Wednesday, December 2, 2009

Health Care—What to Think . . .

I had to read a lot of articles and write a paper on the current U.S. health care system and plans for reform for my Economics class. I also learned about the health care systems of five other countries--England, Japan, Germany, Tawain, and Switzerland. It was very interesting. I want all of your opinions and thoughts on U.S. health care, so make sure to give me your comments.

I'm still not quite sure what the best solution is for health care reform. I definitely think that President Obama and politicians on both sides are trying to look for quick fixes where the American people don't have to change bad habits--something that looks good, but in the long run will be much worse for us. There are so many inefficiencies in the U.S. health care system it's ridiculous. We spend more than any other country and our care is ranked 37th according to a Frontline video made in 2008. That's horrible!

One of the biggest problems is people don't care how much health care costs because the insurance is paying for it. So the health care providers (hospitals, etc) charge outrageous amounts to make large profits and the insurance companies pay for it. They don't really mind because they'll just raise everyone's premiums for next year. In 2005 health care was 14% of GDP (and rising) compared to about 5% in 1965 (see link). Health Savings Accounts seem like a pretty good way to put the money into consumers hands so that they are more conscientious about where the money is going. But I know that's not a solution to everything--and it doesn't work well for people with medical conditions or the elderly.

I also like the idea of universal health care, but the cost without totally revamping the current system would be tremendous (despite what Obama says). Japan has managed to keep mostly private health providers while supplying universal care, but the hospitals are in a lot of debt because of the government regulations of prices.

I think the government needs to help take care of the vast inefficiencies in health care (but the gov't itself is so ineffiecient I don't know how that will work), put money into consumers hands so they care about costs coming down, and learn from what other countries have done to expand coverage to those that don't have it and cut costs.

Comments please.


Steve said...

You discount current reform efforts by saying they won't work because they'll cost too much unless we completely overhaul the system. You're mistaken on a couple points here.

A) Overhauling the system, though certainly effective, is politically untenable. Congress is having trouble passing a relatively modest reform like this, let alone a complete overhaul.

B) You say you don't believe what Obama says about the cost of health care reform. You don't have to. The non-partisan Congressional Budget Office (which has no allegiance to Obama or anyone for that matter) has said that both the House and Senate bills will:
i) cost around $850B over the first ten years, which is actually a very modest sum in relation to the federal budget as a whole, AND ii) would reduce the deficit. Indeed, the Senate bill would reduce the deficit by $650 billion dollars in year 11-20 of implementation. Again, this is a relatively modest amount compared to the size of the budget and our GDP, but it is a good step in the right direction.

If Congress is unwilling to completely overhaul the health care system, these are the best bills your going to get. They contain costs, reduce the deficit and greatly expand coverage to the uninsured. No, they're no perfect, but they're definitely better than the status quo. And you don't have to trust Obama on that.

Tara said...

I'm not completely sure what to think about health care reform except that something has to change. This is going to sound ignorant, but does it really matter how much it's going to cost to reform it? We either fork out a ton of money to try and fix or amend the system or fork out a lot of money for all the people going bankrupt because they can't pay their medical bills (and it's the majority of personal bankruptcies). Either way, it's expensive, and I for one could use some decent insurance (I'm sure you and Christina could too...). Something is very wrong with the system and I'm glad Obama is trying to do something about it, even if it doesn't completely solve the problem.

Jason said...

The type of care that is demanded by people isn't cheap. It takes many dozens of types of doctors, nurses, techs, dieticians, pharmacists, physical/occupational/speech therapists, care partners, transport staff, janitorial, administrators, office staff, laboratories, expensive equipment, and sophisticated computer systems and IT folks to keep it running. No one is willing to accept less care.

The biggest problem with the cost of health care is cost shifting, the idea that someone else will pay for it. If you get expensive care, the portion that you pay for should hurt you financially, don't shift it to others, rather sacrifice a few luxuries. Cost shifting brings into play the 'moral hazard' phenomenon where people try to get as much as they can because it is perceived as free.

This country isn't willing to accept 'less care'. Just look at the outcry over mammograms and how the comparative effectiveness panels were skewered by the right and the left wings.

I will be happy to be on the 'death panel' that decides that it isn't worth it to use other people's money to pay for drugs or treatments that statistically don't add substantial quality years of life. Individual sob stories will abound, but we don't have an infinite amount of resources.

The current reform proposals do nothing to contain costs. They are budget neutral because they take in taxes for 3 or 4 years before they actually start spending any money, and that budget neutrality is still wishful thinking that has excluded many of their more expensive costs. They create hundreds of new panels and beaurocracies, only insure around 12 million of the 50 million currently uninsured.

Doctors are currently near a breaking point. Many are miserable. While most make above average wages, the money doesn't make up for the enormous hours, loss of family time, broken families, lost religion, demanding and litigious patients, and years of hell they had to go through to get to where they now are. Try and force them to see millions of new patients, work even longer hours, ruin their personal lives even further, yet make less money and you will see them leave the field in droves.

I'll fix the health care crisis in America. 1. Eat healthy. 2. Exercise. 3. Stop smoking, drinking alcohol, or using other harmful substances. There, I just cured millions of diseases, saved trillions of dollars that can be used for the truly tragic cases with plenty of money left over, and should be thrown a parade.

Won't work? Same mentality as those who want someone else to pay for their health care.

Craig said...

The most successful systems use the Dutch model of having heavily regulated private insurers. The Dutch manage to cover everyone, including illegal immigrants, and still pay their doctors royally. Their success is due, in the largest part, to the way their government controls prices and practices that the insurers and providers offer. It's a neat system.

The current proposal is not perfect, but the proposed insurance exchange is somewhat like the Dutch system...

Sam said...

You should check out Simple Care. That is a few doctors that accept cash only for thier services. Because there is no government red tape, insurance wait times and other regulated expenses, the services are a lot less expensive for those not insured.

It is because of the government programs like Medicaid, Medicare and Department of Social Services that medical expenses are so high. These programs do not reimburse the doctors and hospitals at a cost that even covers the actual cost. The medical community then has to charge private insured and non insured more to cover those losses.

We may not have the cheapest care, but we do have the best, most advanced medical in the world. (Only that it is sometimes not available through insurance) I do not think that overhauling the whole system is the right thing to do. Too many unknowns exist. It would be better for everyone to use common sense and make changes in stages.

The first step would be to open the insurance industry to competition. Some states do not allow insurance Competition, such as Wa. State.

We also need to limit the insurance agencies from charging more in premiums to those who are individually insured, and group policies that have not used thier policies to the point of costing the insurance companies more than what was paid.

Also, instead of being charged more at a medical facility for not having insurance, there should be the same charges and a discount for cash customers that pay same day.

First, I think the government should fix the bankrupting Medicare. If they can not run that program, why would we believe that the new medical program would be any different.

Last but most important with the amount of money they govt. says it will take for this health care bill, we could insure all the uninsured in the U.S.

My final thought is...
What happened with the stimulas money? Has it helped our economy? Who knows where it even went? Look at how fast our congress jumped on that wagon and how badly it was handled.