American Healthcare; could it be that it is so expensive, because it's the Best?

Ten reasons why American health-care is more expensive - and better (source: Hoover Digest at Stamford)

They are compelling reasons. Can anyone doubt that GOOD medical care does cost more? That's not to say there aren't things we can do to lower costs, but even so, quality usually costs more. Much of what we take for granted isn't even available to others. Even the poorer among us in the USA often get what they need. The assertion that without Obamacare, "poor sick people will die in the streets" is false.

There is room for reform, for sure. The Health Care Industry does not have our best interests in mind, any more than the government does. We are really going to have to insist on reforms that serve OUR interests, building on what's good about the current system, not destroying it.
     

Health Care Costs; why the high prices?

George Will has an interesting article today:

Americans Will Regret Health Care 'Fix'

[...] Most Americans do want different health care: They want 2009 medicine at 1960 prices. Americans spent much less on health care in 1960 (5 percent of GDP as opposed to 18 percent now). They also spent much less -- nothing, in fact -- on computers, cell phones and cable and satellite television.

[...]

The Hudson Institute's Betsy McCaughey, writing in The American Spectator, says that in 1960 the average American household spent 53 percent of its disposable income on food, housing, energy and health care. Today the portion of income consumed by those four has barely changed -- 55 percent. But the health care component has increased while the other three combined have decreased. This is partly because as societies become richer, they spend more on health care -- and symphonies, universities, museums, etc.

It is also because health care is increasingly competent. When the first baby boomers, whose aging is driving health care spending, were born in 1946, many American hospitals' principal expense was clean linen. This was long before MRIs, CAT scans and the rest of the diagnostic and therapeutic arsenal that modern medicine deploys.

In a survey released in April by NPR, the Kaiser Family Foundation and Harvard, only 6 percent of Americans said they were willing to spend more than $200 a month on health care, and the price must fall to $100 a month before a majority are willing to pay it. But according to Grace-Marie Turner of the Galen Institute, Americans already are paying an average of $400 a month.

Most Americans do not know this because the cost of their care is hidden. Only 9 percent buy health coverage individually, and $84 of every $100 spent on health care is spent by someone (an employer, insurance company or government) other than recipients of the care. Those who get insurance as untaxed compensation from employers have no occasion to compute or confront the size of that benefit. But it is part of the price their employers pay for their work.

The president says the health care market "has not worked perfectly." Indeed. Only God, supposedly, and Wrigley Field, actually, are perfect. Anyway, given the heavy presence of government dollars (46 percent of health care dollars) and regulations, the market, such as it is, is hardly free to work. [...]

Government is a big part of the problem. MORE government is not going to make the situation better. Read the whole thing.
     

The Government and Health Care: What's Next?

Where is it all going? What can we expect? This article breaks it down into three areas of consideration; Costs, Mandates, and a Public Plan:

Health care: Deal or no deal? Senators begin work

[...] Sen. Ron Wyden, D-Ore., sees opportunity. "There is a very appealing philosophical truce within the Senate's grasp," he said.

"Democrats are right on the idea that we've got to cover everybody. Republicans have been right on the role of the private sector, not freezing innovation and staying away from price controls," Wyden said. "You meld those philosophical views and you are on your way to 68 to 70 votes."

Consensus is growing on many points: Changes should build on the current system, not scrap it; hospitals and doctors should be paid for quality, not quantity; insurers shouldn't be able to discriminate against people with health problems; small businesses need special attention.

But huge differences remain. Three of the hardest issues are:

Costs:

Obama set aside $634 billion in his budget as a "down payment" for health care over 10 years. Many experts believe that represents less than half the cost. Covering the uninsured could cost $100 billion to $150 billion a year, or more.

Liberal Democrats want to follow Obama's example and get half the money from tax increases and half from spending cuts. Upper-income tax increases and sales tax increases on alcoholic beverages, tobacco products and even sugary sodas are being discussed.

But Republicans and fiscally conservative Democrats want most of the financing to come from spending cuts and from making the health care system less wasteful.

Mandates:

Health insurance is based on pooling risk: premiums from the vast majority of healthy people cover care for the sick. For the system to work, economists say, everyone should have health insurance from the outset so uninsured people don't end up going to the emergency room and driving up costs for everyone else.

Because insurance is expensive, requiring people and businesses to pay for it is politically difficult. Most people now get insurance from their employers, but companies aren't required to offer it and as the economy skids more have cut back.

Obama and Democrats are considering a combination of requirements on individuals, parents and employers, with exemptions for small businesses and sliding-scale subsidies for families making as much as $80,000 a year.

Republicans opposed an employer mandate in the 1990s, but have mixed views on an individual requirement. The insurance industry is supporting an individual mandate. Labor unions are pushing for employer mandates.

Public Plan:

Obama and the Democrats want to give middle-class workers and families the option of joining a government-sponsored insurance plan that would be offered alongside private ones through a new insurance clearinghouse.

Supporters say a public plan could be a testing ground for innovations and a check on private insurers. Republicans see it as a thinly disguised step toward a government-run system. Insurance companies say they wouldn't be able to compete with a government plan.

Efforts are under way to find a compromise, maybe by limiting the scope of the public plan. But Rep. Dave Camp, who is playing a leading role in the House, said he doesn't think a deal is possible. "The public plan is a bright line for us," said Camp, R-Mich. [...]

And so the tug-of-war begins. Who knows what we will end up with. At any rate, we SHALL see.
     

A National Health Care Preview, and a lesson from Natasha Richardson's experience

I had posted about Mitt Romney's health care plan for Massachusetts years ago. Some folks warned me that it was doomed to fail, and it seems that is the case. It seems that these sorts of things have been tried before, and the results are always the same:

National Health Preview: The Massachusetts debacle, coming soon to your neighborhood.

Praise Mitt Romney. Three years ago, the former Massachusetts Governor had the inadvertent good sense to create the "universal" health-care program that the White House and Congress now want to inflict on the entire country. It is proving to be instructive, as Mr. Romney's foresight previews what President Obama, Max Baucus, Ted Kennedy and Pete Stark are cooking up for everyone else.

In Massachusetts's latest crisis, Governor Deval Patrick and his Democratic colleagues are starting to move down the path that government health plans always follow when spending collides with reality -- i.e., price controls. As costs continue to rise, the inevitable results are coverage restrictions and waiting periods. It was only a matter of time.

They're trying to manage the huge costs of the subsidized middle-class insurance program that is gradually swallowing the state budget. The program provides low- or no-cost coverage to about 165,000 residents, or three-fifths of the newly insured, and is budgeted at $880 million for 2010, a 7.3% single-year increase that is likely to be optimistic. The state's overall costs on health programs have increased by 42% (!) since 2006. [...]

The article goes on to look at the usual ways governments use to attempt to fix these problems... and the flaws inherent in them. The article also claims that if this plan is applied on a national level, the results will be even worse, because MA had a far smaller percentage of its population uninsured than the national average.

Yet we are now about to adopt this plan on a National level?

Our current health care system would work better if some government controls were removed, such as the silly laws that forbid people from buying health care across state lines. Such as not taxing health insurance that people (like me!) buy for themselves.

If government is to have a roll in improving our health care system, they need to allow us more choices, not less. They need to stop over-burdening the present system with needless restrictions, and let competition lower prices. And our politicians definitely need to learn from the many mistakes of others who have gone before them. Many of them don't seem to have a good record of learning from mistakes. Hopefully the voters will.


There is a great deal to be learned from other National Health Care systems. Natasha Richardson's experience in Canada is a good example:

CANADACARE MAY HAVE KILLED NATASHA

COULD actress Natasha Richardson's tragic death have been prevented if her skiing accident had occurred in America rather than Canada?

Canadian health care de-emphasizes widespread dissemination of technology like CT scanners and quick access to specialists like neurosurgeons. While all the facts of Richardson's medical care haven't been released, enough is known to pose questions with profound implications.

Richardson died of an epidural hematoma -- a bleeding artery between the skull and brain that compresses and ultimately causes fatal brain damage via pressure buildup. With prompt diagnosis by CT scan, and surgery to drain the blood, most patients survive.

Could Richardson have received this care? Where it happened in Canada, no. In many US resorts, yes. [...]

Read the whole thing. It's not hard to see why CanadaCare failed her. In fact, look at this example of a little girl in the US, with a very similar injury to Natasha's:

Natasha's lesson helps save Ohio girl

[...] The McCrackens took Morgan to the emergency room at LakeWest Hospital in neighboring Willoughby, where doctors ordered a CT scan and immediately put Morgan on a helicopter to Rainbow Babies and Children's Hospital in Cleveland, with her father by her side.

"I knew it was bad when she had to get there by helicopter in six minutes, instead of the 30 minutes it would have taken to get to Cleveland in an ambulance," McCracken said.

When the helicopter arrived at Rainbow, the McCrackens were greeted by Dr. Alan Cohen, the hospital's chief of pediatric neurosurgery. He whisked Morgan into the operating room, pausing for a moment to tell McCracken that his daughter had the same injury as Richardson: an epidural hematoma.

McCracken remembers standing in the emergency room, feeling like the life had just been sucked out of him. "My heart sank," he says. "It just sank."

Unlike Richardson's, Morgan's story has a happy ending. [...]

It was a happy ending for Morgan because of quick action and ample availability of treatment and equipment. The very thing's that did not work out in Natasha's favor under CanadaCare.

There IS a reason why so many Canadian's come to the USA for medical treatment. They don't want to die waiting for treatment in Canada.

I'm sure that there are plenty of things we can do to improve our health care system in the United States, to make it more affordable and accessible. But policies that have a proven track record of failure should not be among them. We have to create better ways.


Related Links:

Health Insurance and Medical Expenses

Lowering Health Care Costs for Everyone

PRIVATE HEALTHCARE ... SAY IT AIN'T SO!

There's No Place Like Home: What I learned from my wife's month in the British medical system.