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The Economist on Healthcare

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Jun 8th 2011, 13:35 by M.S.

..DAVID BROOKS had an op-ed in the New York Times yesterday that proclaimed the near impossibility of restraining costs in health care through centralised government efficiency evaluations, which is being justly ridiculed by people (Jon Chait, Jonathan Cohn, Ezra Klein) who note that every single one of the world's centralised government-regulated health-care systems is far cheaper than America's relatively decentralised private-sector one. Mr Brooks has surely had this explained to him a thousand times by now, and his failure to process the fact or incorporate it into his worldview seems to me most likely to reflect an absence of the ideological furniture on which the fact could sit. Mr Brooks doesn't seem to have an instinctive understanding of how it can be possible for unregulated free-market health-care systems to cost more and deliver inferior care than strongly regulated systems with heavy government involvement, and that's why, while he occasionally must have to acknowledge the existence of the French health-care system, he can't seem to retain it.
 
Couldn't get the chart to post, but it's on their website.
 
Of course it's going to cost more and be less efficient in a for profit situation.

Tell me how many people the commisisons to insurance sales people help with medical outcomes?

How about the billions and billions spent for marketing for insurance companies that provide no services?
 
Jun 8th 2011, 13:35 by M.S.

..DAVID BROOKS had an op-ed in the New York Times yesterday that proclaimed the near impossibility of restraining costs in health care through centralised government efficiency evaluations, which is being justly ridiculed by people (Jon Chait, Jonathan Cohn, Ezra Klein) who note that every single one of the world's centralised government-regulated health-care systems is far cheaper than America's relatively decentralised private-sector one. Mr Brooks has surely had this explained to him a thousand times by now, and his failure to process the fact or incorporate it into his worldview seems to me most likely to reflect an absence of the ideological furniture on which the fact could sit. Mr Brooks doesn't seem to have an instinctive understanding of how it can be possible for unregulated free-market health-care systems to cost more and deliver inferior care than strongly regulated systems with heavy government involvement, and that's why, while he occasionally must have to acknowledge the existence of the French health-care system, he can't seem to retain it.

Is that part true, though? Not a rhetorical question -- I genuinely don't know. I didn't think the quality of care offered in the U.S. was the question, but how much it cost.
 
Is that part true, though? Not a rhetorical question -- I genuinely don't know. I didn't think the quality of care offered in the U.S. was the question, but how much it cost.

Good question, and thanks for the link fu.
 
Of course it's going to cost more and be less efficient in a for profit situation.

Tell me how many people the commisisons to insurance sales people help with medical outcomes?

How about the billions and billions spent for marketing for insurance companies that provide no services?

Looks like I picked the right day to join this forum. RJ is completely wrong when it comes to the cost and efficiency of private vs government controlled healthcare (at least when it comes to the US). I spent 30 years dealing with Medicare and Medicaid and know that the word efficiency cannot be said in a sentence relating to those two programs with a straight face. The cost of the ever-changing regulations the Federal bureaucracy saddles providers with adds billions to cost and steals valuable patient care time from doctors and nurses.

I'm not a big fan of insurance companies, but they are more efficient and better at legitimately controlling costs than the Feds and most states.
 
Good question, and thanks for the link fu.

What's the measure of quality of care? Percent of people who receive care? Quality for those who actually get care?

We've had threads about how our system is less geared toward treatment than getting repeat business and charging for it.
 
Looks like I picked the right day to join this forum. RJ is completely wrong when it comes to the cost and efficiency of private vs government controlled healthcare (at least when it comes to the US). I spent 30 years dealing with Medicare and Medicaid and know that the word efficiency cannot be said in a sentence relating to those two programs with a straight face. The cost of the ever-changing regulations the Federal bureaucracy saddles providers with adds billions to cost and steals valuable patient care time from doctors and nurses.

I'm not a big fan of insurance companies, but they are more efficient and better at legitimately controlling costs than the Feds and most states.

Did you read the article or look at the data?
 
Looks like I picked the right day to join this forum. RJ is completely wrong when it comes to the cost and efficiency of private vs government controlled healthcare (at least when it comes to the US). I spent 30 years dealing with Medicare and Medicaid and know that the word efficiency cannot be said in a sentence relating to those two programs with a straight face. The cost of the ever-changing regulations the Federal bureaucracy saddles providers with adds billions to cost and steals valuable patient care time from doctors and nurses.

I'm not a big fan of insurance companies, but they are more efficient and better at legitimately controlling costs than the Feds and most states.

If the government ran the facilities rather than outsourced them to private companies, that level of paperwork/bureaucracy would cease to exist.
 
Did you read the article or look at the data?

Actually, I read all five articles. Don't know what data you're referencing unless it's the graph in Mr. Klein's . I find none of them compelling, including Mr. Brooks' op-ed.

Neither party has championed a particularly good plan.
 
If the government ran the facilities rather than outsourced them to private companies, that level of paperwork/bureaucracy would cease to exist.

Do you really believe that? It's more likely the paperwork/bureaucracy would triple and patient care productivity would be dramatically cut.
 
Frist of all to do it, they would have to finally modernize all of the systems. That would save some of the work.

As you and others have said you have to fight them for payment and other things. That would disappear.

I think the only way to go is a hybrid like other countries are trying to do. You get helathcare from the government and can buy extra insurance if you so choose.
 
Actually, I read all five articles. Don't know what data you're referencing unless it's the graph in Mr. Klein's . I find none of them compelling, including Mr. Brooks' op-ed. Neither party has championed a particularly good plan.

Really? You don't find anything compelling that every other industrialized country provides health care at a significantly lower rate than the one outlier, the US?
 
I think the big difference is not public vs private, but monopoly versus competition.

I lived in Germany for a few years and found the system there pretty good. I had foot problems while I was there, ultimately ended up needing a procedure called a cheilectomy. In Germany, you can go to any doctor you want to, even a specialist, without having to see a GP first. I saw an ortho guy the day after I called for the appointment. And I could have chosen from any number of orthopedic docs. It took several weeks to get the surgery done, though.

In Germany, there is competition. The UK's NHS, though, is a disaster from what I've been told by friends there. Morale sucks among the people who work in the system and the system is a monopoly. You see long lines lines in hospitals waiting to see specialists
and getting diagnostic procedures like MRI's can take months.
 
I think the big difference is not public vs private, but monopoly versus competition.

I lived in Germany for a few years and found the system there pretty good. I had foot problems while I was there, ultimately ended up needing a procedure called a cheilectomy. In Germany, you can go to any doctor you want to, even a specialist, without having to see a GP first. I saw an ortho guy the day after I called for the appointment. And I could have chosen from any number of orthopedic docs. It took several weeks to get the surgery done, though.

In Germany, there is competition. The UK's NHS, though, is a disaster from what I've been told by friends there. Morale sucks among the people who work in the system and the system is a monopoly. You see long lines lines in hospitals waiting to see specialists
and getting diagnostic procedures like MRI's can take months.

Lived in England. Anyone with the means pays for private healthcare and doesn't wait for a damn thing.
 
If the government ran the facilities rather than outsourced them to private companies, that level of paperwork/bureaucracy would cease to exist.

Did you keep a straight face when you wrote this? Have you ever had the experience of a VA hospital?

I've worked at both a VA and tertiary care medical center, to think that the VA is efficient and the care is acceptable is laughable. The productivity is also laughable, likely due to the multiple layers of complexity and huge amounts of paperwork. Actually taking care of the patient is a secondary concern. There are few if any examples of government control of things that make them run smoother and more efficiently. Healthcare would certainly not be an example of that.
 
Lived in England. Anyone with the means pays for private healthcare and doesn't wait for a damn thing.

Not surprising. The same thing happens in Canada, although in a different way. Private insurance is illegal in Canada. So, rather than wait in the public system, people with the means to do so come to the US for treatment.
 
So all these examples of people wanting to run from their home country to get reasonably acceptable care are supposed to make us want to support government run care here in the US???
 
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Frist of all to do it, they would have to finally modernize all of the systems. That would save some of the work.

As you and others have said you have to fight them for payment and other things. That would disappear.

I think the only way to go is a hybrid like other countries are trying to do. You get helathcare from the government and can buy extra insurance if you so choose.

Rather than ripping you on the first two paragraphs, let me say that I agree with the bolded part. I'd expand Medicare to all ages, but limit coverage to preventative and catastrophic events. I think the private insurance companies would then have a capped risk. Let them fight it out across state lines, but regulate them. I also believe the purchase of some product would have to mandatory so the "good lives" keep the insurance costs down and the foolish don't just depend on Medicaid. Subsidize the cost of insurance for lower income families. Use Medicaid to provide for those who legitimately fall thru the cracks.

I'd also give healthcare providers a bigger platform to recommend changes to Fedral oversight. The whistleblower statutes seem to be working with respect to Medicare/Medicaid fraud. We need something similar to ferret out the more ridiculous regulations and bureaucratic inefficiencies. Speaking of Medicare fraud, the government needs to push harder on eliminating true fraud, but needs to stop treating honest differences of opinion as fraud. Lastly, the Feds need to stop calling profit "waste".
 
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