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Archive for the ‘Health Care’ Category

If you have time (and I encourage you to make time) you will find this article by David Goldhill in The Atlantic Monthly very illuminating.  Goldhill’s father passed away in hospital due to infections he received from the hospital and in this article he chronicles his subsequent obsession with, and research into, the American health care system.  He is not a reporter, he is a businessman… and a democrat I might add.  It is a very honest, commonsense, and thorough look at our whole system and his experiences within it:

For that matter, try discussing prices with hospitals and other providers. Eight years ago, my wife needed an MRI, but we did not have health insurance. I called up several area hospitals, clinics, and doctors’ offices—all within about a one-mile radius—to find the best price. I was surprised to discover that prices quoted, for an identical service, varied widely, and that the lowest price was $1,200. But what was truly astonishing was that several providers refused to quote any price. Only if I came in and actually ordered the MRI could we discuss price.

Several years later, when we were preparing for the birth of our second child, I requested the total cost of the delivery and related procedures from our hospital. The answer: the hospital discussed price only with uninsured patients. What about my co-pay? They would discuss my potential co-pay only if I were applying for financial assistance.

Keeping prices opaque is one way medical institutions seek to avoid competition and thereby keep prices up. And they get away with it in part because so few consumers pay directly for their own care—insurers, Medicare, and Medicaid are basically the whole game. But without transparency on prices—and the related data on measurable outcomes—efforts to give the consumer more control over health care have failed, and always will.

He doesn’t come out against single-payer (which I definitely am against) but his review and critique of the existing system causes serious suspicion upon giving even more leverage and influence to government.  Insurers come out very poorly in his assessment, and rightfully so, but by his own admission they are simply playing the game that has been laid down in law.  From top to bottom you will see how health care has gotten so tangled in a matter of just 60 years.  In light of what is being proposed in congress and the white house you will be interested to have this breakdown of the system in your bag of knowledge.  Be forewarned, it’s not a brief article.

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Quick post this morning about all the townhall meetings that are taking place about the proposed Health Care Insurance Reform bills in congress.  I haven’t followed any too closely but it’s hard not to get a daily dose of a headline talking about a senator being shouted down, or angry protesters at these meetings.  The biggest headline though coming out of all this, in my opinion, is the continual comparison of these protesters to nazis.  House Speaker Nancy Pelosi said that they were carrying swastikas to the meetings, and now this morning I saw the clip below  on Powerline of White House spokesman Bill Burton claiming that again the protesters were carrying swastikas, and dressing up as Hitler:

This would be a stupid statement on behalf of the protesters if it’s true.  But unfortunately I have yet to see a video or picture of it in person.  I have seen video of people being roughed up by union thugs at a townhall meeting, and video of Obama supporters bused in to help even the numbers at another meeting, but no Hitlers yet.

If you have seen any links or images of this please post them in our comments… because otherwise I would be very disgusted with this dialogue coming from our nations leader (Burton) and the democratic party leadership (Pelosi).  A bit of a straw man don’t you think?

townhallcartoon

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This is one of the reasons why I don’t think the idea of universal coverage for health care will work in the long run.  People self-ration when they are faced with monetary or other consequences.  When they are not?  Well, this article from Texas’ American Statesman chronicles how:

In the past six years, eight people from Austin and one from Luling racked up 2,678 emergency room visits in Central Texas, costing hospitals, taxpayers and others $3 million

These are low-income and uninsured people who use the existing
“universal coverage” known as Medicare and Medicaid.  Granted this is not indicative of everyone, and a huge caveat is that 7 of these people are diagnosed with a mental illness and drug addiction… so this is definitely not the average American.  But I think this is still important to show how the system is faulty and can be taken advantage of, not necessarily the behavior of everyone.

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Like many bloggers, radio hosts and pundits (at least of the Fox News variety), I found myself completely confounded by Barrack Obama’s press conference last night.  Here are some questions I’ve been pondering:

1) Is a time coming when everyone (liberals included) will become utterly fatigued from seeing Barrack Obama on television?  It seems that every time I turn on the news or get on the internet I’m greeted with Barrack Obama, whether he’s giving his picks for the NCAA basketball tournament, chatting with Jay Leno, appearing on 60 minutes, or giving another nationally televised pep talk for his budget.  Is he immune to the law of diminishing returns?  Or will everyone soon start to tune him out?

2) What does Barrack Obama mean when he says:

At the end of the day, the best way to bring our deficit down in the long run is not with a budget that continues the very same policies that have led us to a narrow prosperity and massive debt. It’s with a budget that leads to broad economic growth by moving from an era of borrow and spend to one where we save and invest.

Where, and when, exactly, does this saving come in to the picture?  Obama repeatedly blames Bush for raising the federal deficit to unacceptable levels, but tells us that we’ll experience “broad economic growth” if we spend more than ever before, multiplying the deficit by a factor of 8 or 9 by Obama’s own projections.  He tells us that we’re somehow going to save money by bringing down healthcare costs.  Again, this is highly confusing- how exactly does the government save money by spending unprecedented amounts of money on healthcare?  His budget does not show these supposed savings ever bringing down our national debt, only dramatically increasing it.  So are we just supposed to trust him that, sometime in the future, well after his budget has taken our national debt to unfathomable depths, that savings are magically going to appear?  Or, is the idea that, upon seizing more control of the health care system, the government will be able to eventually set price controls on healthcare?  Or does he mean more of a moral savings, like our consciences will be saved from the guilt of a private health care system?  If that’s what he means I wish he’d say it, because telling us we’re going to save money by spending a bunch of it is confusing at best, and duplicitous at worst.

3) Is it just me, or is the media finally starting to turn on Obama?  I was pleasantly surprised last night that the questions were pointed and critical.  One of the most direct questions was about the AIG bonuses:

…when you and Secretary Geithner first learned about this 10 days, two weeks ago, you didn’t go public immediately with that outrage. You waited a few days. And then you went public after you realized Secretary Geithner really had no legal avenue to stop it…But on AIG, why did you wait — why did you wait days to come out and express that outrage? It seems like the action is coming out of New York and the attorney general’s office. It took you days to come public with Secretary Geithner and say, “Look, we’re outraged.” Why did it take so long?

This question was satisfying to me  (needless to say, Obama’s answer was not) and it was really not unique from the other questions in terms of tone.  If the mainstream media is beginning to take a more critical stance towards Obama, I wonder what’s driving it.  Is it possible that, sensing that Obama’s first month is going poorly and that more disappointment might be around the corner, reporters are smelling fresh meat?  Perhaps they are sensing that the ship has some holes, and they want to be the first ones on the scene?  Or perhaps they want to avoid being the last man standing in a suddenly unpopular corner?  Or, did they all finally decide to do their jobs?  Or this all in my imagination, and the treatment last night was no different than what Obama is normally accustomed to?

4) The arrangement of the teleprompter was interesting- mostly off-screen.  Was this a direct response to Rush Limbaugh and others who incessantly point out his reliance on the device?  And, along those lines, is anyone else a bit unnerved by his drastic drop in communication skills when the teleprompter no longer tells him what to say?  Or is the drop off really not that severe, and more a figment of my conservative imagination?

5) One thing Obama said last night that I really appreciated was as follows:

I think that the last 64 days has been dominated by me trying to figure out how we’re going to fix the economy, and that affects black, brown and white.

And, you know, obviously, at the inauguration, I think that there was justifiable pride on the part of the country that we had taken a step to move us beyond some of the searing legacies of racial discrimination in this country, but that lasted about a day.

And — and, you know, right now, the American people are judging me exactly the way I should be judged. And that is: Are we taking the steps to improve liquidity in the financial markets, create jobs, get businesses to re-open, keep America safe? And that’s what I’ve been spending my time thinking about.

I was braced, given the question that Obama was responding to, for him to use his race to further leverage a moral case for supporting him, or to remind us all of how racist we still are, or how great we suddenly are for electing a black president.  I was pleasantly surprised that he chose to take race out of the equation.  I agree with him completely here: watching an African American man get inaugerated to our country’s presidency brought a lot of pride to Americans, myself included.  But now that he’s taken office and begun the job we elected him to, he needs to be judged as the 44th president, not the first black president.  He seems to get that, and I’m very thankful for that.  Is it too early to trust that Obama is committed to leaving his race out of the discussion completely for the next four years?

Thoughts?

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I was recently finishing up a book called The Top Ten Myths of American Health Care by Sally C. Pipes, and was struck by two examples that were brought up in regards to mandates ordered for the good of public health and what the perceived results were.

One, was the Nutrition Labeling and Education Act of 1994 that mandated nutritional and caloric info be printed on all food products.  The argument was, if people knew what they were eating, they would eat healthier.  As the book points out, from 1995 to 2007 “the percent of obese Americans increased by two-thirds.”

Second, was the example of the educational efforts at informing Americans of the hazards of smoking.  Pipes includes this quote from Dr. Daniel Horn who said, “You could stand on the rooftop and shout ‘smoking is dangerous’ at the top of your lungs and you would not be telling anyone anything they did not already know.”  In fact Pipes references a study that show smokers overestimate the potential health risk, with the average smoker reckoning their risk of developing lung cancer at 43 percent, when it is actually between 5-10 percent.  So even when people are theoretically “over-informed” on a hazard, they may still well participate in it.

These are clearly not proven causal reactions, but are certainly indicative of the fact that government intervention is not a panacea for poor public choices.  These two examples (along with our cigar smoking post) caused me to try and think of other areas where mandates for the public good go unheeded.  A few quick ones off the top of my head are:

  • Auto Insurance – Around 14% of drivers are uninsured despite the law requiring it
  • School truancy – By law children of a certain age are required to be in school.  However a quick search of truancy rates in public education will show that behavior does not follow the law
  • The Tax Gap – Close to $300 billion a year is estimated to be owed, yet unpaid, to the government.  There is good proof that as taxes increase people’s tendency to evade or avoid paying taxes increases
  • California cellphone law – Anecdotally, from what I see on the freeway and roads, I can attest to a severe refusal to obey this law
  • Long Beach water prohibitions – Again, anecdotally, I can tell you that people do not follow the rules laid out by the Board of the Long Beach Water Commission, such as times to water lawn, use of hoses for car washing, etc… despite our extreme water situation

I certainly don’t mean to imply that we should rid ourselves of all laws because they aren’t all followed 100% of the time.  I mean this just to show the gut reaction to regulate something does not necessarily produce the desired results.

That said, I would love for us to start to peel back some of the laws that affect personal liberty (ie. helmet laws) and exist solely to “protect” the very individuals that they regulate.  Would love to see more thought/examples in the comments.

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Since 2003 the FCC has enforced measures for Wireless Local Number Portability… meaning that we have the option to keep our wireless numbers if we decide to change carriers.  Previously, many people would stay with a carrier despite poor service or a bad plan because they didn’t want to change their cell phone number and the hassle that came with it.  This competitive measure helped ensure choice for consumers and forced providers to deliver better service or their customers would leave.  This is very similar to a proposal by many in dealing with health care subsidies and rules given to employers.

Currently, employers are not taxed on the wages they provide in the form of health care, therefore many offer that in lieu of real wages of the same amount paid to their employees.  However as more people have come to enroll in their company plans it is becoming more and more like the cell phone portability issue.  Workers do not have the portability available with their plans, and may stay at their current job out of convenience.  In addition, workers who do not receive health care from their employer do not enjoy the same tax breaks as the companies, and are therefore subsidizing those who do.  On top of this, and as part of the tax deal with companies, employers are forced to include certain benefits in their packages that many individuals would not choose independently, which drives up the cost for the insurance – basically, instead of potentially receiving a higher wage, an employee may instead enjoy the insurance coverage for breast reduction surgery.

  • The Acton Institute has a brief article regarding this topic.
  • An even more in-depth and compelling case is made here, courtesy of The Heritage Foundation.
  • Also today, Thomas Sowell discusses a new book by Sally C. Pipes, The Top Ten Myth’s of American Health Care (free .pdf of the book available online here), specifically the political trend toward universal coverage.

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