Posted on 08/12/2009 10:46:26 AM PDT by Lorianne
After the needless death of his father, the author, a business executive, began a personal exploration of a health-care industry that for years has delivered poor service and irregular quality at astonishingly high cost. It is a system, he argues, that is not worth preserving in anything like its current form. And the health-care reform now being contemplated will not fix it. Here’s a radical solution to an agonizing problem. ___ All of the actors in health care—from doctors to insurers to pharmaceutical companies—work in a heavily regulated, massively subsidized industry full of structural distortions. They all want to serve patients well. But they also all behave rationally in response to the economic incentives those distortions create.
Accidentally, but relentlessly, America has built a health-care system with incentives that inexorably generate terrible and perverse results. Incentives that emphasize health care over any other aspect of health and well-being. That emphasize treatment over prevention. That disguise true costs. That favor complexity, and discourage transparent competition based on price or quality. That result in a generational pyramid scheme rather than sustainable financing. And that—most important—remove consumers from our irreplaceable role as the ultimate ensurer of value.
These are the impersonal forces, I’ve come to believe, that explain why things have gone so badly wrong in health care, producing the national dilemma of runaway costs and poorly covered millions. The problems I’ve explored in the past year hardly count as breakthrough discoveries—health-care experts undoubtedly view all of them as old news. But some experts, it seems, have come to see many of these problems as inevitable in any health-care system—as conditions to be patched up, papered over, or worked around, but not problems to be solved.
(Excerpt) Read more at theatlantic.com ...
[L]et’s imagine confiscating all the profits of all the famously greedy health-insurance companies. That would pay for four days of health care for all Americans. Let’s add in the profits of the 10 biggest rapacious U.S. drug companies. Another 7 days. Indeed, confiscating all the profits of all American companies, in every industry, wouldn’t cover even five months of our health-care expenses.
Somebody else always seems to be paying for at least part of our health care. But that’s just an illusion."
My daughter was prescribed an antibiotic yesterday, two pills a day, for 10 days. The insurance company refused to pay for more than six pills in 22 days...
I think Goldhill nailed it.
For years I’ve been screeching to anyone who can bear to listen how the doctor’s office is the only business I patronize that asks me for payment BEFORE I get the product or service and CAN’T OR WON’T TELL ME HOW MUCH THE PRODUCT OR SERVICE COSTS. They’ll tell me my co-pay ( and get that wrong half the time ), but I cannot find out how much an office visit costs.
Catastophic coverage and MSAs. I’m with you.
Of course, while that’s fine for working stiffs like me, what to do for those who can’t even feed themselves, no less buy insurance and save against illness?
The hospital his father died in has an obvious problem -- so rail against that hospital, not against the system.
As someone who's been caregiver to two family members in their final days, and who now has a sibling undergoing chemo for a rare form of lukemia -- a treatment, due to age, that most likely won't be covered under the health care bill -- all I can say is that every patient needs an advocate. If the conditions, the service, the sanitary conditions in a hospital or by hospice at-home services are sub-standard, make a stink! Do something! Spend some money to get the patient out of sub-standard conditions. But, of all things, don't sit back on your heels and watch someone die, then bemoan the situation you did nothing to fight when it would have mattered.
The idea the government can improve on any of these sub-standard situations is ludicrous. Just go and sit in any inner-city clinic that services Medicare and Medicaid patients for hours on end, and get a clue -- this is what government-run health care will get you, and once implemented, advocacy of family or friends will be unheard and ignored by the bureaucrats.
One more thought -- read the House health care bill. The emphasis, over and over again, is on cost and efficiency, not quality. And this is only the framework from which the actual nuts and bolts of national health care will be written, in private, by a non-elected commission making life and death decisions for us all.
The article proposes some kind of government funding for their MSAs and insurance purchases. And it's a tricky areas. First of all, regarding the cost to taxpayers - it's already happening through Medicaid, so that would be a wash. But taxpayer funding for MSAs will probably make food stamp fraud look tame by comparison - all that government money sitting in millions of personal MSA accounts is gonna draw the vultures. So it's definitely an Achilles heel to such an approach.
But despite such weaknesses, it still has the most potential IMO. Medicare and Medicaid are already rife with fraud as it is.
“The hospital his father died in has an obvious problem — so rail against that hospital, not against the system.”
Maybe the point of his treatise is NOT to rail at all, but to improve a less-than-perfect system.
Surely you agree there’s room for improvement?
Let insurance companies offer any package of coverage that the purchaser wants.
Let insurance companies offer insurance across state lines.
Limit tort liabilities and attorney fees. Must go before a panel of experts. Get ‘emotional’ juries out of the equation.
Reduce government regulations of healthcare. The majority of the cost increases in helathcare have been due to regulatory compliance that offer no value to the delivery of healthcare.
Eliminate unions in helathcare settings.
so... what is your point?
You are completely misinformed
Self ping
parsy
Surely you agree there’s room for improvement?
Of course there's room for improvement -- but total control of health care by the federal government is most definitely not the answer.
My underlying point is that I've seen and heard complaints about the system from too many folks who really were totally univolved in an elderly parent's health care. I think, in many ways, the railing against the sytem, whether valid or not, is a way to exiate guilt for not giving a damn until it's too late.
My GP is thinking strongly of dumping insured patients alltogether and just going to a pay-as-you-go.
She keeps two people on staff in her office just to deal with insurance and the gov't. She's also sick of charging $300 to look in a kid's ear, when the real cost is $75, and that's what she gets reimbursed for by the same entities.
Can't say as I blame her. Looking forward to it, actually.
I agree. I don’t want to live anywhere else than the USofA
For later.
I agree with everything you said. Even WITH the flaws in our current system, it STILL beats the h$ll out of ANY socialized medical plan ANYWHERE!!!
I don’t know what part of the country you are in, I’m in Texas and there was an interesting report on the radio a few days ago. The report suggested that Texas could well end up providing a model for healthcare REFORM because, apparently, we passed tort reform a few yars ago and put a cap on malpractice lawsuit limits. As a result, Texas has become a Mecca of sorts for doctors who are flooding into the state from other states. Not bragging, just an FYI.
Through the Navy I’ve seen a little of the world and lord knows If I never see europe again it’ll be ok. I know lots of folks love overseas but I am not one of them.
That's what I grew up with and what we need to return to!
Eliminate all insurance.
Health care isn't a right, it's a privilege to be paid for by the recipient!!!
So he's saying, if I understand him, that having a free-market for most of us, and for governments to directly pay hospitals for care of the indigent -- fraud and the costs of fraud containment notwithstanding -- would be cheaper and better for most of our society.
“...but total control of health care by the federal government is most definitely not the answer.”
We are in complete agreement there.
“My underlying point is that I’ve seen and heard complaints about the system from too many folks who really were totally univolved in an elderly parent’s health care.”
I agree that constructive criticism is more likely to come from someone who has been involved.
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