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AnandTech - Where's the health care benefit in health insurance "reform?"
Even as the Obama Administration and the Congress have abandoned their talk about health care reform and are now saying they are only interested in health care insurance reform, most of the debate on this forum is about some kind of cost benefit to having some kind of government health care.
It is almost impossible to figure out what is actually being proposed at what cost, that is part of the shell game.
But what is now being gleaned by those responsible for the delivery of quality health care to Americans is that we are being sold a pile of manure with a covering of perfume.
While everyone can agree that the system can be improved (what system is so perfect that it cannot?) the questions remain - what is the best approach to retaining the world's best health care?
Are you willing to bet your life and the life of everyone you know on the government delivering the quality of health care that you want and need?
Where's the benefit?
Where's the benefit?
Scott W.
Atlas
The Washington Times
Sunday, October 25, 2009
Dr.
Scott W. Atlas is a professor and chief of neuroradiology at Stanford University Medical Center and a senior fellow of the Hoover Institution at the university.
Regardless of the facts, most of the media seem to focus on one aspect of the proposed health care legislation - cost - as if it is a given that the Democratic reforms are desirable, except for the quandary of how to pay for them.
Heart-warming stories from Europe about in-home visits to assist with healthy newborn babies receive the spotlight, while restricted access through family practice gatekeepers is stated as a goal.
The media then pose questions like "how can we achieve such great care?" - as if the only dilemma is how to pay for it.
Inexplicably, the facts published in the world's top medical journals about our system continue to be ignored:
* Americans have the best survival rates from cancer and most serious diseases, and the most rapid decline in breast and prostate cancer deaths despite being hindered with severe obesity and the largest burden of smokers over 50 of any Western nation.
* Americans have the most successful, most available treatment for chronic diseases like high blood pressure and high cholesterol.
* Americans have the shortest wait times for life-changing surgeries, like cataract and hip replacements, that may not increase survival but greatly impact quality of life.
* Americans have the best access to the newest, most effective drugs.
* Americans have the quickest access to the safest, most advanced medical technologies.
* Americans have the easiest access to specialty doctors, doctors of their choice, doctors who lead the world in health care innovation, regardless of what metrics are assessed.
Instead of solely considering costs, shouldn't we ask if Americans are willing to die sooner from cancer, to give up access to specialists, to be refused safer, more accurate diagnostic imaging, to lose the most accessible screening programs, and to lose their autonomy in pursuing treatments for their families?
Shouldn't we ask if Americans want to replace the most advanced and successful medical care in history with the restricted care and lower cost social programs of Europe, and insure the less than 5 percent of people who don't buy insurance but receive care anyway?
How quickly we forget.
Americans have already soundly rejected gatekeepers limiting access in our own disastrous experiment with managed care in the 1990s.
The backlash against that grand failure should be a strong reminder of what Americans value - yet our government either forgot or doesn't care.
Despite all that, most Americans want reforms to bring costs down if they maintain quality.
So our president and his Democratic allies - possibly in another teaching moment - filled our news media and Congressional Budget Office with a pile of proposals.
And because Americans are optimistic, we jumped in and started digging through the pile, even though that pile looked and smelled like manure.
But we figured that with all that manure, there had to be a pony in there somewhere.
We kept digging through the Democrat proposals in search of the pony.
But there was no pony.
The Max Baucus plan is paid by massive taxes on existing insurance plans that exceed our government's arbitrary threshold and by significant cuts to Medicare.
Its Federal Exchange overtly skews the playing field by subsidizing - directly or indirectly - insurance plans that meet government definitions, and by penalizing existing plans that don't, plans already held by millions of Americans.
The House proposals force a government-run "public option" - an option that shifts huge numbers of privately insured Americans to become the burden of an already unsustainable, taxpayer-funded entitlement program that ultimately eliminates private insurance choices.
A public option would interpose bureaucrats between doctors and patients, restricting access to new drugs, to innovative new cures, and to choice of doctors.
It is already proven a failure the world over, even by our own Medicaid program, where government-imposed, below-cost payments have created patients who cannot even find doctors to care for them.
While Congress and the administration claim otherwise, costs to the taxpayer increase, and choice and access disappear with a public option.
Meanwhile, serious alternative solutions that reduce costs but do not harm the excellence already in our health system are totally ignored, including:
* Allowing people to shop for insurance across state lines at competitive prices.
* Stripping back on costly coverage mandates that most Americans may not value, like acupuncture, massage therapy, in vitro fertilization, and wigs.
* Expanding the availability of high-deductible plans for catastrophic coverage with health savings accounts, making insurance a good value for the millions of Americans who can afford insurance but (perhaps wisely) don't buy it.
* Bold tax reforms like refundable tax credits, cash even for those who pay no income tax, or vouchers instead of tax deductions, to foster personal ownership and control of insurance, creating millions of value-seeking shoppers.
* Forcing doctors and hospitals to post prices, qualifications and outcomes - information that is essential to value-based purchasing and fundamental for stimulating competition.
The American public is beginning to see the threat.
We see their emotional displays at town halls, individuals trying to preserve some of the most personal and important decisions in their lives.
Americans who value control of their own health decisions, access to sub-specialty doctors of their own choosing, and access to safer, more effective treatments are beginning to recognize what they are about to lose.
America's health system, the most advanced in the world, is about to be destroyed, and most of the debate is about how to pay for it.
The unspoken truth is that the president and the Democratic Congress are fundamentally wrong about their radical plans for health reform.
And even a speaker as articulate and persistent as this president - holding a monopoly of congressional power, and despite all the repetition, the distortions and the deceptive rhetoric - cannot hide that fundamental reality from the American public.
Dr.
Scott W. Atlas is a professor and chief of neuroradiology at Stanford University Medical Center and a senior fellow of the Hoover Institution at the university.
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Very good article, and a subject that I think has been lacking in this whole debate.
~We the unwilling, led by the unqualified, are doing the impossible for the ungrateful.
"It is a poverty to decide that a child must die so that you may live as you wish." ~Mother Teresa
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Originally posted by: PJABBER
...
What is the best approach to retaining the world's best health care ?
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I'll sure be glad when a bill gets signed, maybe we will see a reduction in the faux GOP outrage troll posts
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Originally posted by: DealMonkey
Originally posted by: PJABBER
...
What is the best approach to retaining the world's best health care ?
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In trying to keep the Wall O' Text effect to a minimum while citing authoritative sources in any topic I post on, I did not include the author's full biographical profile.
Maybe, in this case, I should have...
Scott W.
Atlas is a senior fellow at the Hoover Institution, senior fellow at the Freeman-Spogli Institute for International Studies at Stanford University and a professor of radiology and chief of neuroradiology at Stanford University Medical School.
Atlas's research interests at Hoover center on issues pertaining to public policy in health care.
He is investigating ways of reducing the shielding of patients from cost considerations by increasing direct patient payments for health care, so that free market effects can play out on prices.
He also investigates the effects of the changing health care marketplace on technology-based innovations in medicine.
Atlas's research also includes collaborations with China on the structure of the health care system there.
Some of Atlas's recent publications on health policy include "Relationship between HMO Market Share and the Diffusion and Use of Advanced MRI Technologies" (Journal Amer Coll Radiol, 2004), with LC Baker, and the book Power to the Patient: Selected Health Care Issues and Policy Solutions (Hoover Institution Press, 2005).
Atlas is also the editor of the leading textbook in the field, the best-selling Magnetic Resonance Imaging of the Brain and Spine, now in its 3rd edition.
He is also editor, associate editor, and a member of the editorial boards of numerous scientific journals and has been a member of the boards of many major scientific societies over the past decade.
Atlas has authored more than 100 scientific publications in leading journals.
He has lectured throughout the world on a variety of topics, most notably advances in imaging of the brain and the key economic issues related to the future of such technology-based advances.
Atlas has received numerous awards and honors in recognition of his leadership in the field.
He was named by his peers in The Best Doctors in America every year since its initial publication, as well as in regional listings, such as The Best Doctors in New York, Silicon Valley's Best Doctors, Top 500 Doctors in the Bay Area , and other similar publications.
Before his appointments at the Hoover Institution and Stanford University, Atlas was on the faculty of University of California at San Francisco, University of Pennsylvania, and Mount Sinai Medical Center in New York City.
Atlas received a B.S.
Degree in biology from the University of Illinois in Urbana-Champaign and an M.D.
Degree from the University of Chicago School of Medicine.
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Hey look. I havent been here in over a month - just popped back in because its a slow morning at work and look!!!
THE FORUM IS STILL LITTERED WITH PJABBER's AGENDA BASED THREADS!!!
ack.
Dood you need to get a life, seriously get a life and gain some perspective on the reality of living on planet Earth.
- America is like the New York Yankees...
Powerful and respected , up until the year 2000.
- Homer Simpson.
- There is nothing wrong with either side believing in what they believe - but if you cant at least call a terd a terd, you have a problem...
Pelosi is a terd, Bush was a terd, and Obama's overspending is starting to stink.
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Originally posted by: retrospooty
Hey look.
I havent been here in over a month - just popped back in because its a slow morning at work and look!!!
THE FORUM IS STILL LITTERED WITH PJABBER's AGENDA BASED THREADS!!!
ack.
Dood you need to get a life, seriously get a life and gain some perspective on the reality of living on planet Earth.
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Originally posted by: retrospooty
Hey look.
I havent been here in over a month - just popped back in because its a slow morning at work and look!!!
THE FORUM IS STILL LITTERED WITH PJABBER's AGENDA BASED THREADS!!!
ack.
Dood you need to get a life, seriously get a life and gain some perspective on the reality of living on planet Earth.
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Originally posted by: retrospooty
Hey look.
I havent been here in over a month - just popped back in because its a slow morning at work and look!!!
THE FORUM IS STILL LITTERED WITH PJABBER's AGENDA BASED THREADS!!!
ack.
Dood you need to get a life, seriously get a life and gain some perspective on the reality of living on planet Earth.
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Originally posted by: boomerang
Originally posted by: retrospooty
Hey look.
I havent been here in over a month - just popped back in because its a slow morning at work and look!!!
THE FORUM IS STILL LITTERED WITH PJABBER's AGENDA BASED THREADS!!!
ack.
Dood you need to get a life, seriously get a life and gain some perspective on the reality of living on planet Earth.
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* Americans have the best survival rates from cancer and most serious diseases, and the most rapid decline in breast and prostate cancer deaths despite being hindered with severe obesity and the largest burden of smokers over 50 of any Western nation.
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The best thing every voter in the land could do right now is to let their Representatives know that they expect at the very least the final version (all should be available IMO) of this bill to be available for public scrutiny.
We've been promised this since our leader was on the campaign trail and make no mistake about it, he has the power to make that happen.
Let them know that this is a requirement.
No one, regardless of their leanings should be against transparency.
Then, after the bill has been scrutinized, let those same Reps know which way you expect them to vote.
Remind them that our system of government is still from the bottom up, not from the top down.
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This article contains a lot of opinion, backed up by very little support.
By that I mean he has made a lot of statements, but presented no evidence supporting them.
In fact I object to about half of his "America has the best" statements.
I know that many studies have demostrated that we have worse cancer survival rates for the 18-40 age group than many other countries.
His opinion is unsurprising given his political leanings.
The things he proposes are solutions are verbatim from McCain's healthcare proposal, which was shown to cost $1.7 trillion dollars while reducing the amount of insured Americans by about 25 million.
[Quote: ]A public option would interpose bureaucrats between doctors and patients, restricting access to new drugs, to innovative new cures, and to choice of doctors.
[/Quote: ]
We have this already, it's called health insurance.
Nothing Republicans/Libertarians/Conservatives have proposed would remove the middle man.
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Originally posted by: Carmen813
This article contains a lot of opinion, backed up by very little support.
By that I mean he has made a lot of statements, but presented no evidence supporting them.
In fact I object to about half of his "America has the best" statements.
I know that many studies have demostrated that we have worse cancer survival rates for the 18-40 age group than many other countries.
His opinion is unsurprising given his political leanings.
The things he proposes are solutions are verbatim from McCain's healthcare proposal, which was shown to cost $1.7 trillion dollars while reducing the amount of insured Americans by about 25 million.
[Quote: ]A public option would interpose bureaucrats between doctors and patients, restricting access to new drugs, to innovative new cures, and to choice of doctors.
[/Quote: ]
We have this already, it's called health insurance.
Nothing Republicans/Libertarians/Conservatives have proposed would remove the middle man.
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Originally posted by: Carmen813
This article contains a lot of opinion, backed up by very little support.
By that I mean he has made a lot of statements, but presented no evidence supporting them.
In fact I object to about half of his "America has the best" statements.
I know that many studies have demostrated that we have worse cancer survival rates for the 18-40 age group than many other countries.
His opinion is unsurprising given his political leanings.
The things he proposes are solutions are verbatim from McCain's healthcare proposal, which was shown to cost $1.7 trillion dollars while reducing the amount of insured Americans by about 25 million.
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Some additional, enlightening reading -
Power to the Patient: Selected Health Care Issues and Policy Solutions
Editor: Scott W.
Atlas, M.D. Authors: Daniel P.
Kessler, Mark V. Pauly
ISBN: 978-0-8179-4592-3
Pub Date: February 25, 2005
Product Format: Paper
Availability: In stock.
Price: $15.00
But, looky here, you can actually click through to this kind of stuff for FREE!
Power to the Patient: The Right Choice to Control Health Care Costs
The Medical Liability System: Current Debates
The Realities of the Growth in Medical Spending
You already have Dr.
Atlas's biographical profile above.
Who are these other guys and what the hell do they know?
Daniel P.
Kessler is a professor at the Stanford University Graduate School of Business, a senior fellow at the Hoover Institution, and a research associate at the National Bureau of Economic Research.
He has a J.D. from Stanford Law School and a Ph.D.
In economics from the Massachusetts Institute of Technology.
His research interests include antitrust law, law and economics, and health economics.
His current research, in addition to work on using claims data to detect Medicare abuse, focuses on the effect that organizational form in health care has on the cost and quality of care.
Mark V.
Pauly holds the position of Bendheim Professor in the Department of Health Care Systems at the Wharton School of the University of Pennsylvania.
He received a Ph.D.
In economics from the University of Virginia.
He is professor of health care systems, insurance and risk management, and business and public policy at the Wharton School and professor of economics in the School of Arts and Sciences at the University of Pennsylvania.
Dr. Pauly is a former commissioner on the Physician Payment Review Commission and an active member of the Institute of Medicine.
One of the nation’s leading health economists, Dr.
Pauly has made significant contributions to the fields of medical economics and health insurance.
His classic study on the economics of moral hazard was the first to point out how health insurance coverage may affect patients’ use of medical services.
Subsequent work, both theoretical and empirical, has explored the effect of conventional insurance coverage on preventive care, on outpatient care, and on prescription drug use in managed care.
He is currently studying the effect of poor health on worker productivity.
In addition, he has explored the influences that determine whether insurance coverage is available and, through several cost-effectiveness studies, the influence of medical care and health practices on health outcomes and cost.
His work in health policy deals with the appropriate design for Medicare in a budget constrained environment and the ways to reduce the number of uninsured through tax credits for public and private insurance.
Dr.
Pauly is co-editor-in-chief of the International Journal of Health Care, Finance, and Economics and associate editor of the Journal of Risk and Uncertainty.
He has served on the Institute of Medicine panels on improving the financing of vaccines and on public accountability for health insurers under Medicare.
He is an appointed member of the U.S.
Department of Health and Human Services National Advisory Committee to the Agency for Healthcare Research and Quality (AHRQ).
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Her209 and I are on the same sheet of music!
Rules for a happy life:
1.
Free your heart from hatred.
2.
Free your mind from worries.
3.
Live simply.
4. Give more.
Expect less.
Edited: 10/26/2009 at 01:11 PM by PJABBER
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Originally posted by: PJABBER
Originally posted by: DealMonkey
Originally posted by: PJABBER
...
What is the best approach to retaining the world's best health care ?
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Originally posted by: PJABBER
her209 and I are on the same sheet of music!
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