[pickledpepperRN]

Many nurses in California worked very hard to defeat the plan that did not offer an alternative to insurance companies.

[HM2Viking]

Until we control administrative costs there can be no real cost control. 26% of our costs in the "efficient" private market are going to administrative costs NOT patient care.

Administrative costs are easily eating up almost 300 BN dollars each year of our health care budget. Taming that monster can free up the money to get everyone into the health care system.

[Jolie]

Originally Posted by HM2Viking

Until we control administrative costs there can be no real cost control. 26% of our costs in the "efficient" private market are going to administrative costs NOT patient care.

Administrative costs are easily eating up almost 300 BN dollars each year of our health care budget. Taming that monster can free up the money to get everyone into the health care system.

There is absolutely nothing stopping the federal government from increasing the efficiency of their healthcare plans. Let them build a system that is so efficient and cost-effective that private citizens want to pay premiums to become part of it!

In the meantime, leave private citizens to spend their money as they choose. There is absolutely no reason to force private citizens into government plans that they want no part of. You may believe that private citizens are wasting their money on inefficient healthcare. No matter. It is their right to do so. Just as they "waste" their money on all sorts of things, including vacations, cars, expensive clothes, electronics, cell phones, jewelry, etc. Or do you propose taking control of all private spending you deem to be "excessive"?

[ingelein]

http://www.news-leader.com/apps/pbcs.../1091/OPINIONS
Hefty increases coming in health care costs

If you think health care is expensive now, just wait. This country spent about $7,000 per person on health care in 2006, but will spend more than $13,000 per person in 2017, according to a new report from government health experts. It's a reminder that as presidential candidates talk about how to get Americans insured, they should also focus on containing costs.

The government can control some costs through how it sets reimbursement rates for physicians in programs including Medicare and Medicaid. But rather than freezing these reimbursements, as President Bush has suggested in Medicare, billions could be saved by cutting subsidies to private insurers taking over the care of seniors in Medicare Advantage plans.


One logical place for this country to cut health costs is in administration.
According to a Harvard Medical school study, the red tape of treating a patient adds up to more than $1,000 a year. In Canada, with a government-run system supplemented by private insurance, it costs about $300 per person.


The U.S. health system, with thousands of private plans, is a labyrinth of administrative waste and inflated payrolls. The thousands of employees who work at health-insurance companies are not changing bedpans or performing heart surgery. They are pushing papers, while this country faces a shortage of medical personnel who actually provide care.

One approach to reducing administrative costs is to allow everyone to buy into a government-run program like Medicare. Unlike private insurance companies, the government isn't beholden to stockholders and doesn't pay CEOs millions of dollars. With everyone in a single pool for health care, this country could more easily move toward everything from standardized electronic medical records to reducing administrative costs.
The United States spends more on health care than any other country in the world. It is also the only industrialized country in the world where the government doesn't offer basic health coverage to all its people.
Coincidence? We don't think so.


Paid by taxpayers
The health-spending report also provides insight into who is doing the spending. Increasingly, it's the government. In other words, the taxpayer.
Currently, federal and state governments pick up about 46 percent of health expenses. That will increase to 49 percent in 2017. And this figure includes only government programs such as Medicare, Medicaid and the State Children's Health Insurance Program.


There are other ways taxpayers fund health care. For example, when employer and employee premiums are excluded from taxes, that results in a loss of revenue collected by the government. That totals more than $100 billion a year. The tab for public employees' insurance — from teachers to lawmakers — is paid at least in part with tax dollars.

To all those Americans opposed to a taxpayer-financed system of health care in this country: We already have one. It's time for a smarter one.

[ingelein]

http://www.tcf.org/list.asp?type=NC&pubid=1808

Will Consumer-Driven Medicine Really Cut Health Care Costs? Email Printer-Friendly Niko Karvounis, The Century Foundation, 2/14/2008 One of the most common justifications for consumer-driven medicine is reduced health care costs. The reasoning here is two-fold:

1. Since they’re high-deductible and low premium, consumer-driven health plans require more out-of-pocket spending. Consumers are more cost-conscious when they have to actively shell out for purchases. As a result, they will user fewer health care services—and thus overall health care costs will fall.
2. If consumers are in the driver’s seat, competition in an open market will drive prices down. For-profit providers will want to offer the best deal to get the most business. Consumers will also have better information thanks to the commoditization of medicine, which will translate medical jargon into universally comprehensible knowledge. Smarter consumers translate into less over-payment for services.

This is standard-issue free market orthodoxy at its finest. Unfortunately, this isn’t the whole story. In fact, there’s an even stronger argument to be made that consumer-driven health plans could lead to higher health care costs.

The Wrong Patients Forgo the Wrong Care
Research by the RAND Corporation’s health insurance experiment shows that when you shift costs to the consumer, patients forego both wasteful and effective care. And this is particularly true of the patients who cost us most in the long run—those suffering from chronic diseases.


The study’s authors--from Harvard, MIT, and the University of Oregon-- found that chronically patients who are asked to shoulder more of their health care costs deferred, neglected, or opted-out of doctor’s visits and drugs when the price got too high. This short-term cost reduction led to long-term catastrophe, as their hospitalization rates were significantly higher than other patients suffering from chronic diseases. Immediate savings ultimately led to a greater—and otherwise preventable—use of more expensive care. Oops.

Whether we are talking about people suffering from chronic diseases or the poor, it turns out that consumer-driven care which shifts costs to the patient leads certain vulnerable populations to disproportionately negative long-term health outcomes.

Whether we are talking about people suffering from chronic diseases or the poor, it turns out that consumer-driven care which shifts costs to the patient leads certain vulnerable populations to disproportionately negative long-term health outcomes.


And here, information is no panacea. Even when markets do their thing and diffuse knowledge, it’s the “haves” who benefit most. A few years ago two Columbia University professors charted the trajectory of public health risks over the past thirty years to show that, even when information did circulate and spur awareness, it was the upper crust that benefited. Many years ago, smoking, HIV/AIDS, and coronary artery disease affected everyone equally. But as time wore on, the affluent became more aware of the risks and dangers. As a result, these health problems settled in at the bottom of the socioeconomic ladder.


In a market-driven system which thinks of patients as “consumers”, this disparity will also get worse: information will also be commoditized, which means that the rich will be able to buy better, more current information (just as they can now for stocks, investments, or market projections).
Currently, the price tag of health care for the uninsured is over $40 billion. A system that perpetuates poor access to care for the have-nots will only drive that bill higher.

[HM2Viking]

Originally Posted by Jolie

There is absolutely nothing stopping the federal government from increasing the efficiency of their healthcare plans. Let them build a system that is so efficient and cost-effective that private citizens want to pay premiums to become part of it!

In the meantime, leave private citizens to spend their money as they choose. There is absolutely no reason to force private citizens into government plans that they want no part of. You may believe that private citizens are wasting their money on inefficient healthcare. No matter. It is their right to do so. Just as they "waste" their money on all sorts of things, including vacations, cars, expensive clothes, electronics, cell phones, jewelry, etc. Or do you propose taking control of all private spending you deem to be "excessive"?

My own thinking has evolved to the following:

Health care and insurance are by definition a shared responsibility. I have not seen a single Reputable sourced article to support these types of claims about medicaid abuse. (What there is is undoubtedly surpassed by administrative costs of private insurance in the BILLIONS of dollars.)

As I have written ad nauseum any UHC plan is not going to be funded by new taxes. It will be funded by either a payroll tax (in a pure single payer system) OR a system where employers and individuals have the OPTION to purchase insurance directly from Medicare (the mixed partnership model) or from a private insurance company. In either case the funding streams will be IN PLACE OF the current premium structure instead of NEW taxes. This along with administrative cost reform will bend the medical inflation cost curve towards sustainability.

There is absolutely no reason that 1 dollar of health care spending should fail to purchase 97 cents of health care instead of the current 70 cents. The private insurers should be able to manage health care financing for 3% administrative costs just like traditional medicare.

The real coverage gaps are between 100-300% of poverty where working families either have NO benefits or the benefits they have access to are unaffordable. Lets stop the bashing of the poor and get down to the business of building a health care system that assures equitable access AND is high performing.
...
There are professional value reasons (social justice etc) for us as nurses to support the idea of a good job for every American but there are also personal reasons. If we don't speak collectively on behalf of the rights of other working Americans for good jobs we place our own "good" job status at risk.

When you take the time to think about it UHC is one leg of the stool to support entry into the middle class. The others are access to high quality education from preschool through college and protection of collective bargaining rights. Each of these removes barriers that get in the way of people achieving their full potential and assuring a fair shake at achieving success in society.

I don't think that I said must take a government plan. I did say that I thought that if we are going to have a mixed partnership model that private insurers should:

1> Accept all insured regardless of "preexisting conditions"
2> 1st dollar coverage for treatment of chronic conditions
3> Administrative costs capped at 5% with profit derived from holding costs below that ratio.
4> Incentives should be derived for improving care quality not from denial of care....

[Jolie]

I'm glad to see your thoughts shifting from your previous support of mandatory participation in government healthcare.

[HM2Viking]

I actually never said mandatory participation in government health care but I am in favor of mandating health insurance with individuals and business having the option to purchase coverage through a Medicare style plan...I think I very clearly was always in favor of making sure everyone was covered....(I think single payer from a technical standpoint is best as it is cheapest BUT I will not let the perfect be the enemy of the good.)

Its far more important to tame the administrative fee monster. THe old saw about the devil is in the details certainly applies to health care reform.

[CO2emission]

Originally Posted by ZASHAGALKA

The gov't, BY DEFINTION, is amoral.

IT MAKES NO SENSE to say that, in order to avoid an amoral method of rationing, we must turn the whole process over to a purposely amoral gov't entity.

You can't have it both ways: 'Separation of Church and State' AND the gov't doing your 'moral' bidding.

With the free market, both parties have a choice. Morality is preserved by either party, at their discretion and only with the approval of the other party to the trade.

~faith,
Timothy.

Are you talking about "a government" or "The Government"? Who do you think wields the power in congress? Is it the common folk? Or dare I say it, is it the most powerful who have built up massive empires from the so called "free" market.. that oh so laissez-faire economy? Have you not noticed that the rich seem to be getting richer and the poor getting poorer? Are the poor in a position to make that choice. Church and state should have nothing to do with one another. History tells us that and while on the subject of history...What has the church got to do with morals? The people have moral standards and in democratic principle at least, the people elect the government. It's not about us and them, its about a core value of respect and care for one another. It's about social tolerance and accepting that democracy does not equal choice. An organ recipient pays a bucket load for his or her survival. The donor was probably someone who wouldn't have stood a chance if the situation was reversed. Regardless of all of the above, as human beings belonging to humanity, pain and suffering, illness and misery, birth and death do not discriminate. Neither should the provision of healthcare.

[Katie91]

Originally Posted by ingelein

Why not wait, there WILL be an improvement in our own health care access here in our own country.

Yes, and how long can we expect to wait for the improvement to come to fruition??