tag:blogger.com,1999:blog-8193628934721963907.post1658693194099451774..comments2024-03-28T10:08:06.291-05:00Comments on Give2Attain: American Healthcare Cost DirversJohnhttp://www.blogger.com/profile/14991027705809503541noreply@blogger.comBlogger30125tag:blogger.com,1999:blog-8193628934721963907.post-1005128347663203012012-02-07T23:03:37.662-06:002012-02-07T23:03:37.662-06:00I would say we have a world of evidence that anyth...I would say we have a world of evidence that anything "free" gets overused and abused, while what you pay for yourself gets used far more prudently and effectively. Start with emergency room care, for one example. Just a $10 co-pay would get rid of a lot of freeloaders on the system. <br /><br />J. EwingAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-89889425255550915862012-02-07T16:10:42.543-06:002012-02-07T16:10:42.543-06:00Ah, but there's a world of difference between ...Ah, but there's a world of difference between giving each of us the bill that we accumulate and handing all of us the bill for everybody else.<br /><br />In theory, perhaps, but not in practical terms. And government always hands us collective bills.<br /><br />--HiramAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-23203816744092594522012-02-07T10:39:06.506-06:002012-02-07T10:39:06.506-06:00Ah, but there's a world of difference between ...Ah, but there's a world of difference between giving each of us the bill that we accumulate and handing all of us the bill for everybody else. One big difference is, that if YOU are paying for mine, I'll have the large sirloin, thank you. If I'm paying for yours, You'll get tofu, but you may not find it very filling. <br /><br />J. EwingAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-71187400354446467022012-02-07T06:42:37.840-06:002012-02-07T06:42:37.840-06:00The only problem would be that you would have to t...The only problem would be that you would have to take more than half of US doctors "out of service" to the general public and make them government employees. <br /><br />VA is generally regarded as high quality care. As always, the problem isn't whether we should provide health care, rather it's who should get the bill? And the reality is, it's the American people who will get the bill, one way or another.<br /><br />http://www.youtube.com/watch?v=KXewIR7Y7cc<br /><br />--HiramAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-55226709176960411452012-02-06T21:28:59.065-06:002012-02-06T21:28:59.065-06:00I am assuming the Doctors can make more in Private...I am assuming the Doctors can make more in Private Practice than at the VA. I wonder how / who they get?Johnhttps://www.blogger.com/profile/14991027705809503541noreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-29550702508798140902012-02-06T08:45:36.436-06:002012-02-06T08:45:36.436-06:00It IS funny.
But VA care and Medicare are world...It IS funny. <br /><br />But VA care and Medicare are worlds apart. If you want to convert Medicare and Medicaid to VA-like programs, I would say it was an excellent first start. The only problem would be that you would have to take more than half of US doctors "out of service" to the general public and make them government employees. That would be bad. Right now we have an increasing number of doctors refusing to even accept Medicaid or Medicare patients, because it costs more-- in time and trouble both-- than they get paid, and Obamacare will only accelerate that process. <br /><br />It's amazing that the Medicare model of health care is such a cost driver for the rest of us, and that Medicare costs are escalating at twice the cost of private insurance plans, while doctor reimbursements are actually being cut. Crazy. I guess it shows the folly of having government arbitrarily setting prices, rather than a free market. <br /><br />J. EwingAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-57665619027091302552012-02-05T20:22:36.285-06:002012-02-05T20:22:36.285-06:00Now that is funny !!!!!Now that is funny !!!!!Johnhttps://www.blogger.com/profile/14991027705809503541noreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-49348152028926832182012-02-05T19:54:59.322-06:002012-02-05T19:54:59.322-06:00Reasons why J's friends appreciate the VA heal...Reasons why J's friends appreciate the VA healthcare services: "the standard there is to do what the patient needs, without all the red tape and paperwork of government or government-like programs."<br /><br />Reminiscent of the Tea Party man at the town hall forum with the sign saying "Keep Your Government Hands Off My Medicare". <br /><br />Irony, thy name is conservative. <br /> <br />--AnnieAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-54841476296962739792012-02-04T20:41:12.158-06:002012-02-04T20:41:12.158-06:00My understanding from my veteran friends is that t...My understanding from my veteran friends is that they PREFER the VA because the standard there is to do what the patient needs, without all the red tape and paperwork of government or government-like programs. It makes a vast difference, I would think. And no, being the federal government, they can't be sued. As I said, the only thing not "perfect" about this system is that there is no competition, and there is some cost control in that the latest treatments are often not covered. <br /><br />J. EwingAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-37266982910284583062012-02-04T09:24:30.930-06:002012-02-04T09:24:30.930-06:00Back to VA hospital thought, as far as I understan...Back to VA hospital thought, as far as I understand there is little or no "choice" in that system. I wonder if American citizens would ever accept the loss of choice.<br /><br />I am guessing it is pretty efficient if you are assigned a Doctor and clinic. And I wonder if they can be sued for malpractice. Finally I wonder what level of staff they can afford. Doctors don't seem to fit in as the basic civil servant. Surgeons for sure...Johnhttps://www.blogger.com/profile/14991027705809503541noreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-10207251316472040592012-02-04T07:33:51.237-06:002012-02-04T07:33:51.237-06:00"The point being that if government can force..."The point being that if government can force you to buy healthcare and force you to pay for whatever they think "healthcare" is-- both very real and essential parts of Obamacare-- then what else can they force you to do to "hold down costs"?<br /><br />An interesting question often asked, rarely answered. What are the limits of governmental authority? They certainly aren't found in the commerce clause, where the authority granted to Congress is sweeping and unlimited. I think the answer is found in the bill of rights, in those parameters talked about in Roe v. Wade. The limits of government authority have to do with the physical person. The way I put it is that the government can make you pay for a peach, but it can't make you eat one. In the health care context, under the interstate commerce clause, the government can make us pay for the medical treatment of others as it does with Medicare, but it can't force us to accept medical treatment, at least not without raising a lot of legal and constitutional issues.<br /><br />--HiramAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-17962921905765863912012-02-04T05:14:18.397-06:002012-02-04T05:14:18.397-06:00Annie, Of course I have no source for the "f...Annie, Of course I have no source for the "forced to go to the gym" "tidbit." Remember, we had to pass Obamacare to find out what was in it? The point being that if government can force you to buy healthcare and force you to pay for whatever they think "healthcare" is-- both very real and essential parts of Obamacare-- then what else can they force you to do to "hold down costs"? Once government pays the bills, they decide what you must do to keep the bills down, whether it is exercise, eat right, or just die. If you don't like death panels, I'm not sure you will like the "good living" panel telling you what to do, either. <br /><br />J. EwingAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-12470130343708585012012-02-03T12:59:23.296-06:002012-02-03T12:59:23.296-06:00Laurie,
Sorry for calling you anon... I have gott...Laurie,<br />Sorry for calling you anon... I have gotten so used to looking for names at the bottom that I forgot to look at the top. Oooopppsss.Johnhttps://www.blogger.com/profile/14991027705809503541noreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-217509755330464332012-02-03T12:31:16.205-06:002012-02-03T12:31:16.205-06:00Wiki Spend per Capita
Wiki Healthcare System
Wiki ...<a href="http://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_(PPP)_per_capita" rel="nofollow">Wiki Spend per Capita</a><br /><a href="http://en.wikipedia.org/wiki/Health_care_system" rel="nofollow">Wiki Healthcare System</a><br /><a href="http://en.wikipedia.org/wiki/Health_care_compared#Cross-country_comparisons" rel="nofollow">Wiki Healthcare Compariosns</a><br /><a href="http://en.wikipedia.org/wiki/The_Omnivore's_Dilemma" rel="nofollow">Wiki Omnivore's Dilemna</a><br /><a href="http://www.foodpolitics.com/food-politics-how-the-food-industry-influences-nutrition-and-health/" rel="nofollow">Food Politics</a><br /><br />Annie,<br />I think I would prefer to separate food price fixing/subsidies from healthcare costs. I don't disagree that many poor are overweight because cereals are more readily available in their neighborhoods and cheaper than vegetables. Though I am not sure that their food preferences would change, even if they were both equally available. (ie back to why are poor poor?)<br /><br />I am still waiting for them to get rid of the "Pizza" line at school...<br /><br />As for my grading criteria comment, if the majority of us are getting good healthcare... Why would should we risk distruption for the minority? Shouldn't they get working harder and pull themselves up by their boot straps? These are valid questions.Johnhttps://www.blogger.com/profile/14991027705809503541noreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-28883077073499983472012-02-03T09:39:09.786-06:002012-02-03T09:39:09.786-06:00".. . .unless we're forced into something...".. . .unless we're forced into something like Obamacare, where you will be REQUIRED by law to go to the gym 4 times per week."<br /><br />Care to source that tidbit? <br /><br />--AnnieAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-53520610363894037742012-02-03T09:19:31.534-06:002012-02-03T09:19:31.534-06:00Annie, if you are looking for why US "results...Annie, if you are looking for why US "results" in the health care system are so poor compared to other Western countries, don't look at the health care system. Like John keeps trying to tell us about the schools, look at the "raw material." We have huge problems with drug use, alcoholism, obesity, lack of exercise, smoking, gun and other violence, and a subculture uninterested in such things as personal health and hygiene and even infant care. Changes to the health care system won't even begin to make a dent in those things unless we're forced into something like Obamacare, where you will be REQUIRED by law to go to the gym 4 times per week. And I'm not sure even that is going to help.<br /><br />J. EwingAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-18606929926820943742012-02-03T09:11:20.094-06:002012-02-03T09:11:20.094-06:00"I believe one cost driver you left out is th..."I believe one cost driver you left out is the tendency here to over test, over diagnose and over treat patients. And no, I do not have a link for this info.<br /><br />My second point is that from what I've read the govt run VA rates high in both quality care and efficiency/cost." -- Laurie<br /><br />Laurie is right on BOTH counts! <br /><br />The tendency in US medicine to over-test is called "defensive medicine" and is caused by the high cost of medical malpractice. The tendency to "over-diagnose" is caused by the fee-for-service model imposed by federal government insurance systems. And the tendency to "over-treat" is caused by the "first dollar coverage" and "third party payer" aspects of government insurance, which almost all private insurance plans have adopted. Get rid of those four government created/mandated aspects of our health care system, and costs drop by half. <br /><br />The proof is in the VA hospitals, where the standard of care is to do what is right for the patient, outside all the hide-bound rulebooks and largely free from the threat of lawsuits, and there you are. <br /><br />J. EwingAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-38736587213013975242012-02-03T00:03:11.270-06:002012-02-03T00:03:11.270-06:00John-Regarding the healthcare grading system:
Her...John-Regarding the healthcare grading system:<br /><br />Here's a ranking of national health expenditures per capita (from two separate sources: <br />http://en.wikipedia.org/wiki/List_of_countries_by_health_care_expenditures<br /><br />And here's a good apples-to-apples comparison of how we rank in several categories of health:<br />http://en.wikipedia.org/wiki/Health_care_compared#Cross-country_comparisons <br /><br />Regarding changing habits: Smoking, seatbelts, kids sleeping on their backs--these were all public health and safety initiatives. If you're interested in how public policy can shape our nationals collective health, I recommend The Omnivore's Dilemma by Michael Pollan and Food Politics by Marion Nestle. There's absolutely a role for personal responsibility and good decisions, but there's also a role for putting our national money where our mouth is, and trying to ensure a bag fresh spinach or a pound of grapes as cheap and available as a box of macaroni and cheese or pop tarts. <br /><br />--AnnieAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-78677899747200646482012-02-02T19:01:03.637-06:002012-02-02T19:01:03.637-06:00Annie,
I forgot... The nation has been pushing hea...Annie,<br />I forgot... The nation has been pushing health and nutrition forever. Yet we keep getting fatter.<br /><br />I don't see more healthcare swaying us from our glutonous ways. I know a lot of well to do obese people. I don't see them lacking for healthcare. (well or sick care)Johnhttps://www.blogger.com/profile/14991027705809503541noreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-80610405468484395972012-02-02T18:48:34.623-06:002012-02-02T18:48:34.623-06:00"across the board, we we pay the most (by far..."across the board, we we pay the most (by far) and have the worst results (by far)." <br /><br />Speaking for the well advantaged lucky folks, this seems quite the stretch. I have full access to every conceivable Specialist, Test, Procedure, Piece of Equipment, etc and I don't have to wait long at all. Seems pretty reasonable and the results have been great so far...<br /><br />Success of a system is relative to the grading criteria...<br /><br />Anon,<br />I added the tests.Johnhttps://www.blogger.com/profile/14991027705809503541noreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-15032835898790732992012-02-02T17:22:01.517-06:002012-02-02T17:22:01.517-06:00Certainly, no nation's system is flawless. But...Certainly, no nation's system is flawless. But across the board, we we pay the most (by far) and have the worst results (by far). <br /><br />The US has excellent facilities for sick care (Mayo, Johns Hopkins)--which most of us will never need or have access to. Conversely, the US is terrible at every level of health care--obesity, diabetes, infant mortality to name a few. <br /><br />This is a logical place for government to perform a public good. Health care (not only sick care), preventative care, public information on healthy diet and exercise--all these things can produce a healthier population. Healthier kids have more success in school, healthier adults take fewer sick days.<br /><br />Building in a profit margin for shareholders and CEOs doesn't necessarily make things less expensive or higher quality. The goal for our nation's health shouldn't be profit. <br /><br />--AnnieAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-84289884153113999232012-02-02T17:02:36.896-06:002012-02-02T17:02:36.896-06:00I believe one cost driver you left out is the tend...I believe one cost driver you left out is the tendency here to over test, over diagnose and over treat patients. And no, I do not have a link for this info.<br /><br />My second point is that from what I've read the govt run VA rates high in both quality care and efficiency/cost.Anonymoushttps://www.blogger.com/profile/09905073449150541750noreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-78856122704285047302012-02-02T12:35:12.421-06:002012-02-02T12:35:12.421-06:00Per the links above, it looks like all the systems...Per the links above, it looks like all the systems have problems... They just vary from one to another...Johnhttps://www.blogger.com/profile/14991027705809503541noreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-33251271905369907102012-02-02T12:33:36.006-06:002012-02-02T12:33:36.006-06:00Useful Links:
BB: Is Europe's Healthcare Bette...Useful Links:<br /><a href="http://www.businessweek.com/globalbiz/content/jun2007/gb20070613_921562_page_2.htm" rel="nofollow">BB: Is Europe's Healthcare Better?</a><br /><a href="http://online.wsj.com/article/SB10001424052748704893604576200724221948728.html" rel="nofollow">WSJ Europe's failling Health</a><br /><a href="http://www.eufutureofhealthcare.com/sites/default/files/EIU-Janssen%20Healthcare_Web%20version.pdf" rel="nofollow">EU Future of Healthcare</a><br /><a href="http://www.nytimes.com/2006/10/18/business/18leonhardt.html?pagewanted=all" rel="nofollow">NYT: A Lesson From Europe</a><br /><a href="http://www.nationalcenter.org/NPA555_Sweden_Health_Care.html" rel="nofollow">NPA Sweden Healthcare</a>Johnhttps://www.blogger.com/profile/14991027705809503541noreply@blogger.comtag:blogger.com,1999:blog-8193628934721963907.post-12358568094018327042012-02-02T11:33:42.521-06:002012-02-02T11:33:42.521-06:00The second thing that happens in countries with go...The second thing that happens in countries with government-run health care is that they control costs by simply not paying for things that we wouldn't dream of rationing here, like mammograms, delivery rooms, hip and knee replacements, cancer treatment, and a whole host of other things.<br /><br />I believe you will find in typical government run health systems, at least in the west, all of these things are paid for.Anonymousnoreply@blogger.com