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03 Dec 09
How to Fix Health Care—Lasik surgery for the medical debate
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The alternative is to base reforms on what works in the other
five-sixths of the U.S. economy, where choice and competition
increase quality and drive down prices over time. -
"How to Fix Health Care" proposes three simple reforms that will
put us on a path to a health-care system that's better, more
affordable, and more accessible. And get this—these market-based
reforms can be implemented without creating new government
programs or raising taxes.
02 Nov 09
The Welfare State Corrupts Absolutely
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Medical insurance has come to mean getting something for free. The receiver of a service need not ask how it is financed. It’s just taken care of. (Passive voice intentional.)
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What’s that? The government is promising to cap our out-of-pocket expenses, require coverage for preexisting illness and free preventative care, and extend the same deal to absolutely everyone? And this will have no negative consequences whatever, such as limits on what we can buy or enlargement of the budget deficit or higher taxes for the middle class — but it will actually save money? Oh thank you, government!
17 Jul 09
Lawmakers Warned About Health Costs
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Under questioning by members of the Senate Budget Committee, Douglas Elmendorf, director of the nonpartisan Congressional Budget Office, said bills crafted by House leaders and the Senate health committee do not propose "the sort of fundamental changes" necessary to rein in the skyrocketing cost of government health programs, particularly Medicare. On the contrary, Elmendorf said, the measures would pile on an expensive new program to cover the uninsured.
17 Jun 09
Snake Oil For Our Health Care Ills
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That Medicare is in serious, serious trouble no one can dispute. Its projected unfunded liabilities over 75 years, from 2007 to 2082, are about $36 trillion, according to the latest Medicare Trustees report.
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Despite Medicare's dismal record, Obama and his comrades hold Medicare up as an example for the private sector. Why? Because between 1997 and 2006, Medicare's health spending per enrollee grew 4.6% annually while that of private plans grew 7.3%. By tapping this 2.7% difference, they argue that they can perform the triple miracle of reining in escalating health care costs, and at the same time extending health insurance to the 46 million uninsured without imposing any extra cost on the economy.
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16 Jun 09
Help with the Spinach
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In health care reform, I have described cost controls as the spinach and expansion of coverage as the dessert.
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I am more than willing to tell Republicans that they should support doing something to control health care spending. But we should have an honest debate over how to do that. I think that spending ought to be controlled in a decentralized way, by having consumers pay for a larger share of health care spending out of pocket (that share is 10 percent currently. Forty years ago, it was 50 percent).
Wonkish Democrats, such as Peter Orszag, want to control health care spending from Washington, by telling people to cut back on wasteful medical procedures. Rabid Democrats, such as Paul Krugman, claim that we can control health care spending by taking profits out of the system.
15 Jun 09
Wrong Way on Health 'Reform'
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The president keeps saying it's imperative to control runaway health spending. He's right. The trouble is that what's being promoted as health-care "reform" almost certainly won't suppress spending and, quite probably, will do the opposite.
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The trouble is that what's being promoted as health-care "reform" almost certainly won't suppress spending and, quite probably, will do the opposite.
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Commentary: US health costs out of control
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Most health care is paid for by insurance. When people are insured they do not pay the full costs of the medical care they receive, so they demand the best and pay little attention to the expense.
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patients and doctors constantly face the choice between high-cost, state-of-the-art care and moderate-cost, conventional care. If these decision makers face little financial penalty for choosing the best possible care, they will do so every time. Thus subsidized-insurance combined with medical advancement means rapidly increasing expenditure.
This suggests that to restrain government health spending, policy must reduce existing subsidies, not introduce new government insurance.
Something's Got to Give in Medicare Spending
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It’s not the profits of the drug companies or the overhead of the insurance companies that make American health care so expensive, but the financial incentives for doctors and medical institutions to recommend more procedures, whether or not they are effective. So far, the American people have been unwilling to say no.
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Scholars have been applying comparative-effectiveness research to Medicare for years, and the verdict is not altogether pretty. It turns out that some regions spend more on Medicare than others — sometimes two or three times as much, as documented by the Dartmouth Atlas Project. Yet the higher-spending regions often fail to produce superior health care results.
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07 May 09
Two Cheers for Shorter Lives!
Radley Balko lists some of the problems with comparing lifespans between the United States and the rest of the world.
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infant mortality is measured pretty differently in different parts of the world. And in the U.S., we’re more likely than most places to count a premature, sickly, or low-weight birth as a life lost if it doesn’t survive
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The other factor here is that thanks to our access to medical technology, we’re more likely to try to save premature deliveries that in other countries would result in stillbirths or miscarriages.
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Free Lunch on Health? Think Again
More preventive care will not save money.
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The theory goes like this: By practicing preventive medicine, doctors can keep many people from getting sick in the first place. Those who do end up with a chronic illness will be closely tracked so that fewer of them develop complications. These steps will result in less illness, which in turn will require less health care. With the savings, the country can then lower its medical bills or provide health insurance for the 40-odd million people who lack it — or maybe even both.
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The current health care system doesn’t pay hospitals, doctors and nurses to keep people healthy; it pays for tests, surgeries and drugs. So Americans often get expensive invasive care of dubious medical benefit while missing out on sensible basic care.
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The Universal Distraction
The "problem" of the uninsured is a red herring.
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the focus of health care policy is on how to get to "universal coverage." In this context, the conservative approach involves mandatory health insurance. The liberal approach involves expanding government coverage. Hence, it is either fascism or Communism.
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The iceberg to which Medicare is headed is trillions of dollars of unfunded liabilities. Before it runs into the iceberg, it makes more sense to take people off the Titanic than to put additional people on board.
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25 Feb 09
?Too Old? for Hip Surgery: As we inch towards nationalized health care, important lessons from north of the border.
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Health-care resources are not unlimited in any country, even rich ones like Canada and the U.S., and must be rationed either by price or time. When individuals bear no direct responsibility for paying for their care, as in Canada, that care is rationed by waiting.
22 Aug 08
Report Rejects Medicare Boast of Paring Fraud
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In calculating the agency’s rate of improper payments, Medicare officials told outside auditors to ignore government policies that would have accurately measured fraud, according to the report. For example, auditors were told not to compare invoices from salespeople against doctors’ records, as required by law, to make sure that medical equipment went to actual patients.
18 Jun 08
Accidents, Murders, Preemies, Fat, and U.S. Life Expectancy
Ronald Bailey accounts for differences in behavior between the United States and the rest of the world, and discovers that U.S. life expectancies aren't so bad.
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Life expectancy rates also depend on personal habits such as smoking, diet, and physical activity. Interestingly, U.S. smoking rates are lower (17 percent of adults) than for many developed countries with higher life expectancies. . . .
The fact that Americans tend to be a lot fatter than the citizens of other rich developed countries increases their risks of heart disease and diabetes.
13 Jun 08
Abolishing the Middlemen Won’t Make Health Care a Free Lunch
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Medical insurance, whether private or government, is always going to be faced with a fundamental problem: patients and doctors will try to get the most out of any system. When they aren’t paying directly, patients will seek extra care and doctors will be happy to oblige. To deal with that problem, health care systems can offer services indiscriminately and write off the resulting losses, spend money on monitoring, or limit services and prices.
Medical Fraud a Growing Problem; Medicare Pays Most Claims Without Review
Advocates of single-payer health insurance (i.e., socialized health insurance) often point to such systems' lower administrative costs as evidence of their superiority. As this article makes clear, single-payer systems don't lower total costs; they shift
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Health-care experts say the simplicity of Campos Ramirez's scheme underscores the scope of the growing fraud problem and the need to devote more resources to theft prevention.
27 Nov 07
Illegal immigrants not US health care burden -study
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The finding from Alexander Ortega and colleagues at the [University of California's School of Public Health] was based on a 2003 telephone survey of thousands of California residents, including 1,317 undocumented Mexicans, 2,851 citizens with Mexican immigrant parents, 271 undocumented Latinos from countries other than Mexico and 852 non-Mexican Latinos born in the United States.
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