Impeding changes to our Health Care system

[TheMercenary]

Originally Posted by Shawnee123

I was employing hyperbole, as I often see in your cited articles.

OK, I'll quit now!

Yea, I know that sillyperson. I was giving it back to you...

[TheMercenary]

Some interesting observations about the Calif Insurance Exchange program and the plans that are being proposed in Congress:

http://online.wsj.com/article/SB124925648163600125.html

It will be interesting to see if the legal mandate, as proposed, that every single person enters the exchange if they do not already have insurance, whether or not that will have enough people to support it without the pitfalls that have helped the Calif plan become a complete failure. As usual, there are very little details about how the Federal Health Plan is going to work so we will not know until the law is already passed.

[Clodfobble]

(As a side note, I just realized I've been saying Medicare this whole time, but I meant Medicaid. Poor people, not old people. Old people don't have any teeth left, so they don't need dentists. )

[TheMercenary]

Originally Posted by Clodfobble

(As a side note, I just realized I've been saying Medicare this whole time, but I meant Medicaid. Poor people, not old people. Old people don't have any teeth left, so they don't need dentists. )

I knew that when you were talking about kids, etc.

[TheMercenary]

Another good op ed with some things to think about as Congress rushes through this change.

Obama’s More-for-Less Health Care Doesn’t Add Up: Caroline Baum

Commentary by Caroline Baum

Aug. 3 (Bloomberg) -- President Barack Obama has been exhorting lawmakers to use the August recess to read health- care-reform bills currently before Congress.

In other words, if the president had gotten his way, members would have voted first and read second legislation to revamp one-sixth of the U.S. economy. No wonder public support for both Obama and his health-care plan is eroding, according to recent polls.

Yes, people are resistant to change, as the president noted, especially when it comes to something as important as their doctor. But maybe something else is at play: the growing realization that the numbers don’t add up.

I listened to Obama’s July 29 town hall meeting in Raleigh, North Carolina, hoping to understand how the government plans to deliver more for less, to cover most of the 46 million uninsured Americans while lowering premiums, limiting out-of-pocket expenses and requiring insurance companies to cover preventive care.

I heard Obama say a lot of people will get a lot more without anyone getting less.

I heard him say two-thirds of the cost of covering everyone in America can be paid for “by money that is already in the health-care system.”

I heard him say he favors a public option to increase competition and keep costs down.

I heard him say he “will not sign a health-care bill that is not deficit neutral” and that doesn’t lower health-care inflation over the long term.

Let’s see how some of these claims stack up:

1. Mind Your P’s and Q’s

Obama wants to insure more people and lower the total cost of care. In economic terms, he wants to control price (P) and quantity (Q). What makes Obama think he can repeal the law of supply and demand?

To achieve higher Q and lower P, the supply curve has to shift outward, to the right. How does the government plan to increase the supply of health care? By making it less attractive to young men and women with a passion for medicine and a desire for independence?

Obama says he wants to encourage medical students to become primary-care physicians via financial incentives, reversing the trend toward specialization, which is where the money is.

Easier said than done, says Paul Feldstein, professor of health-care management at the Paul Merage School of Business, University of California, Irvine. “It takes a long time to produce more doctors.”

Once the government starts to dictate budgets and salaries in an effort to control costs, medicine becomes a less attractive profession.

Rationing is inevitable, Feldstein says, and there are only two options: with price and free choice or with regulation. Surely Obama spent enough time at the University of Chicago to understand his P’s and Q’s.

2. Inefficiencies of Scale

Obama says his advisers have identified $500 billion to $600 billion of inefficiencies in the system that would pay for reforms. When was the last time the government wrung inefficiencies out of anything? Medicare is plagued with waste and fraud.

Health-care reform is long overdue. We need a system that offers wider choice, proper incentives (eliminating fee-for- service) and subsidies for those who can’t afford it.

We don’t need something that fails to cut costs and eliminates choice. Plan B anyone?

3. Enhanced Competition

Obama says the government needs to offer a public health- care option to encourage competition. This line of thinking leads “to the uncomfortable conclusion that the government must be a player in every industry,” says Cliff Asness, president of AQR Capital, a hedge fund in Greenwich, Connecticut, who debunks this and other health-care myths in a paper posted on his Web site.

How do other industries manage to be highly competitive without Uncle Sam’s interference?

Unless the public wants health-care outcomes akin to those of the nation’s schools -- another sector offering a “public option,” Asness points out -- Obama needs a better plan and a more convincing argument.

4. Measuring the Right Stuff

Obama has accused opponents of his health-care plan of “scaring everybody” with intimations of rationing. He scared back, telling his Raleigh audience last week that “if we do nothing, I can almost guarantee you your premiums will double.”

The high cost of health care is another myth skewered by Asness, in his paper, and Kenneth Arrow, Nobel Laureate in Economics, in an interview in the Atlantic.

The gist of their arguments: This ain’t your father’s health care. Innovations in diagnostic and surgical procedures cost money but allow for better and less invasive treatment.

What about the accusation that the U.S. spends more money on health care and boasts life-expectancy rates well below those of most developed countries?

A red herring. There’s a big difference between health and health care. If you eat too many Big Macs, smoke and drink, that’s a lifestyle choice.

Once you suffer a heart attack or are diagnosed with cancer, the survival rates in the U.S. -- especially for cancer -- are second to none. For all the hoopla over Canada’s socialized medicine, the cross-border flows aren’t south to north.

“The low longevity ranking of the United States is not likely to be a result of a poorly functioning health-care system,” according to a new study by University of Pennsylvania professors Samuel H. Preston and Jessica Y. Ho.

What’s the prognosis if ObamaCare is enacted?

“People have to get less or pay more,” Feldstein says.

As a group the elderly are the largest consumers of health- care services. If you want to cut costs, you have to go where it’s being spent.

The Eskimos had an efficient way of rationing: in some cases they simply sent the elderly out to sea on an ice floe. It’s not what Gram and Gramps envisioned for their golden years.

http://bloomberg.com/apps/news?pid=2...d=ah.vuAG5B4iU

[TheMercenary]

White House finally confirms it made a back door deal with the Drug Industry over preserving income. Frankly I don't think they should get any "deal" and neither should the Insurance Industry.

August 6, 2009
White House Affirms Deal on Drug Cost
By DAVID D. KIRKPATRICK
WASHINGTON — Pressed by industry lobbyists, White House officials on Wednesday assured drug makers that the administration stood by a behind-the-scenes deal to block any Congressional effort to extract cost savings from them beyond an agreed-upon $80 billion.

Drug industry lobbyists reacted with alarm this week to a House health care overhaul measure that would allow the government to negotiate drug prices and demand additional rebates from drug manufacturers.

In response, the industry successfully demanded that the White House explicitly acknowledge for the first time that it had committed to protect drug makers from bearing further costs in the overhaul. The Obama administration had never spelled out the details of the agreement.

“We were assured: ‘We need somebody to come in first. If you come in first, you will have a rock-solid deal,’ ” Billy Tauzin, the former Republican House member from Louisiana who now leads the pharmaceutical trade group, said Wednesday. “Who is ever going to go into a deal with the White House again if they don’t keep their word? You are just going to duke it out instead.”

A deputy White House chief of staff, Jim Messina, confirmed Mr. Tauzin’s account of the deal in an e-mail message on Wednesday night.

http://www.nytimes.com/2009/08/06/he...ef=todayspaper

[classicman]

the more things change the more they stay the same.

[Urbane Guerrilla]

Peggy Noonan:

You Are Terrifying Us

[Happy Monkey]

Apparently Peggy Noonan is terrified of her own reflection.

[ZenGum]

She could get surgery for that...

[TheMercenary]

False:
Healthcare Reform will be deficit neutral and $6 billion surplus in 10 yrs

During a town hall meeting, U.S. Rep. Russ Carnahan, a Democrat from Missouri, tried to reassure constituents that his party's health care reform bill would cost less than expected.

"The Congressional Budget Office most recently came out and analyzed the current plan and said that it was not only deficit-neutral, which has been one of the important factors for the president and congressional leaders, but also that over 10 years it would create a $6 billion surplus," Carnahan told an audience on July 20, 2009, at Forest Park Community College in St. Louis.

The audience laughed in response. (To see for yourself, fast forward this video to the 7-minute mark.)

It's a claim that's been repeated by many Democrats since the Congressional Budget Office, a nonpartisan group that does all the number crunching for Congress, released its cost estimate for the health care bill on July 17.

In its report, the CBO estimated the bill will cost about $1.04 trillion over 10 years. That sum would be partially offset by $219.3 billion in Medicare savings and by $583 billion in tax increases over the same amount of time.

Still, the bill would create a $239 billion deficit, according to CBO.

We were perplexed: How could Carnahan proclaim a $6 billion surplus if the budget office was projecting a deficit?

The confusion comes down to an accounting question about how to treat $245 billion in the House bill that would cover the cost of adjusting Medicare reimbursement rates so doctors don't face the potential of a 21 percent cut in fees.

In 1997, Congress agreed that, should Medicare reimbursement rates grow faster than the economy, they would be cut. But instead of following its own rules, Congress has put off those cuts year after year with a Medicare "fix." CBO considers that sum as part of the cost of the bill.

But many Democrats don't. Two days after Carnahan's town hall meeting, the House approved a bill that would require all new spending be paid for by new taxes or spending cuts to other government programs, a practice widely known as pay-as-you-go. That bill exempts the Medicare pay fix from these rules, which effectively reduces the cost of the health care reform bill by that same $245 billion. The pay-as-you-go bill is pending in the Senate.

But in the meantime, CBO will continue to include it as part of the legislation's price tag until the pay-as-you-go rules are put into law.

Back to Carnahan's math: If you accept his assumption that pay-as-you-go ultimately passes both houses of Congress and is signed into law, the health care bill will only cost $797 billion over 10 years. The $219.3 in spending cuts and the $583 billion in tax revenue total $802 billion, so that leaves $5.3 billion extra. (That's not quite $6 billion, but it's in the ballpark. We can assume this is the result of rounding.)

Whether Republicans or Democrats are in charge, this kind of budget trickery is nothing new to Washington, said Brian Riedl, a budget expert at the conservative Heritage Foundation.

"It's the best way to do business in Washington," he said. "You inflate the baseline [of a bill] to make it seem like you're spending less."

So as for Carnahan's statement, he is definitely misstating CBO's findings. The budget office did not say there would be a $6 billion surplus, it said there would be a $239 billion deficit. Only when Carnahan added some optimistic assumptions did the math work the way he claimed. We find his claim False.

http://www.politifact.com/truth-o-me...lth-care-refo/

[richlevy]

From here.

I think this is another example of how the '%70 of the country who are covered by insurance' does not mean 'fully covered'. I'm guessing the $3000 limit on giving birth was not in the large print. I think the only way to have a baby for $3000 in this country is to squat and drop in a potato field with a midwife and a horse blanket.

The individual health insurance market can be a scary place for Americans who turn to it for health coverage. If they're accepted to a plan at all, patients often find that their coverage isn't quite what they were promised, and limits and restrictions lead to high medical bills for covered services that aren't really covered. That's how Sarah Wildman ended up with a $22,000 bill from the hospital where her daughter was born, despite having what she thought was good health insurance with a maternity rider.

Pregnancy on the individual health insurance market requires an additional rider that must be purchased before the pregnancy begins. Without this rider, the fetus becomes a pre-existing condition. Prenatal care, delivery, hospitalization, and any complications are not covered. Not a cent.
Wildman discovered that her maternity rider covered her daughter's birth, but with a limit of $3,000. That is not a typo. Her story ended with the company covering 90% of the bills, but, she suspects, this is only because she happened to be writing a story about it.

[jinx]

It cost my ins co $4,000 for me to give birth with a midwife in a free standing birth center. It cost almost $13,000 to get the same job done in a hospital 2 year earlier.

[richlevy]

Originally Posted by jinx

It cost my ins co $4,000 for me to give birth with a midwife in a free standing birth center. It cost almost $13,000 to get the same job done in a hospital 2 year earlier.

So they're basing their coverage on the lowest possible cost, even though a majority of women still use hospitals.

If the bill was $22,000, there may have been complications, which would possibly have required a switch to the hospital.

I just wonder if anyone told this woman up front "we're only going to cover $3000 because we're assuming that you'll use a midwife."

[jinx]

So it's the insurance company's fault this woman bought and paid for something and had no idea what it was? I'm sure no one told her specifically how much of anything they would cover... I bet it's just all in writing, in a big book they gave her but she never opened.

The "maternity" coverage we purchased didn't cover my labor, delivery, or hospital stay. It was a sham.

Then why did you purchase it? Duh.