TW: Mitt Romney is not stupid he is merely a political pretzel amidst a party increasingly driven by teabaggery.
From Taegen Goodard:
"Some of my libertarian friends balk at what looks like an individual mandate. But remember, someone has to pay for the health care that must, by law, be provided: Either the individual pays or the taxpayers pay. A free ride on government is not libertarian."
-- Mitt Romney, defending the individual mandate to buy health care in the Wall Street Journal back in 2006. Romney now criticizes the same mandate in the recently passed national legislation.
Showing posts with label Health Care policy 2010. Show all posts
Showing posts with label Health Care policy 2010. Show all posts
Wednesday, March 24, 2010
Monday, March 22, 2010
A Health Care Rant From the Peanut Gallery
TW: White House reader and friend with his two cents re personal experience with our health care system. He is one of those plague on both their houses (Dems and Repubs) types (which as he knows I have a problem with as one must in life choose else one lets the loudest make one's decisions for you but I digress). So on with Mercutio...
From a White House reader:
"In celebration of the ramp in healthcare stocks today due to another corporate welfare scheme getting passed. I have an ongoing prescription for stomach medication. A bottle contains 30 tablets. From 2005 until last month, I had one of those gold-plated health insurance schemes. Cost of medication to me: $5. I left my old company awhile ago to start a small business.
Last month COBRA ran out and there is no way we can afford any coverage as a business. I figured I would pay for the medication myself and ordered it figuring there was no way it could be more than $3 PER PILL or $90 total. When I went to the pharmacy, they rang it up at $240. I told them to shove it ... back onto the shelf.
I went online to see what my old insurer had been paying. Cost of medication to them: $150. So I ordered it from the UK for $30 including shipping. I have 17 years of business experience as a consultant and as an entrepreneur. This is an old medication. The UK price is the price. I'll be generous and tack on another $10 to make it $40 for the subsidy our moronic system is providing to theirs in the UK by allowing the pharma companies to stick it to us here.
Our healthcare system bears only the most superficial resemblance to anything capitalist. It is "free enterprise" only in the sense that the enterprises involved are free to rape and pillage. What really incenses me is that not being an idiot, I realize full well I was really paying $150 all along but $145 was hidden as a reduction in my salary to pay the health insurance premiums. All of the people with health insurance who don't realize that they are in fact paying all of these costs are like infants who believe the toy has disappeared when an adult hides it behind their back. Nobody wants to trust the government because it is bought and paid for under both parties by corporate America. This has occurred because we the people have abdicated, but the government isn't supposed to be them, it is supposed to be us.
When people say that government sucks, they are saying they suck. Anybody who wants less government should do us all a favor and off themselves. I want to see the government squash somebody's nuts. I for one want my f#$%ing money back. Enough corporate welfare. 30+ countries out there with better systems than ours, all of which are cheaper. I don't particularly care which one we pick from full socialist to full capitalist. Let's just pick one of the damn things instead of adding more duct tape to this thing we have. Otherwise as a society we will continue to get the healthcare and the prices we deserve."
From a White House reader:
"In celebration of the ramp in healthcare stocks today due to another corporate welfare scheme getting passed. I have an ongoing prescription for stomach medication. A bottle contains 30 tablets. From 2005 until last month, I had one of those gold-plated health insurance schemes. Cost of medication to me: $5. I left my old company awhile ago to start a small business.
Last month COBRA ran out and there is no way we can afford any coverage as a business. I figured I would pay for the medication myself and ordered it figuring there was no way it could be more than $3 PER PILL or $90 total. When I went to the pharmacy, they rang it up at $240. I told them to shove it ... back onto the shelf.
I went online to see what my old insurer had been paying. Cost of medication to them: $150. So I ordered it from the UK for $30 including shipping. I have 17 years of business experience as a consultant and as an entrepreneur. This is an old medication. The UK price is the price. I'll be generous and tack on another $10 to make it $40 for the subsidy our moronic system is providing to theirs in the UK by allowing the pharma companies to stick it to us here.
Our healthcare system bears only the most superficial resemblance to anything capitalist. It is "free enterprise" only in the sense that the enterprises involved are free to rape and pillage. What really incenses me is that not being an idiot, I realize full well I was really paying $150 all along but $145 was hidden as a reduction in my salary to pay the health insurance premiums. All of the people with health insurance who don't realize that they are in fact paying all of these costs are like infants who believe the toy has disappeared when an adult hides it behind their back. Nobody wants to trust the government because it is bought and paid for under both parties by corporate America. This has occurred because we the people have abdicated, but the government isn't supposed to be them, it is supposed to be us.
When people say that government sucks, they are saying they suck. Anybody who wants less government should do us all a favor and off themselves. I want to see the government squash somebody's nuts. I for one want my f#$%ing money back. Enough corporate welfare. 30+ countries out there with better systems than ours, all of which are cheaper. I don't particularly care which one we pick from full socialist to full capitalist. Let's just pick one of the damn things instead of adding more duct tape to this thing we have. Otherwise as a society we will continue to get the healthcare and the prices we deserve."
Wednesday, March 10, 2010
Cutting Costs Is Hard...No Wonder Folks Do Not Like It
From Ezra Klein at WaPo:
"Harvard economist (and former Obama campaign adviser) David Cutler runs through the 10 most promising cost control ideas of the past few decades and notes that six of them are fully included in the bill, three of them are at least partially present, and only one of them -- the public option -- is totally absent. "No one knows precisely how much medical spending increases will moderate," Cutler concludes. "But one cannot doubt the commitment to try. What is on the table is the most significant action on medical spending ever proposed in the United States."
One addendum to Cutler's op-ed: Cutting health-care costs is hard. And it needs to be distinguished from simply capping spending. When liberals say that single-payer will save a bazillion dollars, or conservatives point to Paul Ryan's plan and say that will save a bazillion dollars, they're talking about capping spending. Liberals do it on the provider side, saying that government will only pay so much for medical services people need, and the system will just have to adjust. Conservatives do it on the consumer side, saying that government will only give individuals so much for the coverage they need, and if that proves insufficient, then tough. But voters haven't evinced much appetite for either proposal.
So smart people have spent the past few decades trying to figure out softer ways to cut costs without cutting things that people need. One popular idea is to change payment systems so that they don't reward doctors for volume. That's in the bill. Another is to build more competitive insurance markets so that insurers have a more direct incentive to keep costs down in comparison to one another. That's in the bill. Another is to try to bring individuals closer to the true cost of the insurance coverage, which is currently hidden by employers. That's in the bill. And so on.
The problem, of course, is that no one knows how well this stuff will work. So the legislation is careful in implementation. It takes time to build up enough evidence so that doctors can confidently say what is unnecessary, and for whom. It takes time to figure out how to create new payment systems such that doctors don't find their practices in sudden chaos. It takes time to phase in taxes such that they nudge people rather than shove them, and it takes time to develop a new IT infrastructure and get doctors to use it effectively, and so on. We think a lot of this will work, but maybe it won't. So the bill is careful to move slowly. It tries a lot of different things on a fairly small scale in the hopes that some of them will pan out (hence the legislation's length).
That, of course, makes it harder to explain and less impressive when CBO looks at the savings it can predict with high levels of confidence. But until we decide to be radical with cost control, this is what moving forward looks like. As Cutler says, this is the most ambitious cost control bill Congress has ever passed. And that's a commentary both on the ambition of this bill and on the system's resistance to legislation that's yet more ambitious."
http://voices.washingtonpost.com/ezra-klein/2010/03/modest_far-reaching_cost_contr.html
"Harvard economist (and former Obama campaign adviser) David Cutler runs through the 10 most promising cost control ideas of the past few decades and notes that six of them are fully included in the bill, three of them are at least partially present, and only one of them -- the public option -- is totally absent. "No one knows precisely how much medical spending increases will moderate," Cutler concludes. "But one cannot doubt the commitment to try. What is on the table is the most significant action on medical spending ever proposed in the United States."
One addendum to Cutler's op-ed: Cutting health-care costs is hard. And it needs to be distinguished from simply capping spending. When liberals say that single-payer will save a bazillion dollars, or conservatives point to Paul Ryan's plan and say that will save a bazillion dollars, they're talking about capping spending. Liberals do it on the provider side, saying that government will only pay so much for medical services people need, and the system will just have to adjust. Conservatives do it on the consumer side, saying that government will only give individuals so much for the coverage they need, and if that proves insufficient, then tough. But voters haven't evinced much appetite for either proposal.
So smart people have spent the past few decades trying to figure out softer ways to cut costs without cutting things that people need. One popular idea is to change payment systems so that they don't reward doctors for volume. That's in the bill. Another is to build more competitive insurance markets so that insurers have a more direct incentive to keep costs down in comparison to one another. That's in the bill. Another is to try to bring individuals closer to the true cost of the insurance coverage, which is currently hidden by employers. That's in the bill. And so on.
The problem, of course, is that no one knows how well this stuff will work. So the legislation is careful in implementation. It takes time to build up enough evidence so that doctors can confidently say what is unnecessary, and for whom. It takes time to figure out how to create new payment systems such that doctors don't find their practices in sudden chaos. It takes time to phase in taxes such that they nudge people rather than shove them, and it takes time to develop a new IT infrastructure and get doctors to use it effectively, and so on. We think a lot of this will work, but maybe it won't. So the bill is careful to move slowly. It tries a lot of different things on a fairly small scale in the hopes that some of them will pan out (hence the legislation's length).
That, of course, makes it harder to explain and less impressive when CBO looks at the savings it can predict with high levels of confidence. But until we decide to be radical with cost control, this is what moving forward looks like. As Cutler says, this is the most ambitious cost control bill Congress has ever passed. And that's a commentary both on the ambition of this bill and on the system's resistance to legislation that's yet more ambitious."
http://voices.washingtonpost.com/ezra-klein/2010/03/modest_far-reaching_cost_contr.html
Saturday, January 23, 2010
The Dems Need To Nut Up...
(the image is smaller than usual, click to enlarge a bit)
TW:...and pass some frigging health care reform. Our plans kick conservative ass, implement them. Am tired of this prevaricating and pussyfooting. Just do it.
Tuesday, January 5, 2010
Another Reason Health Care Costs Keep Rising
TW: The trend is decades old but insidious nevertheless. From my view, to the extent we can shift from an increasingly indirect to a more direct payment model the better off we will be. The logic is obvious if one does not see a cost, one does not feel its pain and act accordingly.
Rationing!!!
TW: If we can put a cap on some of the demagougery, we will be able to bend the cost curve. Bending the curve should be a bi-partisan effort.
From Ezra Klein at WaPo:
"The dominant perception in American medicine is that more is better: More insurance is better insurance, and more health care is better health care. If that were unambiguously true, cost control would be a really hard choice: Every dollar you weren't spending would be a dollar of health benefit somebody wasn't getting. But that's not what the evidence shows. Consider, as David Leonhardt does, the case of Richmond, Va.
'Richmond has actually lost some of its hospital capacity over the last decade. In 1996, the area had 4.8 hospital beds for every 1,000 residents. Today, it has about three. The cause of this is, in large part, state regulations meant to cut down on supply. "Hospital care has been, in a word, rationed," Leonhardt says. The result?
The quality of care in Richmond is better than in most American metropolitan areas, according to various measures, and it continues to improve. Medicare data, for example, shows that Richmond hospitals do a better-than-average job of treating heart attacks, heart failure and pneumonia.
When I recently asked patients in Richmond whether they felt as if their care had been rationed, they found the question bizarre. “I feel like there’s nothing cheap about the care,” Janet Binns, a retired school district employee, said. After her elderly father fell down one morning, she e-mailed a doctor and was on the phone with him in minutes.
Yet when it comes to health care costs, Richmond’s rationing has made a clear difference. In 1992, it spent somewhat less than average, per capita, on Medicare — 126th lowest out of 305 metropolitan areas nationwide. Since then, though, costs have risen at a significantly slower pace than they have elsewhere. As a result, Richmond had the 39th lowest costs in 2006.'
The regulations that squeezed the Richmond medical industry are much stronger than anything being contemplated on the national level. The state has a strong "certificate-of-need" program in which doctors and hospitals who want to move or expand need to demonstrate that there's a good reason to do so. That cuts down on expensive entrepreneurial medicine, in which doctors build out, say, a specialty cardiology unit and then, magically, it turns out that the area needed a lot more heart surgeries than it had previously been getting. And that, in turn, lowers costs. But it's hard to imagine any similar command-and-control solution being adopted on the national level."http://voices.washingtonpost.com/ezra-klein/2009/12/in_health_care_more_is_not_alw.html
From Ezra Klein at WaPo:
"The dominant perception in American medicine is that more is better: More insurance is better insurance, and more health care is better health care. If that were unambiguously true, cost control would be a really hard choice: Every dollar you weren't spending would be a dollar of health benefit somebody wasn't getting. But that's not what the evidence shows. Consider, as David Leonhardt does, the case of Richmond, Va.
'Richmond has actually lost some of its hospital capacity over the last decade. In 1996, the area had 4.8 hospital beds for every 1,000 residents. Today, it has about three. The cause of this is, in large part, state regulations meant to cut down on supply. "Hospital care has been, in a word, rationed," Leonhardt says. The result?
The quality of care in Richmond is better than in most American metropolitan areas, according to various measures, and it continues to improve. Medicare data, for example, shows that Richmond hospitals do a better-than-average job of treating heart attacks, heart failure and pneumonia.
When I recently asked patients in Richmond whether they felt as if their care had been rationed, they found the question bizarre. “I feel like there’s nothing cheap about the care,” Janet Binns, a retired school district employee, said. After her elderly father fell down one morning, she e-mailed a doctor and was on the phone with him in minutes.
Yet when it comes to health care costs, Richmond’s rationing has made a clear difference. In 1992, it spent somewhat less than average, per capita, on Medicare — 126th lowest out of 305 metropolitan areas nationwide. Since then, though, costs have risen at a significantly slower pace than they have elsewhere. As a result, Richmond had the 39th lowest costs in 2006.'
The regulations that squeezed the Richmond medical industry are much stronger than anything being contemplated on the national level. The state has a strong "certificate-of-need" program in which doctors and hospitals who want to move or expand need to demonstrate that there's a good reason to do so. That cuts down on expensive entrepreneurial medicine, in which doctors build out, say, a specialty cardiology unit and then, magically, it turns out that the area needed a lot more heart surgeries than it had previously been getting. And that, in turn, lowers costs. But it's hard to imagine any similar command-and-control solution being adopted on the national level."http://voices.washingtonpost.com/ezra-klein/2009/12/in_health_care_more_is_not_alw.html
Subscribe to:
Posts (Atom)