think there is a limit to how much you can social engineer society to a desired outcome. You could social engineer things into oblivion but it won't change certain underlying dynamics of society.

How can you possibly claim this? Medicare is one entity, with one set of forms. Private insurance is thousands of companies, with countless different forms which places a huge burden on the doctors that submit those forms. On top of that, these thousands of private companies advertise and run duplicative operations, AND they rake off a percentage in the form of profits. How in the world could they have a lower administrative cost per patient than Medicare?

Here I'm just referring to averages. The average non-medicare patient with private insurance costs less in administrative costs than the average medicare patient. That is what they are doing when they compare the percent overhead a lot of times between medicare and private insurance. Like I said it is sort of apples to oranges comparison. I'm not really sure what would be a better comparison. Maybe what Krugman is referring to here. I'm not particularly trusting of Krugman's judgement on the matter. I still think the private vs. public medicare plans are still making apples to oranges comparison's. Krugman's answer to everything is socialism (universal healthcare, expand welfare state, massive stimulus, nationalize banks etc. etc.) and he doesn't always make what I consider to be rational arguments.

*Medicare has no "billing department". That's one of many reasons why it's cheaper.

We don't know what is offloaded to hospitals or other departments in the government. The government may have more of an ability to shift that stuff to other places than a private company might. Isn't it a clue that since they have "no billing department", they might be shifting the work to other places?

About the other stuff, like I said it is hard to tell. How do you really make an apples to apples comparison?

Edited by Futurist1000, 23 July 2009 - 04:40 AM.

[Mind]

QUOTE (Futurist1000 @ Jul 23 2009, 04:08 AM) *
It's not meant to be overly partisan. The democrats are mainly in power and there the ones pushing this reform. So it's just a statement of fact.

Niner: I don't think anyone is claiming that we don't have a serious problem with our present system, so why can't we all work together to fix the problems?

Obama has been incessant in claiming the health-care system is broke. It isn't. What we have is not perfect. Single payer systems are not perfect. An engineer would break down the deficiencies one-by-one and make improvements. Obama is a typical politician, not an engineer. The current Bill is a massive overhaul filled with hundreds of new regulations and several layers of new bureaucracy. And they are trying to pass this behemoth before the August recess!! A disaster in the making. Hubris of gigantic proportions.

[Mind]

Niner: This is still magical thinking. We ration now, and until we have infinite resources, we will always have to make triage decisions as to how to deploy resources. I can understand that the concept of rationing is sickening, but that's an emotional response, not a rational one.

Again, you are conflating personal-choice rationing with forced rationing. One is infinitely superior to the other. And speaking of infinity....

Physical resources are as infinite as the universe. Human ingenuity is as infinite as human desire. We can do better. To argue FOR forced rationing is to give up on some human lives. To codify passive killing through forced rationing - to accept this mental stance - is the starting point of a long and dangerous road. The starting point should be that every human life is valuable and we should be striving for zero lives lost. We have to set the goal if we want to achieve it.

[TianZi]

As an American who's worked as an expatriate outside the United States for years in Hong Kong and Taiwan, I thought I'd share my personal experiences with the Taiwan and US health care systems.

While still a grad school student at William & Mary in Williamsburg VA, I developed a severe case of kidney stones, with a large stone having formed in each of my kidneys. The university's doctor misdiagnosed my condition, and so for several months I received treatment for the wrong condition. It was only after a severe episode in which pain triggered uncontrollable vomiting that was only stopped by an injection in a hospital's emergency room that my condition was finally properly diagnosed, long after the time the stones had become very large and moved behind my pelvic bone, and so were no longer treatable by ultrasound.

"Fortunately"--so I thought!--I had insurance through my university's student insurance plan that would cover almost all of the costs for treatment. I required repeated trips to the emergency room, and multiple visits to a nephrologist the hospital recommended who had a private practice. Months after my treatments had started, my insurance carrier decided to deny coverage on the basis of my kidney stones being a "preexisting condition". You see, my insurance was renewed between semesters on schedule, shortly before I started seeing the university doctor. I was suddenly left with a whopping US$25,000+ in debt, and no job to pay for it, since I was a student. Ultimately, I couldn't make the minimum credit card payments either, and lost the cards, and received a negative credit rating to boot. And I was left with no way to obtain any treatment after this, as both stones still had not exited my system, and were growing in size. Surgery had been recommended, until my carrier rejected coverage. This is because stones that don't pass can ultimately cause life threatening conditions through infections at the site of the injuries resulting from blockage (there's lots of tearing when the stones shift, which is why you pee blood), and other causes.

I was fortunate that the stones ultimately both passed on their own, a few more months of agony later (I had them for over NINE MONTHS). It took a few years to pay off the debt + interest, not fun with the mountain of educational loans I also had to repay.

Now, let's compare that to my experiences in Taiwan, a wealthy "First World" county, that has essentially a universal health care system, with public medical services heavily subsidized by the government. Despite (or because of?) this, a number of hospitals have obtained the same international accreditations and certifications (ISO, ISP, etc.) as the top hospitals in the US.

Even though I am a permanent resident, and not a citizen, I qualify for protection under the country's health care system. Even before coverage, services are cheaper typically by a factor of sometimes as much as 10, or more. A hospital bed in the typical US hospital is what, US$1,000 a night? In Taiwan, it's about US$10, before coverage. I had a recurrence of kidney stones in Taiwan. I had a proper diagnosis and treatment from the get-go for a period of months, including ultrasound, and after coverage the costs to me were negligible. Or let's take another example: earlier this year, I developed a severe flu, and had to visit a doctor several times. The cost of three visits + 9 days of antibiotics was less than US$10. How much would you pay in the US for the same treatment, even with insurance, as a co-payment? The Taiwan government has begun to promote "medical tourism" for foreigners, especially Americans, who can often have complex surgeries performed in Taiwan for a tiny fraction of the price they'd pay at home, even factoring in the cost of travel and lack of coverage under Taiwan's health care system.

Of course, not everything I might want done is covered by the local health care system. However, that doesn't prevent me from obtaining such treatments and services locally, with the price still being far, far cheaper than I'd pay in the US. And things like a full range of cutting edge diagnostic tests when no illness or adverse condition has been detected wouldn't be covered by many (any?) insurance plans in the US, either.

There are many things I prefer about the US, but its shameful health care system is not one of them.

I've attached a list of the items on the A+ VIP comprehensive diagnostic screening package from one of Taiwan's leading hospitals. I had this done to "celebrate" my 40th b-day. Look at the long list of items (translated from the original in Chinese; the translation is a bit rough by serviceable), which includes a CT scan and MRI, and a private VIP room, with couch, table, and a 100+ inch screen projection TV for the 6+ hour stay. This is not covered by Taiwan's health care system, or any local insurance coverage I'm aware of (or coverage provided by US carriers either, for that matter), yet the cost? Less than US$1,000. How much would the MRI alone cost in the US?

Attached Files

•  A_class_diagnostic_tests.doc   101KB   3 downloads

Edited by TianZi, 27 July 2009 - 08:07 AM.

[rwac]

Actually, the current health-care system is actually already partially socialized.
This seems to be some sort of inefficient midpoint, a fork in the road.

It is possible to turn Left (towards government run health-care) or Right (towards, say Health Savings Accounts, etc)

Right now, we still have the choice.
It will be extremely hard to turn back once we have turned left.
(Imagine how hard it would be to scale back Medicare for instance)

Obama's health-care plan will be a strong turn Left, and thus the opposition to it.

Edited by rwac, 27 July 2009 - 08:31 AM.

[david ellis]

TianZi's list of tests for $1000. http://www.imminst.o...t...ost&id=6506

Impressive list. Includes as routine a test that I have been waiting two weeks to get approval - -sonogram of my kidneys . My symptoms include uncontrollable high blood pressure. I am a medicare patient and don't yet understand the reasons for the delay. I am under the care of a cardiologist plus my regular doctor.

edit-Still don't understand delay, but my test is scheduled for the 28th.

Edited by david ellis, 28 July 2009 - 05:15 AM.

[Blue]

"drug costs in Europe are an average of 40 percent less than in the U.S... ....Most of the biggest price differences were on older drugs--such as Eli Lilly's Prozac--that face generic competition; apparently, branded drugmakers tend to cut prices in the face of generic competition in Europe, but hold those prices steady in the U.S."
http://www.fiercepha...-u-s/2009-07-08

The US is famous for its free market system which has caused more rapid growth than the more socialized Europe during recent decades. But that the price of generic drugs, which should be the one most subject to free market forces, are those that differs the most between the US and Europe indicates that something is very, very wrong.

Edited by Blue, 27 July 2009 - 08:09 PM.

[david ellis]

"drug costs in Europe are an average of 40 percent less than in the U.S... ....Most of the biggest price differences were on older drugs--such as Eli Lilly's Prozac--that face generic competition; apparently, branded drugmakers tend to cut prices in the face of generic competition in Europe, but hold those prices steady in the U.S."
http://www.fiercepha...-u-s/2009-07-08

The US is famous for its free market system which has caused more rapid growth than the more socialized Europe during recent decades. But that the price of generic drugs, which should be the one most subject to free market forces, are those that differs the most between the US and Europe indicates that something is very, very wrong.

Our system of government is the best that money can buy.

[rwac]

The US is famous for its free market system which has caused more rapid growth than the more socialized Europe during recent decades. But that the price of generic drugs, which should be the one most subject to free market forces, are those that differs the most between the US and Europe indicates that something is very, very wrong.

Well the healthcare system is anything but free-market.
It is stuck in some sort of no-man's land between free-market and socialized health care.

[Blue]

The US is famous for its free market system which has caused more rapid growth than the more socialized Europe during recent decades. But that the price of generic drugs, which should be the one most subject to free market forces, are those that differs the most between the US and Europe indicates that something is very, very wrong.

Well the healthcare system is anything but free-market.
It is stuck in some sort of no-man's land between free-market and socialized health care.

Certainly true but Europe is often to claimed to have a more socialized health care which should worsen free market efficiency.

[rwac]

Well the healthcare system is anything but free-market.
It is stuck in some sort of no-man's land between free-market and socialized health care.

Certainly true but Europe is often to claimed to have a more socialized health care which should worsen free market efficiency.

It does. The US healthcare system is the major driver of innovation.
Essentially we're subsidizing the European health-care system.

Companies can afford to sell their products cheaply in Europe (forced to), because they make money in the US. Socialize health-care here and those new drugs will disappear.

[Blue]

Well the healthcare system is anything but free-market.
It is stuck in some sort of no-man's land between free-market and socialized health care.

Certainly true but Europe is often to claimed to have a more socialized health care which should worsen free market efficiency.

It does. The US healthcare system is the major driver of innovation.
Essentially we're subsidizing the European health-care system.

Companies can afford to sell their products cheaply in Europe (forced to), because they make money in the US. Socialize health-care here and those new drugs will disappear.

Another myth. Pharmaceutical companies make a very nice profit on their patented products in Europe. That pharmaceutical companies does not have to reduce their prices in the US when the patent expire actually has the effect reducing of innovation since the pharmaceuticals have no reason for funding costly research to find better replacements.

The US pharmaceutical industry has the highest ROI (investment being research but also bribes) of all industries. A high industry ROI indicates lacking competition, inefficiency, and covert/overt corruption.

[rwac]

Another myth. Pharmaceutical companies make a very nice profit on their patented products in Europe. That pharmaceutical companies does not have to reduce their prices in the US when the patent expire actually has the effect reducing of innovation since the pharmaceuticals have no reason for funding costly research to find better replacements.

The US pharmaceutical industry has the highest ROI (investment being research but also bribes) of all industries. A high industry ROI indicates lacking competition, inefficiency, and covert/overt corruption.

I bet they don't make enough in Europe to cover R&D costs, but just the manufacturing costs.

The Inefficiency is because people don't care how expensive a drug is.
If you have a $20 copay, you don't care if the drug costs $20 or $200.

What's the answer ? Health Savings Accounts.

[Blue]

I bet they don't make enough in Europe to cover R&D costs, but just the manufacturing costs.

Obviously false since in Europe there are large and dramatic price cuts when the patent expire and competing pharmaceuticals enter the market.

Also the pharmaceutical make large profits that they give to their executives and shareholders in Europe. Just not the abnormal profits seen in the US.

The Inefficiency is because people don't care how expensive a drug is.
If you have a $20 copay, you don't care if the drug costs $20 or $200.

What's the answer ? Health Savings Accounts.

I do not now exactly where the problem is in the US but paying the same amount for all drugs obviously is a large part. If the same still applies with Health Savings Accounts nothing is solved. In my country instead you have to pay the full price but the state then quickly subsides some, most, and then all of the cost when the total yearly costs for prescription drugs gets higher. So you will never pay more than a certain amount a year for prescription drugs. But if you do not consume a huge amount of expensive prescription drugs, as for most people, you will be affected by the cost. Which creates a good free market while protecting the most vulnerable.

Edited by Blue, 28 July 2009 - 04:01 PM.

[rwac]

I bet they don't make enough in Europe to cover R&D costs, but just the manufacturing costs.

Obviously false since in Europe there are large and dramatic price cuts when the patent expire and competing pharmaceuticals enter the market.
How does that invalidate my comment ? This always happens.

The Inefficiency is because people don't care how expensive a drug is.
If you have a $20 copay, you don't care if the drug costs $20 or $200.

What's the answer ? Health Savings Accounts.

I do not now exactly where the problem is in the US but paying the same amount for all drugs obviously is a large part. If the same still applies with Health Savings Accounts nothing is solved. In my country instead you have to pay the full price but the state then quickly subsides some, most, and then all of the cost when the total yearly costs for prescription drugs gets higher. So you will never pay more than a certain amount a year for prescription drugs. But if you do not consume a huge amount of expensive prescription drugs, as for most people, you will be affected by the cost. Which creates a good free market while protecting the most vulnerable.
Actually that sounds pretty good. HSA = save tax free money that you can spend on medical stuff. You pay for your drugs, and see exactly how much it costs.
And a high-deductible insurance.
Reduce incentives for employment-connected health-care, and it might happen.

What the democrats want right now is a public healthcare option, which will quickly end up as government run health.

Where do you live, btw ?

[Blue]

This always happens.

Not in the US as per the report showing the absence of free market mechanisms. Regarding manufacturing costs, if the price in Europe of patented products only covered manufacturing costs it would not be possible to see dramatic price cuts when the patent expire.

Actually that sounds pretty good. HSA = save tax free money that you can spend on medical stuff. You pay for your drugs, and see exactly how much it costs.
And a high-deductible insurance.
Reduce incentives for employment-connected health-care, and it might happen.

What the democrats want right now is a public healthcare option, which will quickly end up as government run health.

If the insurance still includes equal patient payment for all drugs nothing is solved. On the other hand, not all people will be able to save money themselves for retirement. Maybe due to laziness, maybe due to lacking ability or being unlucky enough to get seriously sick when young. HSA is not a solution for such people.

Edited by Blue, 28 July 2009 - 04:36 PM.

[rwac]

If the insurance still includes equal patient payment for all drugs nothing is solved. On the other hand, not all people will be able to save money themselves for retirement. Maybe due to laziness, maybe due to lacking ability or being unlucky enough to get seriously sick when young. HSA is not a solution for such people.

High-Deductible insurance = you pay for everything until you spend x thousand $.

[Blue]

If the insurance still includes equal patient payment for all drugs nothing is solved. On the other hand, not all people will be able to save money themselves for retirement. Maybe due to laziness, maybe due to lacking ability or being unlucky enough to get seriously sick when young. HSA is not a solution for such people.

High-Deductible insurance = you pay for everything until you spend x thousand $.

Sounds goods although I do not know the exact details.

LEF has an interesting proposal that would probably dramatically lower generic drug costs also in Europe by essentially making generics similar to supplements by reducing regulations:

http://www.lef.org/m...-Rip-Off_01.htm

[niner]

What the democrats want right now is a public healthcare option, which will quickly end up as government run health.

My understanding of the public option is that it would be essentially a non-profit insurance company, but would still require people to pay for it. There will still be a private insurance market for all who wish to use it. If there is a subsidy for low income people, they will be able to apply it to the private market as well, so this seems to be a fair system. It will only eliminate the private market if they are truly unable to compete; on service, for example.

[rwac]

My understanding of the public option is that it would be essentially a non-profit insurance company, but would still require people to pay for it. There will still be a private insurance market for all who wish to use it. If there is a subsidy for low income people, they will be able to apply it to the private market as well, so this seems to be a fair system. It will only eliminate the private market if they are truly unable to compete; on service, for example.

1. This non-profit will need to grab a significant chunk of the market to make it worthwhile politically. After all what good is it if nobody uses it.

2. Government can never compete fairly with the private sector, it will lose. It will suck up tax money in order to compete, there are no profitable government ventures.

3.Insurance companies can't compete with a government subsidized program, and will gradually fail.

Besides, that's not what the current bill does.

The current bill allows people to keep their current insurance, without changes.
That means the insurance company cannot even make minor changes to the plan.

And you will only be able to keep it at-most for the next 5 years.

[niner]

My understanding of the public option is that it would be essentially a non-profit insurance company, but would still require people to pay for it. There will still be a private insurance market for all who wish to use it. If there is a subsidy for low income people, they will be able to apply it to the private market as well, so this seems to be a fair system. It will only eliminate the private market if they are truly unable to compete; on service, for example.

1. This non-profit will need to grab a significant chunk of the market to make it worthwhile politically. After all what good is it if nobody uses it.

2. Government can never compete fairly with the private sector, it will lose. It will suck up tax money in order to compete, there are no profitable government ventures.

I don't see why this has to be true. As long as the government venture is run like a business, it will compete. If it sucks up tax money, then it isn't working and should be terminated. The whole idea is to compete straight across with private insurance companies. We wouldn't allow the private insurance companies to cherry-pick only the healthiest people, and deny the rest, so it would be a fair playing field.

3.Insurance companies can't compete with a government subsidized program, and will gradually fail.

Besides, that's not what the current bill does.

The current bill allows people to keep their current insurance, without changes.
That means the insurance company cannot even make minor changes to the plan.

And you will only be able to keep it at-most for the next 5 years.

Well, I don't think the public option (public "insurance company") is intended to be subsidized any more than the private insurance fees would be subsidized, so the only reason that private companies would fail is if they aren't adding value, and people recognize that and vote with their pocketbooks. If the private insurance industry is not adding value, then why should we continue to feed them money?

When they say "without changes", I think it means "without government-forced changes", not that the insurance companies will not be allowed to improve those policies. I've heard nothing to suggest that after five years, your private insurance would go away. That's just not there.

[rwac]

I don't see why this has to be true. As long as the government venture is run like a business, it will compete. If it sucks up tax money, then it isn't working and should be terminated. The whole idea is to compete straight across with private insurance companies. We wouldn't allow the private insurance companies to cherry-pick only the healthiest people, and deny the rest, so it would be a fair playing field.

The point is, it will never be run like a business. Political considerations always outweigh economic ones.

That would lead to insurance prices shooting up for healthy people.
What is then the incentive for healthy people to get insurance if they're paying a lot ?

Besides where have you ever seen a government venture compete fairly with private companies ?
Just one example would be nice.

Well, I don't think the public option (public "insurance company") is intended to be subsidized any more than the private insurance fees would be subsidized, so the only reason that private companies would fail is if they aren't adding value, and people recognize that and vote with their pocketbooks. If the private insurance industry is not adding value, then why should we continue to feed them money?

When they say "without changes", I think it means "without government-forced changes", not that the insurance companies will not be allowed to improve those policies. I've heard nothing to suggest that after five years, your private insurance would go away. That's just not there.

The real problem is that the bill is so big, and very few people have read it ...

Here's a link that suggests otherwise.
http://www.examiner....-existing-plans

[rwac]

Well, I don't think the public option (public "insurance company") is intended to be subsidized any more than the private insurance fees would be subsidized, so the only reason that private companies would fail is if they aren't adding value, and people recognize that and vote with their pocketbooks. If the private insurance industry is not adding value, then why should we continue to feed them money?

Er, if it's not going to be subsidized, why is everyone talking about how it will affect the deficit ?

Of course it's going to be subsidized with tax dollars. That's the whole point of the exercise.

[niner]

Well, I don't think the public option (public "insurance company") is intended to be subsidized any more than the private insurance fees would be subsidized, so the only reason that private companies would fail is if they aren't adding value, and people recognize that and vote with their pocketbooks. If the private insurance industry is not adding value, then why should we continue to feed them money?

Er, if it's not going to be subsidized, why is everyone talking about how it will affect the deficit ?

Of course it's going to be subsidized with tax dollars. That's the whole point of the exercise.

No, the "public option" isn't going to be subsidized, it will be the insurance bills for the poor that will be subsidized. That would be the case whether they used a private insurer or the public insurance plan.

The effect on the deficit is really overblown; the trillion dollar tab is over ten years, so that's 100 billion a year. Not chicken feed, but relative to the size of the budget, or the size of the economy, or the cost of the war in Iraq or military spending in general, it's pretty small.

[rwac]

No, the "public option" isn't going to be subsidized, it will be the insurance bills for the poor that will be subsidized. That would be the case whether they used a private insurer or the public insurance plan.

The effect on the deficit is really overblown; the trillion dollar tab is over ten years, so that's 100 billion a year. Not chicken feed, but relative to the size of the budget, or the size of the economy, or the cost of the war in Iraq or military spending in general, it's pretty small.

Medicare is already becoming unsustainable. Why would you think that adding further deficits will improve things ?

The war in Iraq is comparatively short term. It will decrease as we gradually pull out.

Medicare deficits are already threatening to grow indefinitely, estimated to become 50% of the budget in 2052. It's unsustainable long term, and the democrats would like to spend even more money on health-care ...

This is terribly irresponsible.

[niner]

Medicare is already becoming unsustainable. Why would you think that adding further deficits will improve things ?

The war in Iraq is comparatively short term. It will decrease as we gradually pull out.

Medicare deficits are already threatening to grow indefinitely, estimated to become 50% of the budget in 2052. It's unsustainable long term, and the democrats would like to spend even more money on health-care ...

This is terribly irresponsible.

I don't want to make a pro-deficit argument; my only point is that relative to a lot of important metrics, it's small, but it's being talked about as though it's sure to bankrupt the country. I just want to see it in perspective. The war in Iraq was short term, but the total cost of it would buy us 30 years of the proposed healthcare program.

Medicare is a different animal with serious demographic challenges. It does point out the urgency of getting healthcare costs down. Cost didn't seem to be much of an issue when the Republicans pushed through the costly Medicare drug benefit. I know two wrongs don't make a right, but part of what Obama wants to do is to put us on a path toward lower healthcare costs, which is the ultimate thing that has to be done. Business as usual will destroy us. There's going to be a change, the only question is what it will look like.

[rwac]

I don't want to make a pro-deficit argument; my only point is that relative to a lot of important metrics, it's small, but it's being talked about as though it's sure to bankrupt the country. I just want to see it in perspective. The war in Iraq was short term, but the total cost of it would buy us 30 years of the proposed healthcare program.

Medicare is a different animal with serious demographic challenges. It does point out the urgency of getting healthcare costs down. Cost didn't seem to be much of an issue when the Republicans pushed through the costly Medicare drug benefit. I know two wrongs don't make a right, but part of what Obama wants to do is to put us on a path toward lower healthcare costs, which is the ultimate thing that has to be done. Business as usual will destroy us. There's going to be a change, the only question is what it will look like.

Yes, but the war will close down. Healthcare is yet another open-ended commitment that will only increase with time.

So Medicare will be folded into this new healthcare system. How is increasing the number of people covered by the government going to save money ?

Yes, something needs to be done, but this bill is moving in the wrong direction.
McCain's plan to tax employer contributions to healthcare, while giving a $5000 deduction to make up for it would be a good start.

Your car insurance doesn't pay for oil changes and tire replacements.
Why should your medical insurance pay for regular checkups ?

[Rational Madman]

I'm a bit perplexed by this obsession with expanding health insurance coverage, since health insurance access has never been proven to be the most important correlate for reducing inequity, improving public health, increasing the average life expectancy, and other similar dependent variables. Income and education seem to be the most important correlates, which means that public initiatives to reduce poverty and improve education outcomes are likely to yield more promising results. As for health care, I think the most important problems are inflation and quality, which would require a radically different approach to the major proposals being considered by the Senate and the House of Representatives.

[Rational Madman]

Delete

Edited by Rol82, 04 August 2009 - 05:05 AM.