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best article on health care economics I've read in a while


Azazello1313
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I already read this article, and it is very poignant. Some of my favorite quotes.

 

Well, for every two doctors in the U.S., there is now one health-insurance employee—more than 470,000 in total. In 2006, it cost almost $500 per person just to administer health insurance. Much of this enormous cost would simply disappear if we paid routine and predictable health-care expenditures the way we pay for everything else—by ourselves

 

The data are clear: in our current system, physician supply often begets patient demand.

 

You may think your employer is paying for your health care, but in fact your company’s share of the insurance premium comes out of your potential wage increase. Where else could it come from?

 

I will add more later . . . This was a great article

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And one of the main arguments against government involvement is the resulting bureaucracy. :D

 

Yes, we're all very aware of the skills regularly demonstrated by the government, continually doing more with less. :wacko:

 

Read the article - there's a lot in there that would be fun/good to discuss!

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I am going to bump my own thread here, because this is a seriously good article that deserves to be read and digested.

It's a great article, profoundly well written and it has some outstanding ideas. The example of LASIK in comparison with other forms of medical care is very convincing.

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Yes, we're all very aware of the skills regularly demonstrated by the government, continually doing more with less. :wacko:

 

Read the article - there's a lot in there that would be fun/good to discuss!

So, you're claiming there is no bureaucracy issue right now? Your anti-government obsession blinds you to the existing problem.

 

And I've read it thoroughly - see above.

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Great article. Lots of the issues addressed are not even mentioned in the political debate taking place around the country.

 

They are mentioned in the political debate...but the verbiage is different. I guess one would have to be a wonk to truly understand the whole picture....and believe me, there is no one in Congress, much less the White House, that could come close to grasping the sheer complexities built into our current health debacle. To me, it is a rather simple solution...one that is market based, but also based upon clarified regulation and simplified tort process. The ultimate in health care is to have treatment equate to a desirable outcome. How do you do this? Is there a score keeper? One true reform would be to create an e-health system, which right now would come vicariously close to violating HIPPA laws.

 

Let me give you an example. My mother in law has a friend whose mom was 95 years old and needed a pace maker defrib type device installed to make her ticker keep on keeping on. She went to 20 doctors in the Chicago area....all of which said no to the procedure. She finally found one in Minnesota who would do it....and she is doing fine...but for how long? Lets ask ourselves...shouldn't there be a scorecard somewhere that states a procedure under certain set of circumstances achieve a yield of a set percentage in order to be desirable. This pulling out all stops to extend life sucks. I am not for euthanizing anyone...but can anyone here, if they were a doctor, justify possibly killing a patient at age 95 to add what...3 more years to their life? Now, I am not saying she should not have been able to get the procedure.....she should have...but she should have had to foot the bill. Insurance companies should not be forced to pay for procedures with very bad statisitcal outcomes. This is what drives costs way up for folks who need procedures where very good outcomes exist. I know it sucks, but it is what it is.

 

This is why I have a problem with the health care debate. It is too passionate...too dang emotional. If we were to use simple outcomes as a guide...it would save more lives while spending the least amount of money....meaning we could have a truly competitive system with folks not worried about who is going to get sued. Ask yourself this....if that 95 year old would have died on the operating table....do you think the family had a good lawsuit against the doctor....seriously ask yourself. I think they should have pulled his license for performing such a precarious and wreckless procedure on a patient with a very low liklihood to survive even the surgery itself. But alas....maybe I am cold and don't appreciate life. Or maybe I am a realist and know that if I hit 95, I am living on borrowed time and probably am not going to double down on someone elses dime.

 

bunch of rambled thoughts....but food for thought.

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They are mentioned in the political debate...but the verbiage is different. I guess one would have to be a wonk to truly understand the whole picture....and believe me, there is no one in Congress, much less the White House, that could come close to grasping the sheer complexities built into our current health debacle. To me, it is a rather simple solution...one that is market based, but also based upon clarified regulation and simplified tort process. The ultimate in health care is to have treatment equate to a desirable outcome. How do you do this? Is there a score keeper? One true reform would be to create an e-health system, which right now would come vicariously close to violating HIPPA laws.

 

Let me give you an example. My mother in law has a friend whose mom was 95 years old and needed a pace maker defrib type device installed to make her ticker keep on keeping on. She went to 20 doctors in the Chicago area....all of which said no to the procedure. She finally found one in Minnesota who would do it....and she is doing fine...but for how long? Lets ask ourselves...shouldn't there be a scorecard somewhere that states a procedure under certain set of circumstances achieve a yield of a set percentage in order to be desirable. This pulling out all stops to extend life sucks. I am not for euthanizing anyone...but can anyone here, if they were a doctor, justify possibly killing a patient at age 95 to add what...3 more years to their life? Now, I am not saying she should not have been able to get the procedure.....she should have...but she should have had to foot the bill. Insurance companies should not be forced to pay for procedures with very bad statisitcal outcomes. This is what drives costs way up for folks who need procedures where very good outcomes exist. I know it sucks, but it is what it is.

 

This is why I have a problem with the health care debate. It is too passionate...too dang emotional. If we were to use simple outcomes as a guide...it would save more lives while spending the least amount of money....meaning we could have a truly competitive system with folks not worried about who is going to get sued. Ask yourself this....if that 95 year old would have died on the operating table....do you think the family had a good lawsuit against the doctor....seriously ask yourself. I think they should have pulled his license for performing such a precarious and wreckless procedure on a patient with a very low liklihood to survive even the surgery itself. But alas....maybe I am cold and don't appreciate life. Or maybe I am a realist and know that if I hit 95, I am living on borrowed time and probably am not going to double down on someone elses dime.

 

bunch of rambled thoughts....but food for thought.

 

Well, well, well... Even a blind squirrel finds a nut every once in a while.

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I'd like to see a well argued response against the plan outlined in the article. It appears to be a great solution for the problems we currently face. Unfortunately I doubt we will ever see anything like it, as it reduces the power of and dependency on the government and it would go against the interests of some of the larger lobbyist in Washington.

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I'd like to see a well argued response against the plan outlined in the article. It appears to be a great solution for the problems we currently face. Unfortunately I doubt we will ever see anything like it, as it reduces the power of and dependency on the government and it would go against the interests of some of the larger lobbyist in Washington.

 

Perch, the article hit some good points. Here is the problem, no one really cares...all most people care about is themselves and that is it. The problem, the number one problem, with healthcare is lack of communication and no scorecard. For example, if we were to institute an e-health platform, that would allow for instant communication between doctors and hospitals for records and the such. To further illustrate, lets use a cancer patient who sees her primary care, oncologist, and maybe an endocrinologist. Currently, most patients have tests sent to their primary care, say blood labs or MRI's, so they can communicate the results to their patient. Problem is that the primary care is too damn busy to also forward these results to the oncologist and endcrinologist. So when the patient sees her specialists, they order more tests that are not necessary because of lack of communication....somewhat due to over compliance to HIPPA regulations. However, if they could simply access a database where all these results and reading are available...saves time and money and primary cares and specialists could work together on what is or is not working...saving the patient office visits and repeat tests.

 

Now as for outcomes. As with any database, take an HRIS system for example, there are ways to manipulate the programming to spit out reports and statisitics on how one treatment is working for a person in a classification or what not. So, using our cancer patient, lets assume it is pancreatic cancer, the treatments could be tracked and documented so there is actual data on what worked for this patient...and if you times this by the(making up a number here) 40,000 patients in the US, you could possibly see trends in realtime versus waiting for the next article in Pancreatic Cancer monthly.

 

I do not see the problem with health care as one solved by a simple public option. It is many fold problems and it starts with information not being in hands it needs to be in when health care decisions are made...which causes mistakes and duplication in the process.

 

So, my solution would be a tax subsidized health plan administered by the government for catastrophic coverage only. This plan would work something like this: Your private insurer only covers 3 million in lifetime benefits, the catastrophic coverage will cover all claims over this amount. Also, the catastrophic coverage would also pay for things that health insurance usually does not. Like when someone looses all their teeth due to a medical condition and cannot use dentures due to said condition. This is one example one of my clients are going through currently...no one will pay for it...so since they cannot afford the 40K to put dental implants in....the only solution they have is the wife have no teeth....which will have dire consequences on her continuing health due to lack of proper nutrition...not to mention lower earning capacity due to appearance.

 

After this catastrophic coverage is in place, then we let insurers compete NATIONALLY for business. Throw out all state regs and use the NAIC Model regulations as the authority over all states. Streamline the regulatory mechanisms. But, still keep the employer model for health insurance play because it works and has worked. If you allow companies to compete for all the business, you will find they will find more efficient ways to provide services. Couple that with e-health, and you can leverage your insurance to providers who are statistically achieving outcomes better than other physicians.

 

Again, rambled thoughts.....but stuff I have been calling my Senator and Congressmen and women on for years.

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I already read this article, and it is very poignant. Some of my favorite quotes.

 

You may think your employer is paying for your health care, but in fact your company’s share of the insurance premium comes out of your potential wage increase. Where else could it come from?

 

 

 

I will add more later . . . This was a great article

 

 

I have been saying the same thing with the whole "We'll tax the businesses" mantra that the left leaning political folks have been preaching for the past few years.

 

In the end, expenses to the business mean lower wages for the employees and higher prices for goods. All of these things interplay. I think more folks need to understand this. Putting greater expense on business is never a benefit.

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I will add more later . . . This was a great article

 

 

I have been saying the same thing with the whole "We'll tax the businesses" mantra that the left leaning political folks have been preaching for the past few years.

 

In the end, expenses to the business mean lower wages for the employees and higher prices for goods. All of these things interplay. I think more folks need to understand this. Putting greater expense on business is never a benefit.

 

[obamessiah]Lies! Lies! The evil rich are gonna ante-up and pay their fair share! The have to pay for it ALL, I tell you. Who you gonna believe, me, or a caveman?[/obamessiah]

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I will add more later . . . This was a great article

 

 

I have been saying the same thing with the whole "We'll tax the businesses" mantra that the left leaning political folks have been preaching for the past few years.

 

In the end, expenses to the business mean lower wages for the employees and higher prices for goods. All of these things interplay. I think more folks need to understand this. Putting greater expense on business is never a benefit.

 

There is a great economic benefit to businesses to supply their workforce with health insurance. From a tax standpoint I can think of like 4. businesses should not be taxed any more than they are.

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"Hospitals implementing Pronovost’s checklist had enjoyed almost instantaneous success, reducing hospital-infection rates by two-thirds within the first three months of its adoption. But many physicians rejected the checklist as an unnecessary and belittling bureaucratic intrusion, and many hospital executives were reluctant to push it on them..."

 

Rampant doctor arrogance: still alive and well :wacko: That isn't exactly helping either.

 

Still reading but that one stuck out

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Why bother with insurers at all?

 

Call it my conservative bent - I tend not to want to throw the baby out with the bath water. There may be a better way to go, but I'd rather tweak on some of the better models we have working (non-profits, specifically) than trust something entirely new will work better. Unfortunately, as you mentioned in another thread - the current legislation being considered right now does little more than further entrenching the broken institutions and deeply rooted problems that led us here in the first place.

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Call it my conservative bent - I tend not to want to throw the baby out with the bath water. There may be a better way to go, but I'd rather tweak on some of the better models we have working (non-profits, specifically) than trust something entirely new will work better. Unfortunately, as you mentioned in another thread - the current legislation being considered right now does little more than further entrenching the broken institutions and deeply rooted problems that led us here in the first place.

As the now-famous (here anyway) article states, we use insurance for nothing in normal life other than the things we simply can't handle e.g. house destroyed, liability in at-fault accident, totaled car and so on so why not leave insurance to the catastrophic? I think we're agreed on that. And if such insurance is to be non-profit, why not simply take it via tax? The mechanism already exists. After all, we wouldn't be paying health contributions any more and if Perch is right, we'd all have a nice raise because employers wouldn't be forking over for it either. These would more than outweigh a tax increase.

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As the now-famous (here anyway) article states, we use insurance for nothing in normal life other than the things we simply can't handle e.g. house destroyed, liability in at-fault accident, totaled car and so on so why not leave insurance to the catastrophic? I think we're agreed on that. And if such insurance is to be non-profit, why not simply take it via tax? The mechanism already exists. After all, we wouldn't be paying health contributions any more and if Perch is right, we'd all have a nice raise because employers wouldn't be forking over for it either. These would more than outweigh a tax increase.

 

The tax increase to pay for this, I assume it would be a flat tax levied on everyone equally, or are you expecting me to pay for 10 other peoples health care as well?

Edited by Perchoutofwater
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