Friday, January 30, 2009

A pseudo-solution

In the latest Dose of Reality, Davis discusses the results of a recent study by Families USA:
Overall, it’s not a very pretty picture. Health insurance premiums for Alaskans increased 73.6 percent from 2000 to 2007. That increase is 5.7 times higher than the rise in median salaries, and to make matters even worse, out-of-pocket costs for health care not covered by health insurance also substantially increased.
Alaska Dispatch has a recent article on this same problem.

However, says Davis,
The public is starting to understand that the situation cannot continue in this direction, but only a portion of the public comprehends that the trend can be reversed by instituting a single-payer health care system. The health insurance industry is ahead of the public on this issue, and is very worried that increasing health insurance costs might actually drive the country into establishing a single-payer system that would put the industry out of business.…

Hoping to fight any reform disadvantageous to itself, the health insurance industry is going on the offensive. Its trade organization, America’s Health Insurance Plans…announced a self-seeking health care reform proposal designed to maintain the industry in the profitable lifestyle to which it has become accustomed.

The gist of the proposal is that the industry will agree to insure everybody—even those with pre-existing health conditions, but that the American taxpayer will pick up a big portion of the bill. In short, it is a bail-out akin to that now being given to the financial and auto industries. However, this one will not be a one-time grant, but rather a subsidy that will last forever.

Medicare for all: 2.6 million new jobs

According to the California Nurses Association, in a press release dated January 14, a single-payer health care system would:
• Create 2,613,495 million new permanent good-paying jobs (slightly exceeding the number of jobs lost in 2008)
• Boost the economy with $317 billion in increased business and public revenues
• Add $100 billion in employee compensation
• Infuse public budgets with $44 billion in new tax revenues
This is according to a study (be forewarned, it's a 39-page PDF) conducted by the Institute for Health and Socio-Economic Policy (a research arm of the CNA).

Tuesday, January 13, 2009

If the English can do it, why can't we?

December's Dose of Reality describes how the United Kingdom, which truly does have socialized medicine, continues to improve their system. In the United States, we have a serious shortage of primary care physicians. Yet, primary health care is vital to the wellbeing of a nation's population, and to keeping the costs of that health care down: nip a disease in the bud, or prevent its occurence in the first place, and it's a lot less expensive for everybody concerned. So the UK is taking a sensible approach:
The new emphasis on primary care in the United Kingdom follows two paths. One tactic is to use modern technology to maintain each patient’s lifelong health record; it details each visit to a primary doctor or specialist, lab results, and any treatment and medication received. That allows both the primary doctors and the specialists to easily download the information when needed, and thereby serve the patients better. The second approach is to make more use of interdisciplinary teams for taking care of patients in ways that maximize care and best utilize medical talents.

One consequence is that nurses are taking on an increasing proportion of the work. They may be the first to see patients with minor illnesses, and they are assuming more responsibility for routine management of chronic diseases. Another is that the role of the primary doctor is being emphasized to the extent that primary care doctors are making more money. Paid by a combination of risk-adjusted capitation and a 25 percent additional amount for performance, primary care doctors in the United Kingdom now have average annual earnings of $220,000. The average annual income of a primary care doctor in the United States is far less, about $150,000.
So the question is, if the UK can not only afford to improve health care but also increase doctors' salaries while at the same time reducing overall costs, why can't we? (Hint: they have universal health care and we don't.)