Posting in Government
Private health insurance is rapidly pricing itself out of the market. Government is now the largest buyer of health care services by far.
Almost 30% of us do. And the number is rising.
The Wall Street Journal reports that over 87 people got their health care through the government in 2008, citing Census Bureau figures. Kaiser Health News expects the number to rise substantially when 2009 figures are released.
The growth is coming from Medicaid and State Childrens Health Insurance Programs (SCHIP), and is fueled by the faltering economy.
Despite this the number of uninsured also continues to grow, according to the report. The Census figure was 46.7 million, although the President only claimed 30 million on Wednesday, removing all those who might be in the country illegally.
In terms of economics, private health insurance is rapidly pricing itself out of the market. While some analysts say the trends make it harder to strike a deal, given the increased government burdens, the numbers also move insurers toward the table, because a mandate would mean more customers and more revenue.
There is another hard fact. The government is now the largest buyer of health care services by far.
A failure or refusal to pass health reform won't change any of this. Republicans refusing to vote for reform are betting taxpayers would rather kill Medicare and Medicaid under financial pressure, when it comes to that in a very few years
That's a big bet on the 19th century. (Picture of 19th century Belgian poverty from Ancestry.com)
Sep 11, 2009
Since when does a 30% minority constitute a "majority"? Obama's negatives are now well over 30% and growing, does that mean Obama is now always wrong? As for why private health care costs are growing, much of that is because doctors and hospitals shift the cost of underpaying public systems such as Medicare onto private insurers. Another factor in private health care costs growing is because much of it is shielded from individuals by their employers. Making employees pay a small straight percentage of their health care costs instead of a fixed copay would go a long way in forcing people to make rational trade-offs about their medical care (e.g., no more trips to the doctor demanding antibiotics for a cold or flu).
costs are out of control because there is no sense of personal responsibility. it is far too easy to let the "other guy" pick up the tab - whether the other guy is a taxpayer or another ticket holder in the lottery pool known as insurance. what we really need to get costs under control is a pay as you go plan. when you receive a service, you agree to pay for it and negotiate the cost of the service with the provider. if you can't afford it you decide if you can live without it or not and if you cant live without it you ask your friends and family to help you out or say your goodbyes. somehow the human race has survived for hundreds of thousands of years with very little in the way of healthcare. none of our bodies are designed to last forever and our current healthcare expectations are out of step with reality. health care is not a right, it is a choice and it is a personal responsibility not a government responsibility.
in canada and england. You get less and pay more through taxes. You pay at least $5,000 per year in taxes, or more just to support and inferior government run system, whether you use the system or not. Governments have always had the 'lead' touch, everything they touch turns to lead. Government is so corrupt and inept that it could "bankrupt a whorehouse that sells alcohol".
Snowman's representation of Australian medical care is very misleading. Australian doctors have not been told to maintain doses of 400 mg of caffeine in their bodies. Rather, Queensland Health ( astate-level agency) produced a 102-page document for Fatigue Risk Management that included using stiumlants as an option to increase alertness and fend off fatigue. Queensland hospitals are supposed to use the document to produce a site-specific plan. The Australian Medical Association, The Salaried Doctors Queensland union, Australian physicians, and the press strongly oppose the idea as dangerous, short-sighted, and irresponsible. http://www.news.com.au/couriermail/story/0,23739,26040339-952,00.html One comment from Sam of Brisbane is especially relevant when he says: "[i]The bigger issue is with the specialist colleges that train junior doctors to be consultants. It serves their interests and private incomes to limit numbers on training programmes.[/i]" Also see: http://www.abc.net.au/news/stories/2009/09/08/2679456.htm
Of course "it" isn't viable when people like you deliberately mischaractize the only option as a strictly contrived strawman of assuming a government-run disaster. The US is a democratic republic. [u]You[/u] are the government, along with everyone else who looks in a mirror in the morning. If you're criticizing the government for incompetence, you're criticizing yourself and everyone else for failing to be involved citizens. If you aren't part of the solution, then you're part of the problem. And problems abound with avoidable medical mistakes killing people every year: http://www.medicalnewstoday.com/articles/11856.php Wasting tons of money: http://www.ahrq.gov/qual/errback.htm The doctor shortage - especially in primary care - is a direct result of poor working conditions and inadequate pay: http://www.nytimes.com/2008/06/17/health/views/17essa.html?_r=2&ref=health&oref=slogin http://www.kevinmd.com/blog/2009/07/primary-care-doctors-face-burnout-and-how-that-affects-health-reform.html Pharmaceutical companies push unsafe drugs with inadequate clinical trials in the name of profits: http://www.smartplanet.com/technology/blog/rethinking-healthcare/will-even-a-23-billion-fine-change-drug-marketing-practices/364/ http://www.pharmalot.com/2008/03/glaxo-escapes-prosecution-over-paxil-in-uk/ http://www.injuryboard.com/national-news/merck-pays-for-favorable-gardasil-opinion.aspx?googleid=269292 http://www.cbsnews.com/htdocs/NVICGardasilvsMenactraVAERSReportFeb2009.pdf (scroll to page 3, Conclusion.) The insurance industry fleeces the public while anti-reformers fight vital regulation: http://talkback.zdnet.com/5208-13593-0.html?forumID=1&threadID=68262&messageID=1314973 And there are bountiful options besides just declaring "'it' won't work" (whatever "it" is assumed to be): http://talkback.zdnet.com/5208-13593-0.html?forumID=1&threadID=68316&messageID=1303755 Provide [u]reputable[/u] sources for your claim about Australiab doctors. Your characterization is not what my Australian friends say about their medical care by any stretch of the imagination.
Sure, insurance costs may be going up, but until those running (or is that ruining?) the government are willing to put aside their loyalties to trial lawyers and put torte reform in place, that will continue to be the story. States that have enacted torte reform have seen medical and insurance costs go down and the number of providers go up. Also, instead of making another new government agency that won't work, let's fix what is in place, expand eligibility to medicare and state run children's health plans, and fix social security. We all see how well cash for clunkers was run. If the government runs our healthcare, is that facet going to have to close down in less than a year because it ran out of money? If everyone does have coverage and unlimited access to medical care, but nothing is done to get more doctors trained and on the job, people won't have the opportunity to see if a doctor even if it is free, as the waiting period for an appointment will be at least 6 months. Better not have anything fatal! In Australia, doctors were recently told they need to keep 400 mg of caffiene in their systems, because the 80 hour shifts they have been working under their national healthcare system has been resulting in unnecessary deaths to sleep deprived doctors being mentally unable to make correct decisions about patient care. Sorry, it's just not viable.
semi-adult sure hits the nail on the head too. Re: "[i]Why can't we shop any of the 1300 private insurance companies[/i]? Because private insurers cherry-pick their risks. Just try being a leukemia survivor and get health, disability, and life insurance without qualifying through employment. Even then, your benefits will be capped for life insurance, benefits exclusions will not insure your income for disability, and health insurers are actively trying to exclude all pre-existing conditions from coverage. "[i]Why can't businesses pool their employees together[/i]? I'm not sure what you mean by this. Employers now are pushing for "wellness" - a complicated means for shoving more costs on some of their emplyees by trying to assign "fault" for their medical conditions. Unimplementable and unmanageable. "[i]Why does a doctor have to pay six figures just to have malpractice insurance[/i]? Because malpractice insurers keep jacking up their premiums. "[i]Why do they have to order defensive tests? Because of government regulations[/i]." Was fur quatsch! Doctors order defensive testing to reduce their liability against malpractice claims. That is a market issue, not a government one. Just look at TV and see the ambulance chasing lawyer ads: "You may be entitled to benefits!" That is [u]not[/u] the government in action.
... you'll need it, and a lot of it, as long as you persist in presenting facts. However, some of us are with you, and willing to share the attack on the delusional. For instance, let's take on at least parts of the first three offerings for this post... "Torte reform"... does that mean new recipes? The FACT is, lawsuits in the medical arena in general resolve to far less than 2% of the net dollars on the table. If you want to 'fix' this problem, get the AMA (and the other medical associations) to actively assist in identifying their own failures. How about a public list of quality factors in health care, including the identities of those who generate the problems? Let's find out who does the bad things, whether doctors, hospitals, clinics, or bureaucrats. Along those lines, why can't we know which claims insurance companies deny, and why, and how many of those denials are overturned? Better yet, how many die from the delays of care that IS provided? If there IS a problem, isn't sunlight still the best disinfectant? And by the way, if malpractice premiums are such a terror, why don't we get some truth about how much they generate for the insurors, and how much those same insurors really profit from them? Not so incidentally, all the 'losses' from malpractice suits reduce the insurors' bottom lines... think that might be interesting information? After all, in the end is IS your money... Waste and fraud ARE important, and we SHOULD be concerned. Government is the problem? Yeah like that's serious. Reagan is gone, get over it. FACT here is that government does the best job, by FAR, in delivering services for the least cost. You don't like it, stop driving on my roads, or agree to pay by the mile to some benevolent banker for being able to go anywhere anytime. If you're upset that services are not as efficient at you think they should be, let's get together and make them BETTER. If your complaint is that government doesn't charge enough for what it does, that's one thing, but why are you whining that you're getting a good deal? The health industry, including insurance as a business, starts by adding 30% (OK, pick your number, it might be more) to EVERYTHING they do -- remember, they're vertically integrated and take that slice at every ledger line -- and you pay that FIRST. You're welcome to your distortions of the Adam Smith mythology, but you should at least understand the price delusions carry. And the constant carping about 'government funded insurance'? Nobody -- NOBODY -- with a working understanding of the situation misunderstands who pays, no matter how the game is structured. Nobody with a rational view of the need argues that anything is 'free'. That's not the question, and no matter how loud the screams are it won't be. What we're seeing is a misleading dislocation of the whole argument from what it SHOULD be -- health care -- to the protection of business interests -- insurance care. It's fine that we do that, as long as it's clear what's at stake. I admit it... I'm tired of the bitching and the selfishness and the insane rhetoric of the current discussion. It's fine to not agree with the current administration, or insist on pursuing the inevitable outcome of measuring everything in dollars, but the argument doesn't work with private -- not to mention irrational -- 'facts'. If it's all imagined cost, or the bullet points of profiteers, or 75 years of political 'spin', those are problems in themselves and NONE contributes to anything useful. Here are some better questions to kick around... how many children should die next year to save $20? How many years too soon should grandmothers die for the lack of flu vaccine or simple and cheap cardiac medications? And one more, just to be sure I cover all the options (with apologies to Strunk and White)... who's brother AREN'T we the keeper of?
Come on - government funded insurance?!! Who is the government? We the people! So who pays? You do and I do!!! There is no less cost for you and me, perhaps it could rise even higher than competitive insurance companies. Who will pay for R&D? Just more government control by a few politicians.
I agree. To argue that we need to make a system even more dependent on the government is ludicrous. SS and M&M are already $50 trillion in the hole and unsustainable. Soon they will be bankrupt. Why can't we shop any of the 1300 private insurance companies ? Why can't businesses pool their employees together ? Why does a doctor have to pay six figures just to have mal-practice insurance ? Why do they have to order defensive tests ? Because of government regulations. Now we are down to 30 million uninsured. Of that total there are quite a few people from Medicare and Medicaid that are double-counted into this total and many others simply do not want to pay for their coverage. This is yet another myth concocted by this administration. Government ruins everything it touches and having a public option means an estimated 88 million people will lose what they have now. There is no way I will be forced to take the public option. Fine me all you want. I will go without insurance. They want to arrest me then I will become another unproductive member of society and take resources. It is time to stop the lies and realistically improve the system. Although expensive it is one of the best. We need to improve the economices but a government-run system is not going to be cheaper, better, and will be another control mechanism for our government to lord over us. Read the story about the baby in England that was born at 22 weeks and their guidelines do not support pre-mature births at this age. They didn't even help the poor baby and it died 2 hours later. Long waiting lines, rationing, a centralized committee, and inefficiency await us if we allow this to happen. This is about un-american as it gets.
I believe you are mistaken in your assertion that "Republicans refusing to vote for reform are betting taxpayers would rather kill Medicare and Medicaid under financial pressure..." Republicans will vote for reform if it means reforming the current system to make it financially sustainable by introducing torte reform, allowing national competition (now restricted by the Federal Government), and waste and fraud reductions. To say that because "the government is now the largest buyer of health care services" that we should make it bigger is a rediculous arguement. Everyone can agree that the current system of healthcare is unsustainable; making it more inclusive and bigger results in a bigger problem. Let's see government reduce waste and fraud FIRST, THEN use the savings to increase coverage.