Obamacare

True or False: ObamaCare Will Bring Down Medical Costs

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Suppose I were a skeptic of major promises made about last year's health care overhaul. Now
suppose I were Medicare's chief actuary. But I repeat myself:

Two of the central promises of President Barack Obama's health care overhaul law are unlikely to be fulfilled, Medicare's independent economic expert told Congress on Wednesday.

The landmark legislation probably won't hold costs down, and it won't let everybody keep their current health insurance if they like it, Chief Actuary Richard Foster told the House Budget Committee. His office is responsible for independent long-range cost estimates.

Foster's assessment came a day after Obama in his State of the Union message told lawmakers that he's open to improvements in the law, but unwilling to rehash the health care debate of the past two years. Republicans want to repeal the landmark legislation that provides coverage to more than 30 million people now uninsured, but lack the votes.

Foster was asked by Rep. Tom McClintock, R-Calif., for a simple true or false response on two of the main assertions made by supporters of the law: that it will bring down unsustainable medical costs and will let people keep their current health insurance if they like it.

On the costs issue, "I would say false, more so than true," Foster responded.
As for people getting to keep their coverage, "not true in all cases."

So those promised cost reductions probably won't happen under Obama's plan. Is there perhaps another plan that Foster thinks is more likely to produce such savings? Here's The Daily Caller's Jon Ward with the actuary's answer:

Supervillain?

[Democratic Rep. Chris] Van Hollen pressed Foster on whether [GOP Rep. Paul] Ryan's plan [the Roadmap for America's Future] would work, prompting Foster to point out that one of the biggest problems in health care now is that most new technology that is developed increases costs rather than decreasing it.

"If there's a way to turn around the mindset for the people who do the research and development … to get them to focus more on cost-reducing tech and less on cost increasing technology, if you can do that then one of biggest components of [increasing costs] turns to your side," Foster said. "If you can put that pressure on the research and development community, you might have fighting chance of changing the nature of new medical technology in a way that makes lower cost levels possible."

Foster said: "The Roadmap has that potential. There is some potential for the Affordable Care Act price reductions, though I'm a little less confident about that."

On the one hand, you have the president's health care overhaul, which expands on our current unaffordable system of open-ended support for health coverage. It gathers health insurers into heavily regulated, government-run exchanges and which sets up a variety of new mechanisms for holding down costs through increased micromanagement and centralized decision making. Inevitably, those decisions become politicized, and costs become extremely to hold down.

On the other hand, you have Ryan's plan, which, over the long haul, caps the government's contribution to each individual and gives those individuals a choice about how and where to spend their health care dollars. It's not a perfect plan, but it seems far more likely to produce a basically fiscally sustainable system than the one we just passed.

NEXT: My State of the Union Address

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  1. “…and it won’t let everybody keep their current health insurance if they like it…”

    Tell that to the 700 some-odd organizations that have now been granted exemptions. WTF, WTMFF! was the point of passing this to begin with if everyone who pays off the administration is going to be granted an exemption???

    What were those things the church used to sell? Indulgences? More of Same!!!

    1. What were those things the church used to sell? Indulgences? More of Same!!!

      I’m sure you’re not the only one who thinks Obama is God.

    2. Someone needs to nail some theses to the White House door.

    3. “WTF, WTMFF! was the point of passing this to begin with if everyone who pays off the administration is going to be granted an exemption???”

      The question answers itself.

  2. Depends on how fast government healthcare kills sick people.

  3. so providing medical coverage for tens of millions of people through a bloated government bureaucracy won’t actually save money?

    1. At least the guy was honest and basically says that if we are going to pay for health care for everyone, we have to pressure the researchers to quit coming up with all these fantastic treatments that cost a lot of money.

      Universal access, low cost, high quality–in a health care system you are doing well if you can have two of these–take your pick.

      1. I reject that on its face.

        Technological change breeds more and more access.

        All the Mayans in the Yucatan have cell phones. I’ve seen it myself.

        Lower costs and high quality breeds access.

        1. But technological advancement is relative. What was high tech 50 years ago is low tech today. People will always clamor for the coolest, most advanced stuff available–whatever that is at a particular point in time–if someone else is footing most of the bill. If the govt gave everyone a $50 cell phone people would be bitching because they’d want a $1000 top of the line model.

          1. Yes, that’s what drives technological innovation!

            People clamoring for it.

            They invented a pill that cures impotence because people were clamoring for it.

            It starts out expensive and becomes increasing less so over time.

            So long as it’s something that can be mass produced–like all medical technology can–it always becomes increasingly less expensive over time.

            There’s nothing mutually exclusive about technology and things becoming less expensive–quite the opposite actually! Today’s ubiquitous and cheap healthcare products were yesterday’s technological breakthroughs.

            1. Any guess as to where tomorrow’s cheap ubiquitous healthcare products will come from?

              Just because some presidential jackass believes something, doesn’t mean it should be taken seriously.

            2. Viagra and its ilk don’t cure impotence. They ameliorate its effects. There’s a difference and it means that the drug must be taken as long as one keeps wanting to have sex. Although it does become cheaper as it goes off patent and as the result of competing products coming to market while it is on patent, it still creates an enormous category of expenditure that was never there before, resulting in an increase in the total amount outlaid for health care.

              By the way “erectile dysfunction” is something which every male will generally have at one time or another if they live long enough, making it a norm. Hard to see how drug manufacturers managed to get something that is a norm to be classified as a disease state. The only reason was to get access to the dollars pumped out of Medicare. Something which should be a convenience product and not covered by insurance instead becomes a money pit for the pharmaceutical industry, with physicians under pressure from their patients to prescribe it, despite the risks associated with nitrate based medications.

              The best way to prevent, not cure, erectile problems when you get older is to take care of your body when you are younger. Stay in shape so that you don’t become obese, don’t develop diabetes and hypertension, and don’t smoke. Those are also the way to prevent most of the other chronic illnesses that consume a tremendous amount of health care spending. The kicker is that keeping yourself healthy in this manner doesn’t cost Medicare anything. If you are really interested in holding down the costs of Medicare, having a healthier populace is it. That and they’ll be more likely to be able to get it up. Even if they can’t, they should pay for that out of their own pocket.

              1. I’ll be sure to keep that in mind.

                In the meantime, blaming technological innovation for high costs remains bullshit.

            3. Actually, they invented Viagra when they were looking for a treatment for angina. They thought they had the answer in Viagra, but people reported it did nothing for their angina but a lot for their penises.

      2. Universal access, low cost, high quality–in a health care system you are doing well if you can have two of these–take your pick.

        Actually you can largely achieve these goals if you just take third-party payment (i.e., giving people free money to buy things they want) out of the equation. But as George Carlin once said, we don’t have time for rational solutions.

        1. If what he was saying were true, kids couldn’t afford cell phones.

          If what he was saying were true, we wouldn’t be able to buy laptops for less than $400.

          There’s nothing mutually exclusive about technology and accessibility.

          For Christ’s sake–he’s typing on a color monitor that probably would have cost thousands of dollars five years ago.

          It’s absurd.

          1. The difference is that kids are limited in their ability to run up cell phone minutes by their battery capacity, their free time when they’re not in a place where they can’t use the phone, the availability of their friends to talk, etc. Not to mention that if they have a bill one month that’s too high, their parents can shut off the phone. Not even close to a valid comparison to health care, particularly single-payer, unlimited access. There are no cost controls whatsoever, other than the imagination to come up with new symptoms and diseases needing investigation and/or treatment. Noticed how many kids are on pharmaceuticals for mental illness these days? It’s something like 1 in 6. Do you really believe that there’s an organic cause behind going in the span of one generation from having a kid on psych meds being a rarity to now having things like ADHD and depression being common pediatric diagnoses?

            It’s called a false dichotomy. You are guilty of it. Have a nice day.

            1. Did you mean to say “Straw Man”? Or perhaps “Red Herring”? “False Dichotomy” fallacies have to do with a false choice between two options when there may be other option available. Get your fallacies straight.

              1. Whoops. My bad. Typing while actually working will do that to you.

                1. Are you suggesting there’s something special about healthcare that makes technological innovations not drop in price over time…like it does and has in every other industry for eons?

  4. I want to know it it will save lives

    1. I want to know that you’ve died. Can you die, please, you intolerable little skank?

      1. Warty that’s harsh…..especially so early in the thread.

        1. fish, he’s not being harsh-that’s Warty foreplay….”dirty cunt” is next, and then the final coup de grace is “baby, I’m your piece of shit….ahh I’m cum….mommy…Don… Marquis

          1. Well as long as it’s consensual.

      2. Daddy’s Calling…

    2. Yes, it will save lives. Which will lead to over population and global warming. Which will destroy the world.

      1. Luckily though, it probably won’t save lives. So the world is safe from Armageddon .

      2. Mango Punch, are you arguing that MMGW exists? Even I don’t believe that shit

    3. I want to know it it will save lives

      Since no one dies from a lack of health insurance now, I don’t see why it would.

      1. RC I’m glad you have the company line down pat; good little drone

        1. I am unaware of a single person whose death certificate lists the cause of death as “fatal deficiency of health insurance”.

      2. btw i written an bloog entre about u otday RC

        1. Somehow, I am not motivated to click the link.

          1. Don’t bother. It’s a very poorly constructed blog as the background obscures all of the text. I find that very odd.

            1. screen capture it and send it please-ok pretty please

  5. NOW you tell us this, Mr. Foster? Why the hell didn’t you tell everyone this while the democrats were in the process of lying through their stinking rotten teeth and ramming it down America’s throat?

    Thanks a whole lot for nothing, you fucking asshole.

    1. It wouldn’t have made a difference;

      The people who voted for the law were going to vote for it regardless. It’s a law that is designed to create a system that fails.

      1. It’s a law that is designed to create a system that fails.

        Like entropy?

      2. The people who voted for the law were going to vote for it regardless.

        This is not true. This information easily could have kept many blue dogs and the few republicans that voted for it on the fence.

        1. He did say this at the time. It’s that the media didn’t care, nor did the Democrats. The entire reason that the Republicans called him before the committee was so that he could share this.

          Getting the majority allowed Republicans to give the actuary a platform, instead of Democrats ignoring him and his reports.

  6. If you can put that pressure on the research and development community, you might have fighting chance of changing the nature of new medical technology in a way that makes lower cost levels possible.”

    And the best way to do that is… Have consumers of a service pay for it!!!!

    When the consumers and the payors are different people, there is little economic incentive to come up with lower cost solutions.

  7. True or False: ObamaCare Will Bring Down Medical Costs

    False.

  8. True or False: ObamaCare Will Bring Down Medical Costs

    It depends what the definition of “bring down” is.

    1. If you’re going to mock me, at least do it with proper tags.

  9. Interesting TARP ##s rough:

    Total outlays: $400b
    Repayments: $200b
    COB loss estimate: $28b

    Not saying it was a good idea, but a $28b loss is far, far, super far from the $700b bailout/loss I would suspect most people think we incured.

    1. I’m not sure how $400BB minus $200BB = $28BB.

      1. Projected loss estimate. There’s $200b outstanding, and the COB expects we’ll get $172b of that back.

        1. Sounds like those figures fail to account for the interest we’ve paid in order to borrow the money in order to give to the banks. Although that’s not likely a huge figure, it still should be considered part of the analysis.

          1. So, what happened to the money once it was paid back?

            …returned TARP funds become part of the general revenue of the federal government. The money is treated just like money paid by taxpayers. It simply becomes part of the income of the government that will be spent by politicians and bureaucrats. There’s no lockbox or segregated fund.”

            http://www.businessinsider.com…..z1CGYdinD5

            So, excuse me if something’s changed, but I didn’t fall for Al Gore’s lockbox, and I haven’t heard about the government returning $700 billion to taxpayers or retiring $700 billion of debt either.

            We’re not getting that money back.

            C’mon guys, we’re libertarians. …we’re smarter than this!

    2. The SIG’s most recent report on TARP is not nearly as rosy as your numbers suggest. True, it says “On the financial side, TARP’s
      outlook has never been better”, but only after it says “TARP remains a study in contrasts.” SIGTARP cites the CBO loss estimate at $25B, and adds that TARP could even break even if all works out well with AIG.

      However, the SIG notes that TARP has had “significant, non-financial costs” such as “damage to Government credibility”, “failure of programs to help Main Street rather than Wall Street”, and “the moral hazard and potentially disasterous consequences associated with the continued existence of financial institutions that are ‘too big to fail'”.

      SIGTARP is only responsible for the TARP in particular. However, TARP was only part of a much larger bailout program. He has no responsibility for the problems that it shuffled off to the Federal Reserve Bank, which are of world-historical enormity.

      1. I refuse to entertain an argument about how necessary TARP was predicated on evidence suggesting that it was unnecessary.

        1. I remember when a lot of those recipients fought like hell to pay the fund back–and the government wouldn’t let them…

          I remember Obama remaking Wall Street in his progressive image and using TARP as his justification for that…

          We haven’t seen the end of the TARP story yet–that’s true. But the costs of TARP weren’t the only damage done–what about all the shitty legislation the imposition of TARP supposedly justified? What about the moral hazard going forward?

          We may never see the end of those costs.

      2. Yep, I’m not saying it was a good idea. Just that the losses are much lower than what most people assume are US$700b.

        1. So how much money did you get back?

          I’d love to have you guys as investors!

          You give me $700 billion out of your future paychecks, and then I’ll go invest it somewhere.

          …and if I make the $700 billion back? Then I get to keep the $700 billion!

          I won’t give you any of your money back–and you guys will think I did a great job?!

          Please email me so I put you guys into an investment like that!

          1. We’re libertarians!

            We’re smart!

            Smarter than this.

    3. So it’s not important that the bailout was completely illegal if the projected numbers don’t look too bad?

      You know who else believed the ends justified the means?

      1. SAY IT!!!!

        FUCKING SAY IT, YOU KNOW YOU WANT TO!!!!

        1. Evil Knevil?

          1. It’s spelled with an “e” as in Evel.

  10. So Obama lied??? Is that surprising?? When has he told the truth about anything?? He may go down as the biggest bullshitter in history.

    Want to bring down costs while maintaining or improving quality? How about a free market.

    But Obama and his fellow fascists don’t believe in free markets.

    1. Even worse, he believes his own bullshit.

  11. I would say false, more so than true

    Because it can both bring down and increase medical costs at the same time. After all, up is down, left is right, right is wrong, freedom is slavery, and words have no meaning.

  12. I love how NPR says “Republicans voted to repeal healthcare.”

    It’s a poorly-worded, question-begging statements that does nothing to defeat the common perception of NPR as having a specific and apparent political bias.

    1. Also, puppies are now illegal. No more puppies. Republicans ate them.

      This has been an objective, government subsidized message brought to you for your own good.

      1. I have been listening to NPR forever.

        Even before I classified myself as a libertarian.

        I have often wondered why the hell I listen to it and I think I have finally figured it out.

        NPR is like watching the Movie “Downfall” Essentially NPR is an extreme compared to the American public who are just right of center. Because of this NPR is perpetually falling apart. Always failing and always trying to justify their extreme left wing views despite overwhelming opposition to them.

        It is a delight to listen to the screams of the disillusioned left as their world comes tumbling in on top of them. NPR delivers this on a daily basis.

        1. NPR is a valuable resource for libertarians.

          I’ve listened to NPR since 1979 because it is the most intelligent and accurate expression of the observations and analysis of America’s ruling elite.

          1. Ah, “know your enemy” and all that.

        2. I think “extreme left wing views” might be a bit strong. I know some people with extreme left wing views and that is not what I hear on NPR.

          1. I know some people with extreme left wing views and that is not what I hear on NPR.

            NPR is to the left of Obama and that is pretty far left when you look at the average American.

            The poeple you know encompass about 1% of the population. NPR shares its views with maybe 20% of the population….

            I am sorry if you can’t get over 30% then you are extreme.

        3. It’s pretty left-leaning, but even more, it’s state-loving. Everything starts with and ends with the federal government. Major, major bias.

          1. Da, comrade.

            Everything for the State, nothing against the State, nothing outside the State.

    2. It’s a poorly-worded, question-begging statements that does nothing to defeat the common perception of NPR as having a specific and apparent political bias.

      “Obamacare” isn’t accurate either. NPR is left wing. everyone knows that that cares. It is not as if the majority of americans don’t want it repealed it anyway and it is not as if they are unable to read the code words NPR puts out there.

    3. Re: DanD,

      I love how NPR says “Republicans voted to repeal healthcare.”

      Yes. I also heard they would repeal the sun so those “green jobs” in solar tech the president loves so much would not appear – just out of pure spite, those out-of-wedlock-born(*).

      (*)Disclaimer: In light of what the Editors’ disclaimer says, my posts will feature only purely descriptive language and not offensive language, so I will not use such terms as sheepfucker when describing someone, but instead will say “one that loves ovines.”

  13. Threadjack:
    This is interesting, US lawmaker unveiled legislation on Wednesday to protect individuals who tip off authorities to potential extremist threats from lawsuits, in the event that they turn out to finger innocents.

    1. Link broken

  14. What a bunch of cynics!!!
    Next thing, you’ll be saying that real estate doesn’t always go up, Fannie Mae is great for homeownership AND taxpayers, the high government officials at the Fed and Treasury know exactly what they are doing, and manage the economy to assure the lowest unemployment and inflation and the highest income, as well as a endless supply of unicorns that dispense soft serve chocolate ice cream from their…built in soft serve chocolate ice cream dispensers. (what did you think I was gonna say???)

  15. If you can put that pressure on the research and development community, you might have fighting chance of changing the nature of new medical technology in a way that makes lower cost levels possible.”

    This is a statement that anyone that has ever negotiated with anyone for anything knows to be true. How to achieve it in medical care is the billion dollar questions.

    One way to do this is to tell providers that you will only pay this much for a service. Insurance companies and Medicare do this everyday. It is effective way to control costs and encourage innovation. It is what the intent behind the Medicare caps included in the Affordable Care Act. Congress routinely caves into pressure from doctors and hospitals on these issues and there is no reason to think this will change in the future.

    On the other hand, asking individuals to take charge of their medical spending is also unrealistic. First, the information on quality is not available. Hospitals, doctors and other health care providers do not routinely disclose their success or error rates in a manner that is the average person can understand.

    Second, the majority of people do not have the necessary educational background to judge the best course of action in most medical situations. Third, in an emergency situation, the care you need is time sensitive and waiting until you do your research is not an option.

    So while Ryans plan will shift the burden on to individuals if it is done without the support structure to enable good decision making it also will fail. Medical care is not like shopping for a car. It is a unique good that requires more than a marginal level of expertise and a great deal of information. To pretend otherwise is crazy.

    1. “So while Ryans plan will shift the burden on to individuals if it is done without the support structure to enable good decision making it also will fail.”

      So how does the current system aide in ones quality choice that this system wouldnt?

    2. Yet most people don’t seem to have any decision-making problems when it comes to cosmetic surgery or Lasik/other optometrical services. (generally uncovered services).

      Try again.

      1. exactly, and these procedures have all come down in cost in real terms over the past decade even while the technology has imporved in quality.

    3. “On the other hand, asking individuals to take charge of their medical spending is also unrealistic. First, the information on quality is not available. Hospitals, doctors and other health care providers do not routinely disclose their success or error rates in a manner that is the average person can understand.”

      Yep, under the *current system*, that info is hard to get. Presuming it would be so otherwise gets you the bronze in the conclusion-jump competition.

    4. Bullshit. Every time I need medical care my non-medical knowledged ass doesn’t call the government to tell me what is best for me because they don’t know me or my doctor any more than you do. In an emergency I’ll go to the nearest ER with or without government assistance. In a non-emergency I will find a doctor that is capable of helping me with what I think needs help and if I don’t have confidence in that doctor I’ll find another one, all without the government knowing it is happening. What is some bureaucrat going to be able to tell me? That the procedure I want is too expensive for the community to pay for? Fuck him. If I need or want it bad enough I’ll figure out a way to pay for it, probably with the help of the insurance company I have contracted with to finance such things.

    5. The entire concept of “putting pressure on the R & D community” is idiotic. Innovaters respond to incentives not “pressure.” Give them a little free market incentive to lower costs or increase efficiency and then you will see some results. There hasn’t been a free market in medicine for decades – that’s the real problem.

      As for your speculation about whether people have the ability to choose medical options wisely, it does have some merit. But you miss the larger point. Who’s better equipped to make medical/economic decisions for themselves – a handful of bureaucrats or few hundred million patients? Who will spend their hard earned money more wisely – a handful of bureaucrats or few hundred million people who earned it? Of course it’s the latter.

      1. Innovators respond to incentives not “pressure”

        Sorry Dave, but it took a whole lot of innovation to get astronauts to the moon. All that engineering and construction was born from political pressure, and funded by taxpayers.

        Given that, as you say, there’s no free market in medicine, it’s reasonable to assume that Uncle Sammy plays a large role in directing R&D dollars. Why can’t Foster’s idea work in the same manner that got NASA to space?

        (note: all SLDs apply)

        1. “Given that, as you say, there’s no free market in medicine, it’s reasonable to assume that Uncle Sammy plays a large role in directing R&D dollars. Why can’t Foster’s idea work in the same manner that got NASA to space?”

          Because ‘getting to space’ and developing pharms have near zero equivalence.
          Fail.

    6. Re: Centerist Cynic,

      On the other hand, asking individuals to take charge of their medical spending is also unrealistic.

      Don’t tell me! Don’t tell me! I got this one!

      “Because… people are stupid”?

      Did I get it right? Did I? Did I? Did I?

      First, the information on quality is not available. Hospitals, doctors and other health care providers do not routinely disclose their success or error rates in a manner that is the average person can understand.

      And it’s not like people make decisions based on experience or word of mouth – that never ever ever happens!

      Second, the majority of people do not have the necessary educational background to judge the best course of action in most medical situations.

      Indeed! So somebody should choose for them! And also somebody should choose their accountants, and plumbers, and electricians… because people do not have the necessary skills to judge all of them!

      Forget about Angie’s list and the myriad of consumer journals – NAAAAAH, those don’t exist!

      Third, in an emergency situation, the care you need is time sensitive and waiting until you do your research is not an option.

      Yes! Those lousy bastards, taking advantage of us suffering people! So it should be the same with plumbers! The government should manage those, because when I have the finger in the leak, it is not like I can exercise good judgement when reading through the Yellow Pages! I NEED HELP!

      So while Ryans plan will shift the burden on to individuals if it is done without the support structure to enable good decision making it also will fail.

      Yeah, the stupid people already have too much in their minds.

      Medical care is not like shopping for a car.

      No, of course not. Shopping for a car is MUCH WORSE. All those choices!!! I NEED GOVERNMENT – I’M TOO STUPID TO CHOOSE!

      Ok. Jokes aside, your prescription assumes too much – mainly, that people are too stupid and vulnerable to make choices when in an emergency, even though people seem to do fine in other emergencies, like: flooding, energy blackouts, fire, and the like. It’s only with Medical Care that millions of years of evolution of the human mind suddenly breaks down – IF one believes YOU.

      1. because when I have the finger in the leak…

        I don’t see what your wife has to with this.

        Ohhhh! (dice clay style)

        But yes, that was a great reply. Also worth noting is the potential for increased information availability in a more free health care and health insurance market as health care and health insurance providers have to compete more.

        1. If he would have said “finger in the dyke”, you would have had something there.

    7. Making standardized information on quality available would be one case where government intervention could be useful (and at the very least, falls within the definition of things the government often does in other industries). Of course, the better-performing hospitals could agree on a standard and put together something themselves. They have little to lose from it, and the lower performing hospitals will have to choose between openly disclosing their shittiness or letting people wonder what they have to hide if they don’t participate in the system.

      In regard to the question of “education”, it might be best to encourage a separation of function and interest between those who diagnose and advise, and those who treat. The role of doctors would be to prescribe, the role of specialists and pharmacists and medical techs, to treat. We could then treat failure to disclose conflicts of interest the way we do in other industries.

      Emergency care isn’t actually the issue that people make it out to be. I don’t think it’s ER treatment that drives individuals or the government into bankruptcy, nor is there an issue with people being denied emergency care. For emergency care, the best approach is to let medical professionals provide treatment without anyone worrying about cost — if someone wants to argue after the fact that some treatments were improper or unnecessary, the lawyers and bureaucrats can wrangle over it then.

      1. The problem you are failing to grasp is that there isn’t agreement in the medical community over which numbers reflect good care and how to objectively measure them. The current Medicare quality measures are a bunch of garbage that have absolutely nothing to do with good care and everything to do with running up costs and incentivizing overtreatment. Plus, it’d be easy as a physician to pad my numbers by only agreeing to take on cases that are likely to result in good outcomes. If I’m a surgeon, I can take out gall bladders on young, healthy women all day long and have my numbers look great, while ignoring the morbidly obese diabetic who is more likely to have complications. I still might really suck as a surgeon, but you’d never know it from my outstanding numbers. The best doctors often end up with the most difficult and complicated patients and even the best physician cannot keep someone alive forever. The ranking system you’re talking about exists now and doesn’t work worth a damn in terms of identifying good care. Why not try a free market solution instead? “The more free market and choice oriented method wouldn’t be perfect so we should keep tweaking the current restrictive system” argument that you’re making is bogus.

    8. “If you can put that pressure on the research and development community, you might have fighting chance of changing the nature of new medical technology in a way that makes lower cost levels possible.”

      …he typed on his $170 24″ HD monitor.

      This is all a solution in search of a problem!

      1. +1, I would give you more, but for the fact that you type on keyboards, not monitors.

      2. More of a power grab in search of a pretext, but whatever.

    9. “the majority of people do not have the necessary educational background to judge the best course of action in most medical situations”

      Actually this statement is incorrect … “most” medical situations are in fact handled without requiring professional medical services with simple medications like aspirin and simple medical devices like bandaids.

      Your intended point, I think, is true, but it is true for all sorts of consumer decisions.

      That’s why organizations like Consumers Union, Underwriters Labs, and Angie’s List exist. That’s why If an adequate number of individual health care consumers existed, the quality of information about the cost, quality, and efficacy of medical services available to consumers would be there.

      How many Internet users, for example, really have the faintest idea how their computer works? Somehow consumers are able to make decisions about completely unfathomable technologies without government. They could make medical decisions just as well.

      1. “the majority of people do not have the necessary educational background to judge the best course of action in most medical situations”

        What are you, a creationist?!

        If what we know about human evolution has taught us anything? It’s that people are pretty good at making decisions about their own survival.

    10. “On the other hand, asking individuals to take charge of their medical spending is also unrealistic.”

      Speak for yourself. I do not have health insurance; I do not need it. I never will.

    11. Medical care is not like shopping for a car getting your car repaired. It is a unique good that requires more than a marginal level of expertise and a great deal of information.

      FUYA (fucked up your analogy)

  16. I thought the idea was that when you switch people from gov’t insurance (medicaid, some medicare) to private insurance and health care, it saved the federal gov’t money.

    I realize this is a highly-regulated mess [per usual], but in theory, wouldn’t libertarians want people moved from public healthcare rolls to private ones?

    Or, no, we don’t want that?

    1. That’s an absurd notion that’s been debunked around here a hundred times.

      Medicare and Medicaid don’t pay for the costs of care–only a fraction of it. Hospitals make up the difference by gouging private pay patients.

      Just because Medicaid and Medicare patients don’t have to pay for their own treatment–doesn’t mean the government does…

      That’s why they won’t let anyone set up a private hospitals and refuse treatment to people on Medicare and Medicaid. That’s why inner city hospitals all over the country are in trouble–because they don’t have enough private pay patients to gouge to make up for all the money they lose treating people on government programs!

      Get a clue.

      1. Those hospitals almost always get local subsidies from the state & city for indigent care.

        That’s the thing, we’re already paying for universal health care, one way or another. Maybe it’s not the most efficient system – but you don’t fix it by doing something even worse.

        1. No, they don’t.

          The one I worked in closed.

          King Drew Medical Center Closed.

          There are lots of other hospitals slated for closure, and almost all of them have one thing in common–they serve communities with low rates of private insurance.

          “A 2005 report by the State University of New York Downstate Medical Center on hospital care in the 100 largest U.S. cities and their suburbs determined that from 1996-2002, public hospitals closed at a far great rate than for-profit or private nonprofit hospitals. The report also found that hospitals underserve high-poverty suburbs while low-poverty suburbs brim with them.

          http://newamericamedia.org/201…..nities.php

          Read the whole article. They’re the political opposite of me–the only thing we agree on is the facts.

          The emergency room access we lose because of Medicare and Medicaid under payment won’t be in wealthy white suburbs with lots of private insurance, I’ll tell you that!

        2. Why do you think PPOs go so far out of their way to keep you from getting service at a hospital they don’t have a contract with?

          It’s because they get gouged horrendously! That’s why the guys the in the business office of those intercity hospitals high five all around when a PPO patient comes through the ER–when the PPO can’t deny the claim!

          The name of the game is serving as small Medicare/Medicaid population as possible–and getting as many privately insured patients as possible in your beds…

          If you’re losing money on every Medicare/Medicaid patient–you can’t make it up in volume!

  17. wouldn’t libertarians want people moved from public healthcare rolls to private ones?

    Sure. If, however, you think Obamacare will do that, you are mistaken.

    In fact, Obamacare’s most immediate effect, apparent right now, is skyrocketing Medicaid enrollment.

    1. “In fact, Obamacare’s most immediate effect, apparent right now, is skyrocketing Medicaid enrollment.”

      I guess one person’s “skyrocketing Medicaid enrollment” is another person’s “bridge to the future”.

  18. True or False: ObamaCare Will Bring Down Medical Costs

    “Oh! Oh! Me! Me! Me!”
    “Ok, Jimmy – so, true or false?”
    “FALSE, miss! It’s False!”
    “Wrong! The Great One said it was true so it MUST be true! ‘F’!”
    “Whaaaa…..t?”

  19. Off Topic, but this map is fascinating:

    “What is your state worst at?”

    http://dc-cdn.virtacore.com/20…..Shame2.png

    1. I feel lucky to live in VA, and not drive a motorcycle. Oregon seems like a rather lively state. Party animals?

      1. Washington, not Oregon.

    2. I can live with nerdiness. In fact I do, every day of my life.

      Still, I’m shocked that “College Football Obsession” isn’t there instead.

      1. Better than your heart attack neighbor, that’s for sure.

    3. Well, NJ is no surprise.

    4. Steve Smith lives in South Dakota?

    5. “What is your state worst at?”

      Female Criminals? Niiicccceee. Doesn’t Epi live in Seattle? This map makes it all clear.

    6. Is the map saying that Utah has the most porn usage, the least, or that its citizens don’t know how to use porn?

  20. I want to know it it will cure my genital fungus

  21. There are lies, there are damned lies, there are statistics, and then there’s Obamacare.

  22. The answer to health care is high speed rail.

  23. According to my opinion, in principle President Obama is right to provide cheap health insurance for residents.

    However, the consequence is a big cost but in the long term this will really help the poor people who need health insurance. http://rajomedia.com/online-ca…..hoose/231/

  24. Rates are heading up and fast. Unless we change the bill, we’ll see only a few insurers, leading to certain single-payor. No thanks.

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