[T]he industry has abandoned the basic goal of insurance, which is to spread risk over the population it serves. Instead of spreading risk, the industry has focused on the avoidance of risk for itself, coupled with a transfer of that risk to the public. In the process, it is destroying its own reason for being.The consequences of this transfer of risk are that administrative costs go up, employers and other policyholders are charged more, and fewer people are able to afford decent coverage--and as a consequence, good health care. Yet the problem is getting worse, not better, and this is due to a fundamental problem in how we approach health care in the United States.
Saturday, October 25, 2008
Dose of Reality: Do Not Resuscitate
In the October issue of The Ester Republic, Neil Davis discusses the issues brought out in Dr. John Geyman's book, Do Not Resuscitate: Why the Health Insurance Industry is Dying, And How We Must Replace It. The problem, as Geyman observes and Davis concurs, is that
Wednesday, October 22, 2008
The Economics of Health Care
At the Democratic National Convention, Senator Ted Kennedy stated that health care is a human right, and in one of the presidential debates, Senator Barack Obama said the same thing. What this means, of course, is that this country needs to put in place a single-payer universal health care system.
“This is a completely understandable view and one that, I think, is utterly wrong,” wrote columnist Robert J. Samuelson in NEWSWEEK on September 15, 2008. Then he went on to say that the problem was not to improve insurance coverage, it was to contain health care costs. He said, “We need more realism on health care. The trouble with casting medical-care as a “right” is that this ignores how open-ended the “right” should be and how fulfilling it might compromise other “rights” and needs.” What he means by this is beyond me: how does saying fulfilling one right affect fulfilling other rights, whatever they may be?
Samuelson does not seem to understand that treating health care as a right—which implies instituting a program of universal health care—is the direct route to containing health care costs. Doing so has the potential to cut health care costs by 30 percent, while at the same time improving health care for Americans. Another columnist, Bernadine Healy writing in the October 13/October 20, 2008, issue of U.S. NEWS & WORLD REPORT, describes various ills of our dysfunctional multi-payer health care system and then says, “Changing our 50-50 blend of private and public spending into a single-payer system clearly is not feasible.” Why not?
Both she and Robert J. Samuelson seem to have preconceived ideas about health care, and they would do well to open their minds far enough to read and accept what another well-known economist and columnist, Paul Krugman, has to say about the economics of health are. In his January 1, 2007, column in The New York Times he said, “The truth is we can afford to cover the uninsured. What we can’t afford is to keep going without a universal health care system.
“This is a completely understandable view and one that, I think, is utterly wrong,” wrote columnist Robert J. Samuelson in NEWSWEEK on September 15, 2008. Then he went on to say that the problem was not to improve insurance coverage, it was to contain health care costs. He said, “We need more realism on health care. The trouble with casting medical-care as a “right” is that this ignores how open-ended the “right” should be and how fulfilling it might compromise other “rights” and needs.” What he means by this is beyond me: how does saying fulfilling one right affect fulfilling other rights, whatever they may be?
Samuelson does not seem to understand that treating health care as a right—which implies instituting a program of universal health care—is the direct route to containing health care costs. Doing so has the potential to cut health care costs by 30 percent, while at the same time improving health care for Americans. Another columnist, Bernadine Healy writing in the October 13/October 20, 2008, issue of U.S. NEWS & WORLD REPORT, describes various ills of our dysfunctional multi-payer health care system and then says, “Changing our 50-50 blend of private and public spending into a single-payer system clearly is not feasible.” Why not?
Both she and Robert J. Samuelson seem to have preconceived ideas about health care, and they would do well to open their minds far enough to read and accept what another well-known economist and columnist, Paul Krugman, has to say about the economics of health are. In his January 1, 2007, column in The New York Times he said, “The truth is we can afford to cover the uninsured. What we can’t afford is to keep going without a universal health care system.
“If it were up to me, we’d have a Medicare-like system for everyone, paid for by a dedicated tax that for most people would be less than they or their employers currently pay in insurance premiums. This would, at a stroke, cover the uninsured, greatly reduce administrative costs and make it much easier to work on preventive care.”Paul Krugman just won the Nobel prize in economics, for good reason it would seem. He is a thoughtful man who pays attention to and carefully analyzes factual information. Too bad Robert J. Samuelson and Bernadine don't do the same.
Friday, October 10, 2008
Pundits on Health Care
Right now, the crash of the financial markets is taking center stage, but the nation’s health care problems are still the subject of various press pundits’ commentaries. In the October 13, 2008 issue of NEWSWEEK, one of better known commentators, Jane Bryant Quinn, discusses John McCain’s health plan, and alludes to Barack Obama’s. These, of course, are not health care plans as such, but rather are health insurance plans, a fact that the pundits like her seem to be ignoring, or would rather not talk about. It is an easy way out, and a poor substitute for taking on the health care problem directly and discussing solutions.
Quinn notes that the McCain and Obama health insurance plans over the next decade are likely to cost the taxpayers an additional $1.3 billion and $1.6 billion, respectively. She clearly favors Obama’s plan over McCain’s, but she seems to be trapped in the philosophical box that does not allow thinking or discussion about anything but health insurance per se. She is not a dumb person, and I don’t understand why she doesn’t go outside the box and state what she surely knows is the way to reduce health care costs rather than increase them. Maybe her editors would not let her do that. If they would allow it, Quinn could have gone on to say that both the McCain and Obama plans were off the mark, and that the establishment of a single-payer health care system in this country has the only potential to reduce health care costs—not just a little bit, a lot. Instead of spending 16 percent of our gross national product on health care, we could be spending only 10 percent, while giving all Americans health care just as good as the citizens of all other modern countries get from their much cheaper and more effective universal health care systems.
Yes, Quinn and some of her fellow pundits could serve us better by talking more about health care, and less about health insurance. But at least in her column she does say that McCain’s belief in the magic of the marketplace is misplaced. She says, “Friends, there’s zero evidence that that works.”
Quinn notes that the McCain and Obama health insurance plans over the next decade are likely to cost the taxpayers an additional $1.3 billion and $1.6 billion, respectively. She clearly favors Obama’s plan over McCain’s, but she seems to be trapped in the philosophical box that does not allow thinking or discussion about anything but health insurance per se. She is not a dumb person, and I don’t understand why she doesn’t go outside the box and state what she surely knows is the way to reduce health care costs rather than increase them. Maybe her editors would not let her do that. If they would allow it, Quinn could have gone on to say that both the McCain and Obama plans were off the mark, and that the establishment of a single-payer health care system in this country has the only potential to reduce health care costs—not just a little bit, a lot. Instead of spending 16 percent of our gross national product on health care, we could be spending only 10 percent, while giving all Americans health care just as good as the citizens of all other modern countries get from their much cheaper and more effective universal health care systems.
Yes, Quinn and some of her fellow pundits could serve us better by talking more about health care, and less about health insurance. But at least in her column she does say that McCain’s belief in the magic of the marketplace is misplaced. She says, “Friends, there’s zero evidence that that works.”
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