In that article I linked last night in this thread, there was a little sidebar that said since 1999 health insurance premiums have grown 119% while wages have grown 29% and consumer prices 34%.

Health care costs are hamstringing the economy.

Boomer

Originally Posted by l2ridehd

Tort reform. Until you fix that any system will fail. Get the lawyers out, drop the cost of malpractice insurance for doctors and hospitals and drug componies, and ALL other health care becomes affordable.

I have all kinds of examples of how tort reform would improve and less the cost of healthcare. Just a couple...

-- My orthopaedic surgeon's malpractice insurance costs him over $400,000 per year. That means that starting on January 1, every dollar of income he books up to that amount has to go to paying his insurance premium. Before the office rent, payroll to the receptionist and nurses, fee to be on the hospital staff, new equipment for the office, and finally his own income.

-- If you had a bad accident requiring the attention of a neurosurgeon anywhere in the southern two-thirds of the state of Illinois, they would have to fly you to either St. Louis or Indianapolis. Because of the cost of insurance, all the neurosurgeons formerly in central and southern Illinois have moved to neighboring states.

-- A well-known OB-GYN on Chicago's North Shore gave up her practice a few years ago and became a night shift pharmacist at a local Walgreens drugstore. She reported to the Chicago Tribune that not having to pay the insurance premiums has resulted in her making more money as a pharmacist and she reported that she is far happier in her job.

I'm sure there are more stories like these. Tort reform really does have to be a part of any healthcare reform legislation that is passed by this Congress.

Obama's ultimate mission is the leveling of social inequalities. He offers a tripartite social democratic agenda: nationalized health care, federalized education (ultimately guaranteed through college) and a cash-cow carbon tax (or its equivalent) to subsidize the other two. Problem is, the math doesn't add up. Not even a carbon tax would pay for this expanded welfare-redistribution of wealth state.

What should be done first is entitlement reform - Soc. Sec. and Medicare/Medicaid. That's where the real savings is; trillions could be saved that would not only fund expensive health and education programs, but would also restore the budgetary balance.

Social Security would be pretty easy, but the hard part is Medicare and Medicaid. In an aging population, how do you keep them from blowing up the budget? There is only one answer: rationing.

Why do you think the stimulus package pours $1.1 billion into medical "comparative effectiveness research"? It is the perfect setup for rationing. Once you establish what is "best practice" for expensive operations, medical tests and aggressive therapies, you've laid the premise for funding some and denying others. It is estimated that a third to a half of your lifetime health costs are used in the last six months of your life. Britain's National Health Service can deny treatments it deems not cost-effective -- and if you're old and infirm, the cost-effectiveness of treating you plummets. In Canada, they ration by queuing. You can wait forever for so-called elective procedures like hip replacements.

Do you really want the government to decide your life or health 'is not worth the price'?"
My vote is for a competitive, privatized health insurance system with a government subsidized transition to portability. Then if you are layed off from employment or you retire early or whatever, the ridiculous link between health insurance and employment is finally no more.

However, if you believe that health care is a public good or a right to be guaranteed by the state, then a single-payer system is the next best alternative. Unfortunately, it is fiscally unsustainable without rationing. I noted someone's comment above about some poll saying doctors don't want single payer. I don't know as I trust that poll. My physician is against universal health care and also sited rationing. He thinks it's the worst thing we can do, and he was referring to patients not himself.

Originally Posted by retiredguy

Obama's ultimate mission is the leveling of social inequalities. He offers a tripartite social democratic agenda: nationalized health care, federalized education (ultimately guaranteed through college) and a cash-cow carbon tax (or its equivalent) to subsidize the other two. Problem is, the math doesn't add up. Not even a carbon tax would pay for this expanded welfare-redistribution of wealth state.

What should be done first is entitlement reform - Soc. Sec. and Medicare/Medicaid. That's where the real savings is; trillions could be saved that would not only fund expensive health and education programs, but would also restore the budgetary balance.

Social Security would be pretty easy, but the hard part is Medicare and Medicaid. In an aging population, how do you keep them from blowing up the budget? There is only one answer: rationing.

Why do you think the stimulus package pours $1.1 billion into medical "comparative effectiveness research"? It is the perfect setup for rationing. Once you establish what is "best practice" for expensive operations, medical tests and aggressive therapies, you've laid the premise for funding some and denying others. It is estimated that a third to a half of your lifetime health costs are used in the last six months of your life. Britain's National Health Service can deny treatments it deems not cost-effective -- and if you're old and infirm, the cost-effectiveness of treating you plummets. In Canada, they ration by queuing. You can wait forever for so-called elective procedures like hip replacements.

Do you really want the government to decide your life or health 'is not worth the price'?"
My vote is for a competitive, privatized health insurance system with a government subsidized transition to portability. Then if you are layed off from employment or you retire early or whatever, the ridiculous link between health insurance and employment is finally no more.

However, if you believe that health care is a public good or a right to be guaranteed by the state, then a single-payer system is the next best alternative. Unfortunately, it is fiscally unsustainable without rationing. I noted someone's comment above about some poll saying doctors don't want single payer. I don't know as I trust that poll. My physician is against universal health care and also sited rationing. He thinks it's the worst thing we can do, and he was referring to patients not himself.

http://www.nytimes.com/2009/06/11/us...alth.html?_r=1

Originally Posted by rshoffer

FYI... medical care is ALREADY rationed... spend some time learning about the "PRIOR AUTHORIZATION" process. Everyday in my office I need to smooch the behinds of dozens of insurance functionaries to allow pts to return for a certain # of visits, a certain type of medication, MRI scans etc. You need to spend a day in my shoes for an eye-opener.

Thank you for acknowledging the obvious, "medical care is ALREADY rationed". Perhaps you can help my learning process by explaining how the Obama/Daschle plan will cure the rationing problem? Even though my advancing years occasionally create lapses of recall, I do comprehend the impediments and implications to cost efficiency and quality of care that "PRIOR AUTHORIZATION" generate. Again I ask, " How is the Obama/Daschle plan going to improve this problem?

Do you believe the Federal Board they plan to create in the image of Britain's NICE is going to reduce the bureaucracy, eliminate the politics and reduce costs? I have seen nothing in the early proposals that would create a single nonprofit payer or reduce the bureaucracy. In fact it appears to double down on the bureaucracy and creates more payment options. Please correct me if I misunderstood the scant few points made public.

Digressing briefly, if I recall in one of your earlier posts, you observed that medical profession salaries are lower in Florida because of more competition. Good old capitalism at work. Would the members of your fraternity accept a national effort to substantially increase the number of educated, licensed doctors in this country? Why are so many of our brightest, most talented young Americans forced to go to the Dominican Republic, Costa Rica or abroad to receive their medical training? Could your observation on salaries in Florida be extrapolated to lower medical costs nationwide by increasing the number of practicing physicians? Hmm.....

You haven't walked a mile in my shoes either. I have witnessed politics, greed, and self preservation prevent a needed hospital from being built when funding was in place, because it would effect the profit margin of other hospitals in the area. Long story. not now and at best abstractly relevent.

I am not opposed to improving our medical care and I understand that any meaningful initiative will necessarily involve some government oversight. I just want government's role as exemplified by what's on the table, significantly reduced and the role of medical professionals given more prominence in the equation. Malpractice suits are complicit in driving up medical costs. I would campaign for tort claim and medical malpractice reform to eliminate "the lottery ticket" mentality of those who seek windfall judgements aided and abetted by "ambulance chasing" lawyers. This is not likely with an attorney president who owes so much to American trial lawyers.

Sorry for the rambling, long of wind response. There is just so much more that needs to be said and so little time and space.

Thank you for sharing your professional insights.

Originally Posted by Keedy

This subject should not even be an issue until the country gets it's head well above water. And when it does..it should die a quick death.

Anything the government runs will be filled with pork and bureaucrats. It would be 10 times as bad as the education bureaucracy. Reagan should have eliminated that when he had the chance, too.

Why is that?.... Because you keep electing the same good old boys..... We need term limits no matter what the party... 8 Years max...

Originally Posted by GrayGoose

Why is that?.... Because you keep electing the same good old boys..... We need term limits no matter what the party... 8 Years max...

SHHHHHHhhhhhh Keep it down...why are you yelling????

Like a health care system that is too complex, does not work, drives doctors and other providers to rationing/cheating/cutting corners....etc.

The only complainers are those of us who are on the receiving end. For those in these systems that do not work for us, but obviously provide gain for them, nary a word. And these are the influential groups that have the ear of Washington and the basis for doing nothing.

Same root cause for enrgy independence....banking.....and so on.

Until we affect the gang in Washington not much has changed and not much will change.....it is the realm of the rich/wealthy....and excludes most of we the people.

And that is why it (what ever) doesn't work well and won't get fixed. Intelligent, responsible, accountable people would not leave things in place that do not work. Hence the hope for an effective health care reform that truly meets the needs of the people is not in the cards....IMHO.

Any other theories are welcome.

btk

Originally Posted by Villages Kahuna

I have all kinds of examples of how tort reform would improve and less the cost of healthcare. Just a couple...

-- My orthopaedic surgeon's malpractice insurance costs him over $400,000 per year. That means that starting on January 1, every dollar of income he books up to that amount has to go to paying his insurance premium. Before the office rent, payroll to the receptionist and nurses, fee to be on the hospital staff, new equipment for the office, and finally his own income.

-- If you had a bad accident requiring the attention of a neurosurgeon anywhere in the southern two-thirds of the state of Illinois, they would have to fly you to either St. Louis or Indianapolis. Because of the cost of insurance, all the neurosurgeons formerly in central and southern Illinois have moved to neighboring states.

-- A well-known OB-GYN on Chicago's North Shore gave up her practice a few years ago and became a night shift pharmacist at a local Walgreens drugstore. She reported to the Chicago Tribune that not having to pay the insurance premiums has resulted in her making more money as a pharmacist and she reported that she is far happier in her job.

I'm sure there are more stories like these. Tort reform really does have to be a part of any healthcare reform legislation that is passed by this Congress.

About 6 years ago a medical school colleague of mine was the last solo private practice neurosurgeon in Philly. His malpractice ins then was 300 thousand a year. When he was notified there was going to be a big jump in premiums he quit... later took a salaried posn at a university. I do not believe that Philly has a single private practice neurosurgeon. Out of necessity, they have all taken salaried posns where there ins is covered by an institutions group plan.

Originally Posted by Keedy

http://www.nytimes.com/2009/06/11/us.../11health.html

The American Medical Assn (which this article refers to) is a white elephant with its membership dwindling. It is out of touch with practicing physicians. It is a powerful lobby in DC to protect the status quo.

Originally Posted by rshoffer

The American Medical Assn (which this article refers to) is a white elephant with its membership dwindling. It is out of touch with practicing physicians. It is a powerful lobby in DC to protect the status quo.

Yep... and when there is a new system...there will be lobbyists and then a new status quo.. Lawyers and unions,,,Lawyers and unions...I can't seem to get that mantra out of my head...I'm sorry...where were we????

Originally Posted by Russ_Boston

The majority of bankruptcies in this country are caused by health care bills. So fixing our health care payment system may be a big piece of improving our economy. You're calling the health care system FLUFF?

And as someone mentioned, our companies are currently being strangled by health insurance budgets. Let's face it, the health care payment system needs to be changed or cost curbs (efficiencies) need to be enacted. I don't know which model would work best but the current one is broken.

And Keedy: I don't see what is wrong with loving the country you are in (USA in our case) yet still wanting to see improvements made as we progress. Yes we can learn things from other countries and formulate a plan that will work for us.

A couple of references: (2005) http://www.consumeraffairs.com/news0...tcy_study.html

(2009) http://voices.washingtonpost.com/hea...=moreheadlines

HERE ARE SOME MORE SUPPORTING FACTS...

http://www.pnhp.org/PDF_files/MedicalBankruptcy.pdf

More than one-quarter cited illness
or injury as a specific reason for bankruptcy;
a similar number reported uncovered
medical bills exceeding $1,000. Some debtors
cited more than one medical contributor.
Nearly half (46.2 percent) (95 percent confidence
interval = 43.5, 48.9) of debtors met at
least one of our criteria for “major medical
bankruptcy.” Slightly more than half (54.5 percent)
(95 percent CI = 51.8, 57.2) met criteria
for “any medical bankruptcy.”
A lapse in health insurance coverage during
the two years before filingwas a strong predictor
of a medical cause of bankruptcy (Exhibit
3). Nearly four-tenths (38.4 percent) of debtors
who had a “major medical bankruptcy”
had experienced a lapse, compared with 27.1
percent of debtors with no medical cause (p <
.0001). Surprisingly, medical debtors were no
less likely than other debtors to have coverage
at the time of filing.

Originally Posted by Villages Kahuna

Yes, the Swedes pay higher taxes than we do. But they believe they're getting their moneys worth, seemingly borne out by many of the country comparison statistics. It seems to beg the question of how satisfied we are with our elected officials and the governance they provide?

I question the premise of your conclusion on what you site as being "borne out by many of the country comparison statistics." The one statistic that would seem to distort and throw that rational askew is:

Sweden population - 9,000,000
USA population 301,000,000

Further, Sweden's government is noted for being decentralized and health care largely falls to the counties or municipalities. While the reviews on the quality of care are good, I don't understand how you can make any comparison between Sweden's success and the healthcare crisis in America.

I say that alot of people don't care about their health and are a big drain on the system. Therefore, the people who practice preventive medicine should get some kind of reward.
I see tons of obese people who think only of their next meal and never get off their doff to exercise or help better themselves.
Maybe a tax break or something equal that would inspire more people to take better care of themselves.
My best friend, at the age of 69 was way out of shape and had the worst eating habits. He got tired after just very little physical activity. He was at least 40 pounds over-weight.
It got so bad he wrecked his knees. The doctor suggested he lose alot of weight before he had both knees replaced.
He changed his eating habits and started a work-out regimen that included an exercise machine and bicycle riding.
What a difference...he had both knees done and now he is a different man. He maintained his new lifestyle habits and he is energetic and full of enthusiasm. He never tires easy like before.
In closing, people respond to incentives and to reward people who do not drain the system might be something to look into.
Keedy