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10/12/2009
Very, very worried about health care
The liberals want “health care reform at any price.” Any price. I read a great deal from all sides of the political spectrum – and just don’t see critical analysis on the left. Yes, I’m biased. Over and over I’ve touted the critical need for consumer choice and transparency to be part of the game. Like a broken record, I’ve assailed any plan that does not reduce health care costs – and any plan that does not include more Americans with more skin in the health care game is not going to change the trajectory of health care costs.
It’s time again to get really noisy about any so-called reform now on any table – as final legislation will be the result of backroom meetings, “vapor” language and huge secret deals.
Though much has been offered on serious health reform efforts from the right, the left believes they have the power to push through very costly “reforms” that absolutely don’t address the basic issue – the need to control health care costs.
So… for now the answer must be to reject what’s out there and start over.
It’s not like there aren’t any good ideas out there – conservatives must continue to let more of the world know about them.
John Mackey, Whole Foods CEO talked with Stephen Moore a week ago (“The Conscience of a Capitalist”) about Mackey’s Wall Street Journal opinion piece that got the left all riled up. It’s a great article – both about Mackey - and about solutions.
What Mr. Mackey is proposing is more or less what he has already implemented at his company—a plan that would allow more health savings accounts (HSAs), more low-premium, high-deductible plans, more incentives for wellness, and medical malpractice reform. None of these initiatives are in any of the Democratic bills winding their way through Congress. In fact, the Democrats want to kill HSAs and high-deductible plans and mandate coverage options that would inflate health insurance costs.
…. Mr. Mackey says that combining "our high deductible plan (patients pay for the first $2,500 of medical expenses) with personal wellness accounts or health savings accounts works extremely well for us." He estimates the plan's premiums plus other costs at $2,100 per employee, and about $7,000 for a family. This is about half what other companies typically pay. "And," he is quick to add, "we do cover pre-existing conditions after one year of service."
Imagine. A system that works. And it’s been repeated over and over throughout the country, including Wisconsin’s own Serigraph and KI Industries.
This is an excellent piece from last week that lists Bobbie Jindal’s 10 reform proposals and Heritage adds six more. Great stuff.
Another time: More about problems with the CBO analysis, more about the warren of secrecy that will be part and parcel of getting any bill passed and hopefully, as we learn it, more about problems (good piece from today’s NY Times) with whatever bill is produced from the “vapors” of Baucus.
Definitely, stay tuned.
Jo Egelhoff, FoxPolitics.net
COMMENTS
"Imagine a system that works" I don't have to "imagine" one as I see many examples from other countries. Other than the "public option" as a partial nod to the successes of other countries there is no attempt to ask the question " if they can do it why can't we?" . The problem is that our system is rotten from the core. All the cost control methods mentioned here do not deal with the essential causes of waste in our "system". If any or all of the Republican ideas are implemented the patient's own regulation of services will be the primary driver of service reduction. this is not cost control it is USE control. Overuse of services is a problem but it is not THE problem. The major cost drivers are that we are in a fee for service health economy that does not have a single payer. Choice unfortunately is also a major cost driver since it prevents standardization and promotes smaller buying groups. Let's look at the best practices of other countries like the Taiwanese did when revamping their health economy in the 1990s. Are we too proud or stupid to ignore what works elsewhere? Are we so paralyzed politically that mentioning something other countries do right is immediately labeled as "socialist" etc. I fear we are headed for "reform" that is simply re-arranging a bad system.
dave allen (Mon Oct 12 07:31:40 2009)
Anyone who thinks the Congress is all about "reforming health care" needs to take a step back and look at the little hints accidently dropped by the likes of Nasty Pelosi and others. It's about money. About 20% of our national economy.
With Social Security bled dry, Medicare nearly there, and little hints being dropped about a Value Added Tax, how can our rulers pass up an opportunity to leach on to another big fat vein to feed their corrupt political machines? Oh, yeah, don't forget the other massive tax proposal drifting around out there: Taxing the weather (the Global Warming Hoax)!
Unfortunately for us, the liberals and advocates of nationalized health care have hit upon the perception that opposition is dying down and fading with the turning leaves. Nothing could be further from the truth. What's going down is the temperature, and with it the massive crowds that demonstrated against nationalized health care at Tea Parties outdoors.
We need to find a place to continue the momentum over the winter months so the left can't say we've lost interest in the issue. Our rulers need to realize that their jobs are on the line in November of 2010. Dr. Millionaire needs to get back on the receiveing end of his liberal ideas!
Duke (Mon Oct 12 07:41:28 2009)
I just love it when people bash medicare. It is one part of our health care "system" that is actually working (although not a well as it could). The VA is another. Just look at the management overhead of Medicare compared to private insurance, much less. Look at the satisfaction index for patients, much more. Medicare may run out of money because of the high cost of our system in general and the Medicare "tax" is funded by employers and employees. If you really want to see a drop in the health care expenses put all Americans on Medicare and use the former insurance premiums paid to the health insurers to pay for it. Imagine how flush we'd be if $1000 per month per family went to Medicare instead of the paltry Medicare tax. Anyone who thinks that our private system is more efficient than Medicare (overhead cost, results per dollar spend, patient satisfaction) hasn't looked any facts. Too many of us Americans think we have a great system because we're not paying for it, our employers are and when our job is sent overseas because the health care premiums are too high we blame the union. I deal directly with my health care directly and I recommend everyone give up their employer plan and go it alone. Just for a few months. Pay your own premiums, do your own negotiating, have all that choice. You will see the truth very quickly.
dave allen (Mon Oct 12 08:28:17 2009)
Bunk Dave - much of what you've noted. But I don't have time at the moment to refute, will have to do it later in the day!
Jo (Mon Oct 12 8:33:15 2009)
All bunk Dave. You ar so wrong it is pathetic. Don't have time know, will answer later!
John Hyland (Mon Oct 12 09:48:58 2009)
Absolutely correct Dave. But if you listen to the right wing, anything that doesn't include profits is bad.
Can't wait for Jo's rebuttal.
Jack Lohman (Mon Oct 12 10:06:38 2009)
At any price, Jo? We “liberals” want Medicare-for-all that would be paid for by the national infrastructure (taxes) and cover 100% of the people for the same costs of the middleman insurance bureaucracy we now have.
I personally have been fighting against the current (massive giveaway) to the insurance industry. Mandates which will increase their market from 85% to near-100%? Can’t beat that! But they had to pay $46 million in campaign contributions to get there.
And Jo, please don’t fall for the industry’s “opposition” to the legislation. It is pure “public posture” to give those congressmen on their payroll the political cover they need to “vote against the industry’s wishes.”
So, let’s have that “choice” you holler for. Let’s have a true public option. Let businesses and individuals OPT IN to Medicare at cost, and let the conservatives OPT OUT.
Won’t happen, you say? That’s because the industry owns your politician and they do not want to compete with a system that excludes the extras (like high CEO salaries and bonuses, shareholder profits, broker commissions, and oh, the political contributions they add to their premiums and pass onto the patient). That’s also why it was never allowed on the table and never scored by the CBO.
And as a disclosure, I am retired, already on Medicare and love it, and am not employed or take money from anybody. Same for my wife. But I have kids and grandkids that will suffer if we let the industry win. I have spent 40 years in the healthcare industry, the last 25 as a direct provider of cardiac services.
Jack Lohman (Mon Oct 12 10:42:22 2009)
The liberals want “health care reform at any price.” Any price.
At the cost of their job...their own health...the life of their first born child? Come on! At least give some semblance of civility, deference and moral integrity in your comments.
"The liberals want 'health care reform at a price I do not find acceptable.'” This statement seems to be a far more accurate lead-in to this article.
Dennis (Mon Oct 12 11:05:49 2009)
Thank you for thses comments about making Medicare (MC) available to more people. Early on, as an AARP volunteer, some of us asked whether AARP would support letting people aged 50 (or some other age) to 64 "opt-in" to MC. There was silence from the national AARP. Nothing. Haven't heard it addressed by lobbying groups or congressional reps. Yet, here we have numerous "comments" from us average folks pointing out the common sense of this. As much as I respect Jo's sense of conservatism, the garbage knocking MC is just plain wrong. Medicare does work, and has worked, and has very low overhead. If people want CHOICE--and we ALL do--let us choose between MC and private insurance. Then we would see free enterprise operating and I'll bet insurers would get more REAL!
JeanMarie Hinds (Mon Oct 12 11:09:40 2009)
John,
I look forward to your reasoned and factual response to my "pathetic" comments. But just the facts please. I have facts to back up everything I said. Yes it does take time to look up such things and I am most appreciative and respectful of any time you spend to provide me with factual counterarguments.
dave allen (Mon Oct 12 12:07:30 2009)
Hi Dave! I haven't had a lot of time to cover everything in your comments but I'll try a few here very quickly.
A quick look at Unions whom you seem to admire or whatever....Neenah school systems pay near $30,00 annually for a retired teachers health care. Reason: Union negotiating with a union provider.
Medicare is a good system that I have ben on for near 17 years. If it so well managed and great, why are they going broke. I have a Medicare Advantage plan from a private company and really love it. It has saved us at least a $1,000 per year over regular Medicare. And every September/October we get nearly 100 choices of plans that go into affect in January.
Unfortunately, the liberals are going to take that away.
In my book written in 07 I had a section about tort reform. According to the report, tort reform would save near 25% of the cost of health care. Now I see and hear reports that it could be 3% up to 20%. Who knows?
But Tort reform and adding competition to the insurance companies by allowign sales nationwide, plus saving accounts would do a lot for savings in health care. None even mentioned by Liberals.
I also have VA. Strangely enough, I pay $8 for 30 day prescription and could get the same at WalMart or Sams for $4.00 for 30 and $10 for 90 day. Everything esle is great and they take well care of us.
After 16 operations and being on 12 prescriptions I know a little about what I say--like you (sometimes). And keep remembering that there are only about 8 million uninsured that really need help...not 47 million. So forcing everybody take insurance is crazy.
The Louisiana Governor had it about right as did several other Conservatives!!!
John Hyland (Mon Oct 12 16:07:56 2009)
John,
Ok thanks for the comments. I'd like to take these one at a time. If you provide proof of these items than I'm ok with that. lets start with Medicare. Please provide me with the reasons why you think Medicare is going broke. That's it. Just that for now. Cite your sources.
dave allen (Mon Oct 12 17:16:28 2009)
Dave, that's an easy one. It's been highly reported in the news that the money going out will exceed the money coming in. I thought everyone knew that. Same with SS. Might even be this year, but certainly by 2012.
Then the government has to find the money from somewhere to keep up to current levels both SS and Medicare. Babyboomers coming into the system will not help. Bush tried to get Congress to start working on this problem for 8 years. The Dems just refused. Now the day is nearly here. Cut services, increase our monthly payments, raise taxes on others, are some of the ways to fix it.
The next few years will indeed by interesting!
John Hyland (Mon Oct 12 18:28:29 2009)
Don't have much time, but will address two specific points. First, Medicare. This is a good article, recently published by FactCheck.org. While it knocks AFP for stretching the truth, the analysis is helpful. We're in dire trouble on Part A - Hospital Insurance, and getting into dire trouble category with Parts B and D. Parts B and D (physician services and drug benefits) are "both projected to remain adequately financed into the indefinite future... (The trust fund for those segments, though, 'will continue to require general revenue financing and charges on beneficiaries that grow substantially faster than the economy and beneficiary incomes over time.')"
Not a very stable prognosis, no matter how you look at it.
Ok Dave, systems that work. I included one - John Mackey's health insurance system for his Whole Foods employees. Is the detail from the article enough or do you need more? I mentioned two other excellent examples of programs that work, Serigraph (here's Serigraph data, though it's a bit dated - 2007) and KI (furniture) in Green Bay. My info for KI comes via a radio interview I did with their Vice President of Human Resources and Director of Benefits. Can't take time now to pull up figures, but they were very comparable to Serigraph's.
Transparency of quality ratings and prices. Consumer choice. It works.
Jo (Mon Oct 12 21:23:15 2009)
Yea, Medicare is over-spending, and it is due in large part to Bush's $780 billion giveaway to the drug industry in 2003, which simultaneously opened Medicare to private Advantage plans that cost taxpayers 17% more than traditional Medicare.
And now we have those same politicians claiming that Medicare is going broke, and other right-wingers complaining “don’t you liberals touch my extra $1000 Advantage is saving me.” Duh!
Can you imagine that? And we also had a couple of tax cuts so wealthy folks could send their cash to offshore tax havens, or build jobs in China and India. Good thinking.
That’s all called “starve the beast,” and they are pure giveaways to the yokels that fund the elections. But what they Hey? Deficits don’t matter!
Transparency of quality ratings and prices? Consumer choice?
Oh wow. Here we go again. Transparency of price will drive users to the highest bidder, not the lowest. But you go, Jo.
My view? I agree with dave. Medicare-for-all makes the most sense. But remember what Winston Churchill said: "America will always do the right thing, but only after everything else fails."
Jack Lohman (Tue Oct 13 07:08:58 2009)
And Jo, it absolutely doesn't matter that Whole Foods and Serigraph and others have beat the system (in their mind). They are still paying for health care when they need not be. Under a Medicare-for-all system they wouldn't be, and could be spending that money on creating jobs in the US instead. Sorry if I'm being too practicable about this....
Jack Lohman (Tue Oct 13 10:05:25 2009)
This article discusses Medicare's relative effectiveness in controlling health care spending compared to private health insurers. The big lie spread about single payer systems is that they're "running out of money". The fact is that your private insurer will raise rates every year and you have zero say about it. You can change policies at great stress and risk and then watch that policy rise the subsequent year. Medicare cannot raise the funds it needs as easily as a private insurer. This is a political issue not an economic issue. Medicare's administrative costs are estimated to be far less than private insurers This experience is replicated by every other westernized public plan. In short, we Americans believe our private insurers are somehow operating efficiently and at a low cost compared to medicare. The exact opposite is the case and the facts are obscured by the employer paid system and politics. I welcome all facts that show how Medicare is less efficient than private care. Please, send me something factual showing me to be wrong.
dave allen (Thu Oct 15 07:42:24 2009)
Please, please Dave. This is not about who is saving more money, private insurers or the public "insurer." This is about all health care costs. Get your thoughts out of the public vs. private and into the issue of getting rid of third party pay or vastly increasing transparency so we consumers can make better choices and participate actively in driving costs down. Please. And then realize the point I continue to try to make (apparently not very effectively) that none of the current health legislation addresses the issues of runaway health costs. THAT is the point. And until those costs are addressed, this country cannot afford health care for all. And we must afford it.
Jo (Thu Oct 15 08:35:25 2009)
Jack, if you can pay for all this stuff on the cheap, why are fewer and fewer doctors willing to take Medicare patients for the amount of reimbursement Medicare will pay them? Sounds like a great system. And why should the government have power over CEO salaries (or any other inefficiencies in the system)? Why aren't consumers making choices based on quality and cost data that are easily available? Why Jack? Why do you want the government to make all those choices for you?
And while I'm asking Jack, when you have Medicare paying for everybody in the country, who will be choosing what the best medical care is for me and what the best value is for me, for my family and really, in the end, for the country? Who Jack? What is with people in this country who want the government to manage their life for them? Who is John Galt Jack? Do you know?
Jo (Thu Oct 15 14:08:20 2009)
Jo,
My last posting was in regard to my challenge to John to talk about why medicare is going broke. I agree with you cost is the real beast. I believe we kill it by using a single payer system. Plain and simple philosophy. The experience of other westernized countries is ample proof. Only through a single payer system can we get control of the admin costs, cost shifting, and over capacities. With a single payer system pricing for services and drugs can be negotiated effectively. We should also restrict the fee for service model and eliminate drug advertising. Finally, we should attack malpractice costs. However, a single payer system with the other items implemented, malpractice costs will be reduced automatically because cost shifting is eliminated. There you go, my solution to the cost problem. (not the consumption problem) However, each one of these is a big topic in of its self. If you disagree with any of these lets take them one at a time.
dave allen (Thu Oct 15 18:57:18 2009)
Jo, In response to your response to Jack about consumers taking control of their costs. If you would like a fact based statistical and also a personal experience that shows why this is impossible just let me know. My opinion is that it is impossible for the consumer to control their health care expenditures by shopping for services within our existing "system". Just ask me
dave allen (Thu Oct 15 19:01:38 2009)
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