A timely article that raises excellent questions, but comes to some faulty conclusions. First, the costs comparisons between US health care and Europe are bogus. Since most European countries have two tier systems with 80% or so of the population using the regulated, state controlled health service and the remainder opting for private coverage, private doctors and hospitals. The state systems impose strict controls on drugs, devices, access to those as well as age limitations on certain services etc. (such as transplants and the like). The US system is based on physicians being advocates for their INDIVIDUAL patients, not for some “group”. When you are sick or in need of surgery you certainly want someone focused on what is best for YOU, not the so called “system”. Additionally, using items like the number of uninsured, life expectancy and neonatal death rates is very misleading. The insurance problem can be addressed in large measure with changes that this site has outlined and which could be implemented by the President tomorrow (or could have been by any of the last several Presidents, both Democrat and Republican). Both life expectancy and neonatal death rates are highly effected by behavior. Teenage pregnancy, smoking, alcohol and drug abuse all contribute in a country of this size (over 300 million) in large measure to our poorer “statistical” standing in these areas. When you add in the major health problems presented to our emergency rooms by the estimated 12 million illegal aliens living in the United States (not undocumented immigrants as one NYT reporter euphemistically referred to them), you begin to understand that statistics are in the eye of the beholder. The basis of comparative studies is by definition group modeling and not tailoring therapy or treatment to an individual. These “deciders” in the government will surely be medical doctors and the like, who are far, far removed from caring for INDIVIDUAL patients. Are reforms necessary . . . yes. However, many of the reforms needed are common sense, low cost items that can be implemented without the need to create an ever greater government bureaucracy . . . jomaxx
Tara Parker-Pope writes in the Sciences Times section, that “much of the focus” of the nation’s healthcare reform “is on the role the government and insurance companies will play in a revamped health system,” while “little attention has been paid to the role that patients and their doctors have played in shaping the way medical care is delivered.” But, Parker-Pope contends that “for any reform to work, patients will have to change their behavior” by accepting that the “best” care “doesn’t always mean the newest drug or the latest treatment.” The Obama administration’s “economic stimulus plan includes $1.1 billion for studies that will ask basic questions about the comparative effectiveness of expensive procedures versus less expensive ones,” and some experts argue that making this information accessible to the public “would be important for healthcare reform to succeed.” But, Parker-Pope notes that “even when such comparisons are available,” physicians and patients “tend to ignore it.” She states that “the looming question is whether patients are ready to embrace the realities of reform.”
Read @ A Hurdle for Health Reform:Patients and Their Doctors – http://www.nytimes.com/2009/03/03/health/03well.html?_r=3&ref=health
…most European countries have two tier systems with 80% or so of the population using the regulated, state controlled health service and the remainder opting for private coverage, private doctors and hospitals. The state systems impose strict controls on drugs, devices, access to those as well as age limitations on certain services etc. (such as transplants and the like).
This strikes me as a rational plan for universal health care. (I just noticed the semantic similarity between “rational” and “rationing” Hmm…) A “national” plan, pegged to taxes must divide the pie so that even the sickest and poorest are served. The “private sector” then competes with the public tier. This seems like a good formula to drive down expenses, favoring both taxpayers and holders of private plans.
If everyone is gonna get health care, the money has to come from somewhere. Individual physicians and patients of course want the equivalent of a blank check but I see a need for downward price pressure. You can’t have champagne for beer money so private insurance plans are the champagne and public plans the beer. An eighty/twenty split seems about right.
John, thanks again for your comments. It would seem you are looking at a philosophy of the means justify the end. Lets get “universal” coverage regardless of what we give up along the way. As I have stated, we do not need to throw the baby out with the bath water. The FIRST and sole priority at this time should be health insurance reform which will achieve the goal of nearing 100% coverage – you will not ever get to 100% coverage is this society unless you create a totalitarian government…which I would hope you would oppose.
Expenses, costs, investments related to health care (depends on the term you use) are not unimportant, but are much more complicated to deal with due to their many faceted nature. There are things that can be done. For example, pharmaceutical advertising on national TV did not exist in years past. Health care did not suffer. They are spending far too much money in attempts to influence a medically unsophisticated public to pressure their doctors into using those medications. Those costs are not necessary.
Your 80/20 split may come to pass, but in America, we should not settle for that and we do not have to.
Keep the thoughts coming. Thanks.