![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
Debunking another popular myth
Paul Krugman's latest deals with healthcare:
Those of us who accuse the administration of inventing a Social Security crisis are often accused, in return, of do-nothingism, of refusing to face up to the nation's problems. I plead not guilty: America does face a real crisis -- but it's in health care, not Social Security.
Well-informed business executives agree. A recent survey of chief financial officers at major corporations found that 65 percent regard immediate action on health care costs as "very important." Only 31 percent said the same about Social Security reform.
But serious health care reform isn't on the table, and in the current political climate it probably can't be. You see, the health care crisis is ideologically inconvenient.
Let's start with some basic facts about health care.
Notice that I said "health care reform," not "Medicare reform." The rising cost of Medicare may loom large in political discussion, because it's a government program (and because it's often, wrongly, lumped together with Social Security by the crisis-mongers), but this isn't a story of runaway government spending. The costs of Medicare and of private health plans are both rising much faster than gross domestic product per capita, and at about the same rate per enrollee.
So what we're really facing is rapidly rising spending on health care generally, not just the part of health care currently paid for by taxpayers.
Rising health care spending isn't primarily the result of medical price inflation. It's primarily a response to innovation: The range of things that medicine can do keeps increasing. For example, Medicare recently started paying for implanted cardiac devices in many patients with heart trouble, now that research has shown them to be highly effective. This is good news, not bad.
So what's the problem? Why not welcome medical progress, and consider its costs money well spent? There are three answers.
First, America's traditional private health insurance system, in which workers get coverage through their employers, is unraveling. The Kaiser Family Foundation estimates that in 2004 there were at least 5 million fewer jobs with health insurance than in 2001. And health care costs have become a major burden on those businesses that continue to provide insurance coverage: General Motors now spends about $1,500 on health care for every car it produces.
Second, rising Medicare spending may be a sign of progress, but it still must be paid for -- and right now few politicians are willing to talk about the tax increases that will be needed if the program is to make medical advances available to all older Americans.
Finally, the U.S. health care system is wildly inefficient. Americans tend to believe that we have the best health care system in the world. (I've encountered members of the journalistic elite who flatly refuse to believe that France ranks much better on most measures of health care quality than the United States.) But it isn't true. We spend far more per person on health care than any other country -- 75 percent more than Canada or France -- yet rank near the bottom among industrial countries in indicators from life expectancy to infant mortality.
This last point is, in a way, good news. In the long run, medical progress may force us to make a harsh choice: If we don't want to become a society in which the rich get life-saving medical treatment and the rest of us don't, we'll have to pay much higher taxes. The vast waste in our current system means, however, that effective reform could both improve quality and cut costs, postponing the day of reckoning.
To get effective reform, however, we'll need to shed some preconceptions -- in particular, the ideologically driven belief that government is always the problem and market competition is always the solution.
The fact is that in health care, the private sector is often bloated and bureaucratic, while some government agencies -- notably the Veterans Administration system -- are lean and efficient. In health care, competition and personal choice can and do lead to higher costs and lower quality. The United States has the most privatized, competitive health system in the advanced world; it also has by far the highest costs, and close to the worst results.
Over the next few weeks I'll back up these assertions, and talk about what a workable health care reform might look like, if we can get ideology out of the way.
***************************
Hunh. Well, I've known that the US has terrible infant mortality rates for an industrialized country.
I guess we're discovering yet another area where we're not "#1".
Those of us who accuse the administration of inventing a Social Security crisis are often accused, in return, of do-nothingism, of refusing to face up to the nation's problems. I plead not guilty: America does face a real crisis -- but it's in health care, not Social Security.
Well-informed business executives agree. A recent survey of chief financial officers at major corporations found that 65 percent regard immediate action on health care costs as "very important." Only 31 percent said the same about Social Security reform.
But serious health care reform isn't on the table, and in the current political climate it probably can't be. You see, the health care crisis is ideologically inconvenient.
Let's start with some basic facts about health care.
Notice that I said "health care reform," not "Medicare reform." The rising cost of Medicare may loom large in political discussion, because it's a government program (and because it's often, wrongly, lumped together with Social Security by the crisis-mongers), but this isn't a story of runaway government spending. The costs of Medicare and of private health plans are both rising much faster than gross domestic product per capita, and at about the same rate per enrollee.
So what we're really facing is rapidly rising spending on health care generally, not just the part of health care currently paid for by taxpayers.
Rising health care spending isn't primarily the result of medical price inflation. It's primarily a response to innovation: The range of things that medicine can do keeps increasing. For example, Medicare recently started paying for implanted cardiac devices in many patients with heart trouble, now that research has shown them to be highly effective. This is good news, not bad.
So what's the problem? Why not welcome medical progress, and consider its costs money well spent? There are three answers.
First, America's traditional private health insurance system, in which workers get coverage through their employers, is unraveling. The Kaiser Family Foundation estimates that in 2004 there were at least 5 million fewer jobs with health insurance than in 2001. And health care costs have become a major burden on those businesses that continue to provide insurance coverage: General Motors now spends about $1,500 on health care for every car it produces.
Second, rising Medicare spending may be a sign of progress, but it still must be paid for -- and right now few politicians are willing to talk about the tax increases that will be needed if the program is to make medical advances available to all older Americans.
Finally, the U.S. health care system is wildly inefficient. Americans tend to believe that we have the best health care system in the world. (I've encountered members of the journalistic elite who flatly refuse to believe that France ranks much better on most measures of health care quality than the United States.) But it isn't true. We spend far more per person on health care than any other country -- 75 percent more than Canada or France -- yet rank near the bottom among industrial countries in indicators from life expectancy to infant mortality.
This last point is, in a way, good news. In the long run, medical progress may force us to make a harsh choice: If we don't want to become a society in which the rich get life-saving medical treatment and the rest of us don't, we'll have to pay much higher taxes. The vast waste in our current system means, however, that effective reform could both improve quality and cut costs, postponing the day of reckoning.
To get effective reform, however, we'll need to shed some preconceptions -- in particular, the ideologically driven belief that government is always the problem and market competition is always the solution.
The fact is that in health care, the private sector is often bloated and bureaucratic, while some government agencies -- notably the Veterans Administration system -- are lean and efficient. In health care, competition and personal choice can and do lead to higher costs and lower quality. The United States has the most privatized, competitive health system in the advanced world; it also has by far the highest costs, and close to the worst results.
Over the next few weeks I'll back up these assertions, and talk about what a workable health care reform might look like, if we can get ideology out of the way.
***************************
Hunh. Well, I've known that the US has terrible infant mortality rates for an industrialized country.
I guess we're discovering yet another area where we're not "#1".
no subject
went up to a window told them what's up. sat down. 5 minutes (no exaggeration) a woman asked me into this room. she helped me fill a form out because i didn't know german. this form was one page. i didn't have jack for information, all i had was my host family's name and the town they lived in. no phone, no address. keep in mind also that i'm obviously a foreigner. so we fill out this form, it takes a few minutes but as she's doing that this other lady is prepping me for surgery, doctor comes in does the surgery, they give me a piece of paper and say come back in a few days. i go out of that room and around the counter is the pharmacy where my prescription is already filled and i'm on my way home. seriously, i the whole thing took about half an hour!
i went back three times for follow ups and every time it was the same, _no_ waits, super nice people, insane efficiency.
so that's that. compare that to experiences i've had in us military hospitals or the hcmc downtown that were agonizingly bureaucratic and inefficient makes it clear that it's not government healthcare = sucky and expensive or market competition = awesome. execution is definitely a factor.
people act like it's all impossible to do socialized healthcare and when i tell them i have experienced this impossibility they get all stupid and are just against it. why can't we do what germany did, why we can't just copy them? i really don't understand what the problem is. it seems to me some people are just irrationally clinging to some cold war pinko fear that is just silly.
(no subject)
(no subject)
(no subject)
(no subject)
(no subject)
(no subject)
(no subject)
(no subject)
(no subject)
no subject
Seriously, the health care system is pretty badly screwed up, and I think a lot of it is because most health insurance isn't really health insurance, it's more like prepaid care. So people tend to go running to the doctor for every sore throat and sniffle, which drives up the cost...and there's no good way to comparison shop between doctors and clinics, at least not yet, which is another thing that drives up costs. Don't even get me started on Medicare.
One thing I notice he doesn't mention about the VA: a lot of the efficiency he touts has come from the current administration closing down a lot of VA hospitals (many of which were providing horrible care) and having a lot of veterans dealt with on an outpatient basis or through home health care.
(no subject)
(no subject)
(no subject)
(no subject)
(no subject)
(no subject)
(no subject)
no subject
A very big reason heath care is so expensive is also because americans are so fucking unhealthy. We are fat and lazy. Nobody exercises. And the majority of shit thinly disguised as food that we do put in our bodies are toxic.
So I think for anybody who wants free health care, here is a solution (and free). Why don't we all put down the Doritos, stop going to fast food joints and start exercising for 45 minutes a day and try to prevent poor heatlh. After all, if we all started getting healthy, health care costs would go down.
No I know it's a pipe dream to think we as americans want to assume any personal responsability regarding our own health. But when one is 60 and looks back on their life and sees that they ate like shit, barely did any form of exercise. Don't be shocked if you're broke, in a wheel chair looped up on a ton of drugs with a few months to live.
Now... where did I put my remote control, because there is no way I am getting up from the couch to change the channel. :)
(no subject)
(no subject)
(no subject)
subj
online gambling casino (http://online-gambling-casino.porapahat.com)
Drug interactions - organic nitrates
Side effects
viagra cialis (http://viagra-cialis.vernulsa.com)
4 Drug interactions - organic nitrates
internet black jack (http://internet-black-jack.sotdiha.com)
play black jack online (http://play-black-jack-online.sotdiha.com)
3 Side effects
black jack online (http://black-jack-online.porapahat.com)
generic cialis (http://generic-cialis.vernulsa.com)
It was developed by the biotechnology firm ICOS and marketed worldwide by Eli Lilly and Company under the brand name Cialis.
online cialis (http://online-cialis.vernulsa.com)
Cialis is a drug used to treat male erectile dysfunction (impotence).
buy cialis (http://buy-cialis.vernulsa.com)
buy cheap viagra online (http://buy-cheap-viagra-online.vernulsa.com)
6 Trivia
1 Cialis at work
internet black jack (http://internet-black-jack.vernulsa.com)
play black jack online (http://play-black-jack-online.vernulsa.com)
black jack online (http://black-jack-online.vernulsa.com)
cialis vs viagra (http://cialis-vs-viagra.sotdiha.com)
buy cheap viagra online (http://buy-cheap-viagra-online.bestinop.org)
Chemical information
cialis sample (http://cialis-sample.vernulsa.com)
In the United States, Cialis has Food and Drug Administration approval and became available in December, 2003 as the third pill after Viagra and Levitra. Due to its 36-hour effect it is also known as the "Weekend Pill".
2 Chemical information
gambling casino (http://gambling-casino.vernulsa.com)
gambling casino (http://gambling-casino.sotdiha.com)
cialis side effects (http://cialis-side-effects.vernulsa.com)
Contents [hide]
5 Marketing
buy cheap viagra online (http://buy-cheap-viagra-online.porapahat.com)
Cialis at work
buy cheap viagra online (http://buy-cheap-viagra-online.msna.info)
buy cheap viagra online (http://buy-cheap-viagra-online.comlive.biz)
7 External links
cialis free sample (http://cialis.sotdiha.com/sitemap.html)
online gambling casino (http://online-gambling-casino.vernulsa.com)
The most common side effects when using Cialis are headache, indigestion, back pain, muscle aches, flushing, and stuffy or runny nose. These side effects usually go away after a few hours. Patients who get back pain and muscle aches usually get it 12 to 24 hours after taking the drug, and the symptom usually goes away after 48 hours.
buy cheap viagra online (http://buy-cheap-viagra-online.izmena.org)
buy cialis (http://buy-cialis.sotdiha.com)
cialis sample (http://cialis-sample.sotdiha.com)
buy cheap viagra online (http://buy-cheap-viagra-online.sotdiha.com)
cialis vs viagra (http://cialis-vs-viagra.vernulsa.com)
The empirical formula for Cialis is C22H19N3O4, and its official organic name is (6R,12aR)-6-(1,3-benzodioxol-5-yl)-2,3,6,7,12,12a- hexahydro-2-methyl-pyrazino[1 ,2 :1,6]pyrido[3,4-b]indole-1,4-dione. The molecular weight is 389.41. The tablets are yellow, film-coated, and almond-shaped, and are produced in 5, 10, or 20mg doses.
buy cheap viagra online (http://buy-cheap-viagra-online.nemnoga.org)
Since PDE5 inhibitors such as Cialis may cause transiently low blood pressure (hypotension), organic nitrates should not be taken for at least 48 hours after taking the last dose of Cialis.
It works by inhibiting an enzyme known as PDE5. A 20 mg dose of Cialis is comparable to a 100 mg dose of sildenafil (Viagra).
buy cheap viagra online (http://buy-cheap-viagra-online.zamesto.net)+8067.0166015625