Reader comments
No one way to fix health care, expert says

Roland Kayser | 1:03 a.m. Oct. 14, 2008

The countries of Western Europe and Japan spend half of what we do on health care and achieve a healthier population as a result. Its really not nearly as complex as this author makes it out to be.

Bob G | 5:16 a.m. Oct. 14, 2008

I don't think Mr. Kayser has a clue. It is complex and citizens don't have any say on health care costs the insurance or the medeical treatment they get. Excluding citizens, the health care system is feeding on government policies and payments. Government is too involved in health care and laws and regulaltions have been written to benefit the health care providers. And they want more government involvement because government is a reliable source of money to the health care providers and insurance companies. Insurance companies are shielded from paying claims because they are allowed to deny claims they determine are not necessary. And they have a fleet of highly paid lawyers able to delay medical care for years through court room games. Hopefully and long enough that the claiment dies before settlement. Government has gotten involved in every aspect of health care with laws and regulations protecting the industry than it is doing to aid and help citizens that need health care. And at the same time citizens think government should provide a national health care system. To do that government must first socialize health care then freeze the industry completely. Who owns health care? Wall street and investors.

Living in Europe... | 5:26 a.m. Oct. 14, 2008

I think the problem is as complex as is sounds. I enjoy the benefits of socialistic medicine. It isn't perfect, but it's good. I feel that my needs and the needs of those I know are very well taken care of.
The problem I see is that the system in the US is so broken,and so big, that as the author said, it isn't as simple as imposing a plan like the one I am benefiting from.
The US population is HUGE! The country I am living in has a population of under 5 million. It makes it a much more reasonable number of people to deal with and help. In my opinion, if it is possile, it would be more sensible for each state to take more responsibility for health care reform, and have national guidlines to help.

I don't have the answers. I just know that I have had lots of trouble with the health system in the US. My siblings are all in the States. My sister has 2 multi-handicapped children. I know if she had the system I have, her life would be completely different. So much easier. I want a good system for them.

Comments continue below

25 five years in the business | 7:44 a.m. Oct. 14, 2008

This is the most honest assessement of healthcare I have read. To restore healthcare control to the user, the focus needs to be returned to the state, city and community level. Most importantly, the relationship of certain parties to the process needs to be changed. For example, insurance needs to be repositioned in the process to allow it to function efficiently. Hospitals need to be redesignated as the mechanism for community control instead of profit centers. (Who owns and controls a 501(c)(3) hospital?) All providers, including physicians, need to be allowed to function in a vigorous free market where fixed fee schedules are eliminated. These among many other structural changes, if implemented thoughtfully would improve health delivery and reduce cost by a profound proportion.

Debbie | 7:46 a.m. Oct. 14, 2008

The way to fix healthcare is to get these smart people in the US to study the systems that are working elsewhere. Addendum policies can always be made available for the rich to buy if they worry they might be denied their botox or something. Meanwhile get a system in place that provides good coverage for all without the hoops to jump through. Government needs only to collect the money and give general guidelines, i.e. must cover mental health care, etc. But by removing the red-tape and gatekeepers, millions will be saved that can be used for actual healthcare.

Study the places where it is working and then implement it here. It should not take 15 years to get this in place. Since other countries have pulled it off, we don't need to reinvent the wheel.

I say hire Mitt Romney to do it and begin in Utah. Each state could do their own basic thing. Eventually they all tie in together enough to make moving state to state possible without risk of coverage loss. At first this is the main obstacle of not going national here. But, let's face it, the two candidates are not going to do it.

It is a problem | 7:46 a.m. Oct. 14, 2008

Healthcare is a problem and truly there are no easy answers.

My Spanish instructor is from Europe. Although healthcare is available there, the instructor will not take her children to a doctor in the native country because of a feeling that system provides inferior healthcare.

While in New Zealand a couple of years ago, I spoke to a local about their system. Yes, free healthcare is available from the government there, but one must be on a waiting list for an operation, a list that could put a patient two years out. Those with money use a private system.

Our private system has rendered healthcare too expensive for people in certain income levels, and our healthcare is not perfect, either. A relative died after a botched operation that occurred here in the States.

Good luck to legislators who will try to solve this problem.

slw | 8:10 a.m. Oct. 14, 2008

If John Graham believes that unleashing "market forces" will correct the problems in healthcare I would question his judgement. Unleashing market forces was implemented in the 1980s and 90s with certificate of needs eliminated, PPS, among other factors. What resulted? Abuse and higher healthcare costs.

Government regulation alone is not the answer. However, it has to be part of the solution. We have many problems in healthcare: lifestyle, access, greed (e.g. our physicians make 2-3 times what physicians in other countries), race to technology, etc. I would hope that Utahns are not paying a radical "market solution" consultant to promote unrealistic, unproven, speculative rhetoric.

I agree... | 8:38 a.m. Oct. 14, 2008

I advocate "socialized medicine", but the "fix", in my mind has NEVER been to "simply have the government pay for it". Doctors salaries are too high, because of artificial labor shortages (the AMA succeeded in lobbying congress to cut funding to medical schools in the late 70s). Litigation is a crushing burden, and should be eliminated, except for criminal malpractice (ie, deliberate harm). Four year nurses should essentially be allowed to "practice medicine" as GPs, a doctor is not needed for most routine issues. The oligopolistic structure of hospital care (ie, IHC and HCA together have captured the local market...) needs to be broken up, or managed under state supervision. Lots of things need to change...these are just a few. Oh yea....no more transplants, sorry they are too expensive.

KiT | 8:56 a.m. Oct. 14, 2008

After living in Western Europe I have to say I think Mr. Kayser need his eyes checked. But wait if he were in Western Europe it might be at least 6 months before he could get an eye exam. Does anyone know of any place in the world where healthcare is good. Here it's good but it's killing us financially there it's good financially but killing them literally.

Bob | 9:17 a.m. Oct. 14, 2008

I'm sorry, but doctors salaries are not "too high" as one person stated. As far as I'm concerned doctors deserve every penny they get. Most people in this country don't have what it takes to get a simple 4-year degree, let alone go to school over 12+ years and take on huge amounts of debt in the process. You can argue that the AMA is purposely keeping the number of doctors to a minmum, but as far as I'm concerned any person who is willing to go to school for 12+ years, put in 70+ hours a week, and has the knowledge to save mine and your life, deserves every penny they can get.

So if you think doctors get paid too much, get your butt back in school and finish all 12+ years and then come and talk to me when you're finished, so that I can bring my family to you since you'll be cheaper than other doctors in the area. :)

Roland Kayser | 9:20 a.m. Oct. 14, 2008

To Kit: Life expectancy is higher in Europe than in the U.S. So I'd say European healthcare is not killing them literally.

government intervention needed | 9:22 a.m. Oct. 14, 2008

The way I see it, the main problems with the health care industry are cost and threat of litigation. I have talked to two different players in the health care industry--a lab technician and medical device salesman--and both have independently cited the exact same example of a screw that you could buy at Home Depot for a few cents costing $50 from a medical supply company. This is laissez faire run amok. Government regulation wouldn't be necessary if people weren't so greedy.

The second problem is threat of litigation. Every person working in health care that I have talked to says the same thing. Doctors prescribe above and beyond what is required, not because the health of the patient requires it, but because they're covering themselves from the threat of litigation. When a doctor prescribes double or triple what is actually necessary, and what is prescribed is charged a thousand percent more than it actually costs, you have a perfect storm of spiraling medical costs.

Without government intervention in these areas, medical costs will continue to spiral out of control.

? | 9:52 a.m. Oct. 14, 2008

In many respects, we have ourselves to blame for our own lack of decent health care. How many of us actually ask the doctor questions (although this can be a challenge with him/her running out the door for the next appointment), or do we nod dumbly as we are prescribed the next drug of choice. I am "pharmacy free" in spite of a doctor telling me I was in need of a cholesterol pill, based on a blood test. After asking many questions, and doing a bit of research on my own, I fixed the problem myself, which was confirmed by another blood test. The cost of medicine would be much cheaper if we weren't coninuously bombarded with a host of drugs, many of which are not only unnecessary, but actually cause additional problems. We need to be responsible for our own health through living a healthy lifestyle, and making informed choices by asking many questions. Most doctors, I suspect, do the best they can, but when people expect them to fix everything with a pill rather than making appropriate lifestyle changes, what other option do they have?

RedShirt | 11:54 a.m. Oct. 14, 2008

To thoes of you wanting more government regulation I ask this question? Did you just wake up from a coma? We had government regulation over the banking industry, and they have just about destroyed the economy? Why would you want thoes same people watching out for your health, while allowing them to dip more into your pockets?

There is no simple solution, as was stated. However, they forget to include the cost of hospitals and doctors treating people with no isurance or else people on medicare. If you combine that with the cost of malpractice insurance, you can see where some cost cutting could be done.

Multiple problems | 12:02 p.m. Oct. 14, 2008

With our large, heterogeneous population there is no single or simple answer. Comparison with Japan or Europe is naive. European health care is wonderful if you only consider acute medical situations. They ration care by simply not having enough care available for chronic conditions. It's great if you don't need a doctor.

Jack from Ark | 12:26 p.m. Oct. 14, 2008

It is this simple. Get the profit out of the health care industry. Make everyone in the country in the "group". Make it prepaid health care instead of health insurance. Make everyone take it and make prescription drugs promote efficacy instead of patent protection, By doing these simple tasks it puts the health care back in the hands of the people that use it. It takes insurance companies that feel they can control costs and pocket huge profits out of the loop. It allows all people equal access to "the best medical care money can buy" Allow Co op's to utilize assets like Credit unions do and funnel all proceeds back to health care. It really is this simple. We have to start expecting value and not blaming it on regulation.

Kevin in the Terrace | 12:45 p.m. Oct. 14, 2008

Three things would work at reducing health care. 1) More doctors and 2) Transparancy in cost of proceedures, 3) reduce or limit liability for lawsuits. I graduated in Biology from USU. Most of my classroom peers were pre-med students. The majority of them did not make it into medical school though many were certainly smart enough, studied hard, and I have confidence thay would make great doctors. If people could shop around for medical proceedures then they could compare costs and make financial based decisions. Increasing the number of doctors and allowing people to shop around would force physicians to provide their services at less cost while providing quality care. Finally, most lawsuits are not warranted and are costing us. Removing or restricting lawsuits would allow doctors to make more while avoiding medicical liability costs.

Get the G'ment Oout | 1:06 p.m. Oct. 14, 2008

Jack in the Beanstalk: Who pays for your system? Who would use it? What? Did I hear you say those two wouldn't be one and the same? How is that fair? How is that frugal? How is that an economic reality?

Did you say everyone pays and everyone uses the system? Get real. Even from you disengaged perspective you can't believe that to be true.

K2 | 1:19 p.m. Oct. 14, 2008

Mr. Graham is soo 20th century with his arcane way of "explaining" the complexities of the health-care industry which has been craftily designed over the years to be a money-making assembly line. Thank you, bean-counters, consultants, and lobbyists (pseudo-experts) like Mr. Graham. Their are so many fingers in the pie of health care that it is just unbelievable - a large portion of whom are in it just for the greed they can gain and spread (read as, lucrative). Hold on baby boomers!

Yes, citizens should be able to have all the say-so's in health care with very little interfence from the lobbyists who write the guidelines and then persuade legislators to sign off. Some good ideas presented in above missives; but why not just check and see what the other states are presently doing to clean house, since it is fairly obvious from this article that Utah legislators are stonewalling the reform by bringing in these type of knowledgeable experts.

RedShirt | 2:06 p.m. Oct. 14, 2008

To thoes of you who think that insurance companies can deny you health care, and thoes of you who don't think you have control of your healthcare.

You have control of your healthcare. If you insurance company says that your policy does not cover a procedure or medication, YOU can still payfor it yourself, assuming you can find a doctor willing to take cash or work out a payment plan.

If you don't think you have control in your choice for healthcare, you really are saying that your policy doesn't cover everything you want it to cover without having to pay more.

Living in Europe.... | 2:07 p.m. Oct. 14, 2008

Those who are stating that socialized medicine is lacking in "treating chronic conditions" or "as long as you don't need a doctor" are very missinformed. I am an American living in a socialized eruopean country. I can't answer for all systems in Europe, but many are very good. I believe the system I live in, and I have lived in both systems, is far superior to the one set up in the US today. Socialized medicine is not second class to the US system. I have had two children here, and gotten excellent care. My son is asthmatic, and gets excellent care. I always get a doctor appointment the day I need it. This system is much more fair and helpful. I don't ever have to worry about losing my home, car, or lifestyle because I get sick. Again, I wish for this reality for my friends and family in the States.

Good for those of you coming with ideas and helpful comments. We need more positive people who want to make a difference and who don't want to accept things the way they are anymore. One person CAN make a difference.

Simple Solutions | 2:15 p.m. Oct. 14, 2008

The US leads the world in medical technology research and development. In other words the price caps imposed on Health Care Delivery Systems in nations with socialized medicine would not work here because we fund the research, and all nations benefit. The key components of nations with socialized medicine are price caps and health care rationing. An unfettered free market solution would ultimately be owned by insurance companies -who would deny coverage to all but the extremely healthy, and direct medical treatment from providers. A totally socialized system would ultimately ration care and retard medical advancement and delivery quality.

I don't think the answer is more or less government, but rather a system overhaul. Making sure government controls and subsidies are more effeciently and apropriately applied. There needs to be support for this at both the State and Federal level. Individuals should own their own health insurance policies, not their employers. Total cost disclosures should be available (in the form of a menu on the web) prior to recieving treatment from a health care provider. Free rider loopholes should be evaluated and closed, and yes frivolous litigation should be addressed to elimanated the practive of "defensive medicine".

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