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Ron Bailey is skeptical aboot California's plan for maple-leaf health care.
|3.3.06 @ 3:25PM|#
Unreal!!!!
Besides the obvious ramifications.....it's just fundamentally
wrong. How dare the government tell me that I'm not allowed to
procure better medical care if that's what I want? I would say
thank God I don't live in California.....but Maryland's not exactly
a bastion for free markets.
Timothy|3.3.06 @ 3:44PM|#
Oregon tried this with a ballot measure a few years go, fortunately even in a state that insane it was shot down 80/20.
|3.3.06 @ 3:56PM|#
Honestly, good for California. If states are truly to serve as laboratories of democracy, then sometimes a state has to do something really foolish. One can only hope that California will adopt this system, that it will fail miserably and that the rest of the nation can go about finding real solutions to rising health care costs and not romanticising government run systems.
|3.3.06 @ 3:59PM|#
Honestly, good for California. If states are truly to serve
as laboratories of democracy, then sometimes a state has to do
something really foolish. One can only hope that California will
adopt this system, that it will fail miserably and that the rest of
the nation can go about finding real solutions to rising health
care costs and not romanticising government run systems.
I'll second this sentiment. Let the state run it's expiriment. Just
because it seems to be "coming apart in Canada" doesn't necessarily
mean it will fail/work in CA. Maybe the implementation details will
be different and have a differnet outcome...maybe not. But all this
debate about theoreticals won't answer any real questions unless
theories are put into practice.
I know Ill be curious to see how this turns out.
|3.3.06 @ 4:06PM|#
Maybe it would be better if risky experiments were run in, say, Rhode Island or Vermont or Idaho or some other place with relatively few people to be harmed if it goes awry.
|3.3.06 @ 4:09PM|#
stretch and ChicagoTom:
Agreed. Whether it works or not, the rest of the country can only
win by CA trying this. Too bad for the poor suckers living there,
though.
|3.3.06 @ 4:13PM|#
stretch & ChicagoTom: I like the laboratory of democracy idea myself--I'm just warning people what's likely to happen if they decide to run this particular experiment.
|3.3.06 @ 4:13PM|#
Stretch,
"that it will fail miserably and that the rest of the nation can go
about finding real solutions to rising health care costs and not
romanticising government run systems"
No offense, but are you for real?? Put it into an envelope, I'll
say it now. When the Cali plan fails, rest assured, everywhere you
turn you will hear it's because there was not enough gov.
intervention. The 'real' solutions that people will find will be
things like regulating restaurants, calorie intake and whatnot.
|3.3.06 @ 4:14PM|#
Maybe it would be better if risky experiments were run in,
say, Rhode Island or Vermont or Idaho or some other place with
relatively few people to be harmed if it goes awry.
Undoubtably you're right, but there's no way to control that
without the Federal government picking and choosing who runs what
experiments. Such a situation may actually be worse than just
having the federal government mandate single "solutions" across the
board.
And I'm sure the benevolent Sen. Keuhl doesn't view this as a
"risky experiment" at all ;)
|3.3.06 @ 4:17PM|#
While I understand the argument that states should experiment,
it is unconvincing when the experimentation amounts to blatently
taking away individual freedoms. It is true that a miracle could
happen and the proposed California system could work, but at the
price of denying certain citizens coverage they desire (in the form
of private healthcare).
Also, I cannot agree with the reasoning that the failure of the
system would be a good thing in this case, as lives would be left
hanging in the balance.
|3.3.06 @ 4:17PM|#
No offense, but are you for real?? Put it into an envelope,
I'll say it now. When the Cali plan fails, rest assured, everywhere
you turn you will hear it's because there was not enough gov.
intervention. The 'real' solutions that people will find will be
things like regulating restaurants, calorie intake and
whatnot.
Sadly, that's very likely. I think it's even more likely that it
will be declared a resounding success a year into the program and
everyone will be forced to follow suit.
|3.3.06 @ 4:19PM|#
"a year into the program and everyone will be forced to follow
suit."
Ain't that the truth. That's my fear.
|3.3.06 @ 4:27PM|#
Unfortunately because of the burgeoning influence of the federal government on local politics, many of these laboratories of democracy are not allowed to experiment all that much due to running afoul of federal law. (Witness the medical marijuana issue and assisted suicide issues.) It's kinda sad that now people are reading the tenth amendment as "the powers not delegated to the people by the Constitution, nor to the States, are reserved to the United States respectively."
|3.3.06 @ 4:28PM|#
"all this debate about theoreticals won't answer any real
questions unless theories are put into practice"
Wasn't that FDR's early-New Deal philosophy?
Heck, what could happen?
|3.3.06 @ 4:28PM|#
I own my own business and I'm my only employee. So with this wonderful plan my business pays 8.2% and I pay 3.8% for a total of 12%. Add that to the 15% I'm already paying for social security and medicare and now they get their hands on 27% of my income and in return I get absolutely nothing? Gee, that seems fair.
|3.3.06 @ 4:29PM|#
The funny thing that if this passes, California will be be entering a world that Canada is quickly retreating from. Private surgical clinics are sprouting up everywhere and there is no longer the sense that Government-run medicare is a sacred cow.
|3.3.06 @ 4:29PM|#
I wonder how many Hollywood types will laud this as a great advancement in healthcare for the working man, but will quietly take up official residence in another state when something worse than a sniffle befalls them.
|3.3.06 @ 4:30PM|#
Honestly, good for California. If states are truly to serve
as laboratories of democracy, then sometimes a state has to do
something really foolish.
Realistically, doesn anyone really think that California, having
socialized medcare, would ever go back, regardless of how bad
it gets? More likely what will happen is following the
inevitable crash, the state will install an even more draconian,
Mussolinian "system" - a system where health care is "made to work"
at gunpoint.
Let's see a serious turnaround in the UK and Canada...then I'll be
impressed.
|3.3.06 @ 4:30PM|#
(Witness the medical marijuana issue and assisted suicide
issues.)
Yeah, let's see how the fed reacts when CA starts paying for MMJ
prescriptions.
|3.3.06 @ 4:33PM|#
Just like the other single payor systems, CA will probably find a way to export its costs. The system will look a lot better than it really is due to innovation subsidy from everyone else.
|3.3.06 @ 4:34PM|#
On the bright side, this might finally do something about the cost for a house out here.
|3.3.06 @ 5:02PM|#
"A plan to outlaw private health insurance in California has
been proposed by state Sen. Sheila Kuehl (D-Los
Angeles)."
You mean this Sheila
Kuehl?
|3.3.06 @ 5:03PM|#
Tennessee was stupid enough to try this, calling it "TennCare". It lasted 11 years before its budget ballooned so high the state had to cut it severely. It now serves as a "poorest of the poor" health insurance dumping ground - nobody else really quailifes. In other words, it's Medicaid/Medicare 2.0.
|3.3.06 @ 5:04PM|#
Realistically, doesn anyone really think that California,
having socialized medcare, would ever go back, regardless of how
bad it gets?
Well this is a state that recalled their governor about 9 months
after re-electing him, and they love them some ballot initiatives,
so I do really think that if it gets that ba,d the voters will
force the legislators to go back or not.
But even if it goes to shit and Cali doesn't do an about face, at
the very least, many other states will be able to cite the
California example as why that system won't work.
Too bad for the poor suckers living there, though.
What is it that people like to say?? "People deserve the
governments they elect" or something like that??
|3.3.06 @ 5:07PM|#
For some cognitive dissonance after reading Ron's piece check
out the New York Review of Books, where Robin Wells and her
co-writer Paul Krugman write on "The Health Care Crisis and How To
Fix It." Wells' last para is "So what will really happen to
American health care? Many people in this field believe that in the
end America will end up with national health care insurance, and
perhaps with a lot of direct government provision of health care,
simply because nothing else works. But things may have to get much
worse before reality can break through the combination of powerful
interest groups and free-market ideology."
Ron Bailey, you and your articles are only delaying the
inevitable!
|3.3.06 @ 5:16PM|#
Sheila Kuehl was on Dobie Gillis, Love American Style, and The Beverly Hillbillies. Yet another actor turned politician.
|3.3.06 @ 6:00PM|#
Nobody thinks this will actually pass... right?
No one who actually lives here and isn't totally addled. It's just
Sheila being Sheila, no one takes her seriously.
|3.3.06 @ 6:04PM|#
Nobody thinks this will actually pass... right?
In California? Don't bet against it. These people (I currently live
here, though I am NOT a 'Californian') really are getting the
government they deserve. In a state where they can ditch a loser
like Gray Davis, and then the best thing they can think to replace
him with is Ahnold Shriver, anything at all is possible. Though
insanity is the way to bet.
Larry A|3.3.06 @ 6:12PM|#
Then let's assume that California's economy continues to
grow and that median family income climbs to $80,000.
Somehow I don't think this will be a problem.
Sheila Kuehl was on Dobie Gillis, Love American
Style, and The Beverly Hillbillies. Yet
another actor turned politician.
And she acted on Emergency, so obviously she knows how to
run a medical insurance program. <CLUE> Does her mandatory
shutdown of insurance include the California state senators' health
plan?
|3.3.06 @ 6:19PM|#
Maybe it ain't all bad. I figure it's doomed to failure, but if
it breaks the current systems hold that might be benefit enough.
Then once this fails there might be chance to address the
problem.
Speaking as a small business owner who's plans coverage has
decreased every year, but the premiums have increased every year
for the last 10. I don't know that our system ain't any less broke
then the Canadians.
Also... PPO's have enlightened my workers. What Dr's do and what
they charge for are often two different things. It's a small sample
(9 employees), but I've heard several reports in the office about
this happening. It's also not in the interest of the patient to
squeal.
The biggest problem with our system is it insure everything. The
result is everything has an inflated cost.
Mike Laursen|3.3.06 @ 6:20PM|#
Agreed. Whether it works or not, the rest of the country can
only win by CA trying this. Too bad for the poor suckers living
there, though.
Poor suckers like me, and my family. :-(
As a Californian, though, I've learned not to get too worked up
just because some legislator has introduced some crazy-assed bill.
A crazy-assed bill with widespread support, that's something to
worry about. Please tell me Sen. Kuehl is a lone crusader on this
one.
Ken Hagler|3.3.06 @ 6:21PM|#
Incidentally, although I don't think this has any chance of passing, I note that from LA to Tijuana is an eight-hour round trip via Greyhound and only costs about $50.
brian423|3.3.06 @ 7:12PM|#
Sheila Kuehl Cruel also screws over men
falsely accused of being deadbeat dads.
|3.3.06 @ 7:24PM|#
the wed RINO,
The biggest problem with our system is it insure everything.
The result is everything has an inflated cost.
I agree with this. It is amazing to see the bottom line that
hospitals will 'settle' with insurance companies for.
Ken Hagler,
Tijuana is an eight-hour round trip via Greyhound and only
costs about $50.
Too bad California probably thinks that running a private 'Medical
Bus' to Mexico would be too free-market of a solution. Otherwise I
would see this as a real business opportunity.
|3.3.06 @ 8:28PM|#
This bill does sound horrifying. I agree with most of the
comments that have been made along the lines of AnonNY's, such as
the red flag that goes up "when the experimentation amounts to
blatently [sic]taking away individual freedoms". However, I have
one bit of red meat to throw out to reasonoids: Why is it that
Canada is always trotted out as a prototype of nationalized
healthcare? I suspect that it is because this old straw dog gives
everyone a chubbo.
For example, I've spent quite a bit of time in Spain, and the
Spanish National Health Service is basically the pride of the
country.
This is really just an honest question for all of those in health
care and not those who are only interested in ideological purity.
The Spanish system does work. It encourages (gasp!) primary care
and thus encourages visits to lower cost clinics instead of
curative emergency-care visits by desperate patients--which are
what drain any healthcare system dry. It seems to be pretty
comprehensive. People generally seem to be happy with the bang for
the buck that they get. What's not to like about that?
And is anyone really prepared to argue that the Germans, Spanish,
and Italians are not healthier than we are across the board? I'm
not trolling here. Just looking for someone to go beyond the whole
lame argument that posits Canada as the only other model.
|3.3.06 @ 8:44PM|#
budgie,
My wife is German. You obviously know nothing about the German
system. Only the poor get free health care. Everyone else pays for
their own health insurance. (All Germans are required by law to
have health insurance.) My father-in-law pays for his own insurance
out of his pocket and he works for the government! When you
consider the high tax rates, the not-at-all cheap cost of
insurance, and the not-that-great service they receive for it, his
health-care costs are much MORE expensive than they would be if he
lived in the US.
Oh, and by the way, rationing is awful. Some life-saving drugs
available in the US are banned in Germany because they are
considered too expensive.
And is anyone really prepared to argue that the Germans,
Spanish, and Italians are not healthier than we are across the
board?
God, you're ignorant.
|3.3.06 @ 8:44PM|#
>Just because it seems to be "coming apart in Canada"
>doesn't necessarily mean it will fail/work in CA.
Remember it took decades to fail in Canada, so liberals
will no doubt proclaim it a success before making their
descendants deal with the fallout.
|3.3.06 @ 8:50PM|#
>Just like the other single payor systems, CA will
>probably find a way to export its costs.
Since the feds send matching funds to states for Medicare,
they already to. Even better, since the matching funds are
based on gross dollars spent, the states have an incentive
to increase costs as that increases the amount of the
federal subsidy.
|3.3.06 @ 8:57PM|#
"God, you're ignorant."
Hey The Real Bill. Thanks for the kick in the pants. It took all of
20 seconds to scare up some relevant stats.
http://unstats.un.org/unsd/demographic/products/socind/health.htm.
Sorry it's UN data. Are life expectancy and infant mortality
acceptable to fucktards?
|3.3.06 @ 9:01PM|#
Also, there is no rationing in the example I gave--in Spain, that is. I know. All the models tell us that there will be rationing...I know. It's just that the real world keeps intruding.
|3.3.06 @ 9:08PM|#
There is significant evidence that our higher infant mortality
rate is due to the fact that we have a lower miscarriage rate. Why?
Because our pre-natal care prevents miscarriages which later result
in infant deaths.
The differences in life-expectancy are tiny.
I may be a fucktard, but you're a fucking evil slaver.
|3.3.06 @ 10:24PM|#
Here are a couple of posts (with links) arguing that however bad
health care in other countries may be, it's worse here:
http://www.washingtonmonthly.com/archives/individual/2005_11/007489.php
http://www.washingtonmonthly.com/archives/individual/2005_08/006968.php
Here's a section from the latter: "Americans spend $5,267 per
capita on health care every year, almost two and half times the
industrialized world�s median of $2,193; the extra spending comes
to hundreds of billions of dollars a year.
What does that extra spending buy us? Americans have fewer doctors
per capita than most Western countries. We go to the doctor less
than people in other Western countries. We get admitted to the
hospital less frequently than people in other Western countries. We
are less satisfied with our health care than our counterparts in
other countries. American life expectancy is lower than the Western
average. Childhood-immunization rates in the United States are
lower than average.
....Nor is our system more efficient. The United States spends more
than a thousand dollars per capita per year � or close to four
hundred billion dollars � on health-care-related paperwork and
administration, whereas Canada, for example, spends only about
three hundred dollars per capita. And, of course, every other
country in the industrialized world insures all its citizens;
despite those extra hundreds of billions of dollars we spend each
year, we leave forty-five million people without any
insurance."
If someone could point me to rebuttals of these claims I'd be very
grateful.
Ted
|3.3.06 @ 11:01PM|#
The Dems in California control both houses, but I would think
(hope) the governator would veto it. Even if it becomes law and
makes their lives miserable, the dumb people of CA will keep
electing the same big-government Democrats who created this mess.
They deserve what they get.
Boy, I'm sure glad I left CA last year, and if this passes, it'll
be another reason why I won't come back.
|3.4.06 @ 8:43AM|#
The main rebuttal to the fact that United States patients spend
more than others but use our health care less is simple. When you
have socialized health care, you will go to the doctor for the
frickin' sniffles, making more doctors "needed" (even though they
aren't because the cost isn't internalized) and more visits
"necessary". Additionally, Americans spend more/go less because we
spend our money on when it's going to save our life from some rare
disease. That is, we're willing to spend it, and spend a lot of it,
when it's needed (i.e. when it's expensive) but that's about
it.
Anecdotal example: my grandparents never go to the doctor, ever.
But, this year, my grandfather had his heart valve replaced and my
grandmother had quintuple bypass. Both of them are fine and going
to live another ten years, but they just massively increased the
average spent this year on health care, with relatively view
doctor's visits.
Furthermore, efficiency isn't to be valued above all...you're
looking at strictly numbers, whereas quality may vastly differ.
Additionally, Americans may be "less" satisfied because we demand
more and better if we're paying for it. In other countries, how can
you complain when it's "free"?
|3.4.06 @ 9:23AM|#
Interesting Canada Comment
I was driving up to Northern Vermont last weekend and caught part
of a Montreal radio station.
They have canceled all hip and knee replacements in Montreal until
May of this year - they ran out of money.
|3.4.06 @ 10:06AM|#
"the new California Health Insurance Agency will determine how
much it will pay pharmaceutical companies for new more effective
medicines. This means that Californians, like Canadians today, will
wait a long time, possibly forever, to get access to modern
therapies. In 2002, Sally Pipes, head of the Pacific Research
Institute, a free-market think tank in San Francisco noted,, "One
hundred new drugs were launched in the United States from 1997
through 1999. Only 43 made it to market in Canada in that same
period. Canadians are still waiting for many of them."
"
I'm going to take a counterposition on one element of this proposed
plan. If any political subdivision could possibly make a stab at
being a monopsony pharma dispensary (an approach which I'm going to
call "pulling a Wal-Mart" hereon in), I'd put my money on
California. Canada's buying power appears to be split up by
province, whereas Californa has about 3 million more people than
all of Canada, and somewhere in the neighborhood of 10-15% of the
entire US population. Also, I recall that California's per-capita
income is greater than the US on average. If Vermont or Idaho tried
to pull a Wal-Mart on pharmas and dictate prices, those states
would not have the buying power to keep the pharmas at the table.
If California tried it, the pharma's would negotiate -- and, unlike
a Federal monopsonist, it wouldn't be a life-or-death struggle for
the pharmas. I'll grant that the incentive to lobby the political
process remains in California, but compared to the Federal
situation, the payoff and stakes are lower for the pharmas. Neither
side would have the power to dictate explicit terms (as much as the
moonbats try, they won't get free drugs, but I believe CA could get
cost-plus), but both would have enough power to keep the other at
the table for negotiation.
What if California negotiated "cost-plus" style contracts
(alternately, prepaid for an estimated volume, or in the format of
a futures contract, to protect the pharmas from free-riding by the
other states) for new, state-of-the-art pharmaceuticals, and
actually manages to maintain supplies while holding the line on
pharmacology costs? A prepay scheme might actually turn out to be
win-win for CA and the pharma companies. CA gets guaranteed
price-per-dose, presumably with a bulk discount; meanwhile the
pharmas would get major up-front cash liquidity, and quickly fill
the baseline on making $1B on a "blockbuster drug", while also
delegating the actual marketing of the doses to the state health
agency. The PA liquor control board finally figured out how to work
their monopsony powers for the benefit of citizens; as long as the
politicians can remain ornery enough to avoid lobbyist impacts I
think California can make a go of this element of their proposal. I
don't believe that PhRMA is prepared to play "Atlas-shrugging"
hardball with a single buyer as important a component in the US
economy as the state of California.
When there was all that fooferal about reimportation of US drugs
from Canada, I thought the appropriate response by the pharma
companies should be "Your historical Rx levels and projected
occurance of condition X are xyz per 100,000 citizens. Thus, we're
shipping that count with a 10% buffer for distribution lags, spikes
in presentation, etc to Canada. Work out supply shortages yourself
-- maybe you should check your buyer's residency at point of sale.
Just sayin"
|3.4.06 @ 10:26AM|#
Also, there is no rationing in the example I gave--in Spain,
that is. I know. All the models tell us that there will be
rationing...I know. It's just that the real world keeps
intruding.
[sigh...]
Of course there is rationing. There is rationing in
every health care system because there is always a greater
demand than supply for at least some sorts of health care, and that
reality would obtain even in a free market based system. The only
real questions are how such rationing is to be determined and what
the likely result will be.
In some (though not, I think, all) respects, a market system would
ration the supply more efficiently, but the underlying debate over
health care is really, albeit usually only tacitly, one about both
pragmatic and deontological concerns about how that purely economic
efficiency works out.
Another problem in these sorts of debates is the often implicit
notion that health care will continue to become more and more
expensive or, at the very least, remain as expensive as it is
today. I often note that anyone who would like health care to be as
inexpensive as it was in the 1950 could have his way if he was
willing to accept the quality of health care available then. But
there is no reason to believe that the cost curve will never
decline even assuming that health care will always be, at least
comparatively, labor intensive. That, however, is probably better
saved for a different thread.
As for California and Sheila ("Zelda! Now cut that out!") Kuehl's
initiative, one could argue that the problem with California is
that it hasn't gone quite mad enough -- that the water
isn't quite boiling yet -- and that this is precisely the sort of
measure likely (warning: metaphor mixing ahead!) to turn the
tide.
We can but hope.
Xmas|3.4.06 @ 11:15AM|#
How are Californians going to get health care coverage when they
aren't in California? I mean, if they are visiting Massachusetts
and break a leg, who's going to pay for it?
What's going to stop free-riders from visiting California for a
week to get some medical care?
One thing in the article though. It's not that doctors that are
underpaid for their service don't work as hard as doctors that are
paid reasonably. It's that doctors that are underpaid are much less
efficient than correctly paid doctors. For example, since she is
paid based on a chart of services and tests, a doctor that need to
pay her bills will do minimal exams and as many tests as she can
get away with on Medicare patients. That is the only way a doctor
can earn enough money when the government intentionally underpays
doctors.
I just saw an article about this too posted in one of the Medical
blogs, like MedRants or Medpundit.
|3.4.06 @ 12:44PM|#
I wonder about those who truly believe that our healthcare
system is the best in the world. My guess is that those who do have
not had to deal with a family member in a serious medical crisis,
particularly a chronic one. Not only is access fraught with
difficulties (even with insurance), but quality of care, lack of
interaction with qualified professionals, and basic lack of
best-practice are far more common than would be expected given the
fact that as a "free market" we pay doctors what they are worth
(and nurses, and orderlies...yeah right).
I am with Ted on this one. It takes a healthy set of blinders to
think that we don't need a fix of some sort. Argue about the nature
of that fix, but don't pretend you've got it good, cuz you don't.
This is an example of a value that is not captured well by our
current market mechanisms, and therefore creates a significant
challenge for freemarket solutions.
|3.4.06 @ 5:46PM|#
Ayn_Randian,
I don't support this bill, but don't you think people not going to
the doctor for little things makes it more likely that big things
will happen? If you don't change the oil on your car regularly,
you're in for some deep and expensive doo doo. I'm not saying go in
for the sniffles, but there is clearly the case of people not
getting enough basic care that leads to major problems down the
line. Especially when you look at dental care which is really
underrrated (I think it's funny when people compare us to other
nations on health, they forget that Americans have the best dental
care in the world)
|3.4.06 @ 8:59PM|#
(c) The appointee shall avoid political activity that may create
the appearance of political bias or impropriety.
Oh for heaven's sake, the appointee (the commissioner of health
care) would have to be as red as Lenin to take the job in first
place.
|3.5.06 @ 12:40AM|#
budgie:
Also, there is no rationing in the example I gave--in Spain,
that is. I know. All the models tell us that there will be
rationing...I know. It's just that the real world keeps
intruding.
Wrong budgie! Wrong again! Read and learn:
First we examine the degree of acceptance of a publicly funded
health system such as the use of an intergenerational equity
criteria for health care rationing based on
patient's age.
From:
"Priority setting, public opinion and health care system in
Spain"
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11423028&dopt=Abstract
Also:
"Priorities in healthcare: a perspective from Spain."
http://www.euro.who.int/document/e70504.pdf
|3.5.06 @ 12:53AM|#
Mainstream Man,
How about we get the government out of health care entirely? We
don't have a free market in health care--not even close! Let's try
the free market before we use government and its
guns.
|3.5.06 @ 9:24AM|#
"My guess as to why we have so many healthcare problems is
twofold. First is the lack of incentive for early, preventative
care. "
"Second and more important, we don't have a free-market system.
"
If you increase early preventative care, you will just increase the
cost of health care. The problem with health care is there are only
2 things certain in life and one of them is death. Health care in
all its forms just postpones the inevevitable. If you doubt this,
visit the county hospital and see who the patients are.
Your second point gets closer to the truth. The problem with our
health "insurance" system is that it isn't insurance, but it is
rather a transfer payment system from the young and healthy to the
elderly and ill. The only way health care costs will decrease is if
the people seeking health care have a vested interest in reducing
costs.
Here is an example. There is a relatively new biotech therapy for
sepsis. It costs about $3,000 to administer. Far from being a cure,
about one person in five will show a measurable benefit (though
they might still die before leaving the hospital). Right now, the
issue before health care workers and hospitals is whether or not
they can be sued if they don't administer the therapy. Post hoc, it
isn't hard to find somebody who will testify that the treatment
would have saved Uncle Joe's life.
The current system has almost unlimited demand for health care. The
only thing holding costs down is Medicare refusing to pay for
something or paying such a low amount it essentially is the same
thing. An example of this is lung volume reduction surgery. While
the procedure is far from the panacea its advocates claim, it does
help some people with emphysema. Medicare refused to pay for it,
because it would have broken the bank, but they justified it as an
unproven treatment.
Any system of health care which pays 100% of health care costs will
eventually have to ration care, because there is no way to satisfy
infinite demand. Any system of health care where people have to
make decisions based in part on the cost of treatment will lead to
different care for different people and the inevitable sob stories
this produces.
|3.5.06 @ 10:22AM|#
I want to clarify something. I have nothing against early
preventative care. I think that type of care gives the greatest
benefit per unit cost. It won't, as I said above, reduce total
costs.
Here is an example. A young otherwise healthy man in his 30's gets
a physical exam for life insurance. He is discovered to have
hypertension. His blood pressure, without any symptoms, is 180/110.
He gets treatment and his blood pressure is 130/80. He is very
likely to live much longer and probably will view the cost of the
initial evaluation and the ongoing cost of medication as money well
spent. He will, however, still die. Whether he dies at age 50 of a
heart attack and congestive heart failure or he dies at age 75 of
colon cancer, he still dies and with considerable end of life
expense.
|3.5.06 @ 4:14PM|#
Re: How about we get the government out of health care entirely?
We don't have a free market in health care--not even close! Let's
try the free market before we use government and its guns."
I will refer you to RexRhino's comment.
While I would disagree with his characterization (a bit paranoid
for my taste) of the motives behind socialized medicine, the idea
of a "free market healtcare economy" is such a pie in the sky
fantasy that would not work even if implement since medicine has to
be part of our very controlled economy. The US talks a good free
market game, but we have a very controlled economy (one of the
reasons, I would say, that it is the most successful is that it
uses power to leverage the global system in its favor, this
requires internal controls to be implemented).
Given the current situation, a solution that minimizes middle-man
costs due to profit needs (i.e., private insurance, which isn't
really insurance as has been pointed out) will at least be more
efficient by letting a larger percentage of the dollars spent on
healthcare go directly to providing services (medicare, medicaid,
and the VA have a much better dollar to service provided --i.e.
lower overhead-- ratio than the rest of the healthcare
system).
Making healthcare about pleasing the voters is more likely to
provide the services they want than the current system which views
patients as a very real distraction in the effort to make
money.
|3.5.06 @ 4:46PM|#
For an indepth look at the oppositions position...
http://www.nybooks.com/articles/18802
These are the arguments that a free market approach needs to
address.
|3.5.06 @ 7:28PM|#
Who gets blamed for the cost of energy skyrocketing in California and bankrupting the major utilities a couple years ago? It was blamed on the greed of Enron et al, when in reality it can be directly traced to idiotic regulations designed by the state legislature and labeled "deregulation". If this thing passes, the inevitable failure of the health care system will also be blamed on the lack of adequate government control. As goes California, so goes the country.......
|3.5.06 @ 8:50PM|#
What California needs really is Proposition 998. Prop 998 gives every resident of the state 998 billion dollars to be paid for by bond measure 999. It's important to vote for both 998 and 999.
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