Emergency Room care costs will continue to rise without an alternative

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  • Noodlekaboodle Salt Lake City, UT
    Sept. 28, 2012 2:56 p.m.


    Allowing insurance to be bought across state lines. This is an interesting idea, but in the current market I’m not sure how effective it would be. Currently you have 5 massive insurers. Aetna, Cigna, BXBS, United and Coventry. These companies control a major portion of the insurance market. The rest of the market consists of mainly specialty insurers and TPA's (third party administrators). Local examples of these include companies like PEHP (Public employee health plan) EMI (Educators) and DMBA (Mormon Church employees) these types of companies aren't aggressive in selling policies or aren't allowed to due to nonprofit status. The current amount of regional insurance companies like Select Health isn't very large. If more companies like select health spring up it might work. Otherwise you would mainly be buying polices from the same companies; regardless of what state you live in.

  • Noodlekaboodle Salt Lake City, UT
    Sept. 28, 2012 2:56 p.m.

    Let me address your suggestions. I've worked in the medical insurance field for over 10 years and I’m pretty familiar with these concepts. I've spoken with multiple actuaries (the guys who estimate the amount of risk that an insurance company has, basically the numbers they calculate determine how much the insurance company will have to charge to make money.) They all say tort reform is such a small part of healthcare costs that it doesn't matter what happens with it, it will have a negligible change in how much people pay for healthcare.
    Expanded HSA, as long as we can pay for them it's not a bad idea. However, if you are not taxing people on their income (which is what an HSA does) then we have to have the $$$ to make up for that lost tax revenue.
    Taxing employer sponsored healthcare. That has already been done in PPACA (obamacare) so no change needed there.

  • RedShirt USS Enterprise, UT
    Sept. 28, 2012 2:34 p.m.

    To "Tolstoy" so then you agree that tort reform does actually reduce healthcare costs because it does reduce malpractice lawsuits. You have already refuted your claim that tort reform does nothing, so there is nothing left for me to say.

    To "mark" so you call a program that costs taxpayers more than initial budget estimates and has little impact on people going to the ER for care a success? Wasn't the whole point to lower costs and get people out of the ER and into the Dr. offices the whole point? It is like the ACA, it was sold as cutting costs, but has caused some significant jumps in premiums for insurance, not to mention adding to the cost of medical equipment. How does healthcare become more affordable at the same time it becomes more expensive?

  • mark Salt Lake City, UT
    Sept. 28, 2012 12:56 a.m.

    “Tolstoy" you have not bothered to read the article that was listed.”

    Well, maybe, maybe not. But heres my problem with your list.

    “See "Health Care In Massachusetts: 'Abject Failure'" at NPR”

    Interesting. Abject Failure. But see the problem is that the entire title is: Health Care In Massachusetts: 'Abject Failure' Or Work In Progress?

    Makes me wonder why you would leave out the last four words, and the question mark. Hmnn.

    Reading the article one finds out that “abject failure” was a quote from Rick Santorum.

    And more:

    The Massachusetts law has had strong and steady support — and little opposition. Last year, an attempt to repeal the "individual mandate" — the part that requires most people to have insurance — couldn't get enough signatures. Last week, only 39 people had “liked” its Facebook page.

    And even more:

    Meanwhile, a new study in the journal Health Affairs shows that more Massachusetts citizens are seeing a doctor regularly, fewer are going to emergency rooms for care, and the percentage who rate their own health as "good" or "excellent" is going up.

    The question is, Redshirt, did you read the article?

  • Tolstoy salt lake, UT
    Sept. 27, 2012 10:45 p.m.

    Actually I did read the article and just like every other reference you give it does not support your claims. The article claims that premiums went down but does not say by how much or give any evidence to support the claim. It also states that while lawsuits went down the number of complaints to the medical board and sanctions by the board actually went up. So care to provide some actual evidence to support your claim or refute the facts I presented?

  • Screwdriver Casa Grande, AZ
    Sept. 27, 2012 9:25 p.m.

    Tort reform has already happened. Sing a new song. You are so limited now that a DR. pretty much has to admit he/she messed up before you will have any chance in a court with prepropagandized conservative juries that believe all cases not thiers are frivoless. Awards are capped at rediculously low amounts no matter what the damages are and Dr's won't testify against each other.

    There's also no national standard of care to hold Dr's to and they use that in court everytime. It's pretty hard to make a case when there is no standard of care written down to hold them to and other Dr's won't come out and say a Dr. messed up because they fear retaliation from other Dr's and the insurance companies. It's a racket and it's disgusting for anyone to still be crying that we need Tort reform.

    What we need are less stupid medical errors.

  • jrgl CEDAR CITY, UT
    Sept. 27, 2012 6:18 p.m.

    When politicians say that people can get health care in an Emergency Room they are overlooking the fact that ER's are only able to stabilize a patient and send them on their way. That won't help long term or with a problem like cancer, diabetes, a broken bone, heart problem or any other myriad of medical problems that present at an ER. The ER Dr. will give a referral to a Specialist or Primary care Dr. and those clinics require cash or insurance upfront before surgery or treatment is given!

  • RedShirt USS Enterprise, UT
    Sept. 27, 2012 4:25 p.m.

    To "Tolstoy" you have not bothered to read the article that was listed.

    In addition to "Texas Tort Reform: More Complaints, Lower Costs" at Clinical Endocrinology News where they show that enacting tort reform lowered the costs of healthcare through lower premiums and increased number of doctors in the state.

    Also read "Tort Reform Shows Positive Results in TX and CA" in Emergency Physicians Monthy. There we learn that the cost of unnecessary tests along with the other issues can now be reduced.

    According to the National Bureau of Economic Research study "Does Tort Reform Reduce Health Care Costs?" tort reforms cut the cost of malpractice insurance and does lead to lower medical costs especially for high risk specialists such as OB/GYN, surgeons, and anesteologists.

  • Tolstoy salt lake, UT
    Sept. 27, 2012 3:21 p.m.

    tort reform is nothing but a red herring. medical malpractice tort costs were $30.4 billion in 2007, the last year for which data are available. We have a more than a $2 trillion health care system. That puts litigation costs and malpractice insurance at 1 to 1.5 percent of total medical costs. That’s a rounding error. Liability isn’t even the tail on the cost dog. It’s the hair on the end of the tail and another way to protect multi trillion dollar corporations from being held accountable.

    try reading Professor Tom Baker, a professor of law and health sciences at the University of Pennsylvania School of Law's “The Medical Malpractice Myth,”

  • RedShirt USS Enterprise, UT
    Sept. 27, 2012 2:55 p.m.

    To "Hellooo" the reality is that the ACA will be as useful as a neutered dog stud service. Look at what happened in Massachussetts. See "Health Care In Massachusetts: 'Abject Failure'" at NPR or "Massachusetts health reform didn't cut ER visits" in Reuters.

    To "Eric Samuelsen" and "Tolstoy" here is the most effective way to cut costs.

    Tort reform: "Texas Tort Reform: More Complaints, Lower Costs" at Clinical Endocrinology News

    If buying insurance across state lines in the central point to Obamacare, why do they prevent private companies from doing this? The Federal government runs at 25% overhead, while private insurance companies run at 15% for overhead plus profits. That right there would save at least 10%, or more once you include the massive amount of money the feds lose to fraud.

    The best way to cut costs is to cut the number of mandates. See CAHI report "HEALTH INSURANCE MANDATES IN THE STATES". They found that 20% to 50% of the price of insurance is due directly to the 2400+ mandates on insurance.

    There are some ways that you could easily lower the cost of by at least 30%, if not more.

  • Eric Samuelsen Provo, UT
    Sept. 27, 2012 12:48 p.m.

    >Mark 1
    Thanks for so clearly and concisely making the case for Obamacare.

    >Tort reform
    Does almost nothing to reduce health care costs in states where it's been implemented.
    >expansion of health savings accounts
    Which poor people can't afford
    >Tax employer sponsored health insurance
    Raising the taxes of the middle class, incentivizing companies to not provide health care
    >Allow customers to buy insurance across state lines.
    Central to Obamacare.
    >We need to incentivize people to purchase their own health insurance
    A main tenet of Obamacare

    And then, a trip to Wonderland:

    >Health care consumers need to make better choices about the price of care. When the >consumer is paying the bill, that provides incentives to try and minimize cost.

    Consumers make sensible decisions about which cell phones to buy, or which TV sets. But when your loved ones are sick, you aren't about to price compare. Absolutely nobody wants the cheapest health care; we want the BEST doctors and hospitals and specialists and meds.

    Admit it. Conservatism has NO ANSWERS here. Obamacare is an answer, the closest thing to a conservative answer as can possibly exist. I'd prefer single payer. Obamacare's good enough.

  • WHAT NOW? Saint George, UT
    Sept. 27, 2012 11:27 a.m.

    @Twin Lights

    Twin Lights reported...

    "...I think Romney will be smart enough to not simply repeal with nothing in its place...".

    What did romney pledge?

    romney has pledged that the first thing he will do on his first day in office will be to repeal obamacare.

    Millions of t-party, evangelical, christian, conservative voters will hold him to that pledge.

  • Tolstoy salt lake, UT
    Sept. 27, 2012 11:00 a.m.

    what alternatives? this is a debate that has been raging for decades and I have yet to see anyone articulate an actual alternative other then returning to what was failing us before. Please tell us what alternatives you think are going to work.

  • LDS Liberal Farmington, UT
    Sept. 27, 2012 9:31 a.m.

    The political question that remains to be resolved is this: How does Mitt Romney argue that Americans should vote for him because he cared about those who needed health care in Massachusetts while Romney is, at the same time, arguing that Americans should not vote for Barack Obama because he cared about those who needed health care in the other 49 states?

    I could have voted for Govenor Romney (R) of Massachucetts in a New England Blue Dog second..

    However, I completely despise the Frankenstein Politician the Far-Right-wing out of touch Tea-Party Controlled Republicans have morphed him into.

  • Nonconlib Happy Valley, UT
    Sept. 27, 2012 9:14 a.m.

    "Romney's observation, therefore, should be seen as a warning."

    Nonsense. Romney's "observation" is merely an admission that the GOP has no intention of providing any sort of health care for those the market excludes other than the most expensive, inefficient care possible.

    This opinion piece admits that we as a society have indeed determined that everyone deserves some sort of health care. Why don't we just join the rest of the industrialized world (and much of the Third World) and implement a system that provides all citizens with decent care. And we don't have to reinvent the wheel. We have dozens of systems to choose from, depending on what features we want to emphasize. Take your pick: Germany, Japan, France, Norway, Australia, Iceland, Canada, or even Costa Rica, which, embarrassingly, ranks just ahead of the U.S.

  • Owl Salt Lake City, UT
    Sept. 27, 2012 8:57 a.m.

    Our health care system is financially motivated, inefficient, too costly and in many cases dominated by conflicts of interest. A critical look at health care delivery is necessary by whomever. Current plans either in place of anticipated have made inadequate analysis for the sake of the power interests. Congratulations to Romney or anyone for putting the current system in the spot light. Those who criticize Romney do so for political reasons and not because of substance.

  • one old man Ogden, UT
    Sept. 27, 2012 8:24 a.m.

    So Mitt wants those of us who are paying for our insurance to continue paying for care of those who, for whatever reason, don't have the luxury of insurance?

    And I used the word "luxury" deliberately because for far too many Americans, health insurance now is an unaffordable luxury.

    Despite all its faults, the Affordable Care Act will help make it much more affordable. Republican claims to the contrary are simply more Republican lies.

  • 1conservative WEST VALLEY CITY, UT
    Sept. 27, 2012 7:51 a.m.

    First line from the article: "Republican nominee Mitt Romney was criticized by several media outlets........."

    When DOESN'T the media criticize Romney?

    When will the media consider criticizing Pres. Obama for passing a healthcare bill that the majority don't want?

  • Twin Lights Louisville, KY
    Sept. 27, 2012 7:49 a.m.

    This is spot on. Before we repeal the mandate we need to figure out what happens to those who are uninsured because we DO have a de facto system but it is very high cost.

    BTW, I think Romney will be smart enough to not simply repeal with nothing in its place.

  • JoeBlow Far East USA, SC
    Sept. 27, 2012 7:33 a.m.

    If our politicians would

    -come to the table without preconceived solutions
    -be open to all solutions
    -address the problems in a businesslike manner
    -put solutions and people ahead of lobbyists and contributors
    -make their ONLY goal to craft a good, workable solution

    We would have a better solution.

    This is the way a good businessman would approach the problem.
    This is the way Romney would approach the problem if his hands were not tied politically.
    This is the way Romney DID approach the problem in Mass.
    This is how Romney was able to find a good, workable solution in Mass.

    No businessman who looks at the problem would conclude that poor people should get healthcare from the emergency room.

    Sept. 27, 2012 7:32 a.m.

    Here are just a few ideas to help reign in health care spending. Tort reform, expansion of health savings accounts, tax employer sponsored health insurance and allow customers to buy insurance across state lines. We need to incentivize people to purchase their own health insurance outside of their employment.

    Health care consumers need to make better choices about the price of care. When the consumer is paying the bill, that provides incentives to try and minimize cost.

  • mark Salt Lake City, UT
    Sept. 27, 2012 7:29 a.m.

    "many features of the Act that are contributing to rising care costs "

    And what features would those be, Hellooo?

    "Repeal the law, and there are many alternatives that can be used to moderate the cost of care"

    And what would those alternatives be, Hellooo?

    "promote methods to provide care in cost effective ways to all citizens of the country."

    And what would those methods be, Hellooo?

  • RanchHand Huntsville, UT
    Sept. 27, 2012 6:48 a.m.

    Romney supported ObRomneyCare when it was his plan for MA. He supported reducing the need for Emergency Room care and saved tons of money for the state. His plan will have the same impact on health care at the national level, yet, he has to flop on this one because it's the only way he can get the votes of the heartless right.

    A homeless woman died in jail last week after being arrested for refusing to leave the ER until she got adequate treatment; which she obviously never got. Some health care alternative that.

  • Esquire Springville, UT
    Sept. 27, 2012 6:17 a.m.

    Who else but this paper would take a foolish comment of Romney which is contrary to his prior positions for who knows what reason, and turn it into a "warning" that we need to act? Why does it hurt you so much just to say that the Democrats are the only ones who have tried to address this problem and the Republicans have done everything they can to stop them. The GOP wants the status quo, which you decry, yet you refuse to call out your political party. As for Romney, he has surrendered any leadership authority on reform that he earned as Governor of Massachusetts by his repulsive pandering to the far right. I'm sorry, but this editorial is like something out of Alice in Wonderland.

  • Hellooo Salt Lake City, UT
    Sept. 27, 2012 1:02 a.m.

    The article is alarmist in its call for alternative plan before repealing the Affordable Care Act. Such a declaration would only be a political football for those that want politic advantage rather than solutions. Repealing the Act would at least rid the nation of the many features of the Act that are contributing to rising care costs already even before it is fully implemented in 2014. Repeal the law, and there are many alternatives that can be used to moderate the cost of care, and promote methods to provide care in cost effective ways to all citizens of the country.