What's more Pathetic: Health Care Insurers again losing money or Republicans Lying about Saving Money?

How many times can Republicans keep going to private insurers for help before they realize it's never going to work? Unfortunately, under Trump and the Republicans, we're on the verge of turning our entire health care system back over to private insurers, including...Medicare.

Iowa's latest problem is another huge warning there's big trouble ahead:

Iowa's controversial privatized Medicaid program is facing intense scrutiny and financial concerns from the health insurers, Anthem's Amerigroup, AmeriHealth Caritas and UnitedHealthcare that run it, the Des Moines Register has reported. Iowa's Medicaid managed-care program is “drastically underfunded” and likened it to a “catastrophic experience.”  

Hey, an insurer has to make a profit. At the same time insurers are freaking out about the states dramatic lack of funding, Iowa politicians are bragging about..."saving" money? Funny how that works out like that:

The program went into effect this year and it is expected to save the state $110 million in taxpayer dollars at the end of fiscal 2016 in June. 

Of course they're not savings at all, just spending less on Medicaid. That would make this a big lie. As adults, do we have time for these ridiculous games that screw with peoples lives? 

Even worse, Republicans are guilty of doing what ObamaCare did, and that is provide health care at low unsustainable rates. Profit hungry insurers are now singing the same old song.  

In recent memos and emails, the insurers express to state officials that the program isn't financially sustainable and the reimbursement rates that have been set are deeply flawed. The insurers have also reported millions of dollars in losses since the program went into effect.

I Can't Hear You...: Despite the obvious problems listed above, the Republican secret to success nationwide is that they dig in, ignore the problem, and stay on bragging point. They even added to it by claiming more services and healthier outcomes...why not:

Both Iowa Gov. Terry Branstad, a Republican, and Amy McCoy at the Iowa Department of Human Services, have maintained the program is still expected to save the state millions. “Bottom line, the Medicaid program is still on pace to save Iowa taxpayers $110 million while providing more services and healthier outcomes,” McCoy said.

On health care, Paul Ryan is either a Liar or terribly Stupid.

It's almost comical how difficult it is for the press to correct Paul Ryan's outright lies. They're still rattling on about his takeover as house speaker, a job he didn't even want. What a hero?

Now, in one short but revealing statement, Ryan made it clear why we would be crazy to hand health care reform to him or any other Republican; they don't understood it, and never have. Blame being a career politician.

Keep in mind, Ryan has made this same promise over and over; a detailed Republican plan of their own. Where are all these plans?

Here are Ryan's clueless GOP talking points, that are wrong, wrong, wrong, and wrong:

Ryan: "We really think ObamaCare is failing, whether it's premiums...."

WRONG: Is Ryan kidding? Before ObamaCare, premiums increased dramatically. People were paying $500 to $1,300 a month (plans I looked at). Annual total premiums increased between 2003-10 by 62%.  In 2013 premiums increased 4%, the same percentage we saw in 2015.

Ryan: "...restricted access..."

WRONG: Ryan missed why we needed reform in the first place; it was broken. Nothing is more restrictive than not having health insurance, especially when you can't afford it or can't get coverage because of a preexisting condition. And because of...

Ryan: "...higher deductibles..."

WRONG:  Apparently Ryan didn't know that high deductibles were outrageous before Obama even came up with the idea of the ACA. My own HSA deductible soared to $10,500. Republicans pushed the self-rationing idea of high deductibles to discourage supposed unnecessary visits and treatments from providers. Officially, the average per person deductibles increased by 117%, from $2,283 to $3,962. between 2003-10.

Ryan: "Families losing the insurance they wanted to keep, that's happening all across the country."

WRONG: Ryan really didn't know keeping insurance was always incredibly difficult, due to coverage changes, premium increases or rising out-of-pocket costs? Families lost their insurance when they couldn't afford it anymore; when employers changed their insurer; their insurer dropped them due to preexisting conditions.

Ryan and his party have created a completely fictionalized utopian version of our old health care system that actually let tens of thousands of people die painful premature deaths year after year. And they're going to come up with a plan that doubles down on a more privatized "not-so-patient-centered" system like we had, that bankrupted millions of Americans if they got sick?

Far Right GOP believers ready to toss health care overboard. Voters in Arkansas now worried.

As the wealth gap continues to expand, so will the “health gap,” where the unworthy are being told to find somebody else’s pocket to pick if they want to stay alive. The recent wave of Republican wins nationwide is proof the American public has move on, and wants to focus their attention on the least problematic elements of society; the rich, and what we do for them. This poor and middle class thing is getting tiresome, and people need to get over it. 

We all remember Diane Hendricks? Her actual Wikipedia page describes her this way:

Diane Hendricks owns the Hendricks Holding Company and she serves as chairperson of ABC Supply Co., Inc. She is worth $4.8 billion, making her the richest woman in Wisconsin. 

Watch the plea for more power from the most identifiable face of greed, Diane Hendricks:  

Think about it; why would a unhappy billionaire, who's done extremely well within our current supposedly over-regulated job killing system, complain that we're not "red" enough as a state? What more could she want? Total domination of our political system? A state where people may vote, but business interests end up wining elections. 

  

The Most Surreal Target of all: Health Care: How is it possible a political party can get away with trying to take health care away from Americans? They're doing it, and Republicans are now so extreme, that even conservative solutions aren't cutting it anymore:

Arkansas could be on the brink of another distinction: becoming the first to abandon its Medicaid expansion after giving coverage to thousands of people. A wave of newly elected Republican lawmakers who ran on vows to fight so-called "Obamacare" — including the state's "private option" Medicaid expansion — has raised doubts about the future of a leading model for conservative states.

Senate President Jonathan Dismang, one of several Republicans who helped craft the program and is pushing for its continuation said, "I think there's one thing that's clear and that's the private option is not going to exist in its current form."

The human toll, in this case 213,000 people, isn't even a blip on the GOP’s radar, as they threaten the financial security of every individual and family dependent on their health care coverage:

The prospect of losing their new insurance is already causing anxiety among some of the 213,000 people in Arkansas who got coverage. The program uses money that would otherwise go to expanding Medicaid to purchase the private insurance for the newly eligible. Arkansas, which has a high poverty rate, experienced the largest drop in uninsured in the country — from 22.5 percent in 2013, to 12.4 percent, according to a Gallup survey released in August.

It’s a cruel and unusual torture foisted off onto the American public. Yet they will continues to vote against their own health interests.  

"DEATHS FROM MEDICAL ERRORS ARE EQUIVALENT TO 10 JUMBO JETS CRASHING EACH WEEK" Yet GOP wants Tort Reform.

The title is a line out of story analysis at Voxdotcom about our current state of health care. Obviously, it's not good.

It demonstrated to me how ridiculous the Republican "solution" is, tort reform, because it seeks to reign in malpractice lawsuit settlements instead of eliminating the problem at the front end. Fewer errors, fewer injuries and fewer deaths, a much healthier way to solve the problem than vilifying people killed or injured by a faulty system.

DEATHS FROM MEDICAL ERRORS ARE EQUIVALENT TO 10 JUMBO JETS CRASHING EACH WEEK: We don't know exactly how many Americans are killed in hospitals each year, but we do know that it is a lot.

In 1999, the Institute of Medicine published a seminal report titled To Err is Human, which estimated that at least 44,000 patients — and as many as 98,000 — die in hospitals each year as results of medical errors.

Even using the lower-bound figure, that would mean medical errors in hospitals kill more people annually than "such feared threats as motor-vehicle wrecks, breast cancer, and AIDS."

A follow-up study published in 2013 argued that the IOM numbers were a vast underestimate, and that medical errors contribute to the deaths of between 210,000 and 440,000 patients. At the lower bound, that's the equivalent of nearly 10 jumbo jets crashing every week — or the entire population of Birmingham, Alabama dying every year.

 And hospitals don't really care:

Commonwealth Fund's Blumenthal argues that the problem with hospital errors has much to do with medical culture, in which doctors rarely discuss their mistakes. Blumenthal remembers, shortly after the landmark IOM report came out, trying to start up a consulting business that would teach hospitals how to reduce errors. "I thought it was this great little consulting opportunity," he says. "But there was just no interest. It was sobering, and it made clear that abstract data was not going to change the behavior of complicated health care institutions."

Shifting health care from an accountable government to the individual is one way to hide each and every problem. What we don't know about, won't hurt us right?

And on their own, patient deaths are small events that often happen with little notice or fanfare, making them less noticeable than other events. "Even here in Houston, if a small plane crashes by the airport, that makes the evening news," says John T. James, founder of Patient Safety America, who authored the 2013 report. "But people dying in hospitals are happening one at a time and in insolation, and we pay less attention."

James has argued that the United States should have something akin to the National Transportation Safety Board, which investigates every plane crash in the United States, except for patient deaths from medical errors. Even if it couldn't get to each and every case (there are thousands more patient deaths than airplane accidents), it would create some federal oversight that, right now, does not exist.

Ridiculously Expensive U.S. Health Care vs other Countries.

Here's an update on the condition of the U.S. health care system, pretty much before we completely locked into the Affordable Care Act. 

First up, the Republican vision supporting a free market U.S. model no one in the world would dare try, let alone experiment on, on such a grand scale. You'll notice in the video clip below Singapore's free market attempt didn't work out well. A lesson to be learned? By everybody but Republicans.  

Free market "competition" failed, just like it did in the U.S. within the "individual insurance marketplace." This flew under the radar of most Americans because they received their health care through an employer, just like many career politicians got theirs from taxpayers. 

Lots of Graphs: Pictures tell the whole story, simple enough for even the lamest conservative troll to understand. Click to hopefully enlarge:

Vox: Ways the American health care system is literally the worst: The United States comes in dead last in a new, international ranking of health care systems from a top health-care non-profit. A new Commonwealth Fund report looks at how the United States stacks up against other countries on things like access to doctors and quality of care. It pulls from three separate surveys conducted over the past three years: a 2011 survey of sicker patients, a 2012 survey of doctors and a 2013 survey of adults over 18. It also uses health outcome data from the OECD and World Health Organization.

Vox: This is the most depressing graph in American health care: The chart, from a 2013 report, maps what countries spend per-person on health care against how long people in those countries live. It captures two long-standing truths about the American system: the United States consistently ranks way above peer nations in health care spending, but also ranks way behind in health care outcomes. In other words, we're not getting what we pay for.

GOP Health Care Reform? It’s a bankrupt vision that seeks to profit from human misery and death.

Republican health care reform sounds almost surreal. It doesn't reform as much as it lives out an ideological dream that has no connection to reality. 

The failed old system saw high insurance costs, profits, excluded pre-existing conditions and inflated drug prices. That's the “free market.” What happens when you expand our “freedoms?” The Wall Street Cheat Sheet described it this way and it ain't pretty:

Among House Republicans, there is little unity on a strategy, even though just a month ago lawmakers had rallied around a proposal made by Republican Senators Burr, Coburn, and Hatch. The Patient Choice, Affordability, Responsibility, and Empowerment Act is strongly reliant on market competition, with notable differences from Obamacare; it would likely cover fewer uninsured Americans, increase premiums for many older adults, shrink Medicaid, decrease subsidies for middle class Americans, scale back protections for people with preexisting conditions, and allow private insurers to escape many of the consumer-friendly requirements imposed on them by Obamacare ... it would not maintain Obamacare’s individual mandate. The bill’s authors noted: our proposal is roughly budget neutral over a decade,” ... it seeks to modestly reduce the amount of federal spending and taxation.

Wow, what great alternative?

But like I've been saying all along, if the GOP does gain control in 2016, they will repeal ObamaCare regardless of the dropped policies etc. They're even saying so...:

Representative Tom Price of Georgia, a physician, wants the Affordable Care Act repealed and replaced with he has called a “soup-to-nuts reform of healthcare.”

Representative Steve Scalise of Louisiana has proposed a comprehensive bill that would first repeal Obamacare and replace it with regulations placing new limits on medical malpractice suits and expand access to health savings accounts.

Republican Representative Michael Burgess of Texas, an obstetrician, (says) Larger issues — like a repeal — should be postponed until after this year’s midterm elections, when the Republican party may hold a stronger position in Congress.

Representative Tom Cole of Oklahoma … did admit that passing an Obamacare replacement would be “tricky” in the House, given the complexities of the American healthcare system and the dividing views in the Republican Party. But repeal and reform is not out of the realm of possibility. In general, market-oriented reforms have been among the most popular for GOP lawmakers.

Again, the free market approach to health care has no connection to reality. It’s a bankrupt vision that seeks to profit from human misery and death. That's the Republican Party in a nutshell. 

Will Sen. Tom Coburn ask his neighbors to help with his prostate cancer?

I hate to come across insensitive, but the following news regarding Sen. Tom Coburn’s prostate cancer reminded me of his response to a desperate shattered woman pleading for medical help after being dropped by her insurer. She was given a speech and told to get help from her neighbors. Government is not the solution. I now hope this arrogant Senator will suffer the same inhumanity: 

   

For the past several months, 65-year-old Sen. Tom Coburn has privately been undergoing intensive treatment for a recurrence of prostate cancer, Coburn, an obstetrician, has earned a reputation as a staunch social conservative, pushing anti-abortion measures.

Heritage Foundation offers same old New Health Care Reform Plan.

The authors of the Affordable Care Act, the HeritageFoundation, have another reform idea that gets our Republican government freeloaders off the hook when it comes to helping their constituents get care.

Nothing new, something old: If you really want a confusing and costly “system” of health care, Republicans have just the prescription for you, with a heavy dose of "freedom and liberty." They've decided to combine every bad idea into one big bankrupting plan of action:

After Repeal of Obamacare: Moving to Patient-Centered, Market-Based Health Care: Principle #1: Choose, control, and carry your own health insurance. True health reform should promote personal ownership of health insurance. While Obamacare uses government-run insurance exchanges to limit individual choice, real reforms would focus on encouraging Americans to purchase insurance policies that they can take with them from job to job and into retirement in a competitive, free market.

INTO RETIREMENT? That’s right, the Heritage Foundation is assuming our private plans will stay with us for life, breaking the promise of providing Medicare to seniors. Instead, you'll get a subsidy:

Congress should provide seniors with a generous subsidy to purchase a Medicare plan of their choosing. Seniors who choose a plan costing less than the subsidy would pay less, while seniors who choose a plan costing more than the subsidy would pay the difference in price.

And when those plans premiums go up, year after year, way beyond the subsidy, what happens? 

Getting rid of Employer Coverage: While this is a good idea, Heritage makes it worse by allowing an employer subsidy to their employees. But when that employee is let go, who picks up the employer side subsidy? The person without a job? Sounds costly too.

Rather than providing health insurance directly, employers instead would offer cash contributions to their workers, enabling them to buy the plans of their own choosing. Combined with changes in the tax treatment of health insurance and regulatory improvements to enhance portability, moving to a defined contribution model for health insurance would allow workers to buy a health insurance policy in their youth and take that policy with them from job to job into retirement.

Rights of Conscience. This turns whatever reform Heritage is throwing out there into mush, since “conscience” makes health care voluntary, at the whim of the provider. If you thought insurers were brutal canceling policies, just wait till your employer tells you to take a hike:

Congress should protect the rights of consumers, insurers, employers, and medical personnel to refrain from facilitating, participating in, funding, or providing services contrary to their consciences or the tenets of their religious faith. Enacting these protections would prevent Americans from facing the moral dilemma presented by Obamacare, which has forced individuals, employers, and religious organizations to choose between violating the law and violating their faith or consciences.

Republican Candidate once filed for bankruptcy after Health Insurer Dropped Coverage, sticking him and everyone else with the bill.

Oh the irony. Republicans aren't afraid to declare bankruptcy. They see nothing wrong with walking away from their debts, despite their talk of fiscal conservatism and personal responsibility. You don't stick people with the bill, right? Especially when it comes to health care. They'll buy their cheap junk policies and make due, no matter what happens they say. 

Democrats on the other hand understand that in many cases, bankruptcy can’t be avoided or hard times can’t be predicted.  

Medical Bankruptcy for free market ObamaCare Opponents? A Republican candidate running for the state legislature had a medical bills problem when their insurance company denied them coverage. Yes, the private individual market policy that Obama said you could keep, just willy nilly dropped coverage for someone who needed health care:  

jsonline-Dan Bice: Records show that Republican legislative candidate Jessie Rodriguez and her husband, Aaron, filed for Chapter 7 bankruptcy in 2006. Records show the couple had $15,364 in assets and $157,970 in liabilities at the time. Jessie Rodriguez said in an email that the two were forced into bankruptcy by significant medical expenses. "One of the worst things that happened to my husband and me as a young married couple was when Aaron suffered from serious medical problems that necessitated surgery.

Unfortunately, an unexpected denial of coverage delivered massive bills, and even with both of us working to pay off the debt, our medical expenses overwhelmed our ability to keep up. Eventually, like many families faced with health care-related debt, we were forced to make the difficult decision to work with a trustee through the Chapter 7 process."

You might be wondering where Rodriquez stood on ObamaCare? Aaron’s blog not surprisingly, doesn't mention it.

Aaron Rodriguez is a conservative blogger with the Journal Sentinel's Purple Wisconsin project, where he espouses "limited government and a competitive, free-market economy” … most of their debts wiped clean through bankruptcy. However, they did keep and continue to make payments on a car. Also, some $57,000 in student loans were not discharged.

Again, Democrats aren't immune from defaulting on loans or filing for bankruptcy, it’s just that we don’t vilify those who are going through a difficult time in their lives.

Rodriguez's opponent, Democrat Elizabeth Coppola, had been sued for failing to make payments on a credit card and another bank obligation. A landlord also once went to court to try to evict Coppola for not paying her rent.

Neither candidate is making their financial problems an issue.

Why not save billions with a single payer system? Pure ideology.

Sure I have very firmly held political beliefs, but fiscally, I’ll do whatever makes the most sense to solve a problem and save cash.

A single payer system would solve the huge health care problem we have now, and lighten the massive costly load on businesses. But just like those who vote against their own best interest, business finds itself doing the same thing.

   

University of Michigan professor Mark Mizruchi describes in a new book, The Fracturing of the American Corporate Elite, the reason why business is not behind a money saving single payer system.

WaPo: I've interviewed some Fortune 500 CEOs and HR officials. You would think that it would be in the interest of most American companies, both large and small, to support a single-payer system like Canada's. According to my calculations, in 2009, the Fortune 500 alone spent $375 billion on health care for their employees. Now, if we had a Canadian-style system here, that cost would not be zero, because it would be compensated for in higher taxes. But the cost would be spread throughout the entire population. so it would seem to be in the interest of American companies to not have to provide health-care to their employees, and particularly small business.

So the question is why they would be so opposed to it. The only thing I can think of is just ideology. They just don't like the idea of government involvement. 

Higher Employee Health Care benefits resulting in lower wages.

Rising employer health care costs are coming right out of an employees pay check in lower wages and lower wage increases. The idea of getting rid of the old employer connection with coverage is picking up steam, which means a single payer system isn't too far off. 

From the Washington Post comes this analysis.

The National Journal published a widely-shared article Thursday comparing premiums in the employer market to those in the individual market, exploring what would happen if employers dropped coverage. Clara Ritger, the author, concludes that “for the vast majority of Americans, premium prices will be higher in the individual exchanges than what they’re currently paying for employer sponsored benefits.”
 That conclusion leaves out crucial information about how employers pay for health insurance–and what else they would do if coverage got cut. National Journal’s analysis focuses on … (what) employees might see deducted out of each paycheck. It ignores the really big contribution that employers pay and that economics research shows to come out of workers’ wages. 
 The total premium, including employer and employee costs, come at the cost of workers’ wages. This is known as the wage-fringe tradeoff. “What we do know is that when health-care costs go up by a dollar, wages go down by a dollar.” 

Amitabh Chandra, another Harvard economist, for his part, says he’d actually prefer it if his employer, Harvard, booted him onto the marketplace–and gave him the increase in wages that his research suggests he would receive. “I’m paying for a super generous plan from Harvard right now in the form of lower wages,” he says. “I could take a higher wage and spend some of it on a nice summer vacation.”

More Savings Realized with Expanded Health Care Coverage.

It's pretty obvious already that health care reform has not only changed the way providers do business, but it may result in lower costs overall. But, thanks to Scott Walker, we're still pursuing the most costly and chaotic way to coverage tens of thousands of Wisconsinites. He really cares about us.

jsonline: A state health insurance program that provided improved access to care for adults with very low incomes in Milwaukee County sharply reduced hospitalizations, suggesting that the cost of expanding coverage could be partially offset by the money saved from fewer high-cost hospital stays, according to a study led by researchers at the University of Wisconsin.

The study — published Monday in Health Affairs, a policy journal — found an increase in visits to clinics and emergency departments but a 59% drop in hospitalizations and a 48% drop in preventable hospitalizations.

Some conservative commentators have contended that people covered by Medicaid programs are no better off than people without health insurance.

Benjamin Sommers, a physician and health economist at the Harvard School of Public Health dismissed that contention, asserting that it is based on either ideology or flawed research. "There's now a pretty good body of literature over the past several years that suggests you certainly don't hurt them," he said. "You probably help them in several ways. You help their ability to access care. They are less likely to have major medical bills. Some of their health outcomes improve. And you may even reduce mortality."

Republicans to shift the rising cost of health care to individuals, and let Medicare wither due to Massive Big Pharma Profits!

While Democrats try their damnedest to provide health care to everyone and control costs, Republican free marketers are gleefully watching venture capitalists reap massive profits from lifesaving drugs. Oh, and that problem we’re having with affordable health care…is only getting worse.

If there ever was an argument against Paul Ryan’s competitive free market solution, this is it in spades.

While on one level a few of the more cosmetic but important treatments might benefit from competition, venture capitalists will trash any savings and dramatically drain the economy of consumer dollars. All on the backs of taxpayers who footed the research in the first place:

jsonline: What happens when a disease-fighting charity dives into venture capitalism? In the first case of its kind, the results include one of the planet's most expensive pills, huge sales projections for a drug company and windfalls for executives who sold stock in the glow of enthusiastic news releases about the drug … funding from the Cystic Fibrosis Foundation and by taxpayers through the National Institutes of Health. Yet it costs each patient $307,000 a year to take two Kalydeco pills a day - a price borne by taxpayers through Medicaid and other government programs and by the workers and companies who finance employee health insurance plans. More than 50% of children and one-third of adults with cystic fibrosis have their treatments paid for by taxpayer-funded programs, such as Medicaid and Medicare … Taxpayers helped fund the science that led to Kalydeco.

In the 1990s … the federal health research agency tried to encourage reasonable pricing of drugs developed with the help of its funding, but drug companies were not interested. In December, a Journal Sentinel investigation found that treatment guidelines connected with the 25 top-selling drugs in America were heavily influenced by doctors with financial ties to drug companies. In some cases, nonprofit associations issued the guidelines and also had financial ties to the drug companies.

Adding to the inhumanity of gaming the system:

Robert Beall, president of the Cystic Fibrosis Foundation, said that without its financial support, drugs such as Kalydeco would never get to patients. He rejected the idea of using the royalty money to help patients pay for the medical care, noting that the foundation needed the money to entice drug companies to get involved in risky cystic fibrosis drug research. Beall said the foundation did not ask Vertex to price the drug more affordably. "That would have been a deal-breaker," he said.

And that’s our broken free market health care system. See any reason to completely reform it?

Over reactions and Dumb conclusions regarding Oregon Medicaid study surprising, even Disappointing.

Uh oh, even wonkish Ezra Klein fell for a recent study out of Oregon, that tells us little, and means almost nothing. I placed numbers on the items I found controversial:

NY Times: A study comparing low-income people in Oregon who received access to Medicaid over the past two years with those who did not, found that (1) those on Medicaid visited doctors and hospitals more often, (2) suffered less from depression and were more financially secure. That said, (3) the Medicaid recipients saw little average improvement in blood pressure, blood sugar and other measures.

My quick take:

(1) For those who haven't seen a doctor in years, when offered the chance to do so, were eager for the opportunity. Kids in a candy shop. Americans are starved for health care.

(2) Once Medicaid patients saw the doctor, they were less worried about their health, suffered less depression and felt financially secure. The benefits alone of feeling financially secure is economically and emotionally liberating. It seems that would be a huge benefit to society. The study by the way found many new Medicaid patients suffered from depression, which resulted in treatment. That's bad?

(3) So it's waste of money to see if people are healthy? Do healthy people feel relieved and perform better at work? Ya think? And comparing healthy people covered by Medicaid, with healthy people not covered...that means no one needs health care coverage? Hello, we've got an immensely dysfunctional and deadly private health care system now, doesn't that count for anything? Not according to all the partisan and clueless pundits. Keep in mind, no one shops when they're faced with a life threatening accident or disease. They don't shop for health care when they're healthy either. And everybody gambles on never being sick.

Finally, the study drew this conclusion:

(4) Some have said the study demonstrates that by focusing on routine care, such health insurance provides meager results at great cost. (5) Should health insurance, particularly government programs, provide only catastrophic coverage?

My quick take: 

(4) I never take seriously anything that starts with "some say." Yeah, some will say anything.

(5) Catastrophic programs discourage people from seeing doctors, making outcomes worse if not deadly. How does that make economic sense? That's the kind of system we're supposedly trying to move away from. What's most outrageous about this study is how conservatives are using it to go back to the nothing, lousy, deadly system we have now. Like it's the best we can do, a wonderful fall back position? Around the world, universal care has proven itself to be massively better and economically cheaper. 

Technology may make predicting Health Care Costs impossible.

Ezra Klein posed an interesting question; can we really predict the cost of health care for future generations when the smallest piece of technology can change everything?

Klein points to the following device that really could change everything, if it doesn't disappear into the black hole of time, like so many other game changers:

WaPo: Scientists at Ecole Polytechnique Fédérale de Lausanne (EPFL) in Switzerland have developed a minuscule implant that measures various blood chemicals and sends the results, via Bluetooth, to your smart phone. The upside? Your smartphone knows when you’re about to have a heart attack. And it can call someone on your behalf. It is, after all ,a smartphone. This particular device might prove, for one reason or another, to be bunk. Many seemingly magical inventions do. Consider how dramatically these devices will change medicine. Right now, the medical industry is fundamentally reactive.

Something goes wrong, and we go to them to fix it. This will make medicine fundamentally proactive. They will see something going wrong, and they will intervene to stop it. It’s like “Minority Report” for health care.

This is why I don’t put much stock in projections of health-care spending that run 30 or 50 or 75 years into the future. Will biometric devices in constant communication with the cloud make medicine more or less expensive? Will driverless cars prolong life in a way that saves money or costs it? Will the advances in preventive technology make medicine so effective that we’re glad to devote 40 percent of gross domestic product to it? Who knows?

Time Magazine's article on Health Care should change how we look at costs.

Like I've always said, health care isn't a consumer product. It cannot be part of the free market.

The Time Magazine article, written and narrated below in the video by Steve Brill, is summed up in just over 3 minutes. Not bad for a story that spans over 30 pages. Jon Stewart interviewed Brill recently as well, which I've posted here.

Ask your conservative friends to watch and then have them argue how health care should be in the free market place, with little or no regulation.

Why didn't we Reform the Cost of Health Care?

D.C. has it's own agenda, it's own talking points. When it came to health care, the real issue never came up: why does health care cost so much. Time Magazine's Steven Brill did an extensive report on what we should have been talking about, and what we should have reformed to bring down costs.

Brill also obliterates the idea that health care is a consumer product, and open to free market competition, like we hear so often from Paul Ryan. This is a must see for those brushing up on the whole health care debate. Like Jon Stewart, this is a killer article and interview.

The Daily Show with Jon Stewart

Get More: Daily Show Full Episodes,Political Humor & Satire Blog,The Daily Show on Facebook

The Daily Show with Jon Stewart

Get More: Daily Show Full Episodes,Political Humor & Satire Blog,The Daily Show on Facebook

The Daily Show with Jon Stewart
Get More: Daily Show Full Episodes,Political Humor & Satire Blog,The Daily Show on Facebook

Free Market Health Care? "The more competitive the market, the worse these perverse outcomes will be."

John Mackey, CEO, Whole Foods Market, is another one of those blind free market fools. He’s quick to point to other free market countries as an excuse to turn health care into a purely profit driven business, instead of a lifesaving one. But like every other cool aid drinker, he fails to mention factors that would betray his argument. Take the Swiss system of health care; it’s private alright, with price controls and heavy regulation. It also exposes the major faults in the Republican version of a free market system.

First Mackey’s misguided and misinformed comments:

I made a poor word choice to describe our health care system, which I definitely regret. The term fascism today stirs up too much negative emotion … if the goal is universal health care, our country would be far better served by combining free enterprise capitalism with a strong governmental safety net for our poorest citizens and those with preexisting conditions, helping everyone to be able to buy insurance. This is what Switzerland does and I think we would be much better off copying that system than where we are currently headed in the United States.

I believe that health care should be competitive in the open market to promote innovation and creativity. 

I’m sorry, that doesn't even make sense. I haven’t seen a lack of innovation and creativity in medical advancements, have you? You might even go as far to say these advancements have made health care even more expensive. Obamacare actually provides for almost every point he makes.

But here’s what Mackey isn't telling you, or just doesn't know about, from Healthblog.ncpa.org:

The Good. Swiss health care is predominantly private. Individuals are required to buy insurance and almost all of them do. Private companies compete to provide insurance, and there are subsidies for lower income buyers.  The insurance is individually owned, personal and portable. The Bad. Despite competition, It has mandated benefits, price controls on providers and other regulations that make it hard for entrepreneurs to solve problems.

Since when do medical entrepreneurs help the sick for pure financial gain? It doesn't happen.

But here’s where we see the problem of “junk policies,” coverage so stripped down with so many exemptions, that coverage is nonexistent. Republicans refer to this as “buying insurance across state lines.” If you remember anything from this blog, this is the most important argument against Paul Ryan’s free market solution to health care:

The Ugly.  The Swiss have been moving in the direction of managed competition; on the buyer side, people have an incentive to underinsure when they are healthy and over-insure when they are sick. On the seller side, health plans have an incentive to overprovide to the healthy (on whom they make a profit) and underprovide to the sick (on whom they incur losses). The more competitive the market, the worse these perverse outcomes will be. 

That last line is the kicker, and "perverse" is word that describes Ryan's free market health care fantasies.

U.S. Health Care Falling behind other Advanced Countries. We're killing our citizens.

The Institute of Medicine had some shocking news. While Republicans insist we're living longer and need to raise the retirement age of Americans, we're not really living longer after all. Opposite day everyday in Republican world?:

U.S. Health in International Perspective: Shorter Lives, Poorer Health

The United States is among the wealthiest nations in the world, but it is far from the healthiest. For many years, Americans have been dying at younger ages than people in almost all other high-income countries. This health disadvantage prevails even though the U.S. spends far more per person on health care than any other nation. To gain a better understanding of this problem, the NIH asked the National Research Council and the IOM to investigate potential reasons for the U.S. health disadvantage and to assess its larger implications.

No single factor can fully explain the U.S. health disadvantage. It likely has multiple causes and involves some combination of inadequate health care, unhealthy behaviors, adverse economic and social conditions, and environmental factors, as well as public policies and social values that shape those conditions. Without action to reverse current trends, the health of Americans will probably continue to fall behind that of people in other high-income countries. The tragedy is not that the U.S. is losing a contest with other countries, but that Americans are dying and suffering from illness and injury at rates that are demonstrably unnecessary.

The details are even more distressing. Here's the link.

Large Medical Groups dictate too many tests, raise prices through roof.

Even before health care reform, consolidation started kicking into high gear. Now it's on steroids, and that's going to cause new problems when it comes to reducing the cost of care. The larger hospitals have been jacking up the price of services because they can. Boston has seen this problem for years. Now markets across the country are experiencing the same problem:

NY Times: A little over half of the 1,400 doctors in southwestern Idaho are employed by St. Luke’s or its smaller competitor, St. Alphonsus Regional Medical Center.

Republicans liked to blame "people" for demanding too many unnecessary tests, but they are intentionally ignoring hospitals and doctors affiliated with clinics. Now doctors are losing part of the action:

Many of the independent doctors complain that both hospitals, but especially St. Luke’s, have too much power over every aspect of the medical pipeline, dictating which tests and procedures to perform, how much to charge and which patients to admit.

In interviews, they said their referrals from doctors now employed by St. Luke’s had dropped sharply, while patients, in many cases, were paying more there for the same level of treatment. St. Alphonsus went to court seeking an injunction to stop St. Luke’s from buying another physician practice group, arguing that the hospital’s dominance in the market was enabling it to drive up prices and to demand exclusive or preferential agreements with insurers. The price of a colonoscopy has quadrupled in some instances, and in other cases St. Luke’s charges nearly three times as much for laboratory work as nearby facilities, according to the St. Alphonsus complaint.

Boise’s experience reflects a growing national trend toward consolidation. Across the country, doctors who sold their practices and signed on as employees have similar criticisms. In lawsuits and interviews, they describe growing pressure to meet the financial goals of their new employers — often by performing unnecessary tests and procedures or by admitting patients who do not need a hospital stay.

As long as we maintain the private free market system, we can expect more of the same. Business models will always morph and adapt to whatever system comes along:

Today, about 39 percent of doctors nationwide are independent, down from 57 percent in 2000, according to estimates by Accenture, a consulting firm ... the consolidation of health care may be coming at a hefty price. By one estimate, under its current reimbursement system, Medicare is paying in excess of a billion dollars a year more for the same services because hospitals, citing higher overall costs, can charge more when the doctors work for them. Laser eye surgery, for example, can cost $738 when performed by a hospital-employed doctor, compared with $389 when done by an unaffiliated doctor, according to national estimates by the independent Congressional panel that oversees Medicare.

According to two emergency room doctors who worked at Carlisle Regional Medical Center in Pennsylvania, the message could not have been clearer: more patients needed to be admitted. After another physician, Dr. Cloyd B. Gatrell, raised concerns that the hospital had too few nurses to keep patients safe, an EmCare executive warned him to “back off,” according to a lawsuit Dr. Gatrell filed last year.

Doctors at numerous hospitals said it was often difficult to criticize the policies instituted by hospitals or investor-owned physician groups because, as employees, they could easily be fired. “We all have families, and we have mortgages,” said an emergency room physician. “If you get fired, it looks bad and it’s hard to get another job.”

The Affordable Care Act was a start, but more will need to done.