Average ObamaCare price: $328 per month.

[piezoe]

Quote from tandh:

If the government stayed completely out of health care, then health care cost would drop dramatically. We're in the mess we're in today because of government involvement, and then the answer is always more government involvement. After Obama care implodes, once again the answer will be even more government involvement.

The sentiment you've expressed is not at all uncommon, but it is not supported by facts. The U.S. despite medicare and medicaid still has the most privatized medical care among all developed nations. It is a cartel in fact; a government protected one. But that's not what you meant when you made a plea to get the government out of health care!

All our sister industrialized nations have better health outcomes than we and at much lower cost but much greater government involvement. I'm afraid reality does does not support your view that we are in a mess because of government involvement.

 

[Lucrum]

Quote from piezoe:

....All our sister industrialized nations have better health outcomes than we and at much lower cost...

You made a similar statement in another forum. Maybe I'm just being stubborn, but I'm still very skeptical of this claim.

I have certainly heard of Americans traveling to get procedures that are not FDA approved here. But don't recall anyone going to get BETTER medical treatment than we have here. Cheaper maybe, but not better.

 

[cmb]

Lol skepticle? I don't think anyone denies that our healthcare costs are outrageously high compared to other 1st world countries for the same and most likely better care.

 

[Lucrum]

Quote from cmb:

Lol skepticle? I don't think anyone denies that our healthcare costs are outrageously high compared to other 1st world countries for the same and most likely better care.

"LOL" I didn't question the cheaper part. Only the better part.

 

[piezoe]

This is a good thread. I've read some very astute comments, and it is nice to see that many of my ET colleagues have given considerable thought to this extremely important issue to all of us.

Here are a few summary comments based on my reading and personal experience.

1) Early 21st Century medical care in the U.S. has had many of the hallmarks of a Cartel; a highly regulated one, protected, and thoroughly sheltered by the government from competition.

2) Healthcare may be one of the few parts of our service economy not well served by the capitalist approach, since so much of health care does not lend itself to shopping for the best deal.

3) The most successful health care in cost and outcomes is universally found in highly industrialized countries where the systems are tightly controlled by governments. But government participation in those most successful countries is very different from the of control and participation of our U.S. government in U.S. healthcare. We have been doing something very wrong, while our sister countries have figured out how to do it right.

In other countries, for example, many routine medications can be prescribed by pharmacists, and one can freely import medication, though there is no need too. On the other hand, access to medication is tightly controlled by the U.S. Cartel. Every prescription, by law, must pass through, at additional expense and time, the hands of a licensed M.D., or someone supervised by an M.D. Name Brand Medication that costs $300 with a co-pay of $45 in the U.S.is available directly from the manufacturer in India or Ireland via an importing Canadian pharmacy for $45 plus a Fedex charge. When the medication is purchased directly from a U.S. pharmacy it originates from the same plant in India or Ireland. The U.S. co-pays are adjusted to mimic the total cost of the identical drug in Canada. Something is obviously very wrong here!

4) As U.S. medical prices have become less affordable we have seen small chinks appear in the Cartel's armor. We are seeing the growth of physician assistants and in some States "prescribing pharmacists," always against persistent strong opposition based on the hard to pin down quality, safety, and efficacy argument. Risk is always overstated by the opposition based on experience of other countries we compare ourselves to. Cost savings are potentially huge.

5) Now we are embarking on a new chapter, Obamney care. The ideal model for the U.S. would have been the Swiss one, whose costs to patients, at 50% less than the U.S., is the closest in cost of all our sister nations. The Swiss mandate coverage of all citizens residing in Switzerland, The base features offered by Swiss private insurers are regulated by the government, but companies compete on cost and perks. It is nearly the exact equivalent of the selection of group policies U.S. companies have heretofore been offered. Everyone in the same age and sex category has the same rate and there is no restriction for pre-existing conditions. The great advantage of the Swiss system besides the 50% lower cost, is that insurance is not tied to an employer. If you lose your job, you don't lose insurance coverage.

In an economy where people are constantly switching employers and jobs, having employer provided health insurance is a terrible idea. (One understands the political necessity of assuring an anxious public that they can keep their current coverage once Obamney care kicks in, but it is time to dump that bad idea in favor of something much better -- portable insurance.) Everyone should obtain their coverage from the insurance exchange, which should have been uniform and national, not State by State. [That's another subject for another day, insurance regulation. It is high time to jettison he 1945 McCarran-Ferguson Act and recognize the primacy of the Sherman Act. Instead we are doing things piece meal and its made a royal mess.] Employers who want to subsidize the insurance costs of their employees have that option in any case, but the policy has got to belong to the individual. If an employer can not offer a sufficient wage or salary for their employees to afford exchange purchased insurance at salary adjusted rates, the quality of their workforce will soon adjust to take this into account.

We must get away from employer provided insurance. Obamney care has provided us with a golden opportunity to move everyone in the country to portable, individual policies at group rates and conditions.
This would be exactly in line with the successful Swiss system.

Obamneycare needs to be adjusted to bring it fully in line with the Swiss model. It won't be difficult to do.

6) In addition, if we license prescribing pharmacists in all fifty states, we will save many billions in medical costs annually. We may never achieve universal medical care as fine as what the French have, but there is absolutely no reason for us to continue to limp along with medical costs twice the next closest nation and 38th place in quality. It's a disgrace. It is long past time to do something about it.

To inaccurately paraphrase and abuse Nancy Pelosi, "There is way more here than we can wrap our feeble brains around, we'll just have to wait and see what's in this ACC." I would plead with everyone to be patient. This is a big change. It will take time to work out the kinks. It's going to be much better than what we have had, but it won't be perfect. Take heart in the fact that it is impossible for Obamney care to be as horrible as our old broken and dysfunctional system that only the wealthy or healthy could afford.

Let's all look forward to the day when you can't be cancelled because you're sick, you can get the group rate despite any pre-existing condition, and no more families will end up in bankruptcy because of medical costs.

 

[piezoe]

Quote from Lucrum:

You made a similar statement in another forum. Maybe I'm just being stubborn, but I'm still very skeptical of this claim.

I have certainly heard of Americans traveling to get procedures that are not FDA approved here. But don't recall anyone going to get BETTER medical treatment than we have here. Cheaper maybe, but not better.

Lucrum it is very easy to access the data my statements are based on. I have personal experience with health care in another a country that we would not consider comparable to the U.S., yet I found both the access and the quality of care there superior to what we have in general. For those who know what to look for and have the means to pay for it, a very high level of care is available in the U.S. This is not the norm however. Even those with adequate insurance, can receive very substandard care if they simply rely on the system and don't pay attention. You must be very vigilant in the American system if you have any complicated issue. We can compete on wart removal with the best ($200) but go into the hospital as a diabetic patient with a kidney stone and a badly infected kidney and there is a surprisingly good chance you won't come out alive! Of course this is very dependent on the level of care in your town and your personal circumstances. It is very uneven.

 

[Lucrum]

Quote from piezoe:

Lucrum it is very easy to access the data my statements are based on. I have personal experience with health care in another a country that we would not consider comparable to the U.S., yet I found both the access and the quality of care there superior to what we have in general....

Critics of the U.S. health care system frequently point to other countries as models for reform. They point out that many countries spend far less on health care than the United States yet seem to enjoy better health outcomes.
The United States should follow the lead of those countries, the critics say, and adopt a government-run, national health care system. However, a closer look shows that nearly all health care systems worldwide are wrestling with
problems of rising costs and lack of access to care. There is no single international model for national health care, of course. Countries vary
dramatically in the degree of central control, regulation, and cost sharing they impose, and in the role of private insurance. Still, overall trends from nation-
al health care systems around the world suggest
the following:
•
Health insurance does not mean universal access to health care. In practice, many countries promise universal coverage but ration care or have long waiting lists for treatment.
•
Rising health care costs are not a uniquely American phenomenon. Although other countries spend considerably less than the United States on health care, both as a percentage of GDP and per capita, costs are rising almost everywhere, leading to budget deficits, tax increases, and benefit reductions.
•
In countries weighted heavily toward government control, people are most likely to face waiting lists, rationing, restrictions on physician choice, and other obstacles to care.
•
Countries with more effective national health care systems are successful to the degree that they incorporate market mechanisms such as competition, cost sharing, market prices, and consumer choice, and eschew centralized government control. Although no country with a national health care system is contemplating abandoning universal coverage, the broad and growing trend is
to move away from centralized government control and to introduce more market-oriented features.
The answer then to America’s health care problems lies not in heading down the road to national health care but in learning from the experiences of other countries, which demonstrate the failure of centralized command and
control and the benefits of increasing consumer incentives and choice...

http://www.cato.org/sites/cato.org/files/pubs/pdf/pa-613.pdf

I plan to read the rest of it later tonight.

 

[Lucrum]

Quote from cmb:

Lol skepticle? I don't think anyone denies that our healthcare costs are outrageously high compared to other 1st world countries for the same and most likely better care.

...When you compare the outcomes for specific diseases, the United States clearly outperforms the rest of the world....when former Italian prime minis-
ter Silvio Berlusconi needed heart surgery last year, he didn’t go to a French, Canadian, Cuban, or even Italian hospital—he went to the Cleveland Clinic in Ohio. Likewise, Canadian MP Belinda Stronach had surgery for her breast
cancer at a California hospital. Berlusconi and Stronach were following
in the footsteps of tens of thousands of patients from around the
world who come to the United States for treatment every year.
One U.S. hospital alone, the Mayo Clinic, treats roughly 7,200 foreigners
every year. Johns Hopkins University Medical Center treats more than 6,000, and the Cleveland Clinic more than 5,000. One out of every three Canadian physicians sends a patient to the Unites States for treatment each
year...
http://www.cato.org/sites/cato.org/files/pubs/pdf/pa-613.pdf

 

[Lucrum]

Quote from Lucrum:

"LOL" I didn't question the cheaper part. Only the better part.

"Conditions in Italy’s public hospitals are considered substandard, particularly in
the south. They lack not just modern technology, but basic goods and services; and overcrowding is widespread."


"The health care system is the largest single factor driving France’s overall budget deficit"


"Spain has fewer physicians and fewer nurses per capita than most European
countries and the United States. The lack of primary care physicians is particularly
acute"

"In Japan The reimbursement schedule for physicians creates an incentive for
them to see as many patients as possible. The result is assembly line medicine."

"In Norway Waiting lists are so long and so prevalent that the European
Observatory on Health Systems says that they veer toward “defacto rationing.”

"Essentially, the Greek health care system is funded through payroll taxes, general tax revenue, and bribery.

"As many as 750,000 Britons are currently awaiting admission to NHS hospitals" (2008)
Explicit rationing also exists for some types of care, notably kidney dialysis,
open heart surgery, and some other expensive procedures and technologies"

"Waiting lists are a major problem under the Canadian system."
U.S. patients are actually more likely than Canadians to receive preventive
care for chronic or serious health conditions"


"The broad and growing trend in countries with national health care systems is to move away from centralized government control and introduce more market-oriented features."

 

[Swan Noir]

Many who have made serious attempts to examine and quantify the cost/benifit equation believe that France is certainly among the world's best. It shocks the hell out of me that France can deliver efficiently but appearantly they can and do. Other countries in Europe do it pretty well (certainly at lower cost than here) but lets stick with France.

Doctors earn much less. The whole damn system isn't run for doctors to feel entitled. Most doctors here have job like aspects to what they do -- after all they use largely public funded hospitals as their office, cutting table etc. -- many are educated at great cost in publicly funded universities yet they get entrepenurial payoffs. The very top surgeons in NYC make 5 mil+ ... I repeat upward of $5,000,000. When I called the Hospital for Special Surgery on an ankle problem I was told not a single one of their ankle surgeons accepted insurance. Not just my insurance but ANY insurance ... strictly carriage trade. Certain things in life do not work well in a flat out capitalist equation. We certainly needed public utilities at one time ... and maybe not now and, of course, it would hard to get rid of them. Maybe medicine works better if we examine some alternatives. The medical establishment is simple appropriating money on a massive scale and hurting the country.

This thing is rotten to the core and does not serve the general population well. At one time it did but that is now long past. The system is littered with fraud and not just at the bottom. We need to get very tough and figure out how we force them to play by a reasonable set of rules or be severly punsihed and in the case of frauid do serious time behind bars.

I taked to pain specialist for 20 minutes in August and he billed Medicare $900. They knocked his bill way down;my copay ended up as $37.50 which my supplemental private policy will pay but he came in very high and I bet ended up with an extra $50 because of it. I want him hung by his balls. They do it all day long ... and it's real money in the aggregate.

Quote from Lucrum:

You made a similar statement in another forum. Maybe I'm just being stubborn, but I'm still very skeptical of this claim.

I have certainly heard of Americans traveling to get procedures that are not FDA approved here. But don't recall anyone going to get BETTER medical treatment than we have here. Cheaper maybe, but not better.