Cost of Health Care Continues to Rise

[Boreas]

Originally Posted by whell

We swerved into a discussion of the Canadian system due to a remark about the virtues of single payer.

"We" didn't. "You" did. If you felt that Finn's comments would be best responded to by introducing a document painting a rather jaundiced view of the Canadian system that's fine but you should be prepared to own it. Don't ascribe it to the collective "we". You are far too good a wordsmith to be ignorant of your framing here.

John

[whell]

Originally Posted by Boreas

"We" didn't. "You" did. If you felt that Finn's comments would be best responded to by introducing a document painting a rather jaundiced view of the Canadian system that's fine but you should be prepared to own it. Don't ascribe it to the collective "we". You are far too good a wordsmith to be ignorant of your framing here.

John

Yes, I did, to provide context for my comments. The document, I thought, was pretty balanced by the way. It covered both the best and least attractive aspects of the Canadian system. Which, by the way, is an example of single - payer. Which, was one way to respond to a sentiment that single payer should be an objective. I could have posted comments about the health system of just about any Western Social democracy, many of which are now trying to figure out how to continue to pay for their health care system. Many in this forum post comments without citations or reference to sources. I was trying to provide source material.

[d-ray657]

I would suggest that an extremely important reform to the health care and health insurance industry, which did not survive the intense lobbying, is the repeal of the antitrust exemptions for those industries. (Wasn't health care a profession at one time, rather than an industry?) One needn't be a PHD in economics to conclude that price-fixing raises costs for most any product. When health care providers on one side, and insurance providers on the other side are able to engage in price fixing, the consumer loses.

Ironically, this would not be regulation, but an insistence that those industries actually operate in a competitive market. The libertarian Ron Paul, who opposes most all regulation, strongly advocates strict enforcement of anti-trust laws to prevent imbalanced operation of the market. In this market, consumers are essentially powerless and badly in need of help by someone with the authority and resources to stand up to the accumulated capital of the insurance companies.

By the way, the mish-mash of state regulation would be eliminated by a single payer plan, or by exclusive federal regulation of insurance. The multi-employer, self funded health and welfare plans (union sponsored) are regulated exclusively by the federal government under ERISA. As a rule, with no profit, no commissions, no dividends, minimal advertising, and no executive bonuses, those plans operate quite efficiently at delivering services to their beneficiaries, at a lower costs than the corporate insurance industry. Taking the greed out of the provision of health coverage seems to be a much better way of serving the consumer.

Regards,

D-Ray

[merrylander]

Originally Posted by whell

If you read the article on the link that I posted, you'd see that these facts are acknowledged in the article as well. It also provides reasons why this might be the case: reasons that are disconnected from the delivery of health care in Canada.

All I could find was the allegation that Canadians smoke less, I am trying to figure out what effect that has on infant mortality, pretty certain that they don't smoke while in the womb.

There are just as many mickey dees in Canada as here, for all our Dunkin Donuts they have Tim Hortons, and Dairy Queens, etc.

Long waiting time my arse, my son was driving to work and experienced severe pain, stopped by the Ottawa General, they put him in the MRI machine popped him in bed and removed his appendix the next morning. My sister-in-law in Toronto had chest pains, her children took her to the hospital emergency, next morning they installed a pace maker.

We do raioning here as well, insurance companies do not cover everything, but in both countries that does not stop people from getting treatment, in particular the case of macular degeneration noted, my 85 year old sister has it and is beinng treated.

AFAIK there is no law in Canada stating that you cannot buy supplementary health insurance should you want it.

I sometines wonder how much it costs Aetna, US Healthcare, Kaiser P and big pharma to get all these studies published.

[merrylander]

To return to your original post, yes the cost of healthcare is rising and IMHO it out of control here even moreso than countries with universal healthcare, so leave them aside. What do you suggest can rein in these rising costs.

I certainly doubt that setting up a Senate comittee under Max Baucus with six senators who among them represented less than 3% of the population was a half assed way of resolving the issue.

In another thread here someone posted a link to a C-SPAN video of a Representative from Florida and near as I recall he stated that over 47,000 families a year are bankrupted by medical expenses. This is unacceptable.

Due to some recent family problems I have been investigating certain drugs, a common thread among all modern drugs ". . . do not take XXX if you have liver problems." say what? The page after page of side effects make most seem worse that the disease. My favourite is ". . . may cause death, if this occurs consult your doctor." Really?

Some drugs (Avastin, Ritalin) should never, never have been approved and have caused heart attack or severe personality change.

[whell]

Originally Posted by d-ray657

I would suggest that an extremely important reform to the health care and health insurance industry, which did not survive the intense lobbying, is the repeal of the antitrust exemptions for those industries. (Wasn't health care a profession at one time, rather than an industry?) One needn't be a PHD in economics to conclude that price-fixing raises costs for most any product. When health care providers on one side, and insurance providers on the other side are able to engage in price fixing, the consumer loses.

Ironically, this would not be regulation, but an insistence that those industries actually operate in a competitive market. The libertarian Ron Paul, who opposes most all regulation, strongly advocates strict enforcement of anti-trust laws to prevent imbalanced operation of the market. In this market, consumers are essentially powerless and badly in need of help by someone with the authority and resources to stand up to the accumulated capital of the insurance companies.

I don't disagree with this. While we're at it, though, I suggest that we go all the way. Eliminate state - level regulations on health insurers as well, and allow health insurance to be sold across state lines. State mandates for health insurance can be a significant driver of health insurance costs. For example, in Illinois and other states, group health plans are required to carry a rider the covers fertility treatments. Why in the world should an entire group be required to pay extra premium for coverage that most of the members of the group will never use?

Originally Posted by d-ray657

By the way, the mish-mash of state regulation would be eliminated by a single payer plan, or by exclusive federal regulation of insurance. The multi-employer, self funded health and welfare plans (union sponsored) are regulated exclusively by the federal government under ERISA. As a rule, with no profit, no commissions, no dividends, minimal advertising, and no executive bonuses, those plans operate quite efficiently at delivering services to their beneficiaries, at a lower costs than the corporate insurance industry. Taking the greed out of the provision of health coverage seems to be a much better way of serving the consumer.

Regards,

D-Ray

If we eliminate the anti-trust exemption and reduce or eliminate state regs, and allow insurance to be sold across state lines, it would open up the whole market to significant competition. I'd suggest at that point you might see prices impacted in favor of the consumer, and more freedom to innovate insurance product design.

[merrylander]

Originally Posted by whell

I don't disagree with this. While we're at it, though, I suggest that we go all the way. Eliminate state - level regulations on health insurers as well, and allow health insurance to be sold across state lines. State mandates for health insurance can be a significant driver of health insurance costs. For example, in Illinois and other states, group health plans are required to carry a rider the covers fertility treatments. Why in the world should an entire group be required to pay extra premium for coverage that most of the members of the group will never use?


If we eliminate the anti-trust exemption and reduce or eliminate state regs, and allow insurance to be sold across state lines, it would open up the whole market to significant competition. I'd suggest at that point you might see prices impacted in favor of the consumer, and more freedom to innovate insurance product design.

So if we allow sale across statelines what will prevent, oh say Aetna, from establishing themselves in a state with little or no regulation and thus be free to screw people more than they currently do? I pick on Aetna because in my last employment they administered the health insurance. I retired at 73 so every time I submitted a claim after I reached 65 (Hell I was 69 when I started there.) some clerk would send it back saying that I should submit it to Medicare as they were my prime insurer. Then I would have to point them to the place in company litereature where it said they were prime for all employees regardless of age. They were not the sharpest knives in the drawer.

The voters in Illinois should have the fertility rites removed if that is how they feel.

[noonereal]

Originally Posted by whell

This thread seems to get contentious early, as two of my posts were immediately dismissed as "BS". I brought no ill will to this discussion, but it seems as if ill will was assumed by some.

This is very inaccurate. My post was not dismissive I addressed each line of your post. How is that dismissive? You ignored all of it, that is dismissive. BTW it was one post not two.
Here is what it said:

"All tax codes are mess. This is not unique in healthcare.

Overall I'd say your post was a bunch of hooey.

Of course I am not in the industry. In fact once I became ill I lost all medical coverage so maybe I am unaware of the great healthcare industry."

(the word hooey was inserted for BS within minutes as I posted I was not sure how to spell hooey but it sure seemed to fit so I found out how and changed it)

If by contentious you mean "disagree" you are correct, other wise not so much. Anyway I will leave it alone unless more fact is altered.

Healthcare is a mess and pharmaceuticals are unethical at best.

[noonereal]

Originally Posted by merrylander

Some drugs (Avastin, Ritalin) should never, never have been approved .

Ritalin is the one true "gateway drug."

The relationship between the drug company and doctor is as unholy as it gets. It's down right unectical and should be illegal. (did I say that before )

[whell]

Originally Posted by merrylander

To return to your original post, yes the cost of healthcare is rising and IMHO it out of control here even moreso than countries with universal healthcare, so leave them aside. What do you suggest can rein in these rising costs.

I certainly doubt that setting up a Senate comittee under Max Baucus with six senators who among them represented less than 3% of the population was a half assed way of resolving the issue.

In another thread here someone posted a link to a C-SPAN video of a Representative from Florida and near as I recall he stated that over 47,000 families a year are bankrupted by medical expenses. This is unacceptable.

Due to some recent family problems I have been investigating certain drugs, a common thread among all modern drugs ". . . do not take XXX if you have liver problems." say what? The page after page of side effects make most seem worse that the disease. My favourite is ". . . may cause death, if this occurs consult your doctor." Really?

Some drugs (Avastin, Ritalin) should never, never have been approved and have caused heart attack or severe personality change.

I've got some more "realistic and politically feasible" ideas, a couple of which I've already posted, but let me try this one on you first. There's no way in hell this idea would see the light of day in our current political climate, but here goes:

Let's eliminate health insurance completely, or at least scale it back significantly. Health insurance is an idea that has been distorted far beyond its original intent, pushed by regulations, market conditions, good intentions gone awry, and utilization that is off the scale.

The rationale is pretty basic: insurance is insurance. At its core, there's no magic or mystery that makes health insurance unique from home, auto, or any other insurance product.

Most folks, for example, buy home owners insurance, they size the policy appropriately based on their needs, and they hope like hell that they never, ever have to file a claim. However, when it comes time for open enrollment at work, employees will look for what they consider the "best" policy: the plan with the lowest deductibles, co-pays and co-insurance. Many end up buying more insurance than they need, spending money on premium for a product that they didn't use much last year, won't use much this year, and might not use much next year. For the occasional medical need that they have, they could have "bought down" to a more affordable policy, pocketed and saved the money they paid out in premium for the richer plan, and used that savings to cover the stay doctors office visit or prescription if they ever needed it.

When many of these folks buy health insurance, they fully expect to generate claims. This stands in stark contrast to how and why individuals buy just about any other kind of insurance product.

These folks might also be less inclined to engage in more healthy lifestyles if there was a financial incentive to do so. The latest health plan designs that reward healthy lifestyles with premium rebates, or offering richer plan designs without premium increases do show promise. If these programs caught on and folks truly worked to achieve healthier lifestyles, economies of scale could be achieved that prevented the delivery system devoting resources to minimize the health impacts from poor individual health maintenance, and allows resources in the system to be devoted to dealing more cost - effectively with those who have chronic health conditions or disabilities. I think PPACA acknowledges the need for some of this by creating a pool of funds to help businesses install wellness programs. It also requires non-grandfathered health plans to provide first - dollar coverage for many preventative care services.

We certainly have those who are chronically ill, disabled, or otherwise in need of more focused care. Certainly the marketplace, or government reforms, would need to deliver well - conceived options for these individuals. Possibly expanding health savings accounts would be one element of a solution. Deregulation of insurance would potentially allow customization of insurance products that might better meet the needs of those with chronic health issues. Reducing the overall cost of coverage as outlined above would positively impact this group as well. Other solutions would need to be brought to bear on this segment of the population as well.