HawthorneWingo wrote:Hey Newguy, welcome. You raise some good points. Let me start with "the googling on the internets" and see what I can learn.
In the meantime, I'd be interested in reading what you thought of the Frontline video on world comparative health care expose' (scroll up).
Thx, Wingo. I watched the 12 min. video covering Great Britain and I especially liked reading the even handed Nigel Hawkes interview:
http://www.pbs.org/wgbh/pages/frontline ... kes.html#2A CEO of one of the best hospitals in this country said to me "The quality of US primary care is middle-of-the-pack.... what we are best at is catastrophic (heart, cancer, etc.) care." After reviewing the video and interview above, my take is that the British system seems to be the opposite. Hawkes: "Where I think it (British System) can fall down is on elective care -- hip replacements, heart operations, this kind of thing -- where care tends to be rationed by queues."
I find it a correlation that the US seems to have unhappy GPs (I believe US GPs are declining in number), and in Britain, family docs are happy but the hospital docs are not. So my guess is the US system (that offers "hospital docs" more money, more control, more equipment) attracts the world's best catastrophic care docs.
I, a one-time heart patient, if forced to choose... I choose quality catastrophic care over primary.
Duetta, I agree that curtailing health care spending would help make American business more competitive. I just don't see our politicians capable of curtailing spending.
As you may know the problem is due to underfunded "entitlement creep." Every year or so since WWII both private and public entities have met with labor to cut a deal. For example a mayor or a boss can't afford to increase wages nor experience a strike, and the union leader can't go back to his members empty handed. So each time short term salary is exchanged for long term benefits. Two years ago, GM was worth 15 billion. It's entitlement debt was 200 billion. California owes 3-400 billion, Illinois 100 billion, of entitlement money it doesn't have. Meanwhile teachers are retiring at age 52 and car companies are spending more on health benefits than steel. The California state treasurer recently scolded the California senate: "Without entitlement reform we will be bankrupt, and you people are incapable of bringing about entitlement reform."
Creating wealth is our way out, and govt. jobs do not create wealth. The British NHS is the world's 3rd largest employer (Chinese Army is the largest, then India's RR system). And to pay for NHS they use an economy depressing VAT tax.
Regarding our 47 million uninsured. That's 15% of our population (including non-US citizens, young people who don't choose to buy insurance, those who qualify for medicaid but don't bother, etc). We've been at 15% uninsured since President Eisenhower... before that it was about 30%. Today, less than 700,000 uninsured are over the age of 65. That's one-fifth of one percent of our population. And hospitals are required by law to provide all uninsured free care via the emergency room, despite inability to pay. If we can improve our system, and I think we can, we should be able to do it without throwing an additional 10% of our GDP at this problem.
Regarding rising costs / affordability. If more and more couldn't afford healthcare, the above "15% uninsured since 1960" would not be true. I looked up US Census Statistics regarding distribution of wealth. Comparing 1974 to 2008 (most current)... of the six income stratas the three lower reduced in size while the upper 3 increased... by 12%... that's a good thing... but all we hear about are CEO compensation and Wall Street bonuses. Some argue the total amount of our non-discretionary expenditures (% of income) has not changed over four decades, despite rising health care costs.
I commend you guys for discussing this topic without delving into a red blue p-match. And I wish politicians could read this blog and see how much they underestimate the intelligence of the American public.
I don't think anyone really has all the answers... my recommendation is to follow private business... before you roll out a new product/program you test it.
Hey, Newguy. I checked out the AMA report card. Are you sure it stands for the very broad proposition you cite it for? I don't know that it necessarily refutes Krugman's point (no. 1).
As for point no. 3, exactly which political base is the bill designed to "maintain." The left? LOL. Progressives are not happy with this bill at all. I'm not happy with everything in this bill. But it does stop two things that the insurance companies have been been doing for decades and that is (1) refusing to insure people with pre-existing conditions, and (2) cutting off coverage because it'll cut into their profits. These bills stop those practices.
I find that people's perspectives on this issue diverge based on their own moral belief. You either believe that the people of the greatest country on the planet deserve health care or you don't. The fact that it makes fiscal sense to do is a benefit, to boot.
And if you're going to try an argue to me that insurances companies (AIG?) aren't making big profits, don't waste your time.
Wingo you'll want to read this...
http://www.boston.com/bostonglobe/edito ... yo_clinic/After reading the article above, do you really think reform makes fiscal sense? Is it not telling that private insurance is servicing the majority at a profit, while govt. is servicing a minority at a $38 Trillion loss?
Regarding moral beliefs, which is more brutal... forcing uninsured people to receive free healthcare via the emergency room (US system) or telling grandma she can't have that new cancer treatment (British system)?
One third of the world consumes $2 per day, the entire world averages $12 per day. I find the "because we're rich we deserve better" argument the furthest thing from a "moral belief."
