“ . “The U.S. government is making a costly and open-ended commitment,” he writes. “Let’s not pretend that it isn’t a big deal, or that it will be self-financing, or that it will work out exactly as planned. It won’t. What is really unfolding, I suspect, is the scenario that many conservatives feared. The Obama Administration … is creating a new entitlement program, which, once established, will be virtually impossible to rescind.” Why are they doing it? Because, according to Mr. Cassidy, ObamaCare serves the twin goals of “making the United States a more equitable country” and furthering the Democrats’ “political calculus.” In other words, the purpose is to further redistribute income by putting health care further under government control, and in the process making the middle class more dependent on government. As the party of government, Democrats will benefit over the long run.
Mayo Clinic Criticized for Limiting Medicare Patients - washingtonpost.com
So I see this as more evidence that medicare underpays, and of course, if it were the case that taking on Medicare patients was profitable, Mayo would just hire more docs…but the fact is this is just another example of government screwing up in running healthcare, and btw it’s also their failure to properly regulate private insurance co’s that’s an issue…I continue to believe that we should rely on private insurance that’s better regulated…
“ The Finance Committee bill would postpone a big cut in Medicare payment fees to doctors that is scheduled to take effect in 2010, but then assumes the cut would take effect the following year and result in a 25% decrease in Medicare payments to doctors. The bill also sets Medicare payment rates for other health-care providers at rates below inflation. Congress often acts to postpone such cuts, under pressure from interest groups or in a desire to please voters, and many experts expect that to happen again. “I’m willing to bet you right now that won’t happen,” said Douglas Holtz-Eakin, a former CBO director and a top adviser to Republican Sen. John McCain when he was running for president.
—
Senate Health Bill Gains Momentum - WSJ.com
Obama is deceptive here. He claims he’ll cut doctors fees this much in the future, but the reality is he likely won’t and his plan will cost more than expected….
Op-Ed Contributor - Big Food vs. Big Insurance - NYTimes.com
an ok article but it agrees with me, so I like it more.
yes, one reason why American health care costs so much is because we have a horrendous diet here - and other countries eat more much healthily than we do..
yes, bad food should be taxed… I go back and forth on this issue…but yeah, I mean as long as the government subsidizes healthcare, then the government will pay your health bill and if you eat in an unhealthy manner, that ultimately costs the government money, so cheap, bad food should be taxed…. and of course, if anyone has trouble affording food, then of course the government should help out. That’s why the food stamps program exists…
The Telltale Wombs Of Lewiston, Maine : NPR
It was doctors, not patients, who drove medical consumption, and all kinds of things influenced the decisions a doctor makes when a patient enters his office. Sickness and patient preference play an important role, but a much smaller role than patients and the health care community had originally thought.
…
And so in the state of Maine began this incredible experiment. Four or five times a year each medical specialty would gather together for a kind Talmudic dissection of doctor choice conducted by the doctors themselves. They wanted to look at all the geographical differences, figure out why they existed, and then try to bring their medical decisions in line with one another. They figured that by doing this they could eliminate excess care.
[however when doctors left the meeting their behavior didn’t change much]
…
One reason some doctors mentioned was fear of lawsuits; some worried that if they didn’t do every possible thing they might get sued. Another reason was temperament — some doctors were clearly just more eager to take action than others.
…
For instance, it turns out that if you increase the number of doctors in an area, chances are that the use of medical services will rise. If there’s one doctor in a town with 100 patients, then he’ll schedule your heart checkups for once every six months, but if another doctor comes to town — and now the first doctor has 50 patients — the doctor will just schedule your heart checkups for once every three months.
…
the decisions made by your physician when you enter his office are profoundly influenced by the way that doctors get paid in this country.
Most of the doctors in this country are not on a salary but are paid basically like pieceworkers in a clothing factory. This is called “fee for service,” and the way it affects doctor behavior is clear
….
And while most Americans just assume that more care is good, it turns out that more isn’t always better for patients.
…
A couple of years ago Keller and some colleagues did an elegant study of one kind of back surgery in Maine, a procedure called discectomy. Keller found communities in Maine that had high rates of this surgery, communities with low rates, and communities that were somewhere in the middle. Then he followed patients who had had surgery in those communities over a five-year period to see how they fared. Keller says the conclusion was undeniable.
“In the high rate of surgery overall, the patient outcomes were the least good of those three categories. In the middle rates, the outcomes of the patients were in the middle. And in the low-rate areas — less frequent operations per capita — the outcomes were the best.”
The reason that areas with more back surgery did worse, Keller says, is that doctors in those areas were operating on people whose issues were less severe; that is, patients who might not have been good candidates for an operation. So the problems associated with the surgery probably outweighed the problems of their actual sickness. For them, more wasn’t better.
….
Fisher compared Medicare recipients with similar levels of sickness in areas throughout the whole United States. Fisher looked at places where elderly people used relatively few health care services and compared them with places where elderly people used a lot of health care services. “The patients in the high-spending regions were getting about 60 percent more care; 60 percent more days in the hospital; twice as many specialist visits,” Fisher says. “And yet when we followed patients for up to five years, if you lived in one of these higher-intensity communities, your survival [rate] was certainly no better, and in many cases a little bit worse.” … Fisher and other researchers estimate that almost one-third of the care given in our country today is that kind of care — care that isn’t really helping people. The United States spends more than $2 trillion on health care every year. So the cost of that 30 percent unnecessary care annually? $660 billion.
the way doctors get paid distorts health care, and leads to lower quality care….Also didn’t realize that doctor’s temperment could influence health decisions so profoundly, and of course insurance/malpractice system feels broken…
“ The talk of potential savings is a little beyond comprehension,” Grill said. “Why hasn’t it been saved before? It’s virtually impossible to save $500 billion and not do any cutting of benefits.
—
How health care overhaul could change Medicare - Yahoo! News
Believe Obama is pretty full of it when it comes to Medicare…He claims massive savings are possible….to make his plan look even less costly than it actually is…
Tort Reformed - Yahoo! Finance
Texas enacted reforms that include a reasonable limit on noneconomic damages for pain and suffering of up to $750,000 per incident. Since then, says Gov. Rick Perry, doctors’ insurance rates have declined by an average of 27% while the “number of doctors applying to practice medicine in Texas has skyrocketed by 57%.”
In … just the first five years after reforms passed,” Perry adds, “14,498 doctors either returned to practice in Texas or began practicing here for the first time.”
A 2006 Harvard School of Public Health study found that four of every 10 medical malpractice lawsuits filed in America each year were “without merit.” The Pacific Research Institute estimates that tort abuses cost every American family $7,000 per year.
Tiger Joyce, president of the American Tort Reform Association, notes a Massachusetts Medical Society survey published last November that found on average 18% to 28% of tests, procedures, referrals and consultations, and 13% of hospitalizations were ordered to avoid lawsuits.
Litigiousness and defensive medicine, says Joyce, add at least $1.4 billion to annual health care costs in Massachusetts alone, and national estimates range as high as $200 billion.
The accounting firm of PricewaterhouseCoopers says about 10% of the cost of health care services is attributable to medical malpractice lawsuits.
These are some pretty impressive stats, and looking at the Texas example, in theory more doctors leads to higher quality, more cost effective care… These numbers on the impact of lawsuits on health insurance costs and the degree to which they force doctors to do things they otherwise wouldn’t are damn shocking. And of course Obama is a total hypocrit for asking for tort reform “demonstration projects” at the state level, since many already exist….
In Canada, a move toward a private healthcare option -- latimes.com
Hoping to capitalize on patients who might otherwise go to the U.S. for speedier care, a network of technically illegal private clinics and surgical centers has sprung up in British Columbia, echoing a trend in Quebec. In October, the courts will be asked to decide whether the budding system should be sanctioned.
What System Does the US Have?
Would you rather have a fully privatized health care system like the one they have in America?
America doesn’t have a privatized system. The US government spends more money on health care per capita than any OECD country other than Norway. That’s just government spending, not the amount people spend themselves on private insurance or care. That’s not the amount spent per person covered by Medicare and Medicaid, that’s the amount spent on those programs divided by every person living here. This doesn’t include the obscene outlays for future expenses, this is how much the government spends now. The US government has pricing power in the programs it administers, yet still manages to be more expensive per person covered than any other plan (including Norway).
I find it amusing that people think that government is the answer to controlling healthcare costs when it spends more per capita; still this analysis is PER CAPITA, and that’s misleading because much US spending is on older people, and older people PER CAPITA are more expensive.
![U.S. Health Care Costs: Background Brief
What is driving health care costs?
Controlling health care expenditures requires a solid understanding of the factors that are driving the growth in spending. While there is disagreement on exactly what those are, some of the major factors to consider are:
Prescription drugs and technology – Spending on prescription drugs and new medical technologies has been cited as the primary contributor to the increase in overall health spending. Some analysts state that the availability of more expensive, state-of-the-art drugs and technological services fuels health care spending not only because the development costs of these products must be recouped by industry but also because they generate consumer demand for more intense, costly services even if they are not necessarily cost-effective. [5]
Chronic disease – The nature of health care in the U.S. has changed dramatically over the past century with longer life spans and greater prevalence of chronic illnesses. This has placed tremendous demands on the health care system, particularly an increased need for treatment of ongoing illnesses and long-term care services such as nursing homes; it is estimated that health care costs for chronic disease treatment account for over 75% of national health expenditures. [6]
Aging of the population – Health expenses rise with age and as the baby boomers are now in their middle years, some say that caring for this growing population has raised costs. This trend will continue as the baby boomers will begin qualifying for Medicare in 2011 and many of the costs are shifted to the public sector. However, experts agree that aging of the population contributes minimally to the high growth rate of health care spending. [7]
So basically, technology and drugs help people live longer and technology and drugs cost money, and then if they live longer, they have more health problems, and someone has to provide the more costly health care that’s required because they’re living longer - so that leads to even more technology and drugs, a true vicious circle…if you are a younger population that dies off at at early age because you’re clueless on health, then you’re not going to spend a lot on healthcare…so maybe all this extra spending isn’t bad - especially if you care about those around you living longer…and you care about living longer…..](http://9.media.tumblr.com/tumblr_kqgnvaDWK31qz7j9go1_400.jpg)
U.S. Health Care Costs: Background Brief
What is driving health care costs?
Controlling health care expenditures requires a solid understanding of the factors that are driving the growth in spending. While there is disagreement on exactly what those are, some of the major factors to consider are:
- Prescription drugs and technology – Spending on prescription drugs and new medical technologies has been cited as the primary contributor to the increase in overall health spending. Some analysts state that the availability of more expensive, state-of-the-art drugs and technological services fuels health care spending not only because the development costs of these products must be recouped by industry but also because they generate consumer demand for more intense, costly services even if they are not necessarily cost-effective. [5]
- Chronic disease – The nature of health care in the U.S. has changed dramatically over the past century with longer life spans and greater prevalence of chronic illnesses. This has placed tremendous demands on the health care system, particularly an increased need for treatment of ongoing illnesses and long-term care services such as nursing homes; it is estimated that health care costs for chronic disease treatment account for over 75% of national health expenditures. [6]
- Aging of the population – Health expenses rise with age and as the baby boomers are now in their middle years, some say that caring for this growing population has raised costs. This trend will continue as the baby boomers will begin qualifying for Medicare in 2011 and many of the costs are shifted to the public sector. However, experts agree that aging of the population contributes minimally to the high growth rate of health care spending. [7]
So basically, technology and drugs help people live longer and technology and drugs cost money, and then if they live longer, they have more health problems, and someone has to provide the more costly health care that’s required because they’re living longer - so that leads to even more technology and drugs, a true vicious circle…if you are a younger population that dies off at at early age because you’re clueless on health, then you’re not going to spend a lot on healthcare…so maybe all this extra spending isn’t bad - especially if you care about those around you living longer…and you care about living longer…..
The Evil-Mongering Of The American Medical Association - Forbes.com
Yeah, we need more doctors…and the AMA sucks for not letting us have them…
Still…yeah, the article is a bit nasty, and some details are conveniently de-emphasized…
but it’s more than just the AMA…. the government needs to fund more residency slots too…
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1785175
In 1997, caps were placed on the number of resident positions funded by Medicare. The American Medical Association believes these caps should be lifted and residency programs allowed to grow in those regions and specialties which need more doctors. We also believe that all payers (not just Medicare and Medicaid) should contribute to the costs of GME.
Also physician salaries are a low percentage of overall health costs (5% or so)…which to me was kind of shocking…
“On a PPP basis, all European countries in the graph except the U.K. have per capita GDP below America’s poorest state. In other words, if Italy, France, or Germany left the European Union and joined the U.S., they would be the poorest of the U.S. states, and the same would apply to the European Union as a group, and the same would apply to Japan.”
(via CARPE DIEM: MS Per Capita GDP (PPP) Higher Than EU, Japan via devin)
thanks hilker
Right, and this is partly because the US has better economic policies than Europe and Japan in general. Part of that is because we don’t have nationalized health care and the huge tax structures necessary to support it. The idea with healthcare is to provide subsidies so that everyone can buy health insurance, but not to go overboard like a lot of European countries do…
Government Has Twins! (You Get to Raise Them) » The Foundry
This is a fun video helping you visualize the amount you owe the government because of social security and medicare - yes you owe the government more than what it will cost to raise your own children. Crazy. I dislike how these entitlement programs are structured…They are giant ponzi schemes which I dislike…Of course health care needs to be reformed, so one can’t totally blame Obama for adding to this burden… but still - Someone needs to actually have some guts here, and so far it looks like Obama is gutless - Bush actually tried with a baby step, but he should have tried something harder… We need to decrease COLAs for social security, and increase premiums charged by medicare - and allow private insurers to compete with medicare…. this is the fastest way out of Ponzi-ness
Thanks hilker
