« Why Don't You Just Die Already, You Oxygen-Thieving Waste Of Skin? | Main | Obama Speech Day »

Plugging the Gap in Health Care Reform Costs

Over the weekend, Max Baucus, the chairman of the Senate Finance Commitee, put up a new plan for health care reform. Senator Baucus, D-MT, has been working with the gang of six, on a bipartisan alternative to the House Democratic plan.


Over the weekend, the committee's chairman, Montana Democrat Max Baucus, distributed a draft of his health proposal that leaves out the public plan in order to win support from a small group of Republicans. Mr. Baucus's plan costs less than $900 billion over 10 years and would expand insurance coverage to tens of millions of Americans.

The goal appears to be to produce a plan that doesn't have the $1.6 trillion price tag of the house bill, or the $1T price tag of the Senate Health Committee plan, but rather a more modest $900 billion. Do you wonder what they left out to get the plan down to the firesale price of $900B? Nothing. They just added a tax on health benefits and called it good.

The committee needed to plug a $100 billion shortfall in the plan's budget over a decade, and Mr. Baucus assembled a combination of spending changes and revenue increases to make up for the gap, according to people familiar with the proposal. The main new item is an across-the-board fee placed on insurance companies that is based on their market share and is estimated to raise tens of billions of dollars over the next decade, according to people familiar with the plan. Another plank of the plan would tax insurance companies on particularly generous health-insurance plans.

People: A tax on insurance companies is not a tax on insurance companies! A tax is a cost of doing business and will be passed on to employers in the form of higher costs, and then on to employees as lower wages.

The people who have complained about stagnant wages and rising benefit costs need to understand that employers offer employees packages of wages and benefits. When one goes up, the other has to come down. And get ready for higher unemployment if this idea goes through. If you make something more expensive, like hiring employees, you will get less of it.

The insurance industry balked at the fee proposal. "New taxes on health-care coverage will only make coverage less affordable for families and small businesses," said Robert Zirkelbach, a spokesman for America's Health Insurance Plans, the industry's main trade group.

Update


Don't want to buy insurance and prefer to take the cash and self-insure? You'll have to pay.

WASHINGTON (AP) - A top senator is calling for fines of up to $3,800 on families who fail to get medical insurance after a health care overhaul goes into effect.


TrackBack

TrackBack URL for this entry:
/cgi-bin/mt-tb.cgi/36695.

Comments (52)

sounds like how they got th... (Below threshold)

sounds like how they got the top RINOs to go along with the porkulus - cut the free cookies and beer for ACORN and SEIU meetings and trim off a couple of mil, crow about how much you saved, and call it good

These assholes need to be p... (Below threshold)
GarandFan:

These assholes need to be put up against a wall! Are they even on the same planet as the rest of us? My wife's portion of our health care plan at work went up last month. She couldn't understand why. It's because the insurance companies know what's coming from those fucking retarded idiots in Congress. They need to throw everything out and start over. FIRST ADDRESS ISSUES OF THE CURRENT SYSTEM! Oh, and get rid of that $10 BILLION prop to the UAW's health care plan.

"A tax is a cost of doing b... (Below threshold)
davidt:

"A tax is a cost of doing business and will be passed on..."

Why are there so many people in this country who cannot understand this simple truth about all taxes on all businesses?

David: Let's see...<... (Below threshold)

David: Let's see...

-public schools
-aging-hippie-run colleges teaching 'the wit and wisdom of Pac-Man' and 'transgenderism in Milton'
-disingenuous politicians at every level and every party
-uneducated reporters
-biased editors
-culture that treats actors as statesmen and gurus

that's a good start

I see the dems are going to... (Below threshold)
Hank:

I see the dems are going to try every combination they can to get some sort of health bill passed.

Once done, it will evolve until they get single payer national health care.

Unfortunately for them, americans are catching on and I doubt they're going to be able to pass any health care bill.

The Democrats seem to be in... (Below threshold)
GarandFan:

The Democrats seem to be in disarray at the moment. Nancy still has her smile and her talking points on 'universal coverage, reduce costs, increase benefits, it will pass, yadda, yadda, yadda.' Hoyer is saying the 'government option' won't pass. Barry says the 'government option' isn't mandatory, but he could live with it (How does he straddle so many issues and get away with it?). Can only hope that Barry does some warm-up exercises before his speech, otherwise he'll pull a muscle.

Baucus has a 'plan'. So do... (Below threshold)
GarandFan:

Baucus has a 'plan'. So do I, and it involves hanging Baucus by his.......

http://www.breitbart.com/article.php?id=D9AJ8OBO0&show_article=1

They need to throw every... (Below threshold)
hyperbolist:

They need to throw everything out and start over.

Excellent idea! Start with asking insurance companies to justify their own existence--to explain in cogent terms what value they add to your nation's health care system.

Once they fail at that, proceed to step 2, which is a rational discussion of how to fund Medicare for all citizens.

"proceed to step 2, which i... (Below threshold)
JLawson:

"proceed to step 2, which is a rational discussion of how to fund Medicare for all citizens."

A 90% tax on ALL incomes ought to cover it. Remember, right now there's close to (depending on who you talk to, with R. Nader being a trifle on the high side) $50 to $200 BILLION annually in waste and fraud with the current system. If we expand the system to cover everyone properly, we should be able to get up to the trillion mark in fraud and waste a year without any problems.

Big expenses require big funding. No need to pussyfoot around on the money grab - might as well go for the big bucks.

There's broad support for h... (Below threshold)
Mac Lorry:

There's broad support for healthcare reform, just not the details of how to do it and there's a reason why. The fundamental problem is how to control costs, which are ultimately being driven up by two main factors. One is an aging population, and two is advances in medicine. The fact that the older a person gets the more medical care they need, on average, should be no surprise to anyone. The fact that advances in medicine tend to increase costs is more complex, but nevertheless true.

If someone has a condition that there's no treatment for there's no medical cost. There may be an economic loss to the economy due to that person not being able to work, but even that's not true if it's a retired person, which we have more and more of thanks to the post war II baby boom. An example of this is a certain kind of eye degeneration that affects people more and more frequently as they age. Only in the last few years has medical science been able to cauterize extraneous blood vessels growing around the retina of the eye using a cold laser. This vision saving procedure costs lots of money, but well worth it to anyone who finds themselves in need of it. Problem is, we all pay for it through higher insurance premiums or taxes if it's covered by Medicare. Joint replacement surgery is another example. The faster medical science advances the faster medical costs tend to increase.

Even if we could pass tort reform, open competition across state lines, and squeeze out the last bit of inefficiency in the system it would only offset the inexorable rise in healthcare costs for a few years at most, and then we would back where we are now.

Either we have to quit getting older, or we have to quit inventing technologies that let us get even older, or we have to ration healthcare for the oldest. Sorry, nature doesn't allow any easy or cheap choices when it comes to staving off deterioration and death.

One idea (yes it's a form of rationing) is to give everyone a maximum lifetime healthcare amount of say 2 million credits on their 18th birthday (prior to that nothing counts against them). It can be that high because many people will die without using much of it. Each person is then in charge of how they use those credits (it's not actually money, but a one to one dollar limit on how much can be spent on your behalf). Knowing this, people would take better care of themselves in order to save the money for when they get old. They might also forgo cosmetic surgery to save their credits for something more important. The credits are non-transferable and expire on a person's death. Once you're out of credits you would have to appeal to a death panel to see if your value to society warranted more credits. Up to that point every adult is in control of their own healthcare and that's what makes it work. Individuals will shop for the best care at the lowest credit price, which will finally put free market pressure on healthcare.

Everyone gets the credits, so it's now fair to require everyone to pay into the system, and now there's a limit on how high the total cost can be.

Baucus doesn't HAVE any . .... (Below threshold)

Baucus doesn't HAVE any . . . !

Another deposit in the great pile of manure in the Dems back yard. Trust me, there is no pony under there, folks!

Why not leave well enough alone. Wait ten-twelve months or so and we can revisit the subject again - preferably with some business minded legislators who know what they're doing. After we have elected them to replace the dummies currently occupying those seats!

I still say do it at the St... (Below threshold)
JustRuss:

I still say do it at the State level instead of the Fed. That will encourage interstate competition in health care. Of course just like a drivers license your health card has to be good in all other states as well. The Fed can set guidelines but keep its hands out of the running of it.

Meanwhile allow private insurance to have "top up" plans that cover the costs of catastrophic injury or illness. Because you simply cannot budget for that type of thing in a government run system. You can't save up from healthy people in order to have resources available when the super sick come for help.

Over all the plan currently in the works is complete and utter crap and needs to be thrown out. Then the Reps and the Dems need to sit down and have an actual conversation about what they agree on and what they dont.

Hell, just make the entire thing "plain language" to remove loopholes and gray areas and even HR3200 might pass scrutiny, if it is truly written the way the dems claim.

The faster medical scien... (Below threshold)
Tim:

The faster medical science advances the faster medical costs tend to increase.

That's just ridiculous. Just because there is something new available that costs more, does not mean that people must BUY it.

In the meantime, early adopters who can afford the new technologies eventually help lower the costs and prices and increase availability. As an extreme - but very illuminating - example, many courses of treatment that today cost $50 or less could likely have been a massive undertaking to produce even 50 years ago, if they were even possible at all.

Another good way to look at it is to replace "treatment" with "CPU" and examine the retail lifecycles of new CPUs. To the extent that healthcare is currently jacked up, much of it can be laid at the feet of excessive government meddling, both from ours and from others.

People who don't comprehend basic economics need to stop wasting our time.

The "Update" on the OP -- I... (Below threshold)
James H:

The "Update" on the OP -- I really don't think allowing people to self-insure is a good option. I reminded of a caller to a conservative talk show I listened to once. The caller said he didn't want an insurance mandate, and he didn't want one! And the man didn't have insurance for himself or his family either! The host asked the caller what insurance he used ... and the man replied, "prayer." The caller also said he had 13 kids.

Something happens to one of those 13 kids, the rest of society picks up the bill because he can't be bothered with insurance. So, yeah, I am to the point of supporting an insurance mandate if only to ensure that twits like that guy have to pay for their health care.

hyper - "Once they fail... (Below threshold)
Marc:

hyper - "Once they fail at that, proceed to step 2, which is a rational discussion of how to fund Medicare for all citizens."

Then perhaps you have a solution how to add all those millions to Medicare without adding to the trillions the program is already in the hole.

Hyper is happy with his hea... (Below threshold)
GarandFan:

Hyper is happy with his health care system. They get overloaded with patients, they just send them over to those NASTY MONEY GRUBBING US HOSPITALS. We Canadians would take care of our own but we want to spread the wealth......and the bullshit.

Hey hyper, what are you going to do when Obama sinks the US health care industry and we're forced to stand in line like you folks. You somehow getting dispensation to move to the front of the line?

President Obama at his news... (Below threshold)

President Obama at his news conference on Wednesday September 9, 2009, will announce that he has put foreword his own health care plan entitled: HEALTH CARE- HOW TO SERVE AMERICANS, see it here, http://stopthepresses2.blogspot.com/search/label/Serve%20Americans

"...which are ultimately be... (Below threshold)
dkAllen:

"...which are ultimately being driven up by two main factors. One is an aging population, and two is advances in medicine..."

Not precisely.

Health care is expensive, as an aggregate, because there is a substantial demand for it (which is somewhat of a foundation for the aging/advancing argument above, but we need clarity here), and because of high malpractice insurance.

It cannot be made less expensive, period, unless either (or both) of these causes are reduced. The latter can be affected by tort reform, which has been discussed on the right - and ignored on the left - in many other fora.

The issue of demand is actually exacerbated by insurance. When your insurance covers office visits, you're going to visit the doctor's office more frequently; hence, increasing demand. The cure here, is less, not more, insurance.

The various plans being tossed about currently, are nothing more than an exercise in redistributing wealth. They will most certainly not decrease the aggregate cost of health care; and to the extent that they increase demand (which they surely will do), they will produce upward pressure on that cost, which can then only be contained by forcing a reduction of fees paid to medical providers, which will subsequently produce a scarcity of health care. Remember the gas lines in the 70s? We didn't have a shortage of fuel - it just wasn't possible to produce gas at the pump for anything other than a loss, with the price controls which were in place. If you think you have to wait a long time for your doctor appointment now, just wait until his price is controlled.

Addressing the issue of demand is a conundrum; how do you get people to visit the doctor less? Should they do so? This has a direct bearing on the current status of emergency care - many people are abusing the ER because they don't have to pay for it. In the end, we may just need to accept that health care has a cost, and pay it, as we are able to do -- and just as we do with food and clothing.

Of course, on the flip side, that equality may just spring itself upon us in the next few years... Can you say "grocery and textile reform?"

That's just ridicu... (Below threshold)
Mac Lorry:
That's just ridiculous. Just because there is something new available that costs more, does not mean that people must BUY it.

Your logic fails because people want whatever treatment medical technology can provide if it extends their own lives or allows them to avoid a debilitating condition. They might not spend their own money if it means putting their family out on the street, but they have no such misgivings about insurance or tax money being spent on their behalf.

In the meantime, early adopters who can afford the new technologies eventually help lower the costs and prices and increase availability.

Not as much as you think because the current system is isolated from free market pressures. Under the lifetime credit limit there still would be demand for innovative advances and the cost of those technologies would drop even faster because free market pressures would be at work in healthcare.

To the extent that healthcare is currently jacked up, much of it can be laid at the feet of excessive government meddling, both from ours and from others.

You can remove all the meddling and inefficiency in healthcare and the best you can do is offset the curve, but you can only bend the curve by addressing the fundamentals drive the increase in healthcare costs. We can't do anything about the increasing number older people and no one wants to stagnate medical technology, so the only options is some form of rationing. The method that puts individuals in charge and introduces pressure for people to take better care of themselves and also puts free market pressure on healthcare providers is the best form of rationing.

People who don't comprehend basic economics need to stop wasting our time.

I agree!

Health care is exp... (Below threshold)
Mac Lorry:
Health care is expensive, as an aggregate, because there is a substantial demand for it (which is somewhat of a foundation for the aging/advancing argument above, but we need clarity here), and because of high malpractice insurance.

malpractice insurance is an offset cost, not a fundamental driver of high healthcare costs. If there's no demand for some treatment there's no malpractice insurance cost. If there's no treatment for some condition there's no malpractice insurance cost. The two fundamental drivers are demand and treatments. The more people there are and the older the average age the more demand there is. Advances in medical science create more treatment options.

The issue of demand is actually exacerbated by insurance. When your insurance covers office visits, you're going to visit the doctor's office more frequently; hence, increasing demand. The cure here, is less, not more, insurance.

Less insurance is not the answerer either because untreated conditions can become expensive conditions.

They will most certainly not decrease the aggregate cost of health care; and to the extent that they increase demand (which they surely will do), they will produce upward pressure on that cost, which can then only be contained by forcing a reduction of fees paid to medical providers, which will subsequently produce a scarcity of health care.

Yes, that's the form of rationing used in Canada and the UK. Make healthcare hard to get and don't offer the newest (and most expensive) treatments.

No society provides unlimited state-of-the-art healthcare to everyone, at least not for long. Some form of rationing must limit demand. Of all such systems the lifetime maximum credit system offers the most advantages. 1) individuals are in charge and they have an incentive to limit their use of healthcare, and thus, will take better care of themselves and avoid seeking healthcare for trivial or untreatable conditions (the common cold). 2) individuals will shop for healthcare to find the best care for the least credits, and thus, healthcare providers become subject to free market forces for the first time in maybe 70 years.

There's still the issue of how to pay for healthcare, but there's a maximum cost set by society in the form of how many credits each adult is given, and free market forces will bring the actual costs down.

hyperbolist wrote:... (Below threshold)
iwogisdead:

hyperbolist wrote:

Start with asking insurance companies to justify their own existence--to explain in cogent terms what value they add to your nation's health care system.

Well, for one, they provide a rational system of administration and spreading the risk. The left brags that the Medicaid/Medicare cost of administration is several percentage points lower than that of private insurance. At the same time, Obama has said that Medicaid/Medicare is losing "hundreds of billions" on "waste and fraud" (which he has done nothing to attempt to fix, even though no legislation would be needed to do so).

"Hundreds of billions" paid out in improper claims by the government--that's some special administration, isn't it? Just wait until all of healthcare is administered by government dunderheads. Then how much will "waste and fraud" be? Trillions?

Since their eventual goal i... (Below threshold)

Since their eventual goal is government run healthcare for all, how do they plan on paying the bill once they force private insurance out of business and thet have zero market share to tax?

Hey GarandFan, I'm pretty s... (Below threshold)
hyperbolist:

Hey GarandFan, I'm pretty sure I'm using American English words when I comment here, so your inability or refusal to read what I say is your problem and no one else's.

For the last time: Canada's health care system sucks, and has for over a decade. But Japan's doesn't. And neither does Sweden's, France's, Switzerland's, Austria's, etc. etc. etc. They're all WAY BETTER than America in terms of efficiently delivering good outcomes. And what Obama has proposed is most similar to the system in Switzerland. So kindly avail yourself of that particular model and then speak to that, rather than what you imagine people's beliefs to be.

Marc: the discussion would begin with "Why the fuck does it cost twice as much to do the same shit in this country as it does in France, with their oppressive taxes and massive welfare state and perpetually crazy unemployment rate?" Once that question can be answered, then the discussion could proceed to the next step.

Nobody doubts that some Americans have great healthcare. But a greater percentage of Americans travel abroad for it than Canadians (i.e. to Mexico and Thailand). The question isn't about improving quality, but access. I've never seen any empirical evidence suggesting that implementing a public option--like in Switzerland, not Soviet Russia, GarandFan! Try to keep up!--would necessarily lead to a decrease in innovation. Probably because no such evidence exists. And even if that were the case, but people lived longer despite less innovation, then who the hell cares whether Pfizer makes $10bill or only $1bill patenting a new drug? Improving outcomes is the objective, not maintaining the status quo for certain special interest groups within your economy.

Now, it's a fact that insurance companies are awful and a world that didn't need them would be a better world than ours. They're inherently immoral (or amoral, to be charitable) in that they actively seek excuses to deny treatment for people to improve their margins. People who are fortunate to grow up in civilized countries where human health is not a commodity understand that. When someone has to sell their house and liquidate their kids' college funds because they got cancer, then the system is immoral and needs to be scrapped for one where that sort of thing is never an issue.

But go on advocating against your own self-interest, people. You'd think everybody here works in PR for an insurance company or something.

Macklin: you should also re... (Below threshold)
hyperbolist:

Macklin: you should also read about Switzerland's healthcare system, which is closest to what Obama wants. "Government run" is not an accurate way of describing a system with a public option. It's dishonest to suggest otherwise.

hyper Sta... (Below threshold)
pvd:

hyper

Start with asking insurance companies to justify their own existence--to explain in cogent terms what value they add to your nation's health care system.

They exist for the same reason that every other insurance policy is created: to spread the risk evenly across populations. We do it with home insurance, car insurance, disability insurance, life insurance.

Should all those come under the "public" option as well? There is no difference in principle.

Regarding Sweden: link

Sven R. Larson tells about some of Sweden's problems in "Lesson from Sweden's Universal Health System: Tales from the Health-care Crypt," published in the Journal of American Physicians and Surgeons (Spring 2008). Mr. D., a Gothenburg multiple sclerosis patient, was prescribed a new drug. His doctor's request was denied because the drug was 33 percent more expensive than the older medicine. Mr. D. offered to pay for the medicine himself but was prevented from doing so. The bureaucrats said it would set a bad precedent and lead to unequal access to medicine.

Malmo, with its 280,000 residents, is Sweden's third-largest city. To see a physician, a patient must go to one of two local clinics before they can see a specialist. The clinics have security guards to keep patients from getting unruly as they wait hours to see a doctor. The guards also prevent new patients from entering the clinic when the waiting room is considered full. Uppsala, a city with 200,000 people, has only one specialist in mammography. Sweden's National Cancer Foundation reports that in a few years most Swedish women will not have access to mammography.

What Obama propses and you endorse has yet to work anywhere. And still, despite our issues, the US still leads the world in medical innovation.

Please document your assertation that Americans as a percentage engage in more "medical tourism" than Canadians. How many of them travel to countries more tightly regulated than the US market? Illegal immigrants don't count. That will knock down a large percentage headed to Mexico, I think.

You want to see government ... (Below threshold)
GarandFan:

You want to see government run health care at it's finest in the US? Check out what our wonderful government bureaucracy does to the American Indian. Their motto is to always get sick in the first 6 months of the fiscal year, otherwise, forget it.

And what Obama has... (Below threshold)
Mac Lorry:
And what Obama has proposed is most similar to the system in Switzerland.

Reading about Healthcare in Switzerland here and here, I don't see where it has much in common with what Obama has proposed, particularly because he hasn't offered a plan of his own as of yet. Also, a plan that works for 7.5 million people all located in a small geographic area might not scale up to work in the U.S. For example, the public part of Switzerland's healthcare system is made up of just one hospital, the University of Geneva Hospital. In the U.S. we have more than 3 times as many illegal aliens as Switzerland has citizens. Does anyone think illegals are going to pay for insurance as required in Switzerland?

What's more, healthcare in Switzerland is having the same problem with unsustainable rising costs as we have in the U.S. I submit that no healthcare system that doesn't impose rationing by some means can contain costs over the long run. If we (the U.S.) can admit that and then design a rationing system that puts individuals in charge and puts market pressure on the healthcare delivery system we'll leapfrog ahead of all other nations in terms of healthcare.

Switzerland is much smaller... (Below threshold)
JustRuss:

Switzerland is much smaller than the US, lets do just that but do it at the STATE level. It reduces bureaucracy and if one part of the system goes fraudulent its only in that state.

Let the people vote on it though, I bet at a state level they would vote yes.

Switzerland is muc... (Below threshold)
Mac Lorry:
Switzerland is much smaller than the US, lets do just that but do it at the STATE level.

Unfortunately, the Switzerland healthcare system doesn't control costs as they are finding out. At some point they'll have to ration healthcare using the same technique Canada, the UK, and Sweden use, which is to make people wait in long lines and then to make them wait for treatment. Nobody in their right mind would think that's a good system.

Hey everybody? Where did H... (Below threshold)
pvd:

Hey everybody? Where did Hyper go?

We've shot down Sweden, Switzerland, Canada, the UK, the Indian reservations....

....I'm thinking I need to check on Monaco and Lichtenstein for Hyper's next "it worked for 6 months in ______________ ( please fill in your micro-state of the moment)!"

A lot of the arguments here... (Below threshold)
James H:

A lot of the arguments here highlight why I would really prefer that states tackle healthcare reform rather than the federal government:

1) The states could individually decide their own healthcare priorities and regulate insurers to their preference. Florida, for example, could mandate that all insurers include extensive eldercare coverage, while West Virginia might have some choice words about health conditions stemming from coal mining. Meanwhile, a state like Vermont that has low population and high liberalism could design a single-payer system. This also gives individuals greater choice than they might have under a federal plan. If somebody wants to pay high taxes in exchange for (presumably) superior healthcare, he could move to a state that provides such.

2) States are called the "laboratories of democracy" for a reason. If a solution works reasonably well at the state level, the federal government would have the option to examine whether that solution scales well nationally.

Hyper-bullshitLets... (Below threshold)
914:

Hyper-bullshit

Lets be clear, You hate America because just like the big O You were not born here?

Or are You just mac44 in hyperdrive drag?

James H -I'm in pr... (Below threshold)
JLawson:

James H -

I'm in pretty fair agreement with you on the healthcare reform problem - loosen things up in the insurance marketplace and let the states figure out what's best... however, I doubt seriously that Washington would even momentarily consider such an option.

Which is a shame. Their approach is equivalent to using a cannon as a flyswatter. Yes, if aimed properly it'll kill the fly - but the ancillary damage is likely to be horrendous.

hyper:Bu... (Below threshold)
_Mike_:

hyper:

But a greater percentage of Americans travel abroad for it [healthcare] than Canadians (i.e. to Mexico and Thailand).

Huh ? Got a reliable source for that assertion ?

JLawson:Gotta add:... (Below threshold)
James H:

JLawson:

Gotta add: If insurers were allowed to write policies across state lines, that would kill states' ability to regulate them.

pvd, I have a job. Much as ... (Below threshold)
hyperbolist:

pvd, I have a job. Much as I would love to get paid to discuss healthcare reform with you all day, I do have to spend 8-12 hours a day earning a living.

You didn't "shoot down" Japan. Despite our system's failings, you didn't really "shoot down" Canada either. And the current American system is "shot down" by pointing out that great innovation does not ameliorate the fact that some people do not have access to critical care because they don't have enough money to pay for it. Outcomes in your country are awful vs. other developed countries, especially given how much it costs; and care is already rationed by insurance providers.

Here's a link detailing the nature and volume of Americans traveling abroad for health care. It's old, but we can assume that things have gotten worse in this regard since 2006, not better. I can't find the article comparing Canadian vs. American healthcare tourism, but I think it was written by Krugman so you wouldn't like it anyway.

914: still, with the birther conspiracy? Christ, you're a retard--a seriously stupid human being. Honest question for you: are you drunk all the time, or semi-literate?

For the record, I agree with James H. @ #31. Seems like a good compromise, given the regionalized hostility towards a public option. If people in Wyoming don't want the government interfering in their lives--except when it comes to maintaining their infrastructure, subsidizing their farms, defending them, putting out their fires, and providing health care for senior citizens, to give a few examples--fine. But they shouldn't be allowed to deny universal access to people in Vermont.

hyper:There's noth... (Below threshold)
_Mike_:

hyper:

There's nothing in the article that supports your assertion that "a greater percentage of Americans travel abroad for it [healthcare] than Canadian".

If you watch cable news at ... (Below threshold)
Mike:

If you watch cable news at all, you've seen the ads for "health care reform", now being called "health insurance reform". "It is an interesting subtle switch in language". Mike Oliphant runs a small Utah health insurance website http://www.benefitsmanager.net/SelectHealth.html and http://www.dentalinsuranceutah.net whom deals with people day to day struggling to find affordable coverage. "I think it's important to not understate the huge difference in meaning between "health insurance reform" and "health care reform". Let's not lose focus on the need to reform a broken health care system which includes not only health insurance carriers but also billing practices of medical providers. Why isn't TORT reform part of the national discussion? Studies show that alone could lower costs by 15% for both the medical professionals and health insurance carriers (Humana). Perhaps the federal government should take notice of what Utah has accomplished with first step of health insurance reform and promises for reform in the medical provider arena. Several interesting changes took place with the passage of H.B. 188. House Speaker Clark has championed the need for change while recognizing the experience of the private health insurance sector. To see more about this visit http://www.prweb.com/releases/utah_health_insurance/health_care_reform/prweb2614544.htm

hyper,I didn't que... (Below threshold)
pvd:

hyper,

I didn't question your employment so I don't really understand the hostility. I too have a job. Most people do.

You chose to make statements that you haven't backed up with a source except a newspaper article that relies on an anecdotal source.

You did not answer the question regarding how health insurance is different from any other form of insurance.

Regarding outcomes - if you are female, would you rather have the US healthcare system or any of your favored ones if you had breast cancer?

If you are born at 24 weeks gestation, here or Canada? We count those as live births - not everyone does.

In the Netherlands, babies below 25 weeks gestation are no longer resuscitated, but rather given only palliative treatment. Those at 25 to 26 weeks are generally resuscitated and kept alive, but the decision depends on the facts of each case.3 The result is underreporting the number babies that may be live-born but who are not offered aggressive treatment.

Switzerland only uses two of the four WHO criteria, respiration and heart beat, and does not aggressively treat very premature babies. In some cantons, the baby must be 30 cm long to be registered as a live birth. Switzerland also requires registration of still births only from 6 months gestation and has no rule regarding registration of live births. Studies have found significant underreporting of premature births in Switzerland, which can alter the overall mortality rate by more than a percentage point.

Your agruement at some people do not have access to innovative care in the US is interesting given that in Canada, the UK and most of Europe, most (if not all depending on treatment regimen) do not get innovative care. Indeed, in those countries it is discouraged because it increases costs.

Add in the lack of development and the US gets to foot most of the R&D in medicine for the world - many of whom then co-opt it and sell it at forced discounts to their citizens, raising our costs.

Not that you really care.

Have a nice day at work.

hyperbolist wrote:... (Below threshold)
iwogisdead:

hyperbolist wrote:

And the current American system is "shot down" by pointing out that great innovation does not ameliorate the fact that some people do not have access to critical care because they don't have enough money to pay for it.

But that's not what Obama says. He says that there's a "hidden cost" in my health insurance premium that's put there to cover health care given to the uninsured by American hospitals. By the way, arguing against innovation is not exactly a selling point. I don't want to be stuck with 2009 medicine for the next (hopefully) 40 years of my life--just like I'm glad we're not stuck with 1969 medicine today.

By the way (part two) the link you provided to prove that a whole bunch of Americans are going abroad for healthcare is pure bullshit. It cites two whole people who got medical care abroad (one who got hurt overseas and had to stay there for care) and some writer claiming that 100,000 Americans are going abroad for "cosmetic procedures." I'm guessing that the 50,000 patients in Thailand are there for cosmetic procedures, but it's hard to tell from this disjointed article. The emphasis in the story about the guy who got heart surgery in India was that he got treatment from an American trained doctor. That's important because the best training is right here. The best people from all over the world come here to train and to practice. Naturally, having the best people costs money, but it also leads to the best healthcare. And, now, the Democrats want to change all that.

Here's a great quote from your article: "more than 100,000 Americans a year travel beyond the boarder for cosmetic procedures alone." [my emphasis]
I'm not putting much stock in "facts" cited by a writer who didn't even bother to proofread his article. Unless he meant to say that Americans are traveling farther than the tenant is for their plastic surgery.

Before making dumbass comments, please find better sources.

Hyper isn't worried about h... (Below threshold)
GarandFan:

Hyper isn't worried about health care in his country. When on overload (as they are in some areas right now) the Canadian system DUMPS THEIR PATIENTS ON OUR SYSTEM. One wonders what will happen when the idiots in Washington decide to subject us to the Canadian way. What country will get Canada's overload then?

Sorry, but the "Where is hy... (Below threshold)
hyperbolist:

Sorry, but the "Where is hyper?" remark seemed to imply that you thought I had no response, whereas sometimes I don't have time to read blogs.

And you'll have to excuse the hostility, given that I have to fucking bathe in it when I wade through threads populated by 913.5, SlowWillie and the like.

Health insurance is unlike other types of insurance in that human well-being is not a commodity, like a car or a house or a savings account. It's intrinsic to living a respectable life, and is therefore a necessary component of the pursuit of happiness--something that we all have a right to. So that's why health insurance is different in kind from insurance on commodities.

People are better off getting breast cancer in Canada. Outcomes do not vary significantly, and it doesn't cost anything out of pocket. You could surely produce a list of Canadians who have had to travel to the United States or elsewhere for treatment due to long wait times, but then there are many Americans who have not been able to get treatment--or have had to bankrupt their families--because they couldn't afford it, or their insurance company decided not to cover it for some evil, arbitrary reason.

As for the discouragement of innovative care, that's false. I know quite a few people who have had cancer, and all of them have received excellent treatment, and none had to wait longer than clinical guidelines stated was acceptable. (E.g., my father waited a month to have a prostate tumor removed, but could safely have waited longer.) His father has had multiple surgeries and a shit-ton of medications paid for by the gov't despite a general lack of interest in prolonging his own life. No rationing for that 85 year old man. And my uncle, who has had AIDS since the late 1980s (and HIV since '82) is alive and well, all things considered, because he had access to experimental retroviral medications. So for every horror story you have about the Orwellian Canadian health care system, I have many more success stories--and even then I freely admit that our system is in severe disrepair. Still, it's better than the American system. (Better outcomes, delivered more efficiently.)

Better source for medical tourism.

Sorry, that source is terri... (Below threshold)
hyperbolist:

Sorry, that source is terrible as well.

This one is better. Impossible to track the actual volume of tourists going abroad for medical procedures, but suffice to say it's a hell of a lot, and it will be a hell of a lot more as costs continue to increase.

My country has a roadmap for dealing with escalating costs and reducing wait times, whereas you people are still trying to hamstring those who would reduce the role of insurance companies in the healthcare system such that poor people with diabetes and asthma might get access to decent primary care. And of course the scariest part is that you think you're right.

Well hype... that make 2 li... (Below threshold)
Marc:

Well hype... that make 2 links in a row that are self admitted junk, van you do better with the third?

As your third link suggests there is NO reliable estimate of how many leave the States for medical treatment yet... you conclude "it's a hell of a lot."

The low number given is 150,000. Math is not my subject but that appears to be less than one half percent of the U.S. population.

And even that raises the question, why are they traveling? How many are doing so to get treatment not authorized by the FDA for various reasons?

"My country has a roadmap for dealing with escalating costs and reducing wait times, whereas you people are still trying to hamstring those who would reduce the role of insurance companies in the healthcare system"

You people?


Obviously not those that are calling for tort reform that can, and will eliminate high insurance rates to doctors and conceivably lower costs.

"You people" also fails to include those calling for an all-out war on Medicare fraud that this admin and many previously only spend 5 percent of resources to combat it.

Oh, and BTW, screw your countries "system."

Here's my favorite section ... (Below threshold)
iwogisdead:

Here's my favorite section from the "third" hyperbolist link:

On the one hand we have McKinsey saying that fewer than 50,000 Americans go overseas; but they don't count people going to Mexico, Canada, Cuba or anywhere else that has a border with the USA. At the other extreme we have a 2008 report from Deloitte estimating the number to grow to six million by 2010 . . .

There's so much here I don't know where to start. How about looking at a map to learn that Cuba does not have a border (boarder?) with the US? Plus, I'd like to hear the story of any person who ever went from the USA to Cuba for medical care in the last 50 years. Doesn't exist. Best of all is the concept that 6 million people will go overseas for medical care in 2010.

Hyperbolist, man up and concede that you can't prove this claim.

hyperbolist wrote:... (Below threshold)
iwogisdead:

hyperbolist wrote:

. . . you people are still trying to hamstring those who would reduce the role of insurance companies in the healthcare system such that poor people with diabetes and asthma might get access to decent primary care.

The Democrats have never proposed such a plan. The two plans written by the Dems that I have seen are blueprints to dismantle private healthcare through use of (among other things) the government option and onerous regulation of private insurance policies.

If the Dems want just to provide health care to poor people, we would be having a completely different debate. That's not what they want--they want everyone to have the healthcare that the Dems think they should have. That's the source of the resistance in this country, and the Dems just can't seem to figure that simple fact out.

"There's so much here I... (Below threshold)
Marc:

"There's so much here I don't know where to start."

Not to mention hyper's other link suggests some un-Godly number of Mexicans are going back to their homeland for med care. AND, wait for it, many are illegals.

And this "Due to its close proximity to the U.S., Mexico has become a top medical tourism destination with 40,000 to 80,000 American seniors spending their retirement there with a considerable number receiving nursing home and health care."

Is stunningly STUPID, if seniors are spending their retirement there, they ARE NOT crossing the border for treatment, they are LIVING there.

GEE, I retired to the Philippines, do I count by using these numbskulls criteria?

"That's not what they w... (Below threshold)
Marc:

"That's not what they want--they want everyone to have the healthcare that the Dems think they should have."

Well, almost.

They DON'T think the peons and great unwashed should have what obama and the rest of the congress-critters have.

after last year i gave up o... (Below threshold)

after last year i gave up on politics...i just pray for the best...

I do not agree with the fee... (Below threshold)
Lisa:

I do not agree with the fee.

By "you people", obviously ... (Below threshold)
hyperbolist:

By "you people", obviously I meant "Oriental-types". Ha! No, I meant opponents of the public option.

Actually, iwog, when I was in Havana I met a bunch of Americans. They flew out of Toronto or Halifax. AND, one of them was there with his wife, who was getting cosmetic surgery. Ding!

I concede that I can't find where I read that a greater proportion of the American population than Canadian travels abroad for health care. Anecdotally, I have never met a Canadian who has gone to the United States for treatment, nor anyone who has even known someone who has done so. On the other hand, out of the few hundred or so Americans I have ever known, I have met some who have gone to India, Thailand, Mexico, and Cuba to receive treatment or to have an elective procedure performed.

If your information on the Canadian system--the deeply flawed system! remember, I'm not denying that!--comes from someone who wants to maintain the status quo for insurance companies in the United States, then you most certainly are not getting accurate information. You can concede that. Actually, I'll concede it for you. Point: conceded. Thank you.

hyper,Hea... (Below threshold)
pvd:

hyper,

Health insurance is unlike other types of insurance in that human well-being is not a commodity

But you claim,

When someone has to sell their house and liquidate their kids' college funds because they got cancer, then the system is immoral and needs to be scrapped for one where that sort of thing is never an issue.

It seems that you understand that insurance is to offset the financial costs associated with care. The majority of people in the US get very good care. You think they should not have to pay for it.

TNSTAAFL

Someone will pay for it or the service will not get delivered. I prefer a system of insurance that over delivers rather than the rationing systems in most of the more socialistic societies.

I say this as someone with 2 pre-existing conditions who pays 100% of my own (and family's) healthcare costs - Insurance, copays, deductibles, everything is paid by me as I am self-employed.

And yes, I ration my care. Voluntarily. When I or a family member needs help, we go to the doctor. We don't go for every common cold or hangnail.

Are you familiar with the concept of the tragedy of the commons? Having the users of healthcare foot the bill 100 percent with later reimbursement might go a long way to controlling costs.




Advertisements









rightads.gif

beltwaybloggers.gif

insiderslogo.jpg

mba_blue.gif

Follow Wizbang

Follow Wizbang on FacebookFollow Wizbang on TwitterSubscribe to Wizbang feedWizbang Mobile

Contact

Send e-mail tips to us:

[email protected]

Fresh Links

Credits

Section Editor: Maggie Whitton

Editors: Jay Tea, Lorie Byrd, Kim Priestap, DJ Drummond, Michael Laprarie, Baron Von Ottomatic, Shawn Mallow, Rick, Dan Karipides, Michael Avitablile, Charlie Quidnunc, Steve Schippert

Emeritus: Paul, Mary Katherine Ham, Jim Addison, Alexander K. McClure, Cassy Fiano, Bill Jempty, John Stansbury, Rob Port

In Memorium: HughS

All original content copyright © 2003-2010 by Wizbang®, LLC. All rights reserved. Wizbang® is a registered service mark.

Powered by Movable Type Pro 4.361

Hosting by ServInt

Ratings on this site are powered by the Ajax Ratings Pro plugin for Movable Type.

Search on this site is powered by the FastSearch plugin for Movable Type.

Blogrolls on this site are powered by the MT-Blogroll.

Temporary site design is based on Cutline and Cutline for MT. Graphics by Apothegm Designs.

Author Login



Terms Of Service

DCMA Compliance Notice

Privacy Policy