[jeffkrol]

It would save them even more now that their premiums have skyrocketed to comply with obamacare.

That was inevitable either way, contrary to the propaganda.... and you do REALIZE some is just posturing by the ins. companies..




http://facts.kff.org/chart.aspx?ch=707
funny:

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Last edited by jeffkrol; 01-26-2011 at 12:51 PM.

[mikemike]

funny:

That shift in the late 1990s could probably be attributed to HIPAA. I know a lot of people working in hospital IT and that law basically stimulated a complete rewrite of every information system and the business process workflows used in the medical industry between 1996 when the law passed and 2003 which was the compliance deadline.

[jolepp]

Some OECD statistics: OECD Health Data 2010 - Frequently Requested Data

In 2008 it seems we have been using $3008/capita for health care here in Finland while in the US the figure is $7538. Is it really worth ~$4500/capita/year to avoid public health care like we have here? ;-)

[Parallax]

............ Is it really worth ~$4500/capita/year to avoid public health care like we have here? ;-)

Sure, as long as it is somebody else's money.

[Nesster]

We must keep in mind that the national security priority is to control medical costs as the projections have Medicare and Medicaid ballooning out of control over the next years. This also makes sense from a business point of view, as the cost of insurance has eroded both salary increases and the in-pocket remains thereof for the workers.

With all its faults, the democratic plan at least attempted to address these issues, and I've yet to see anything convincing from the other side - the ostrich strategy just won't make the problem go away.

I've seen poll analysis that seems to show that the simplistic, black or white Repeal or Keep type of question will hide actual opinion, and tends to favor the Republican position best. Actually, there's a sizeable contingent of real Americans who want to amend and fix and improve the bill - e.g. single payor - or to fix aspects of it to improve its function, or even to get rid of some specific portion that seems to be onerous. To me this more nuanced take on public opinion tends to support the Dems approach.

[jeffkrol]

Lumping in the "repeal but make it single payer Medicare type system" doesn't really help either..... just skews the statistics even more and unfortunately supports the WRONG conclusion from one of the sides.
And yes the Repubs still got nothing.. but they promised to "look into it".. no time frame please....
It amazes me what fantasy world some choose to live in......

[GeneV]

Sure, as long as it is somebody else's money.

As someone who pays that cost for myself and employees, I have to point out it isn't someone else's money. It is also a drain on our competitiveness.

As someone who has used a lot of healthcare lately, I have to say that it takes about one evening in the system to get an idea why it is so expensive and why, for just one example, having a huge chunk of our population get its care in the ER is causing massive expense.

[jeffkrol]

As someone who pays that cost for myself and employees, I have to point out it isn't someone else's money. It is also a drain on our competitiveness.

As someone who has used a lot of healthcare lately, I have to say that it takes about one evening in the system to get an idea why it is so expensive and why, for just one example, having a huge chunk of our population get its care in the ER is causing massive expense.

Yes Gene......
INSURANCE by it's very nature is SOCIALISTIC.... get others to pay for others..
Apparently the only difference is profit.. such a simple concept few understand..

[GeneV]

I've seen poll analysis that seems to show that the simplistic, black or white Repeal or Keep type of question will hide actual opinion, and tends to favor the Republican position best. Actually, there's a sizeable contingent of real Americans who want to amend and fix and improve the bill - e.g. single payor - or to fix aspects of it to improve its function, or even to get rid of some specific portion that seems to be onerous. To me this more nuanced take on public opinion tends to support the Dems approach.

The most unpopular part of the bill is one of the most necessary, though I'm not sure how effective it will be as written. We absolutely have to get people with colds and flu and other common ailments out of the emergency room and into physician care that is appropriate to the malady. In addition to the quality issues and expense of having these folks treated by doctors who have never seen them before and have to reinvent their medical record, you have people with serious injuries and folks (like myself) who are in great danger from a serious emergency condition which might require surgery sitting next to someone puking her guts out. Everyone who spouts about government run health care should be required to spend an evening in one of those privately owned chairs.

[jolepp]

It seems that medical care is by its nature ill-suited for a market based solution: price elasticity is hardly there, rather it boils down to a "your life or your money" offer-you-cant-refuse, in particular, when you need it most (ER) you are not in any position to shop around or negotiate price. When that choice does exist there is the issue that the patient-doctor relationship is not quite as transferable as with other services. An important practical aspect of this are the medical records, some of which effectively exist in the mind of your current MD only.

[jeffkrol]

It would save them even more now that their premiums have skyrocketed to comply with obamacare.

wrong again.... sort of.......
The Truth About Health Care Reform’s Impact On Insurance Premiums - Rick Ungar - The Policy Page - Forbes

even California Blue Shield does not blame the law for the painful rise in its premium prices. In a statement issued with the announcement of the increase, the company said, “These rates reflect trends that were building long before health reform.” The company further indicated that higher prices demanded by health care providers, more use of health care, and healthy people dropping their coverage because of the bad economy were the real culprit.

Further, in a recent analysis conducted by Hewitt Associates, a well-respected human resources firm, the company estimated that employers would likely see a rise in premium costs averaging 8.8% in 2011. This is within the norm for what we have seen in annual raises over the years preceding passage of the health care reform law. Further, the firm estimates that the new law will account for, at best, one to two percent of the increases.

the agency has also suggested that those left to buy their own, individual policies may experience increases come 2016. These increases could total up to 13% more than what individual policy holders might have had to pay for an insurance policy had there never been an Affordable Care Act.

That, of course, is the part the GOP likes to hit hard.

But when they do so, our Republican friends tend to leave out the added codicil to the CBO projection. With the benefit of government subsidies being made available to help small business and lower-income people purchasing individual coverage, about half of the folks who will purchase the individual policies will end up spending less out-of-pocket than they would have without the reform act.

Bottom Line –

The Republicans are being more than a little disingenuous when they blame health care reform for raising our current health insurance rates.

As for the bold predictions of lower premium rates being offered by the Democrats – time will tell.

This is just for fun...........

Hell Freezes Over — GOP Joins Union Rally Against Budget Cuts
The usual suspects were on hand – union leaders, democratic party leaders, people in wheelchairs wearing green, pro-union t-shirts, liberal activists and…

…. three Republican state legislators?

That’s right – GOP elected officials at a union rally rejecting proposed cuts in the budget.

Who says we can’t all just get along?

Anyone who lives in California has become all too familiar with the GOP tactic of walking in lockstep with the republican leadership when it comes to cutting taxes and spending. Indeed, state-subsidized in-home care has been a frequent target of the GOP who allege that the program is rife with waste and fraud and stands as a beacon to the Democrats’ desire to throw money at any problem.

But not this week.

http://blogs.forbes.com/rickungar/2011/01/30/hell-freezes-over-gop-joins-uni...t-budget-cuts/

[GeneV]

Some interesting thoughts, SOMFW. I have posted here many times that, as an employer, I want out of the healthcare loop for my employees. I am one of the relics who still pay 100% of the premium, and my folks haven't had a raise in years other than the increases in premiums I pay.

I do think it is a bit off the mark to focus so much on what doctors are paid. The doctor is just one piece of the cost chain, and one that has undergone the most training and accepts the most responsibility. Doctors and nurses seem to me to be the links in the chain that most deserve substantial salaries. The cost aside, it takes something like 25 years of education and training for some specialties. I don't begrudge someone compensation for that.

Much, if not most, of the cost is in equipment, operators of the equipment, hospital facilities, nurses to staff the facilities and Pharmaceuticals. The last one is huge. When was the last new drug introduced that actually cured something? Antibiotics and vaccines come to mind, most of which were developed half a century ago, perhaps chemotherapy could qualify, but most drugs today "control" a disease, giving the company a customer for life. Is this a coincidence? Are Pharma companies actually out there working hard to develop cures for depression, chronic pain, epilepsy, AIDS and all these other illnesses for which the patient must currently take medicine indefinitely?

As I mentioned above, you could wring a good piece of the cost out of the system by putting more care back in the hands of professionals who know the patient, and getting it out of the emergency room. My trip last week to the ER and then ICU as a result of my wife asking a young doctor who did not know us well a question on the telephone seems, in my humble and unprofessional and possibly erroneous opinion to have been a waste of money as well as very stressful for all involved.

[jolepp]

... most drugs today "control" a disease, giving the company a customer for life. Is this a coincidence? Are Pharma companies actually out there working hard to develop cures for depression, chronic pain, epilepsy, AIDS and all these other illnesses for which the patient must currently take medicine indefinitely?

Good point: it would seem that the incentive to prefer one kind over the another is certainly there: most money (as a stable, long lasting revenue stream, no less) can be had by the choice that is not in the interest of the affected people or society in general. An(other) example of how medicine and business can in practice combine poorly.

[shooz]

I think you're making WAY too much sense, for in here, SOMFW.

[GeneV]

Sorry, SOMFW, but though I agree with a most of what you say (including trading malpractice suits for changes in mode of compensation), the part about doctors needing to cut their pay is just not based on fact. Doctor net compensation is only 10% of the total healthcare cost. Interns/Residents who provide much of the care in hospitals make about the national median salary ($40-50k). You could cut doctor salaries significantly and barely affect the cost of the system. Do American doctors get paid too much? - By Christopher Beam - Slate Magazine You might, on the other hand, affect the quality of the applicants for this 20-25 year education. The average doctor makes $137k after 23 years of training. That is probably less than her/his student debt, and that is average, not starting pay.

The specialists who make substantially more train longer and are fewer and farther between for basic care. Many are also involved in elective procedures such as plastic surgery or Lasik.

On the other hand, there are things we could do to ease the pressures on physician salaries. One is to shorten the education by removing the requirement of a BS or BA degree in something else before starting medical school. In most European countries with the better medical programs, students major in medicine (or law, for that matter) from the time they enter the university rather than getting a degree and then entering a professional school. This cuts at least two years off the process and adds to the length of a doctor's career without sacrificing quality. The cost of those years must be paid by the system somewhere.

I also agree with getting payment for medical mistakes into a different system. However, remember, medical mistakes are a huge cost to the system with or without jury awards (medical cost of mistakes close to $20bn), and they are a humanitarian cost, so practicing in a manner that might make those mistakes more likely (i.e. eliminating "defensive" medicine) does not save as much as some like to argue, and direct cost of malpractice insurance is a little more than 1% of the total healthcare bill.