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Comments about ‘Is removing the American Medicare straitjacket possible?’

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Published: Tuesday, April 2 2013 12:00 a.m. MDT

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sigmund5
Salt Lake City, UT

The Facts are that we spend 200-300% more on our health care system than other industrialized countries and our outcomes rank 35th in the world. All of these countries have either a single payer system or heavily regulated industry. These are the facts. While people go on about adopting business model and having businessmen as politicians what company would not adopt the best practices of other companies that have 300% lower input cost? America used to be considered a pragmatic country that looked at a situation and made decisions that were practical and based on facts and science. Now we have an ideological theocracy where reality and facts don't matter...just like with global warming and taxes. For facts on this check out the Frontline documentary on PBS "Sick Around the World". This is not a liberal site using liberal facts. They rely on WHO, UN and governmental statistics to show we have the 35th best system in the world.

Roland Kayser
Cottonwood Heights, UT

If we got our per-capita medical costs down to the level of Germany, or France, or Australia, or Japan, or any other developed country, our long term deficit would almost entirely vanish. The only reason we can't is due to the amount of "donations" that the medical/industrial complex makes to our politician.

Twin Lights
Louisville, KY

From the article:

"Unfortunately, Medicare can't require proof that an expensive new product is any better than the one it's replacing; it's explicitly prevented from doing so by law."

First, I agree this is problematic. But consider the other side of the coin - that Medicare "bureaucrats" get to choose which therapies are the most effective.

I think we NEED to have that discussion. Private insurers certainly look there. But there was the major eruption over the ACA/Obamacare about "bureaucrats" deciding who gets what care.

So . . . which do we want? Do we want "bureaucrats" (be they govt. or private insurers) making decisions about efficacy or not? If we do want efficacy considered in coverage, under what circumstances?

Nate
Pleasant Grove, UT

The writer: "The practical result of this policy is that the U.S. healthcare marketplace lacks the strength to distinguish valuable innovations from those that simply drive up costs."

Well, yeah. Remove market forces from health care, and it stops behaving like a market. We haven't seen the last of the unintended consequences of Medicare, nor of Obamacare.

sigmund5
Salt Lake City, UT

@Nate
when you say "Well, yeah. Remove market forces from health care, and it stops behaving like a market. We haven't seen the last of the unintended consequences of Medicare, nor of Obamacare." you don't get it. Our system has been driven by the market. Countries that have a government run system or are highly regulated have health care costs 200-300% less than ours and have better results. This includes Europe and industrialized Asia...and we rank 35# in the world. CHeck out the pbs frontline show "Sick around the world" or other journalistic sources...this doesn't include FOX, beck, rush et al.

Nate
Pleasant Grove, UT

@sigmund5 "Our system has been driven by the market."

I wish this were true. Most of the readers here cannot remember a free market in health care. Medicare has been around since 1965, and has distorted the market throughout its existence. Tax incentives for employer-sponsored insurance have also distorted the market. (Health care costs go up when its recipients imagine that someone other than themselves will be paying for it.)

It's a cycle: Government intervenes in the market. Prices go up. The poor are unable to pay the higher prices. There is a call for action. The government intervenes even more.

No one stops to realize that it was the central planners who created the problem in the first place.

The Hammer
lehi, utah

Our current medical system is not driven by a true market. A true market would put the customer in the drivers seat making the decision completely about how he spends his medical dollars. Right now and for the last 50 years there has been no true costumer. People go to the doctor and the doctor bills some company back in New York or they will bill medicare or medicaid. That company has to guage what the cost of care will be and then turn around and charge a premium to their consumer who is actually a government agency, or corporation or a small group health organization. Medicare/medicaid is just a system that pays what the doctor orders with very little thought about if that care is proper or not. Our current system is already a managed economy with mulitple payers and nobody to keep costs in check.

sigmund5
Salt Lake City, UT

It shouldn't be driven by the market. Again look at countries with 200-300 percent lower costs...no market. It is insurance it is not like buying a hamburger or pizza. It can't be made off the shelf and cost assigned by toppings. Every wonder why fire and police services aren't market driven? "ahh sir...please swipe your card and we will try to order some hoses and hire some guys from the temp agency and will be right over. Oh you don't have the 100K to rent the fire truck..sorry we are a business you know." This libertarian right wing delusion comes from the dark ages and moral depravity of the 1950's of dr. making house calls and fixing you with things in his bag and black servants

Twin Lights
Louisville, KY

Nate and The Hammer,

Although there has been govt. involvement in healthcare over the past decades we have BY FAR the most free market oriented healthcare system in the developed world. As a corollary, we also have the most expensive system in the world (by far). Overall, looking at how other countries provide healthcare, free market deliver seems to hold little promise of actually saving much money.

Also, one of the most significant issues is how to provide care for those who have the least ability to pay (free markets serve best those who have the most ability to pay).

And there have been several attempts to modify insurance programs to give consumers more incentive to save. So far, not much in the way of results.

Not all products respond well to free market pressures. An example is higher education where for profit entities are highly competitive but tend to provide the least real education for the most money. The more I look at healthcare, the more it seems it is one of the industries that does not respond well to market forces.

Truthseeker
SLO, CA

An extremely interesting look into the U.S. healtcare delivery system can be read in the Time magazine article, "Why Medical Bills Are Killing Us."

How can market forces be applied to healthcare when heart attacks, strokes, cancer, accidents, and any manner of disease are not the same as buying a TV? Healthcare is a necessity, and often an emergency, with life or death consequences. Even if hospitals were required to disclose and establish prices and success rates, (which should be required) insurance companies dictate where their beneficiaries are to go for care.

There is no rhyme or reason in healthcare costs in the U.S.

The Hammer
lehi, utah

It does not matter how much freer we are than the rest of the world. We are strapped into a system that is not free and does not focus on low costs. True very few can afford a 50,000 dollar hip surgery or a million dollar cancer treatment. But this is where true insurance steps in. High deductible plans would be far cheaper per year and with indemnity plans that pay cash for the minor expensive hospitalization you would pay a max of 7000-10000 out of pocket every year in a bad year. But in good years where everyone is healthy you would pay your premium and other small co pays and have a maximum cost of 2-4000. This is far better than our current system and freer and it will force doctors and hospitals and other participants in the market to act in good faith. Single payer systems may work in countries like Chile where there are no states rights that have sovernienty. Unfortunately the care they provide is very basic and there is no advanced care or medical discoveries of note in any of those countries, but that is the reality of single payer systems.

Hutterite
American Fork, UT

Single payer system for everyone. That's how we do it.

Nate
Pleasant Grove, UT

@Truthseeker

Food is also a necessity, often an emergency, with life or death consequences, and is not the same as buying a TV. The free market does a wonderful job of delivering food.

@Twin Lights "...free market oriented..."

What does that even mean? Either the market is free, or it isn't. And if it isn't, then don't blame the free market for failures in the health care system.

"[O]ne of the most significant issues is how to provide care for those who have the least ability to pay...."

Yes, true. Freedom does the most good for the most people, but even the best system is not perfect. There will always be a need for Christian charity.

@Hutterite "Single payer system for everyone."

Yeah, get your health care at the DMV.

sigmund5
Salt Lake City, UT

What would a more capitalist market driven system look like? I don't get it. Single payer systems are more efficient. There isn't duplication of services and endless paperwork and bureaucracy. Overhead costs for private insurance companies is 30% while medicaid is 5% or less. Can someone on this thread address the fact that our system costs 200-300% more than other industrialized countries? Ideology and beliefs about things that don't address reality are very dangerous and deadly things.

Nate
Pleasant Grove, UT

@sigmund5 "Can someone on this thread address the fact that our system costs 200-300% more than other industrialized countries?"

Several explanations have been cited: higher doctor compensation, higher drug prices, higher obesity rates, and ready access to expensive medical technologies.

In addition, I am fascinated by a chart I found on the Forbes website, titled "Annual Per Capita Healthcare Costs by Age". It shows, beginning at age 60 and continuing to end of life, a wide separation between the U.S. and other developed nations on health care expenditures for the elderly. The U.S. spends vast amounts more than other nations for the health care of its grandmas and grandpas.

This may change when the you-know-what panels begin to operate under Obamacare.

@sigmund5 "Ideology and beliefs about things that don't address reality are very dangerous and deadly things."

They certainly are.

UT Brit
London, England

@Nate

"The U.S. spends vast amounts more than other nations for the health care of its grandmas and grandpas."

For little to no benefit. Most countries with UHC have people living older or around the same lifespans as senior Americans. So thats twice the cost with no gain. Sounds like things are working out just fine.

"This may change when the you-know-what panels begin to operate under Obamacare."

You already have death panels, they are formed by insurance companies.

"They certainly are."

Libertarians always talk about the holy grail that is the free market. Its the get out of jail card in every argument, "well if we had a free market......". Its easy to pull out that line because its a fantasy and will never exist. How about discussing reality? #
The US healthcare system is the least regulated by far in the developed world, spends twice as much per person than the rest of the developed world while producing worse results than the rest of the developed world.

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