How Do You "Solve" the Health Care Problems?

Well, I think the first thing we should do is ask Americans to stop getting sick.

After that, we can ask them to stop shooting each other, injuring themselves or others, and other activities that will land a person in the hospital.

I think once we have those 2 down, we'll be fine.

I think we should all start going to the clinics they are opening at Walmart.  Walmart will squeeze the prices on healthcare just like they have on everything else making it more affordable.  Problem solved. 

Most of their previous price squeezes have resulted in American countries outsourcing to other countries in order to lower costs and meet the low price benchmark Wal-Mart wants. In fact, when dealing with Wal-Mart, the only way to effectively sell them anything for a margin is to approach them with a product that they don't have a benchmark for already.

How will they squeeze healthcare costs, I wonder?

I cant comment on the candidates views on health care, only on this conservatives view - which is leave it alone! No system on earth is perfect,and this one is not. But it does care for the people when necessary, and allows people the basic human right of choice.

ALl others deprive people of that basic human right, and compound it with problems of their own. IN essence, our system is not perfect, but it is a damn sight better than any thing else going on.

Thank you as always for a thought provoking blog article. Always a pleasure to read and comment on.

In 1960, healthcare costs represented 3% of the Gross National Product. Today healthcare represents 15% of the GNP. In other words healthcare spending has increased at 5 times the rate of the rest of the economy. We spend 83% more than Canada (9.1%) and almost twice the median percentage of other industrial countries (8%) with government administered healt plans.

Yet, conservatives continue to aver that our government cannot be as efficient as other governments. There is some reason to support this point of view.

President Bush has promised to veto a bi-partisan bill that would have required Health and Human Services to negotiate the best possible prices for drugs paid for under Medicare Part D. Thats right, we INSISTED on paying retail and not a penny less.

Other legislation enacted as part of the President's Medicare legistlation effectively crippled the ability of pharmacies to offer generic drugs to Medicare patients.

So, yes, as long as we have a Republican President pandering to Big Pharma, the government won't come close to being efficient. Can you imagine if we gave no-bid contracts to other companies...oh, wait. Haliburton. Nevermind.

We have flat out acknowledged that our government cannot do what almost every other industialized nation already does.

What are the consequences of this fiscal mismanagement? The Federal Government is already the single largest payer for healthcare. With, by the way, the lowest cost of administration (2% as compared to over 20%.) When healthcare costs rise so dramatically, it effects the entire economy.

I have elsewhere documented that many heads of major corporations have implored the Federal government to take action. In 2005, Richard Wagoner, chairman and chief officer for General Motors, addressed the Economic Club of Chicago. "Failing to address the health care crisis would be the worst kind of procrastination," Wagoner said, "the kind that places our children and our grandchildren at risk and threatens the health and global competitiveness of our nation's economy."

He was ignored. GM has already laid off more than 40,000 workers since 2006. Earlier this month, on February 12th, GM offered buyouts to the entire US manufacturing force, some 74,000 emplyees. Employees with more than 10 years of service can receive up to $140,000 in a lump sum payout...if they give up their pension and health benefits. Effectively this would dump tens of thousands of families into the pool of the uninsured.

Chrysler has announced that they expect to buy-out as many as 12,000 workers under a similiar plan.

John McCain, speaking at a Michigan factory that had just laid-off 200 workers, said that jobs lost to overseas competitors "are not coming back." Unemployment in Michigan is already 50% higher than the national average and is expected to reach 8.7%. In all fairness, John McCain has promised to create new jobs, but didn't say where or how. Can you say "food service industry?"

John McCain may be the only candidate for President to actually speak out against "hope." In the same speech that he used the phrase "secure the dream" he also said that "hope is a platitude." Yes, I understand that he was attacking Barach Obama's vision for an economically strong America with health care for all, but saying there is no hope? That is scary.

Maybe the answer is to vote for someone who does offer hope.

 

Larry, how does going from 3% of GDP to 15% constitute by definition a "bad" thing? It's not like that money goes into a rat hole. The automobile industry went from 0% of our GDP to something like 15% - was that a bad thing? The very industry that permitted you to post your comments has gone from 0% of our GDP to god-knows-what. Obviously, arguments based on the notion that there is a "right" amount of GDP to spend on something/anything don't move me much.

Daiwa, an astute question, but one that I think I answered. Under our current system big American companies are being bankrupted by costs that are spiraling out of control. Now some might say "Who cares if GM goes bankrupt? I can still buy a Toyota." But as an American I want to see out companies compete on a level playing field. And a national health care policy is part of that.

Single payer health care seems a reasonable step to me. But if not that, can we at least agree that the Federal Government, as the largest payor and custodian of our tax dollars, should work to get the lowest prices? Here is an article from Fortune Magazine, not exactly a Socialist journal, on how Big Pharma works the system: http://money.cnn.com/2008/02/19/news/companies/generics_patent_settlements.fortune/?postversion=2008022005

In short, they pay makers of generic drugs not to go to market with those drugs. The FTC is investigating the practice as is the EU. Members of Congress from both sides are proposing legistlation to make the practice illegal. (It is certainly in restraint of trade, which is why the FTC is already investigating.)

One of the things that I just don't comprehend is how opponents at the facts, at countries like Canada and Switzerland and Sweden, and say "Well, sure, those countries provide a better quality of care for their citizens at a LOWER cost, but we in the United States have lost the ability to make impactful change."

To summarize: Americans pay more than almost any other industrialized nation for healthcare. TWe allow Big Pharma to artificially inflate these costs. While the costs have risen meteorically over the past 40 years, the quality has declined. Our Republican President has vetoed legistlation that would at least attempt to control some costs. As a result of these rising costs, major companies are laying off tens of thousands of workers. If these workers are re-hired, it will be without healthcare or with diminished care, placing even more of a burden on an over-taxed system.

And John McCain says we have no hope of fixing the system.

Island Dog, something that you said troubles me.

"Conventional liberal thinking is that the government (and more money) can solve anything."

I don't think we Liberals say that, but are you asserting that the Federal government can't solve anything? I think that I have offered enough in the way of response that healthcare is a problem. I think that I have established that for most industrial nations the proven response is a single payor system. There is no free market in healthcare, the major pharmaceutical companies have a long and documented history of unethical, if not illegal, practices.

Are you saying that Canada, for example, is capable of implementing a system that cuts costs by 40% and provides better care, but we in the United States can't do that? Are we too dumb?

Regarding the sorry state of the Veterans hospitals, are you saying that you trust the government to fight a war in Iraq, but not to take care of our wounded vets when they return home?

Because if you are saying those things...well, that seems very sad.

 

I say that Larry because in matters of healthcare, education, security, etc. the left always want to spend more money on the problem, than actually take on the real problem.  Education isn't good, well just give more money to the schools and that is not the way to solve problems.

I fully acknowledge healthcare is a problem, however as I have said, bringing the government into is definitely the wrong direction to go in solving it.  I was reading an article yesterday, and hopefully I can find it again, where the "free" government healthcare systems in other countries are failing due to several reasons.  One of them being that people have to wait weeks for simple procedures which in time gets worse, and the fact that people who smoke, drink, etc. are using up an enormous resource of the "free" healthcare system.




Partially, yes.

Here is what the healthcare in other "nations" is coming to.

http://www.dailymail.co.uk/pages/live/articles/news/news.html?in_article_id=515332&in_page_id=1770

By shifting all the cost of healthcare onto individuals in the form of taxes. If you really want the US to end up like Europe, that's the ticket.


I beg to differ. Not about costs per se, since they are directly measurable, but about your belief that quality has declined. That is simply a myth.

Life expectancy in the US has climbed significantly in every decade over the past 40 years. That can't happen while quality is simultaneously declining.

The technological advances in caring for life-threatening diseases have been mind-boggling. Death rates from heart disease, the number one killer 40 years ago, have been dropping like a rock. People spend a fraction of the time in hospital now for illnesses that used to keep them there for weeks. The development of laparoscopic surgical techniques has cut morbidity from acute surgical illnesses immensely. Gallbladder surgery was a very painful event that meant a 1-2 week hospital stay and as much as a month off work in 1975. Now, it's an outpatient procedure, sometimes involving one night in the hospital, and you are back to work in 2-3 days. We now have the luxury of early detection of diseases that used to kill people quickly once apparent (saving lots of money, BTW); they now live many more years "consuming" healthcare resources. Death is the ultimate cost-saving device in a system kvetching over cost. I could go on & on but I suspect you get the drift. The problem is all this progress is simply taken for granted.

Calculating the cost savings of such progress is damn near impossible because the bean-counters can't count the cost of things that don't happen. All they can do is count cash outlays, which gives a very distorted picture of the true "cost" of our healthcare system. I believe an argument can be made that the net cost to our economy is lower than in those countries with nationalized healthcare and that part of the reason the measured direct cost in those countries is lower is in no small part because of the indirect benefits of what happens here in our system.

I say we tax everyone at 80%, turn over all health care to the government, and then we can all feel good when people are dieing while they wait for government run medical facilities to treat them. That's the ticket!

Did you know that Walmart, more than any single source, is the reason so many of our goods are outsourced to China?

Just remember unintended consequences.

I don't think health care costs are a problem.

Larry wrote how healthcare costs have increased massively since the turn of the century.  Indeed they have. That's a good thing.

At the turn of the century, the average American male lived 48 years.  Today, they can expect to live into their 80s.  How much is an additional 30 years of life worth to you?

Then there's the quality of life we live. People generally live lives of health that would have been impossible to imagine 100 years ago. Even 50 years ago, disentary, yellow fever, ill health from infection, etc. were quite routine.

And yet liberals think that the increase in our health care is...bad?

When people talk about "efficiency" in health care I have to scratch my head. What constitutes "efficiency"?  Do we want "efficiency" in health care? We're not talking about running a train here or something. We're talking about our health.   

I don't want efficiency. If I have some illness, I want insane amounts of money spent to cure it. My cousin has stage 4 lung cancer. Do you know what efficient Spain, Belgium, Denmark, and Germany do? They make you comfortable while you die. Inefficient USA, by contrast, allows pepole via their insurance to spend hundreds of thousands of dollars to prolong life. Sure, it may only prolong life by a couple of years but that should be the choice of the individual, not the government.

Most liberal arguments of efficiency point out that most of the expense on healthcare occurs in the last 3 years of life. That's absolutely true. And my answer to that is: So what?  The decision should rest with individuals, not with government lackeys.

There are some powerful assumptions in that statement that remain very much open to debate, Larry. I'm not willing to accept it at face value.

The value judgment inherent in the argument that we spend too much on end-of-life care is that the individual has no value... to those making the argument. That's why turning such decisions over to distant third parties is problematic. The Wannsee Conference comes to mind.

Island dog- did you know that the average Cuban now has a longer life expectancy AND lower infant mortality rate than the U.S? I guess their free healthcare really did a number on them

As to the failing free healthcare here in Canada I can state that I am quite comfortable with it and it is not failing. In fact although I have out of country coverage if anything happens when I travel I prefer treatment back in country. If I get sick in the U.S, I will not seek treatment there. So long as the condition is not potentially fatal or debilitating I would be heading back to Canada post-haste! I have friends and colleagues that have done this, and for good reason- if you cut open your hand slicing a tomatoe and you need some stitches, maybe a tetnis shot for good measure to top it off the bill is thousands of dollars! All for a few minutes of time and a band-aid. THAT is a complete waste of money that could better be spent elsewhere. 

  I do not have any worries about getting sick and getting denied coverage because I had a "pre-existing" condition I did not disclose, or because I only bought the "bronze" coverage instead of the platinum. I do not have any worries about not being able to afford expensive prescription drugs should they be necessary. And if our healthcare really is failing like you assert, then why aren't the majority of people in other developed countries DEMANDING we switch to more privatized systems like the U.S?

The truth is that the majority of developed countries have some form of socialized medicine. If it really didn't work like you say, then they would switch to more privatized schemes. But they don't, because it does work! Universal healthcare is not the evil many make it out to be.

Sounds like you should pack up & move there, Artysim. Peoples' Paradise & all that. I wouldn't necessarily trust any numbers coming from the Cuban government, myself.

Daiwa, we are here to debate, right?

Here is the National Coalition for Health Care website, a good source for facts:

http://www.nchc.org/facts/cost.shtml

A Science Daily article entitled "US Ranks Last Among Other Industrialized Nations On Preventable Deaths, Report Shows" from last month: http://www.sciencedaily.com/releases/2008/01/080108082944.htm

A nice Wikipedia article comparing US and Canadian Health Care systems can be found at:http://en.wikipedia.org/wiki/Canadian_and_American_health_care_systems_compared

I was in Health Care finance professionally from 1980 through the mid-19990s. As an "expert witness" I provided documents and analysis for legislative and judicial bodies in New York, New Jersey and Michigan. I also provided testimony for the Claude Pepper's Congressional commitee and helped to enact Catastrophic  Health Care. I will be happy to share information on the state of health care in America and I think I can document and support all of my assertions.

Health care is an important issue that effects the American economy and our quality of life. I think debate is merited.

According to..whom? Michael Moore?

Sure, debate is merited. The problem I have is that the terms of the debate are framed in ways I don't accept.

As a lover of statistics, I know when statistics are being abused and health care debates are where they are abused the most. 

For instance, "US ranks first on preventable deaths".  Let's take that at face value. My answer would be: What does that have to do with universal healthcare? You made an assertion with no connection whatsoever. 

Your first step would be to demonstrate that there's a connection between the "40 million" uninsured Americans and that statistic.  Then you would need to identify who those 40 million people are.  And then you would need to demonstrate how universal health care might have prevented it and then you would need to make the case that other people should pay for their health care.

Larry, you are operating on the premise that many liberals operate on - that if only your opponents were more educated and enlightened they would come to see in the correctness of your viewpoint.  I don't accept that premise.

I don't care about "the people". I care about individuals.  If someone came up with a pill that cost $1000 a dose simply because of the raw costs associated that added 20 years of great health onto the average human lifespan, I want that pill. But in a socialized utopia, that pill would never exist because the cost would have been considered "inefficient" to research it OR I would be massively taxed to ensure everyone could have it.

Liberals like to say that everything we need to know we learned in Kingergarten. Okay,l fine: When a child is required to share a treat with the entire class or not bring in the treat at all you end up with a class with no treats at all.

Did you know the average American has freedoms?  If you think the Cuban healthcare system is so great, why don't you go talk to some refugees from Cuba and hear their stories.

 

Because it's a political disaster.  Once it's implemented there is pretty much no going back no matter how bad it gets. 

 

Actually it is.  I have been reading extensively about the problems with "universal" healthcare and unfortunately, the democrats and media don't talk about the things like I posted above.  I have also been reading that more and more people are opting for private healthcare because the systems are failing.

 

I would also add to what Island Dog said. Once an entitlement has been enacted, it's political difficult to remove.

Social Security is a disaster and yet there's no political will to fix it. Inertia is a powerful thing.

Thanks for the references, Larry.

However, the NCHC starts with a conclusion - universal healthcare. The article you cite is a collection of selective statistics without context, I'm afraid, intended to support & justify the starting premise. It may be non-partisan, but it may not be wholly objective.

The Science Daily article is also couched in a very biased way, giving no information on baseline "amenable deaths" and whether those countries which improved at a faster rate had greater room for improvement in the first place. It's also an article about an article, not the source document. The following quote from the article is also telling:



I respect your credentials & experience, so let me tell where I'm coming from. I am a practicing physician, a general internal medicine specialist in private practice since 1983. I was Director of Clinical Services for a naval medical installation while I was in the Navy in the late 1970's. I practiced as a trauma/critical care specialist at a Level 1 trauma center for a little over 3 years prior to entering private practice. Over the years I've been Chairman of the Department of Medicine, Treasurer and member of the Medical Staff Executive Committee of my primary hospital. I've participated in a degree of clinical research over the years. I am an Aviation Medical Examiner for the FAA. I've served as a medicolegal expert in the fields of nursing home practice and medical malpractice. I have extensive experience at the system/society interface of our healthcare industry, both in the private sector and a socialized (military) system.

BS!  It might cost a couple of hundred but not thousands.  Sounds like a Canadian urban legend to me.  At least you would get treated.  I had a friend who cut his hand on a hotel mirror and was turned away from the ER because he didn't have $100 Canadian up front.

Health Care really isn't the issue.  Health Insurance is the issue.  The business of health insurance and medical billing is what it is all about.  Anyone on the planet, legal, illegal, whatever language, color, religion, etc. will get treatment here in the US.  How that treatment gets paid for and how much is charged is what we have to worry about.

I do think that people with pre existing health porblems should be able to get insurance.  Sure, it will cost them more just like auto insurance costs you more if you have a bad driving record.  But they should have the opportunity to be covered.   People need to be responsible for their own health care though.  If they don't have to worry about the cost, they'll take more risks and they'll go to the doctor for every sniffle which will impede care for those who truly need it.