Blogcritics Comments on The Health Care Crisis and Why it Was Inevitable

Comment by Baronius on The Health Care Crisis and Why it Was Inevitable

Sat, 1 Mar 2008 00:09:50 EST

Bliffle, insurance isn't an oligopoly, but it will be if we lose our right to opt out of it.

Comment by Clavos on The Health Care Crisis and Why it Was Inevitable

Mon, 25 Feb 2008 12:21:59 EST

"Also, because there's no assurance that after you pay premiums for several years that the insurance company will actually pay for your healthcare when the time comes. They're experts at wriggling out of their responsibilities." Never had one do that yet, and my wife is hitting them for more than $50K a year (the amount not covered by Medicare) on a premium of $10K a year. Occasional initial denials, which invariably are paid when we object, usually because their clerks have made an error.

Comment by bliffle on The Health Care Crisis and Why it Was Inevitable

Mon, 25 Feb 2008 11:25:52 EST

"Why are there 47,000,000 uninsured? Because they are not stupid enough to pay for the other guy." Also, because there's no assurance that after you pay premiums for several years that the insurance company will actually pay for your healthcare when the time comes. They're experts at wriggling out of their responsibilities.

Comment by Doug Hunter on The Health Care Crisis and Why it Was Inevitable

Mon, 25 Feb 2008 08:42:05 EST

"Why are there 47,000,000 uninsured? Because they are not stupid enough to pay for the other guy." One of the best arguments for some sort of forced or universal care. Lots of healthy people aren't covered, yet they know in a medical emergency they get de facto coverage and within a period of months with a debilitating disease they could adjust their income enough to qualify for free healthcare anyway. In a way we almost have universal healthcare already, we just don't have universal sharing in the cost. As a far right winger I'm usually against most programs pandering to the poor, but in this case the poor are already covered. This is one democratic idea that might actually remove some stress from the middle class. How to implement it is anyones guess, but I like tax credits for coverage except for those with no income who should get coverage vouchers. Why do I make this possible exception to my right wing views? Simple. Everyone receives de facto health coverage, therefore everyone should have to pay for that priviledge.

Comment by troll on The Health Care Crisis and Why it Was Inevitable

Mon, 25 Feb 2008 08:02:07 EST

*O, those evil executives!* executives aren't evil (necessarily) - they serve many useful functions in our economy and deserve a good $25/hr...maybe even $30/hr depending on experience

Comment by REMF on The Health Care Crisis and Why it Was Inevitable

Mon, 25 Feb 2008 01:17:02 EST

"Without questioning the validity of what you say, SS, I do have to point out that I can't recall anyone from another country with socialized medicine being as enthusiastic about their system as you are about yours." I disagree. Being close to the border, I know plenty of Canadians who are more than happy with their system.

Comment by Clavos on The Health Care Crisis and Why it Was Inevitable

Mon, 25 Feb 2008 00:00:31 EST

O, those evil executives! We should make it a capital crime to be a businessman and execute them all forthwith. Scum...

Comment by bliffle on The Health Care Crisis and Why it Was Inevitable

Sun, 24 Feb 2008 23:49:59 EST

The Federal Government, as well as the weak system of state governments, has been successfully manipulated and suborned by the Insurance companies to ensure their iron grip on the finances of the US health system (do you ever hear a mention of health care financing without reference to "the need to secure Health Insurance"?). It is always so, with monopolies and oligopolies, just as the other abusive corporations in the USA use their power and deep purses to bludgeon elected officials into conformity with their objectives, which are set by the top executives, and, conveniently enough, serve mostly to enrich those same execs.

Comment by Baronius on The Health Care Crisis and Why it Was Inevitable

Sun, 24 Feb 2008 17:15:49 EST

Handy is right to compare health care and education. Both sectors are experiencing enormous inflation. The more government gets involved in them, the higher the prices go, and the less say the consumer has. If I want to go to college, the payments are essentially a deal between a loan officer and a registrar's office. If I want to go to the hospital, an insurance company works out a price with a hospital administrator. Everyone makes bookkeeping entries, but no money changes hands. I have no say, because I'm not paying. The doctor has as little input as I do. Every year, the government promises to pay a little more of the exchange. So the payments increase proportionately. The actual payments (from me, to the doctor) are on the margins. Fortunately, in the medical field, technology is progressing so quickly that it's able to sustain this pyramid scheme. In the academic world, the overbooking of college is sustained by the continual lowering of standards (grade inflation). The fracture point in the medical field is the supply of doctors. We're creating new layers of techs, doctor's and nurse's assistants, et cetera, just to keep the system running. Both political parties are committed to government expansion in health care and education. But we know that's only going to drive up prices further. As P.J. O'Rourkes says, if you think health care is expensive now, wait till it's free.

Comment by Alec on The Health Care Crisis and Why it Was Inevitable

Sun, 24 Feb 2008 00:16:26 EST

John - Very good article. A nicely reasoned analysis of some of the key issues regarding health care. However, I think that some employer-based plans, especially some PPO's were not just creatures of politics and the tax code, but initially reasonable attempts by employers to offer plans which would help their employees. The original elements of the Kaiser Health plans come to mind, as do the various health care plans offered by aerospace companies in California during the Golden State's boom years. RE: Let's give the free-market and freedom of choice a chance. Has this worked anywhere recently without some form of government intervention?

Comment by STM on The Health Care Crisis and Why it Was Inevitable

Thu, 21 Feb 2008 20:34:20 EST

"Golden revolution" ... sorry, typo. Make that Glorious revolution. For more clues on the origin of the US constitution and the declaration of independence, see John Locke.

Comment by Daniel X. Wray on The Health Care Crisis and Why it Was Inevitable

Thu, 21 Feb 2008 16:51:56 EST

The health care system in the United States has been crippled by the Federal Government. For people between the ages of 18 and 55 the average health care annual expenditure is about $600(with the exception of childbirth related expenses). Even crisis intervention for critical life threating issues is extremely low for this segment of the population. Death rates from medical related conditions are on the order of 3 in 100,000. If those three people require $500,000 in care the cost for the rest of the 100,000 people is $15 each. So if the cost of health care for the 18-55 year olds is $600-700/ year, why does health insurance cost $8500? The answer is that the Federal Government decreed that the folks on medi-care get really cheap Health Care. While that is both literally and figurative the cost to subsidize this care comes from your insurance. Right now it is estimated that 80% of all your health care costs are incurred in the last two months of your life. Your $8500 insurance bill is another transfer payment to the older folks because the Congress of the United States has already spent all of the money. Why are there 47,000,000 uninsured? Because they are not stupid enough to pay for the other guy.

Comment by bliffle on The Health Care Crisis and Why it Was Inevitable

Thu, 21 Feb 2008 14:36:56 EST

Bamby misses the point, as usual: "No insurance company is anywhere as bad as medicaid with screwing doctors. Do we want to put everyone under their care?" A healthcare system exists for the benefit of peoples health and not primarily for the enrichment of providers and insurers. We have to remove Insurance companies as gatekeepers and restrict their roles. The first step is to repeal the odious McCarran-Ferguson act of 1945 which enables the insurance company oligopoly.

Comment by John Bambenek on The Health Care Crisis and Why it Was Inevitable

Thu, 21 Feb 2008 03:09:18 EST

Well, we have Medicaid now that's supposed to cover all the poor people... yet we still have 50M insured supposedly. That, and at least in Illinois it takes 180 days for a provider to get their first denial letter from medicaid for payment. Then the cycle of sending more information begins. Medicaid has forced providers to operate on a Net 450 for those patients! No insurance company is anywhere as bad as medicaid with screwing doctors. Do we want to put everyone under their care?

Comment by STM on The Health Care Crisis and Why it Was Inevitable

Thu, 21 Feb 2008 02:51:19 EST

It isn't perfect, though, I have to say. But it works. How it might translate from a country with a population of 20 million to one with 400 million, however, might be the acid test. I suspect that a big bureaucracy would be needed, although that DOES create work. Remember: you have nothing to fear but fear itself :)

Comment by Dr Dreadful on The Health Care Crisis and Why it Was Inevitable

Thu, 21 Feb 2008 01:31:01 EST

Well, Clav, from his description it does seem that Australia has managed to strike a happy balance between universal access to free health care and providing top-quality health services. I'm sure the system must have its critics, and one of these days I'll read up on it a bit. But to be frank, Australia's health service could be on a par with rural Burkina Faso and I'd still want to live there. Now remind me why haven't I bought my plane ticket yet, again?

Comment by Clavos on The Health Care Crisis and Why it Was Inevitable

Thu, 21 Feb 2008 01:10:43 EST

Without questioning the validity of what you say, SS, I do have to point out that I can't recall anyone from another country with socialized medicine being as enthusiastic about their system as you are about yours. Australia's system apparently is much better than most.

Comment by STM on The Health Care Crisis and Why it Was Inevitable

Thu, 21 Feb 2008 00:42:16 EST

If the dems get in, you guys are going to get a form of universal health care. I know that Hillary was in Australia looking at our system on a visit with Bill, so if you get something like ours it probably won't be so bad, because it combines optional private hospital cover with public cover. The good thing about it is that with Medicare, even as a private patient, with no waiting lists and doctors and hospital accomodation of your choice, a lot of stuff is free. That keeps the cost down for the individual. A lot of people were sceptical when we first got our system, but it's been honed nicely over 3 decades, has led to a lot of work in the health sector, and is world-class. Perhaps you can learn from the mistakes made by others and step in just at the right point. One thing I am certain of though is that once you get and you realise how good it is, you'll be kicking yourselves and wondering why you haven't had it since the year dot. People on both sides of the political spectrum here love it, which is always a REAL measure of how good something is. It is really nice to know that if you get sick, and ultimately you can't keep working, you have care that is world-class and isn't going to cost you a cent. It's not perfect, obviously, but it's still pretty damn good. This is the kind of stuff governments should use your taxpayer dollar for, not spending billions on aircraft carriers and fleets of bombers that are sitting around rusting away because, dang, there just ain't no more superpowers in the same league. A happy country is a good country.

Comment by Lumpy on The Health Care Crisis and Why it Was Inevitable

Thu, 21 Feb 2008 00:10:19 EST

The problem is that there are operations that cost a million dollars. That's unjustifiable on any basis. Fix that and u fix the system.

Comment by bliffle on The Health Care Crisis and Why it Was Inevitable

Wed, 20 Feb 2008 20:59:13 EST

#15 — February 19, 2008 @ 23:43PM — handyguy ... The key, whether we end up with a single-payer system or not, is to somehow give incentive to insurance companies to pay for care. Now their incentive is to deny care. There's NO way to incentivize an InsCo to pay for a million dollar operation on a 30k auto mechanic, so eventually the InsCo bureaucrat MUST deny the operation and condemn the guy to death. The whole system of "incentives" has to be demolished in order to reveal the real costs of maintaining a facade of "free markets" and "private enterprise".

Comment by Clavos on The Health Care Crisis and Why it Was Inevitable

Wed, 20 Feb 2008 00:51:48 EST

"And he doesn't really address the many millions of Americans without coverage. Some are poor; some are not. Some have employers who don't offer care." The only uninsured Americans deserving of concern are those who can't afford insurance, or those denied insurance because of a "pre-existing condition". The fact that your employer doesn't offer it is literally irrelevant, because insurance is available for the vast majority of the population, provided they can pay for it, regardless of whether or not it is offered by an employer. There are literally millions of self-employed people who are buying insurance on their own. Rather than try to set up a government-paid insurance program which would, inevitably, end up as corrupt and wasteful as Medicare, I think we should seek solutions whereby the poor and those who have been denied insurance are able to get it. We should do this without attempting to completely tear down and re-build the medical industry. As bad as our government is at doing anything right, the last entity in the world we want controlling our entire health care infrastructure is the people who build bridges in Minnesota using $600 hammers.

Comment by handyguy on The Health Care Crisis and Why it Was Inevitable

Tue, 19 Feb 2008 23:50:48 EST

It is also, forgive the overused word, disingenuous for John to give Ted Kennedy sole responsibility for the HMO Act of 1973, which was the result of studies and committees developed by the Nixon White House. And Nixon welcomed the bill and signed it gladly. [Michael Moore in Sicko claims that Nixon was so enthusiastic because Ehrlichman or Haldeman told him it would help insurers make more money, since they could deny care that cost too much or was outside the rules of the system. I'll leave it to others to decide whether MM was overreaching here.]

Comment by handyguy on The Health Care Crisis and Why it Was Inevitable

Tue, 19 Feb 2008 23:43:15 EST

John doesn't really address the illogical connection of employers to health care. Why should employers be the main source for so many? And he doesn't really address the many millions of Americans without coverage. Some are poor; some are not. Some have employers who don't offer care. I understand the hesitancy about a government-run system. But we let the government finance and run schools and police forces. For some of us, this analogy isn't so far out. And it's just not morally acceptable to allow so many people to be shut out of the system. The key, whether we end up with a single-payer system or not, is to somehow give incentive to insurance companies to pay for care. Now their incentive is to deny care.

Comment by alessandro on The Health Care Crisis and Why it Was Inevitable

Tue, 19 Feb 2008 23:40:33 EST

Doc, technically the Chinese came up with it. Then Bismarck's Germany. Germany (Britain's pal) is considered to be the first welfare state. So am I to understand Americans choose their health providers like they do mutual funds?

Comment by STM on The Health Care Crisis and Why it Was Inevitable

Tue, 19 Feb 2008 23:37:51 EST

Nice to see Bamby giving a nod to the notion that the founding fathers just grabbed all their ideas out of thin air. Once again, and I'm sick of saying it over and over again for the benefit of those Americans who are too ignorant to make the effort to understand this stuff, all of us in the English-speaking countries have near-identical rights that as Bamby rightly says, we were born with rather have had bestowed on us by government. The ideas of the founding fathers come largely from the Magna Carta (the idea of due process comes from a statute of Edward III added to the Magna Carta, and the wording's almost identical to that of the US constitution but predates it by 400), and the unwritten (in the sense that it combines many laws both written and taken to have existed) constitution of Britain that includes such documents as the English Bill of Rights and a zillion judgements made at common law. Even US law is based largely on Blackstone's treatises on English law. One major guiding train of thought behind the American Revolution was the train of thought behind the ideals that blossomed in Britain in the 17th century and led to the Golden Revolution. It is why the British, probably rightly, saw themselves as the defenders of real democracy and civilisation in that period through to the mid-19th century against the bogus claims of the French Revolution, and dare I say it, the American revolution which was essentially a mockery and a sham that while offering "rights, freedom and liberty", kept one group of people in virtual penal servitude simply because of their colour. The reality of the US Bill of Rights didn't catch up with its well-intentioned promise until the mid-1960s. This is something all Americans should be cognisant of before they open their traps in regard to rights taken to exist rather than bestowed. As for the French, well ... the guillotine got a fair work out and if that's liberty and freedom, I'll eat my hat. The founding fathers didn't exist in a vacuum (unlike many modern Americans, including those who can lay claim to a decent education but who still haven't a clue). Just because these things haven't been written down in a constitition doesn't mean they don't exist as rights every bit as powerful and protected at law as those enjoyed by Americans. When discussing the deluded and fancy notions in regard to rights that so many Americans seem unable to rid themselves, it's important to have an understandg as Doc does and I do in far off Australia of why they AREN'T different. They might be different in France, Germany and Spain, but they are essentially the same in all the countries that inherited their legal systems from England. However, on health care: while I like the right to pay a gap insurance that means I'm never out of pocket, it's also nice to have had a right added should things go belly up ... that's the right to get sick without going bankrupt, and the right to quality healthcare for everyone no matter what social strata they occupy. I put it in the same league as, say, having the right to catch a bus to work without a lunatic taking pot shots at me with an AK47. I say that right overrides the right for all citizens to bear arms. So yes, government can bestow some rights in addition to those we have, or at least can enumerate them.