The real reason | 1:12 a.m. Nov. 5, 2009
Another excellent and accurate article by Dr.Sowell! What is really behind this scramble by the left to take over the health care industry has nothing whatsoever to do with reducing the costs! It has everything to do with shifting the costs from personal responsiblity to other people! It is entitlement greed, pure and simple! Who cares what it costs as long as I can force my neighbor to pay my bills, right? It's all about greed and getting people to vote for you! Vote for me and I will force other people to give you what you didn't earn, don't deserve and shouldn't get!
Timj | 3:30 a.m. Nov. 5, 2009
It may be easy to attack lawyers, but there are many other great ways to cut costs that Sowell conveniently ignores.
First, stop paying doctors based on how many surgeries/consultations they do. Right now we're paying for quantity, and not for quality of care. Many doctors perform expensive care that's not really necessary. I saw a lot of this when I worked in healthcare.
Second, encourage patients to discuss end-of-life care with their families and doctors. At work, I recently looked over billing records for an elderly woman with multiple health problems who was living in a nursing home. Her last month of life cost almost a million dollars. And she died miserably, in a sterile hospital.
Third, there's little incentive for preventive healthcare, as it does not bring hospitals more money, and sometimes insurance doesn't cover it.
There are many reasons people in the US pay more for healthcare than people in other developed countries. It's easy to blame one group of people for all of our problems. It takes a bit more brainpower to realize the problem has many causes.
Anonymous | 4:19 a.m. Nov. 5, 2009
"If doctors' incomes were cut in half, that would not lower the cost of producing doctors through years of expensive training in medical schools and hospitals, or the overhead costs of running doctors' offices."

That must explain why Canadian doctors have less overhead and have far less student debt then their American counterparts while paying way less for malpractice insurance then U.S. doctors.
Comments continue below
Doug G | 6:53 a.m. Nov. 5, 2009
If one of those consequences is a reduction in the fat profits of insurance companies, bring it on. Same goes if it consequentially eliminates the bureaucracy of claim 'processing'.
RedShirt | 8:24 a.m. Nov. 5, 2009
To "Doug G | 6:53 a.m. " your ability to miss reality is amazing. Since when is a 2.2% profit margin fat? Most business people call that a thin profit margin.

If the government is running health insurance, there will still be the bureaucracy of claim "processing".
RedShirt | 8:36 a.m. Nov. 5, 2009
To "Timj | 3:30 a.m. " what you fail to recognize is that much of the cost is due directly to lawyers or government mandates or policies.

Thanks to government mandates, your health insurance costs 20% to 50% more.

Thanks to lawyers suing doctors, odds are you are paying an additional 9% for unnecessary tests. Those tests are not effective and are only done to avoid lawsuits.

Also, malpractice has driven some doctors out of states where their insurance rates are high, creating a health care problem because of a lack of doctors.

The state of Texas has documented how the health care in their state was improved by enacting tort reforms.
Some Facts | 9:17 a.m. Nov. 5, 2009
The Harvard School of Public Health study involved rigorous reviews of 1,452 randomly selected malpractice claims. Researchers concluded that frivolous litigation is far from rampant and does not cost the system as much as some claim.

Nine out of 10 claims involved a physical injury, which was generally severe, with 80% resulting in a major disability and 26% resulting in death.

In 73% of cases in which no medical errors were found by the researchers, plaintiffs did not receive compensation.

Meritless or frivolous claims accounted for 13% to 16% of the direct cost of medical malpractice
H1N1 Savings | 9:21 a.m. Nov. 5, 2009
Obamacare has already saved a grundle of money on the H1N1 vaccine. Rather than let americans have it, they have given away, what was it, 10%? to other countries because we have too much? Right. Welcome to Obamacare. Looks like I'm vindicated; I have said all along that there will be massive rationing. H1N1 rationing is just the start. I wonder how Obamaites are going to blame this one on Bush? The entire fiasco started, developed, and was mis-handled by Obama.
No such thing as a FREE lunch | 9:27 a.m. Nov. 5, 2009
One of the first economic leasons of adulthood I remember my father teaching me was, "There's no such thing as a free lunch... there's always a cost, it may be well hidden but whoever's giving away the free lunch ALWAYS has something to gain".

In my life I've only found a few ways to legitimatly reduce the cost of things I purchase:

1. Shop around and find a store with a cheaper price. Often this involves going to a store that offers a slightly inferior product (but not always).

Nobody wants inferior healthcare... even IF it reduces the price.

2. Shop extensively to find a store with the SAME product but a better price.

But the current plan doesn't even encourage consumers to shop around to find the cheaper options.

3. Try to find someone who's giving it away.

There's always a hidden cost. They have a plan. They may give it free this time but they have a plan to make money from you down the road somewhere.

4. Do it yourself.
Not good for healthcare.

5. Coop with friends/neighbors.
Again not good for healthcare.

Theres no free lunch people!
I hope | 9:30 a.m. Nov. 5, 2009
the communists win this battle. Some of us really want that. That is, those of us who really don't care about money.
More Facts | 9:30 a.m. Nov. 5, 2009
Medical malpractice litigation is not to blame for the relatively high cost of health care in the United States, according to a Johns Hopkins Bloomberg School of Public Health study.

A study by the Robert Woods Johnson Foundation found:
Malpractice premiums vary, in part, on the performance of investments made by insurance companies. When investment returns were higher for stocks in the Dow Jones Industrial Average, growth in malpractice insurance premiums was reduced.

The growing empirical literature has now established that damage caps have reduced medical malpractice premiums, but the evidence with respect to defensive medicine and physician location decisions is less clear cut.

Malpractice reforms over 1991—2004 had no effect on the health insurance premiums paid by employers.


Ultra Bob  | 9:41 a.m. Nov. 5, 2009
To “The real reason | 1:12 a.m.“

Your conservative training obviously has caused you to see everything in terms of money. I suspect that you have a dollar sign ($) tattooed on the left side of each eyeball.

Cost is certainly one of the problems of the Health care system, and greed is probably the main problem of all problems. But it is not the greed of folks needing medical care that causes the problem, it’s the greed of the suppliers of medical care.

The phrase “ force my neighbor to pay my bills” exposes your tie to the people who are using lies to prevent a societal solution to the Health care problems.

We are not asking you or your neighbor to pay someone else’s bills. We are asking that you and your neighbor share in the care and support of our society.

And no one will force you to share, you have the option to leave our society any time you please.
Ultra Bob  | 9:54 a.m. Nov. 5, 2009
To RedShirt | 8:24 a.m.

Do you really believe that a company would stay in existence with a 2.2% profit margin. You can get more than that on almost any other investment.

Only when unscrupulous management is doing bad things would a corporation get by on that margin. And then not for long.

BTW, if the corporation is the government, your option to go to the competitor means that you would leave this country and go to a new country.

You might try Mexico, it is my understanding that their government is owned by an oil company.
Ultra Bob  | 10:06 a.m. Nov. 5, 2009
To H1N1 Savings | 9:21 a.m.

I suspect that the people doing the work on the vaccine are republicans.

And it is the duty of every good republican to oppose, disrupt and discredit the Democrat government.

A good way to do that was to drag their feet in the production of the vaccine.

I also think that we got a late start with the battle against H1N1 because of the poopoo attitude and campaign of the conservatives who were saying that the swine flu was just anther attempt at take over of America.
Ultra Bob  | 10:37 a.m. Nov. 5, 2009
To “No such thing as a FREE lunch | 9:27 a.m.”

You said "There's no such thing as a free lunch... there's always a cost, it may be well hidden but whoever's giving away the free lunch ALWAYS has something to gain".

And pretty much I agree. Only the gain is not always in dollars and cents.

My old mama used to tell me “if you want to be loved, give it away. The more you give, the more you get“.

I’ve heard a thousand times, “If you want other people to respect you, you have to respect them“.

In a management class, “The way to get more authority is to delegate it, the more you delegate authority to others the more you will have“.

And if you share with others, they will share with you. And you both will have more than you had before.

I think that working together to share health costs is a good thing for everybody.
To "Ultra Bob | 10:37 a.m." | 11:44 a.m. Nov. 5, 2009
Ultra Bob | 10:37 a.m.

Of course working together is a good thing. And of course singing cumbia together is good for all of us.

But you and I BOTH know that's NOT what this plan is about. It's about gradually doing away with Private Insurance.

Doing away with Private Insurance and Private Providers MAY be a good thing. I don't know about that. But hiding behind platitudes and ideological statements does little to help the conversation.

If this bill were just about working together... Why all the focus on huge taxes against anyone who stays with the current system? Why pass rules that we all KNOW will drive them out of business?

THIS law is more about grabbing power for a particular political party than it is about working together (in MY opinion).
re: 11:44 | 12:15 p.m. Nov. 5, 2009
you: "doing away with private insurance."

Private insurance companies continue to do business in countries with single-payer, universal healthcare.

House bill's employer mandate, which requires LARGE (exempts employers with a payroll of less than $500,000) employers to offer health insurance for their workers. (This is a major difference with the Senate bill, which is not expected to include an employer mandate.) So the House bill does tax employers that don't offer insurance.

Well, actually | 12:26 p.m. Nov. 5, 2009
It's Kumbaya
the left | 12:45 p.m. Nov. 5, 2009
has one response to everything..."you are too greedy"

If you don't want to pay for my food...you are greedy
If you don't want to pay for my school...you are greedy
If you don't want to subsidize failing businesses...you are greedy
If you don't want to pay for my medical care...you are greedy
so my question is this
Is there anything...anything worthwhile...that the left believes people ought to try doing on their own? Or are we in fact greedy unless we all carry all the deadweight until we too become dead?
DMH | 12:53 p.m. Nov. 5, 2009
Actually the House bill's idea of a large employer is a business that has over 50 employees and a payroll that starts at $250,000. I work for such an employer and there is no way that our company can survive in this economy and also pay to insure all of our employees, of which most are part-time. We just recently had to re-nogociate our current insurance plans just to keep our current full-time employees insured and still make money. If this bill passes we can be assured of one thing and that is a lot of people losing their jobs, because their employers cannot afford to insure them, or pay the fines that the government will collect if they don't. Sowell's article is correct and our government is going about this in the wrong way.
The real left | 1:24 p.m. Nov. 5, 2009
Starving people can't work.
Sick people can't work.
Desperate people will often resort to crime in order to survive.
Uneducated people benefit our country, in fact, the future of our country depends on the educational level of its citizens.

The "left" believes every able-bodied adult should provide for their own but sometimes circumstances make it impossible (mental/physical illnesses etc). Therefore, a civilized society can/should help the unfortunate.

As for me, I'v always paid my own way. But I was lucky to have been able to do that. People don't choose the circumstances of their birth. I was lucky, born to an intact home with 2 parents. I harbor no illusions that one day unforseen circumstances couldn't change that.
Finally, I understand the message of the Christ. Nowhere does it say govt. shall not help the less fortunate. Pretty much it says to love thy neighbor as thyself and to care for the poor. We all have to help.
Wrong DMH | 1:27 p.m. Nov. 5, 2009
“The House bill originally exempted small businesses with payrolls of less than $250,000 from the penalty. Under the new proposal, businesses with payrolls of less than $500,000 would be exempt.”

more info on politifact
RedShirt | 1:59 p.m. Nov. 5, 2009
TO "Ultra Bob | 9:54 a.m." yes health insurance companies run on 2.2% profit margins. Your neighborhood grocery store runs on smaller margins.



To "The real left | 1:24 p.m." if liberals that able bodied people should work and provide for their own, why is it that the welfare programs they support do not require work? Why is it that liberals want to punish those that have worked and now own or run businesses?
Happy Valley Heretic | 5:18 p.m. Nov. 5, 2009
Redshirt
Why is being asked to participate in society a punishment? and how can everybody who needs help or assistance be a lazy liberal who only wants a free handout. May you find the tribulations that will help you understand how some of your brothers have come to be where they are. Perhaps a health problem that your insurance won't cover so that you'll have to exhaust your savings, mort your home, can't work cause your ill, maybe your conservative friends will help you, but it will probably be some bleeding heart liberal.
Anonymous | 5:47 p.m. Nov. 5, 2009
The real Left,
Ultra Bob and
Myself.

That's 3 for a better world.

vs.

RedShirt and Mike Richards
That's 2 for the greedy Archie Bunker fan-club.

Keith Cavanaugh | 5:48 p.m. Nov. 5, 2009
Excellent column! Some readers have correctly stated that lawsuits are not the only cause of high health-care costs. Consider an allegory:
It is a cold night with foxes, coyotes, weasels and thieves lurking. The chicken-house door is left open. In the morning, the chickens are all dead or gone. What killed the chickens? The cold? Foxes? Coyotes? Weasels? Thieves? Probably all five, but the BASIC PROBLEM was the open door.

So, why astronomical health care costs? Lawsuits? Yes, but that is just one reason. The BASIC PROBLEM is we left the door open when we depended for many, many years on "full coverage" health insurance provided (mostly) by employers. If we had continued our traditional practice of paying for most instances of health care ourselves, using insurance only for serious illness, etc., we would have caught the rising costs and "nipped them in the bud". In 1970, the cost of a day in a SLC hospital was about $100. If we had continued paying for a 4 or 5 day hospital stay, we would have been yelling, screaming and rebelling long before the daily cost reached the present $10,000+.
The lesson? Personal responsibility and accountability.
@RedShirt | 6:13 p.m. Nov. 5, 2009
you: To "The real left | 1:24 p.m." if liberals that able bodied people should work and provide for their own, why is it that the welfare programs they support do not require work? Why is it that liberals want to punish those that have worked and now own or run businesses?

me: are you talking about healthcare? "Should work" but recognizing that for many reasons some are not able. Here in the U.S., i don't think we should have people dying from starvation or lack of healthcare. WE are not a third-world country. Republicans argue against govt. safety-nets--yet they don't enact laws to close ER's to the destitute or defund food stamp programs. What about Social Security and Medicare? When are Repubs going to repeal those programs?
Safety Net? | 6:52 p.m. Nov. 5, 2009
Govenment healthcare a safety net or a very, very expensive hammock?
RedShirt | 10:24 p.m. Nov. 5, 2009
To "Happy Valley Heretic | 5:18 p.m." is isn't that I am being "asked to participate". It is the fact that I am being forced provide something for others that they should be providing for themselves.

If I have no desire to work hard to provide for my family, why should I force you to provide for me? I am no longer a benefit to society, but am a burden.



To "@RedShirt | 6:13 p.m." but we don't have people dying of starvation, unless they have chosen to do so. (If chidren the DFS is supposed to protect them) 95% of those without insurance are that way by choice. Who are you to decide that you know better for those that have chosen to not be insured?
Anonymous | 11:34 p.m. Nov. 5, 2009
In a utopian, perfect society with perfect people, a government plan that was implemented to help those who couldn't help themselves would probably work o.k. What so many left-leaning liberals apparently don't see is that people are by their nature very IMPERFECT. Not all, but many, are lazy, irresponsible, self-centered people who are perfectly content to let somebody else take care of them. Where is the accountability in Obamacare? Of course there are those who genuinely need help with their health care through no fault of their own. But many, many others simply want to take the easy way out & let others provide for them, and that is why I strongly oppose this massive, bloated, bureaucratic "health care" plan.
David Decker | 8:36 a.m. Nov. 6, 2009
Thomas Sowell (as usual) summed it up perfectly and hit the nail on the head. Without TORT reform all the rest ijust talk. From the husband of an 18 year veteran of Med Mal defense.
Happy Valley Heretic | 3:20 p.m. Nov. 6, 2009
With tort reform, who will decide what your life is worth. Because with every one of these tort reform bills the GOP wants to make sure that a persons income, or net worth, should decide how much money they can sue for. Cause a wealthy persons malpractice suit can't be compared to a blue collar workers life, I mean really, one employs people, the other is just another worker.

Or is it more of those poor victim Health Care Specialist, don't want to be held accountable for their errors.

Medical Errors - A Leading Cause of Death
225,000 deaths per year in the US

Prescription Drugs - Leading Killer in USA
100,000 deaths. 75 per cent of these were dose-dependent, not allergic reactions.

A GOP Death Squad will decide what your worth is.

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