Does government know how to end health care waste?
This editorial in today’s WSJ points out that Obamacare rests on a number of unproven assumptions:
The main White House argument for health-care reform goes something like this: If we spend now on a hugely expensive new insurance program for the middle class, we can save later by reducing overall U.S. health spending…
The magic key is the dramatic variations in per patient health spending among U.S. regions. Often there is no relationship between spending and the quality of care, according to a vast body of academic research, most of it coming out of Dartmouth College. If the highest spending areas could be sanded down to the lowest spending areas, about 30% in “waste,” or $700 billion each year, would be saved. More than enough to pay for ObamaCare. Or so the theory goes.
The rest of the article (entitled “Obama’s health cost illusions”) is devoted to showing how stunningly little is actually known about what causes these variations in health care costs, how little evidence there is that the 30% actually represents waste, and how correspondingly difficult it will be for government planners to control costs—something they have little track record of doing even in simpler arenas than health care.
I wonder whether Obama actually believes in these illusions, or whether he’s just counting on the American public to believe them—which would be just as good for his purposes, if his goal is to get his health care reform plan passed on the basis of them.
The WSJ article is complex and somewhat boring. That’s true of all such matters, and I believe Obama is counting on this as well: the fact that most of the American public will not or cannot or haven’t the time to follow the arguments involved, or evaluate them objectively.
In addition, most newspapers aren’t making the case against Obama’s proposals, either because their journalists are so firmly in his pocket or because they themselves don’t understand the issues involved. Or perhaps both; the two are certainly not mutually exclusive. It’s no accident that this piece appeared in the Wall Street Journal, a paper specializing in financial matters, with writers who therefore have a certain amount of expertise in the field, as well as a readership interested in following such matters more closely than average.
I speak of the Obama administration as though it were a unitary thing. But, as this piece in today’s NY Times points out, there are disagreements and tensions in the group of economic advisers at the White House.
This is to be expected. There are a host of big personalities there—in particular, Larry Summers has a reputation for abrasiveness—and they each bring a different economic perspective and preference to the mix. But the results are also reflective of the lack of a coherent vision and organization, so that the different parts of the program sometimes seem to be at war with each other.
Let’s pretend for a moment that, god forbid, you break your arm. And somehow you end up with a team of doctors all trained at Obama University. As you lie there on the table in the ER, one doctor treats your arm by banging on the unbroken one with a ball-peen hammer. The second doctor takes the unusual course of setting your hair on fire. And the third one uses leeches.
Undeterred by your arm’s stubborn refusal to set, soon the doctors start blaming one another. And even though all of them are doing nothing but compounding your injury, none will take any blame. In fact, the louder you scream, the harder they go to work on you.
That, apparently, is what’s going on in the West Wing these days.
Green’s satire is, like all satire, exaggerated. But it underscores the point made by the Journal article, which is that—organized or disorganized—the President’s advisers seem to have no good idea of the actual (versus the intended) consequences of their actions in the real world.
A related point was made yesterday in a very different article on a different subject. Entitled “Think twice about ‘green’ transport, say scientists,” it points out that it is nowhere near as easy as people think to figure out the environmental cost of various forms of transportation. Those greenies who are so earnestly trying to reduce their carbon footprints may be inadvertently enlarging them instead:
Well, there could be a nasty surprise in store for you, for taking public transport may not be as green as you automatically think, says a new US study.
Its authors point out an array of factors that are often unknown to the public.
These are hidden or displaced emissions that ramp up the simple “tailpipe” tally, which is based on how much carbon is spewed out by the fossil fuels used to make a trip.
Environmental engineers Mikhail Chester and Arpad Horvath at the University of California at Davis say that when these costs are included, a more complex and challenging picture emerges.
It goes on, but you get the picture. These systems in general are far more “complex and challenging” than the simplistic propaganda uses made of them for political purposes would suggest.
What’s a person to do? Well, the old saying that applies to doctors might be a good guide for government policy as well: “First, do no harm.” This means that intervention in complex systems should be done with extraordinary care and only rarely. If that happens to coincide with the more conservative view of things, so be it.
Obama has made a very weak case that his health care reforms will actually save any money at all. I’m far from certain that he believes they will do so; he may just be using the best argument he can find to soothe the American people into going along. Once this is passed I cannot imagine that there will be any turning back.
As the WSJ says:
None of the complexities surrounding regional health spending variation would matter as much if the Obama Administration were merely trying to defossilize Medicare and save the federal fisc. But instead it is exploiting the looming bankruptcy of our current entitlements as a pretext to pass the largest entitlement expansion since 1965. And it is selling this agenda with a phony cost-control “plan” that doesn’t even exist.
My inescapable conclusion is that Obama knows this, and that he is using the financial crisis, and the overwhelming Democrat majority in Congress right now, to ram it home while he can.
And yes, he can.
I am in no way a health care expert. I have a few suggestions, why not first concentrate on the people who do not have insurance, not disrupt the entire system. Why not set up a Veterans Admin. like system that would not be fee for service, but would depend on salaried personnel, which would be available to the uninsured for a fee according to income. I also have a suggestion some people will not like, my husand and I had to enroll in Medicare because we have a small business. Why not allow all Seniors who wish to buy private insurance opt out of Medicare. This would certainly bring about some savings to Medicare.
It’s about redistributing healthcare to an underserved population.
My guess is that Barack does not believe health care reforms will save money, yet does believe health care reforms will be “fair”, i.e. will transfer health care resources to an underserved population of Americans.
The precedent is Charles Gibson’s questioning of Barack re Capital Gains Taxes. Barack did not deny that raising Capital Gains Taxes would result in less tax revenue to the government. He argued for the fairness of it even if, ostensibly, tax revenue were reduced.
The philosophical grounding for this is found, amongst other places, in Black Liberation Theology’s advocacy of redistributing income by any means necessary, including force of government decree. Redistributing healthcare certainly is a cousin of redistributing income.
An aside: What burns me about Black Liberation Theology (amongst several things) is that it throws religion right into the center of government policy. Jesus said “Render unto Caesar what is Caesar’s”. This was clear instruction to keep religion separate from government. Black Liberation Theology stomps all over Jesus’ message.
As in “more complicated than you thought”, I saw a study that said a Hummer is more enviromentally delicate than any of half a dozen electric or hybrid cars.
The key was not the mpg or emissions. The key was to calc the impact(s) from “dust to dust”, from mining the raw materials to disposing of them when the thing is scrapped.
Among other things, the surprising amount of nickel needed for the battery is horribly degrading to the immediate mining area–see Sudbury, ONT–and its processing and travel from continent for further processing is expensive in energy and emissions–and disposing of the battery is a real clunker not solved by the folks who think getting mercury in the rug when your lightbulb breaks is a conundrum.
After further reflection, that was not a run-on.
However, the more complicated calculations can be ignored until years later when we’re eating the results. Then we can be led to blame the nasty manufacturers. Again.
When I buy home insurance, I think of it as insurance against catastrophes – mainly fire, flood, and the like. Therefore, I’m reasonable sure that such an event won’t break me.
Why not the same for health insurance? Didn’t it used to be that way (I can’t remember how my parents payed for routine Dr visits 35-40 years ago)? Except for major (ie., expensive) medical procedures, perhaps we should be paying as we go.
This has the huge added benefit of motivating people to take better care of themselves so that they avoid the constant Dr. visits.
Foolishness. My prescient vision sees the following: NHS Bureaucrat…”I’m sorry sir/madam but the drug/procedure/treatment is much too expensive for the risk/benifits. I’m afraid I must deny services.” Sir/Madam…”Deny? But I’m a taxpayer. I gave of the sweat of my life and labor for this program. This was all supposed to be guaranteed!” NHS Bureaucrat…”Undoubtedly. But alas, you are only one taxpayer, whereas we must consider the many. Terribly sorry. Oh…by the way, the NHS thanks you for your lifetime of contributions. Good day.”
it cant end the waste since it grows by the waste and crisis it causes.
in the trash here they throw out stuff al the time..
one day i got permission to take this device with motorized micrometers and platforms on it. kind if nice since each micrometer and platform new was 15,000, and was just trash.
i liked it when they decided to improve things… they put dots on the floor for people to follow. problem was that a dot has no cardinal direction. so when there was in intersection, which way do you go?
i remember mentioning this in passing and got in trouble for it. but 6 months later they carved complicated arrows into the tiles and embedded these into the embedded circles. of course they ONLY did it at the one intersection where i got in trouble mentioning to the geniuses how stupid they were.
their ways of doing things will not work…
their only tool is a hammer… they cant promote, they can only inhibit. they even think they can promote by injibiting everything else. but they dont even work cohesivly… that is their rules are capricious, reacionary, stupid, and wholly incompetent.
they are currently killing THOUSANDS a year… (400-1200 in withholdin cancer information in the news this morning. 800 others starving to death from their care, and others pullint teeth with pliers)
but since its a buracracy, not a business, you cant do anyting about it. they even limited pay outs so after your screwed, they pay out, but hold the money disbursing it!!!
kill one its a trajedy, kill thousands and its a statistic and we get to experuiment on people.
mengele would be amazed how little protest there is today to his kind of experimentation on the population.
oh.
and its only one thing they actually want… its not lower caosts, its control
they control med, they then say they are justified in controllig your behavior to control costs.
so no more play is allowed, you mught fall.
to read somet of the things in the UK would make ones head spin. but its all predicated on a bunch of mediocratic people who beleive that talent doestn exist, and so any one with or ability or talent for a job is not allowed to have it. (or else they woudl show the otehrs up!).
they are idkiots who come up with very idiotic solutions that dont work at all!!!
and most of their methods are based on complete control.. that every failure is a faiulure of others not to comply with idiocy.. .
they say they will teach people to fly.
people then refuse to jump off the cliffs to learn
they then call them enemies and threaten to kill them… Those that fall slower are proof of progress in learning to fly.
here is how much lack of vision they have.
they are worried about polution… even though in time the whole contentent will be recylced and melted internally.
they are worried we will run out of supplies. in a solar system we have access to that has more material thatn all the material that makes up our planet, at our disposal.
they are luddites pretending that their ideology is very modern. when it amounts to stagnation.
animals move from one area and invade another. rather than that being seen as the great engine of speciation and development and man just a part of it, they spend billions trying to stagnate darwin… (in themselves too).
they are worried about nuclear waste… but we can dispose of it in the sun in less than 100 years… so why build containers and storage for 50k years (5 times longer than civilizatio has existed!)
with a galaxy to colonize they worry about population…
they are worried we terraformed earth to kill us, but yet if we had that power, how about terraforming mars to give us space?
they are just trying to stop progress cause each time it fractures, they lose control.
gossip fractured to news, news fractured to radio, radio fractured to tv… and tv fractured to the internet.
imagine where they would be witout the internet.
is it now any wonder why they want to control technology? it keeps screwing up their plans..
it causes too myuch trouble to march people into gas chambers.
better to conficne them to do themselves in.
abortion, eugenics, euthanasia, beuracratid rationing, failrue to respond to pandemics, etc.
If the government knew how to end health care waste why would they not work their magic to improve Medicare/Medicaid? The answer is that they do not have a clue. The distortions and added cost that the government already imposes associated with the existing entitlement programs is absolutely tragic. Just ask any hospital or medical clinic administrator. It is an absolute joke that our Congress would swallow such a specious argument.
Green’s satire is, like all satire, exaggerated.
is it?
A stroke victim died after an ambulance driver who had finished his shift drove to his depot to clock off instead of going to hospital. The driver complained to a colleague that he had worked 15 minutes’ overtime already and wanted someone else to take over. The condition of the patient, Ali Asghar, 69, from Stockton on Tees, in Cleveland, deteriorated during the journey and he died of a suspected heart attack after arriving at North Tees Hospital.
Scans showing possible cancer were not passed on to consultants for months at scandal-hit Mid-Staffordshire NHS Foundation Trust, MPs have heard. Forms detailing serious incidents also ended up in the waste paper bins of senior managers or in a “black hole”, the Commons Health Select Committee was told. Between 400 and 1,200 more people died than would have been expected in a three-year period, with the poorest examples of care at Stafford Hospital. Families described “Third World” conditions at the trust, with some patients so thirsty they drank water from vases and others left screaming in pain.
The heads of an NHS trust were told to apologise in person to the parents of a cancer patient who bled to death after a breathing tube was inserted incorrectly in his neck.
A nurse caring for a woman who died from excessive bleeding after undergoing a caesarean section had been too busy to read an operation report that identified a tear in the woman’s uterus, an inquest has heard.
Rebecca Murray, 29, died a day after giving birth to her third child at Bathurst Base Hospital on June 24, 2007. She had lost about one litre of blood – enough blood to soak through two pads, sheets and bed linen – and was forced to wait almost 20 minutes after nurses observed the blood loss before being given any fluids or before nurses called a doctor.
Thousands of patients could undergo unnecessary spinal operations because of new NHS guidelines on treatments for lower back pain, warn experts. Dozens of hospital consultants say the ‘cost- cutting’ restrictions mean more patients will end up having major surgery. They claim less risky procedures using spinal injections have been wrongly dismissed as ineffective, even though they help hundreds of thousands of patients with chronic back pain each year.
POTENTIAL swine flu victims are mingling with other out-patients at the first specialist clinic set up by Queensland Health to deal with the H1N1 flu crisis. The clinic, which opened yesterday at the Gold Coast’s Robina Hospital, is in an area separated from the main accident and emergency ward only by a room divider.
While medical staff and paramedics wear full bio-suits and protective masks when dealing with potential swine flu victims, general outpatients enter through the same door as those visiting the flu clinic and are not issued with masks. The flu clinic waiting area is only a few metres from the outpatient waiting room. Queensland Health yesterday refused to let the media film inside the flu clinic because of the risk of infection.
Tens of thousands of medical records have been lost by the NHS (National Health Services) due to a series of data security leaks. The health organization has been asked by the Information Commissioner now to tighten their data security. This year, 140 security breaches took place in NHS between January and April, which exceed the total number of cases put together from the local authorities and the central government.
14 NHS institutes have been observed to have broken the data regulations. According to Mick Gorrill, assistant information commissioner, NHS has offended laws by losing such confidential information. In one instance, the database of 10,000 people was downloaded onto an insecure laptop and the laptop was said to have been stolen from the home of the NHS employee.
An inquiry has been launched into how a patient died while one of the nation’s most experienced emergency doctors was in a nearby office and junior doctors attended a training session and were not available to help clear the crowded emergency department
Dozens of elderly people were left in pain and requiring further surgery after botched work by Scandinavian surgeons brought in to reduce NHS waiting lists, an investigation has found. An audit of hundreds of patients sent to the “flying doctors” for knee operations found that one in three suffered a poor outcome, with one in five cases so bad that the operation needed to be redone.
Dr Lal retained his registration after the Court of Appeal upheld a ruling by the Victorian Civil and Administrative Tribunal (VCAT) allowing him to treat patients. The doctor was refused registration by the Medical Practitioners’ Board because of prior sexual assault convictions and appealed to VCAT.
VCAT granted Dr Lal registration on the condition he see only male patients aged over 16. The tribunal ruled that he had a low moral culpability because an obsessive compulsive disorder contributed to his offending.
An extraordinary rise in the number of patients killed by drugs given out by the Health Service has led to calls for an investigation. The figure has more than doubled since Labour came to power, rising from 520 in 1998 to 1,299 last year. Official figures also show that the number of such deaths last year was up by more than a quarter on the figure of 1,030 recorded in 2007.
A mother-of-two died from meningitis three days after a GP told her worried family to ‘stop fussing’ and she would soon be ‘right as rain.’ Two doctors put Karen Finan’s symptoms down to a nasty stomach bug when they were called out to see her on successive days. But she became so ill she was rushed to hospital by ambulance and admitted to intensive care. Despite carrying out tests and scans, hospital doctors also couldn’t correctly diagnose the problem, said husband Darren Finan.
The 37-year-old mother’s brain became swollen and her life support machine was switched off after doctors said nothing more could be done for her. A post mortem later revealed she died from meningitis of the brain and septicaemia.
Family doctors accused of misconduct are being suspended for up to four years and at a cost of up to £900,000, according to figures revealed by the NHS under the Freedom of Information Act.
Primary care trusts in England disclosed that 134 GPs have been suspended over the last three years. The trusts pay 90 per cent of the doctors’ salaries during suspension, costing the NHS £8.2 million.
and those were only last month and this month!!!
i literally have thousands i can pull up.. starving people, wront drugs, rationing them to death, throwing away records. leaving them in ambulances so that the hospitals stats are nice…
I would just like to comment that the young woman in Ireland I mentioned the last time we discussed the charms of nationalized health care – the one who had been waiting for months for a biopsy of a lump in her breast that was discovered in January – is still waiting.
http://sigmundcarlandalfred.wordpress.com/2009/06/02/obamas-health-care-plan-in-a-nutshell/
The use of government to constantly tinker with complex systems is criminal. If the government cannot do a good job with Medicare, Medicaid, and the Veterans Administration, it is not going to be able to do it with socialized medicine. They don’t know the least thing about how it all works.
This is gong to be a disaster. It is going to kill people in the long run.
Haven’t read all the comments yet, but some more interesting info. in Saturday’s/Weekend Edition of WSJ on the columns page in column by Betsy McCaughey. She is a past lt-governor of New York — and a longtime Democrat, and she has now devoted her energies to being a patient advocate. She is extremely knowledgeable and succint.
Obama’s Voodoo Health Economics:
http://online.wsj.com/article/SB124416366699887489.html
Video of interview w/ Betsy McCaughey this weekend by Paul Gigot, WSJ Editorial Page Editor on their Fox News show:
http://online.wsj.com/video/obamas-voodoo-health-economics/F979C566-89E1-4F42-A617-89A079C16557.html
This is gong to be a disaster. It is going to kill people in the long run.
thats the point, then you dont have to pay back social security. not to mention that once there are no people capable of dissenting and doing anything about it, well, its not going to be pretty…
Ms. McCaughey’s interview was interesting. I did not know that in Canada they had a policy of denying cardiac care to people over 65. That means that under socialized medicine the recent emergency surgery to replace my mother’s congenitally defective aortic valve would have been denied to her and she would be told to die, but we’ll throw in the morphine drip to help you get there! My mother is 75, so she would have been deemed to be ripe for death.
The liberals/Leftists want to murder you in utero and at the end of life in old age. Marxism is anti-life. Completely. Totally.
Now you can understand the passion and immoderation behind some of the things I write. Or why I would be opposed to turning this country into a social-democratic state. Why I would even go to war to prevent it.
The most revealing thing about the insolvency of Medicare is how little they pay doctors and hospitals for visits and procedures. Literally, they pay a minor fraction of typical billing amounts.
If they can’t afford to pay somewhere near market rates, who do they think will provide the services? Or the facilities? Or the knowledge and expertise?
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I’m going to have to disagree on this one, not because I think the Democrats have a solution, but because the Republicans don’t have one either.
The days of the family doctor who knew who you are and cared about you… well, I don’t think many people experience that these days. I certain don’t. And, insurance companies and federal bureaucrats already set fee structures and manage care for the elderly. While I don’t have a great complaint about the current medical care system, it isn’t warm and cozy. Doctors are scared to death of their own patients because of malpractice liability.
The only real way to reduce medical costs is to let people die. I work in the health care field. Hospitals and nursing homes are filled with people surviving on 10 to 20 medications and life support systems. We’re spending hundreds of thousands of dollars per person to keep people alive for an extra 5 to 10 years, when they would be better off dying. In the nursing homes, especially, people are being kept alive to keep the Medicare and Social Security payments flowing.
We’ve decided to extend the lifespan by 5 to 10 years by propping up people who would otherwise be dead on a diet of dozens of medications and life support systems. Those people would be better off dying.
This is the real issue in terms of cost. I forget the exact figure, but I read recently that a third of a person’s lifetime health care is consumed in the last few months of life.
I know it seems cold, but what’s the purpose of this incredible expenditure to keep people alive when their bodies have rely given out? Can we really afford everything? Besides, when you really live with this, you begin to wonder whether these people aren’t really being kept alive for the profit of the medical care system, for the jobs it provides, and for the profit of the pharmaceutical companies.
We could just line ’em up and shoot ’em. After, of course, they’ve gone through an Old Age or Death Review and Determination administered by the Department of Reducing Health Care Costs by Eliminating Old People.
I’ve spent long hours in nursing homes and hospitals and the idea that their inhabitants are wretched old beings just wasting health care dollars is horseshit.
My 75 year old mother would be one of those who, under the new regime, would be considered ripe for the Grim Reaper. Now, thank God, she is getting better and starting to do things for herself AT HOME. Yes, she is on about 22 different pills at this time, but most of them will be gone as she progresses.
Under the new regime I would have had to wait at least a year for each of my hip replacements. The pain I endured from 1997 to November 2000, and then in 2005 and 2006 for the other hip, was something a lot of people would find intolerable. It only got worse when they took Bextra and Vioxx off the market because for some people it MAY have been causing heart attacks, stroke, and death.
Oh, and under the new regime, which will imitate the British NIH, expect greatly increased mortality in women with breast cancer. Among other things.
Socialized medicine will only be a boom for embalmers and funeral directors.
Shouting Thomas typifies Leftist totalitarian thinking: WE KNOW WHAT’S BEST FOR YOU (WITHOUT ASKING WHAT YOU THINK OR WISH), AND YOU NURSING HOME PATIENTS ARE BETTER OFF DEAD.
He also cites the old shibboleth of most money is spent on the last few months of life. Let’s kidnap Shouting, threaten him with death unless a large ransom is paid, and let’s see how he feels when his family refuses.
Shouting is the type of guy who undertakes “mercy killings” while working in health care. Very caring, indeed.
I must speak up on behalf of my 88-year-old mother-in-law, who is currently a resident of a nursing home, has recently received a great deal of expensive medical care, is still fairly frail, but has recovered from her most recent health crises to the point that she is able to enjoy her life and her family very much, thank you, and we are able to enjoy her.
She is not being kept alive to keep anybody’s paycheck coming. She is being kept alive because she likes being alive and wants to continue in that fashion as long as possible. She may not be worth much to Shouting Thomas and his ilk but she’s worth a great deal to her family and to herself. I do not accept that the fact that she’s a few years older than S.T. makes her any less valuable or worthy of necessary health care than he is. In fact I might argue that she is more valuable, because she would never have had the smallness of soul to suggest that our more expensive citizens ought to be bumped off in order to save the rest of us a few lousy bucks.
There are ways to cut costs that do not require us to sever ourselves from our souls. Any governmental attempt to establish some sort of sliding scale of human value as a cost-cutting metric will drive me straight to the barricades. It might be good enough for Shouting Thomas and his loved ones, but not for me and mine.
While I don’t agree that the govt. should be the one to decide when people are ‘better off dead’, I also don’t think the populace should be held financially responsible to keep said persons alive. If we have socialized health care, we’ll have both of these scenarios. Oops.
The answers to my post are pure BS. First, I’m not a leftist. Second, I didn’t suggest bumping anybody off.
At some point, we’ll have to make a decision that we aren’t going to spend hundreds of thousands of dollars to keep alive people who would quickly die if not for their two dozen medications and life support systems.
It is my respondents who are mesmerized by the dumb culture of “compassion.” At some point in the future, we will run into hard reality.
How much are you willing to spend to tack on five years to the life of a person who really cannot survive without a pharmaceutical cocktail or life support.
There is a price tag to everything.
This issue is why medical costs cannot be controlled. Everybody is interested in limited costs in the abstract. In the individual case, everybody wants maximum care, damn the cost, no matter how ridiculous the situation. Each of the respondents to my post is guilty of this. You are the cause of the outrageous cost of medicine.
In the past month I’ve attended patients whose every system had broken down, who will never get out of bed again and who could not survive for 15 minutes without their chemical cocktail.
What is we’re just broke and we don’t have the money to prop of this monstrosity?
Anybody interested in a sane discussion of this? This is the problem we face. Go ahead. Call me names and insist that your 93 year old auntie should be maximum care without regard to cost.
Who’s going to pay for it?
Well, I’m genuinely sorry I was so sharp, S.T. — I forgot that you are a physician (which I did know from a previous thread) and have considerable personal and professional knowledge of this subject. Of course you’re right that we’re going to have to do something to control costs and that maximum care is not always the right answer in every situation. There are times to let people go. Perhaps it’s that time for the person you mentioned who’ll never get out of bed again. But you and she and her family ought to decide that. I don’t want government to make that decision — even when it’s paying for the care, and especially not if, as seems possible, it has so thoroughly taken over our health care system that there’s nowhere else to turn when it says no.
I pay right now, either through my taxes or my insurance premiums, for plenty of expensive drug cocktails and medical equipment and repeated surgeries for young people who have disabilities or chronic illnesses and will need all that care for a whole lot longer than my m-i-l will. Would you tell parents that their sick four-year-old should die rather than receive years of some expensive “cocktail of drugs” or other costly but available medical services that would allow him to enjoy his life? If so, you’re way beyond anywhere I’m ready to go. If not, I have to ask, how come the four-year-old who’s done nothing to earn any care should get it, but not my m-i-l, who spent her whole life paying for other people’s medical costs through taxes and insurance premiums, and hardly used any health care services at all until she finally began to need some recently?
Obviously, we are going to have to make hard decisions and we can’t afford everything. Clearly, we need to find ways to cut costs. But I don’t think we are forced, yet, to cut them at the expense of the most vulnerable and powerless members of society when we have not yet tried available measures that are within the power of the rest of us (such as, perhaps, treating health insurance more like motor vehicle insurance — there to pay for the expensive catastrophes, but not for day-to-day maintenance and repair, which would be the responsibility of the body’s owner. I realize that idea raises problems of its own, but so does every proposed solution, including yours.) I was reacting to what seemed to be your suggestion that the combination of age and need for expensive care makes a person expendable. If that’s not what you meant to suggest, I once again apologize.
I do firmly believe, mesmerized though I may be, that recognizing that we have to cut costs is not the same thing as recognizing that we have to devalue human beings to do it.
It’s about redistributing healthcare to an underserved population.
Substitute “providing” for “redistributing” and I’ll perhaps agree with the writer. When you are “redistributing” wealth you are giving money to folks that didn’t earn the money. But to me the term is kind of strange to use in regards to healthcare — because you are speaking of mere money in one case and life itself in the other. I feel that a janitor, farm worker or any other low-class, low-wage earner should have as much longevity as Bill Gates or George Soros. Does that make me a Marxist?
This[making folks pay for health insurance] has the huge added benefit of motivating people to take better care of themselves so that they avoid the constant Dr. visits.
Well, people are going to “pay” — no matter what. They pay now in various ways. I’m wondering if the writer believes there is a correlation between owning health insurance and good health habits. Or that there is a correlation between owning insurance and number of office visits. I would be willing to bet — if there were a way of proving it one way or another — that folks who do not have health insurance visit doctors’ offices LESS often than those who do have insurance.
Let’s say a person smokes a pack a day, drinks good whisky, eats steak heartily and often. Isn’t this person, by probably dying earlier and quicker, more likely to cost the healthcare system LESS? Isn’t part of the problem due to the demographic fact that folks are living longer these days?
Speaking of longevity, I wonder what the life expectancy is for folks who live under some version of a nationalized healthcare as opposed to a mainly private system as we have in America. Anyone care to look that up?
If the government knew how to end health care waste why would they not work their magic to improve Medicare/Medicaid?
Yes, I have been wondering this myself. Why didn’t the Republicans, while they were in power, do ANYTHING to improve “Medicare/Medicaid?” After all, they had ALL that time while they were in power to “improve” things. But they didn’t. What they DID do was to act as if the problem did not exist. Too busy worrying about gay marriage, shamnesty and family values, I guess.
Now the Democrats are in power. Too bad the Repubs did NOTHING while they had a chance, because all this healthcare stuff might not be such big thing if they had. But here we are, on the verge of large and probably detrimental changes in how healthcare is administered. Missed opportunities can sure bite you in the butt, as the saying goes.
Mistakes made that cause suffering or death in Great Britain.
Mistakes are also made here and now in the good old USA. Let me assure everyone that medical mistakes and malpractice happen all the time in America. In fact, malpractice suits — brought on by medical mistakes — are often cited as the bane of the American medical community and as contributing significantly to the cost of healthcare.
Literally, they[Medicare patients] pay a minor fraction of typical billing amounts.
Literally, they(patients who can afford health insurance) pay a minor fraction of typical billing amounts.
I guess it all depends on how “typical billing amounts” is defined. There will be those patients that have no insurance and are not covered by Medicare. They will pay whatever the doctor wants to charge, which will probably be more than those covered by insurance or Medicare. Should we call that “typical?”
My prescient vision sees the following: NHS Bureaucrat…”I’m sorry sir/madam but the drug/procedure/treatment is much too expensive for the risk/benefits. I’m afraid I must deny services.”
MY vision sees the same thing said by insurance company executives when disallowing benefits to insurance claimants. Many claims adjusters are paid and promoted on the basis of how many claims they can disallow. And if the claim is disallowed unfairly? Well then that individual can hire a lawyer and try to fight it out in court. Good luck on that, considering that the insurance companies keep a bank of the best and brightest lawyers money can buy. You stand a good chance of dying before the issue would be resolved by the legal system.
We’re spending hundreds of thousands of dollars per person to keep people alive for an extra 5 to 10 years, when they would be better off dying.
I think the writer probably does not have a life-threatening health issue. I’m thinking also that if the writer did have a life-threatening illness, at whatever age, that the writer would probably not want to lose those “extra 5 to 10 years” and would not believe he would be “better off dying.”
Shouting Thomas > I actually agreed with you, in a short way. If someone wants to stay alive only through a drug cocktail, more power to them. Assuming, of course, that they or their family are picking up the bill. Don’t ask me to do it via taxes. My quip about the govt. deciding on who would be “better off dying” was in response to the other posters.
grackle > I feel that a janitor, farm worker or any other low-class, low-wage earner should have as much longevity as Bill Gates or George Soros. Does that make me a Marxist?
Maybe it does, in a small way.
Health care isn’t free. If a person claims a right to health care, they claim a right to another person’s time, effort, and money. Nobody should have the right to force me live my life for them, even in the smallest amount. It’s not the quantity, it’s the logic.
Tell me where we draw the line:
A janitor should have the same longevity as Bill Gates.
A janitor should have the same quality of nutrition as Bill Gates.
A janitor should have the same sense of security as Bill Gates.
…
…
A janitor should have the same amount of money as Bill Gates.
I know it’s a logical fallacy to imply a slippery slope, but that’s not what I’m doing. I’m giving a list to motivate the necessity of a philosophical basis which determines where the line should be drawn. If we do it emotionally rather than logically, we can’t even discuss it intelligently. Do I want to turn away a person who’s having an asthma attack, when all they need is a $30 nebuliser treatment? Of course not. What if they’re 103 years old, and they need a $2000 treatment, daily? Who makes that decision?
It seems impossibly complicated to me unless we make every person responsible for their own wellbeing, and let the rest be a result of charity rather than entitlement. At least it would give those who live off of others a sense of humility.
grackle > I feel that a janitor, farm worker or any other low-class, low-wage earner should have as much longevity as Bill Gates or George Soros. Does that make me a Marxist?
Maybe it does, in a small way.
Tell me where we draw the line:
A janitor should have the same longevity as Bill Gates.
A janitor should have the same quality of nutrition as Bill Gates.
A janitor should have the same sense of security as Bill Gates.
…
…
the same amount of money as Bill Gates.
I draw the line at: “A janitor should have the same amount of money as Bill Gates.”
I know it’s a logical fallacy to imply a slippery slope, but that’s not what I’m doing. I’m giving a list to motivate the necessity of a philosophical basis which determines where the line should be drawn. If we do it emotionally rather than logically, we can’t even discuss it intelligently. Do I want to turn away a person who’s having an asthma attack, when all they need is a $30 nebuliser treatment? Of course not. What if they’re 103 years old, and they need a $2000 treatment, daily? Who makes that decision?
I drew my line. Now I ask the writer to draw a line. First let me say that I do not think there are enough folks who are 103 years old to take much out of the writer’s pocket — or the taxpayers’ collective pockets — even at $2,000 per day — to be much of an economic burden on the taxpayers or the writer.
It seems impossibly complicated to me unless we make every person responsible for their own wellbeing, and let the rest be a result of charity rather than entitlement. At least it would give those who live off of others a sense of humility.
One of the issues that seems to be important to the writer: of everyone being “responsible for their own wellbeing” and of folks “who live off of others” not having the necessary degree of “humility” for living “off of others.”
Dictionary.com defines humility as:
the quality or condition of being humble; modest opinion or estimate of one’s own importance, rank, etc. and goes on to list synonyms for humility as … lowliness, meekness, submissiveness.
So it is evidently important to the writer that those who need medical care and cannot pay for it and do not have an insurance company willing to pay for it be confined to getting whatever medical care they may need and receive through charity and not through any entitlement so that the writer may thus be satisfied that those who seek medical care will be properly meek and submissive — because the care will be endowed entirely through charity.
I find that to be an interesting thought but not very logical. It seems to me to more emotional than logical to be focused on whether or not folks who seek medical care be endowed with the writer’s idea of their proper degree of humility. Such a thought smacks of anger — not logic. Perhaps it is justifiable anger but it is definitely not unemotional logic.
What about people who receive the services of the police or the fire department? In our present system no one pays directly out of their pocket for these services — yet we all receive these services. I am certain that most people would consider these services as essential to their “wellbeing.” Shouldn’t we all feel ashamed? Shouldn’t we all consider ourselves to be excessively prideful if we believe these services to be … entitlements?
Shouldn’t we all go out and hire our own police so that we can be properly “responsible” for our “own wellbeing?” Does the writer pay directly out of his own pocket for police protection? If not, by the writer’s own philosophy, shouldn’t the writer be deeply ashamed for living “off of others?”
Sorry, I didn’t check this for a day or so.
There’s obviously the concept of ‘free riders’ in any significantly developed economic system. We can’t all pay for our own roads, individual police, etc.
I was using excessive examples, but the point I was trying to make is that health care isn’t free, so we, as a society, need to decide where to draw the line between collective and individual responsibility. It is unreasonable to ask each individual to pay for their own police force or highway system. We benefit from a lawful society even when not directly interacting with law enforcement. We benefit from the highways we don’t personally use, via more efficient commerce.
The question that arises in this context is, “Is it unreasonable for each person to pay for their own individual health care?” You seem to imply ‘yes’, since you draw the line at more money, rather than a greater sense of security. How, though, are we to give the janitor as good of a sense of security as Bill Gates unless we spend enough money to give him the same quality of healthcare? Unless we transplant him to a better neighborhood, or buy him a home security system? What if the conversation extends to emotional security? How can we guarantee the same feeling of stability unless we fill his bank account? how are we to provide him the same level of nutrition unless we buy him the more expensive organic food that Gates might hypothetically eat?
Give me the philosophical underpinning for where you drew the line. Is there a value system that can pick apart the borderline cases with any degree of objectivity? If not, would you trust the government with the same level of subjectivity over your own health care?
I admit the quip regarding ‘humility’ came off as emotional rather than logical, but it was more in response to the mentality of entitlement that many advocates of universal health care have. I’m actually a lot more heartless than you might believe. Heck, I’d even advocate free markets over socialist systems strictly for societal efficiency, even if it meant a few people had to die. I’m not advocating the death of those unable to take care of themselves, of course. But a fear of lack of food and medicine if a damn good motivator for those marginal cases who can but won’t if they don’t have to.
See this !
http://www dot medicalforgery dot com