This is a just published op-ed which does a very good job of exploding the myth of the superiority of the American private health insurance system.

http://www.nytimes.com/2009/11/05/opinion/05kristof.html

It makes the great point that Americans die faster than virtually everywhere else in the Western world at all ages, until age 65, when they finally qualify for decent health insurance, otherwise known as our socialized Medicare, at which point we miraculously live longer than average.

>>Opponents of reform assert that the wretched statistics in the United States are simply a consequence of unhealthy lifestyles and a diverse population with pockets of poverty. It’s true that America suffers more from obesity than other countries. But McKinsey found that over all, the disease burden in Europe is higher than in the United States, probably because Americans smoke less and because the American population is younger.

>>Moreover, there is one American health statistic that is strikingly above average: life expectancy for Americans who have already reached the age of 65. At that point, they can expect to live longer than the average in industrialized countries. That’s because Americans above age 65 actually have universal health care coverage: Medicare. Suddenly, a diverse population with pockets of poverty is no longer such a drawback.<<

- Larry Weisenthal/Huntington Beach, CA

Like or Dislike: 0  0

Response to Missy still forthcoming, but, in the meantime, I just came across a very well-written analysis, from a neutral perspective, which is very relevant to the main topic of this thread:

http://www.newyorker.com/online/blogs/johncassidy/2009/11/some-vaguely-heretical-thoughts-on-health-care-reform.html

What is really unfolding, I suspect, is the scenario that many conservatives feared. The Obama Administration, like the Bush Administration before it (and many other Administrations before that) is creating a new entitlement program, which, once established, will be virtually impossible to rescind. At some point in the future, the fiscal consequences of the reform will have to be dealt with in a more meaningful way, but by then the principle of (near) universal coverage will be well established. Even a twenty-first-century Ronald Reagan will have great difficult overturning it.

As I wrote elsewhere, it’s my personal wish that the present Congress pass health care reform and additional legislation to discourage carbon consumption, and then for Congress to shift over to narrow GOP control in 2010. I view 1994 – 1998 (pre-impeachment) as a Golden Era in American governance, to which I’d love to see a return — but only after we have gotten irreversibly on track towards fixing our health care system.

- Larry Weisenthal/Huntington Beach, CA

Like or Dislike: 0  0

@missy: Still haven’t gotten back with you (mostly distracted by the necessity to pay attention to my day job, and I’ve been researching further the literature pertaining to the role of health care expenses in personal bankruptcies). Hope to be able to post my reply soon.

- Larry W/HB

Like or Dislike: 0  0

@missy: Thanks for the positive rejoinder. Deserves a counter-response — back with you later. – Larry W/HB

Like or Dislike: 0  0

Democrats that opposed the prescription drug bill opposed it because it didn’t spend enough, others in the House and Senate, like me, opposed it because it spent too much and, you know the results. What was it supposed to be? $3-4 billion over 10 years? Well, look what was stalling dem support”

House Democratic leaders have endorsed prescription drug legislation that would cost $800 billion to $900 billion over 10 years.

And the ‘cough’ centrist, bipartisan dems Mr. Rahm Emanuel, Mr. Dooley and a handful of New Democrats broke with party leaders to offer a compromise because the big money dems legislation sure wasn’t going to go anywhere but, they still wanted it:

http://www.nytimes.com/2003/04/02/us/medicare-drug-benefit-plan-is-proposed-by-2-democrats.html

Now the bipartisans show up in the Senate for the bipartisan prescription drug boondoggle:

Supporters of the bill — including some Democrats who, like Sen. Dianne Feinstein of California, said it was better than no bill at all — hailed the vote as a victory for senior citizens.

“This bill is an extraordinary day for seniors and indeed all Americans,” said Senate Majority Leader Bill Frist. “The legislation we just passed is consequential, it is far reaching. … It is epochal in the sense it modernizes Medicare to provide 21st century care for our seniors.”

“We will continue this battle here in the United States Senate and in the course of the elections,” Kennedy said. “I’m absolutely sure that at the end of the day we will preserve the Medicare system … and we will get to the day when we have a real prescription drug program.”

Sen. Barbara Mikulski, D-Maryland, said senators had “squandered the opportunity to truly change history and to truly change the lives of senior citizens” by providing them with “a skimpy benefit.”

“This issue is not finished,” she said. “I intend to come back in January … to really try to get control of the cost of prescription drugs and to try to redirect these enormous subsidies that are going to insurance companies.”

Despite the strong Democratic opposition to the bill, Frist, R-Tennessee, praised it as a bipartisan effort.

“It was bipartisan legislation from day one,” he said. “It is with great satisfaction that we stand together in a bipartisan way with a bipartisan vote.”

Among the 11 Democrats who voted for the bill was Sen. John Breaux, D-Louisiana, who said it was “a balanced piece of legislation that is truly reform.”

“This is the end of a Medicare program that forces seniors to choose between food on the table and the medicine that they need,” he said.

Fellow Democrat Max Baucus of Montana said he was “extremely proud” of the bill, which he said brings “Medicare up into this century.”

http://www.cnn.com/2003/ALLPOLITICS/11/25/elec04.medicare/index.html

We lose more to fraud and malpractice insurance than bankruptcy:

The Healthcare Bankruptcy Myth

http://www.realclearmarkets.com/articles/2009/07/30/the_medical_bankruptcy_myth_97335.html

Deja vu for those into the Big Pharma, remember, Obama likes them too:

When Republicans passed the prescription drug bill, they initially pushed for a complete overhaul of the Medicare plan, but by the time the conference report got to the House, that reform was much more incremental. They were able to frame the issue not as radical change, but common-sense reform. And while many conservatives hated the bill because it spent too much and many liberals hated it because it spent too little, enough folks in the middle found it nonthreatening enough to pass it into law.

The White House also has stumbled when it comes to engaging the interest groups. When Republicans moved on prescription drugs, they targeted the drug industry and seniors groups. It was a rare but fruitful alliance. The Obama White House also has corralled the support of PhRMa and they are running supportive ads. But the drug industry doesn’t have enough grassroots power to pass this themselves, and the support of seniors groups, especially the AARP, has been ill-defined and overly vague.

http://www.cnn.com/2009/POLITICS/08/24/feehery.bipartisan.health/index.html

Here is an outline of President Bush’s early health reform policies:

http://www.heartland.org/publications/health%20care/article/12160/How_the_Presidents_Health_Care_Plan_Covers_the_Uninsured.html

Tort reform:

Both of these measures, as well another tort reform bill, passed the House this session and are pending in the Senate.

Despite ongoing lobbying efforts by business groups, the Senate is not likely to act on the legislation when it returns to Washington after Labor Day. Supporters appear to be short of the 60 votes needed to block a filibuster, and Senate leaders feel they must address more pressing issues in the few weeks that remain in this year’s session.

http://atlanta.bizjournals.com/extraedge/washingtonbureau/archive/2000/08/21/bureau1.html?market=atlanta

the President in 2001 and 2002 supported two major health care tax credit proposals, worth $13 billion and $15 billion, respec­tively, to provide health care coverage for displaced workers as part of a multi-billion dollar economic stimulus package. While the House passed these generous health care tax credit proposals twice—in December 2001, and again in February 2002—the Senate blocked them on both occasions.[24] The pro­posals would have provided a 60 percent refundable tax credit for health insurance for displaced workers who had lost their insurance coverage.

Footnote:

Senate Democrats, like their House counterparts, mostly favored Medicaid expansion and tax credits restricted to COBRA coverage only. The Bush proposal would have allowed the credit to be used for COBRA and other health insurance coverage.

Certainly because medicaid was doing so well it needed to be expanded instead of fixed.

http://www.heritage.org/research/healthcare/bg1804.cfm#_ftn24

More malpractice obstruction:

http://docs.google.com/gview?a=v&q=cache:G7MULPfiMlcJ:www.tcf.org/Publications/healthcare/medicalmalpractice.pdf+senate+democrats+block+bush+tort+reform&hl=en&gl=us&pid=bl&srcid=ADGEESiwe-wI8dluASFtgOkT6Wh7PwE4i0RK1fIytFjp5rVEVxR_A7Tw12-WvQ_ws5W3Ad7KdHl6cacvHqVWEf0NP0DkAB_HSvE6t-I0nW1J11RJP5dxE3eiq-z6y1E1jmjxc5ud0oP1&sig=AFQjCNGl8w1mkPn6hUxiUV0HLh99MbsDEA

In short, they blocked anything they couldn’t lard up and anything that would interfere with their gravy train.

Like or Dislike: 0  0

@missy:

Sorry — “reaching across the aisle” as the motive for massively increasing the socialization of Medicare by the GOP doesn’t cut it. And neither does the assertion that the GOP really tried to reform health care, only to be frustrated by the Dems.

To start with the first: this wasn’t about reaching across the aisle. This was about a big time reward for big pharma, perhaps the biggest lobby in all of DC. Guaranteed government payment for super-expensive, proprietary new drugs and FORBIDDING Medicare to negotiate over drug prices, which is something which the health plans of all other countries do, which is why Americans pay 30% to 200% more for prescription drugs than elsewhere in the Western world. The biggest payout to lobbyists in my lifetime. If the GOP had wanted to “reach across the aisle,” they’d have gone along with allowing Medicare to negotiate over drug prices.

In fact, when the Dems got control of Congress in 2007, they tried to change the law to allow Medicare to negotiate prescription drug prices and thereby lower costs to the government and to Medicare beneficiaries. President Bush threatened to veto the bill the House passed. and the GOP filibustered it to death in the Senate:

http://www.sourcewatch.org/index.php?title=Medicare_legislation

When the GOP controlled both Congress and the Presidency, they could have, indeed, “reached across the aisle” to do improve health care coverage for uninsured Americans and to install a safety net to prevent personal bankruptcies in insured Americans for catastrophic health problems which exceeded their insurance benefits (the number one cause of personal bankruptcy in the USA, as I documented by citing peer-reviewed research [was it you who were the one who challenged me to produce this and then failed to acknowledge it, when I promptly did?]). But they didn’t.

After President Bush had already been in office for 6 years, he finally proposed a health care program package to make health insurance more available and affordable. He proposed making health insurance tax deductible for people who bought it on their own and taxing health insurance benefits (beyond a certain amount) for people who got it through work.

http://money.cnn.com/2007/01/23/pf/taxes/health_proposal_effect/index.htm

It was way too little, way too late.

You say that the GOP tried to do something during the first 6 Bush years but were blocked by Democrats. I say that’s poppycock. But don’t take my word for it, see what neutral, liberterian-oriented writers have to say about it:

http://reason.com/archives/2009/09/14/the-republican-health-care-fai

One reason the president has a good chance of getting ambitious legislation passed this year is that so many health care failures have gone unaddressed for so long. Obama and his allies can justify their program partly because the GOP has been so slow and tepid in offering alternatives. If the choice is between the quite imperfect Democratic plan and nothing, the public may prefer the Democratic plan.

It didn’t have to be this way. Republicans actually have some plausible ideas for improving the health care system. Let small businesses band together to buy insurance? Sure. Medical malpractice reform? Bound to help. Giving federal subsidies to help low-income individuals buy coverage? Go for it.

But for Republicans to propose all these measures brings to mind my friend who, new to Chicago, approached a city transit officer and said he’d like to get to State and Randolph streets. The frosty reply: “Buddy, who’s stopping you?” The only people who stopped Republicans from putting these ideas into practice were Republicans.

Former Reagan administration official Joseph Antos, a health care expert at the conservative American Enterprise Institute in Washington, is among those who wonder why. “The sad thing is Republicans have been talking about these things for a long, long time,” he told me.

You may have forgotten that George W. Bush made a big deal of proposing tax credits of $7,500 per person or $15,000 per family to purchase medical coverage. He did that in 2007, only to be spurned by a Democratic Congress. Why did he wait till the seventh year of his term? He didn’t. He had offered the idea in 2004, only to encounter raging indifference in his Republican Congress.

The truth is Republicans just can’t muster an interest in the subject until a Democratic president comes along and offers legislation, which is their cue to wake up and scream in horror. They solemnly agree the existing system has a host of serious flaws. But they can never get excited about fixing them—only about making sure Democrats don’t get to

.

Where’s your evidence that the GOP tried to reform healthcare during their 6 years of total power, only to be blocked by the Democrats?

- Larry Weisenthal/Huntington Beach, CA

Like or Dislike: 0  0

GOP “had it’s chance” is a myth. Never did they have a filibuster proof majority and as you see now, the shut out Republican ideas of fixing healthcare are not the same as the democrats.

President Obama, Pelosi, the House and Senate committees, with the exception of the Senate Finance committee, all slammed the door, locked the Republicans out.

What they did get done during the “had it’s chance years” you know the “massive increase in socialized entitlements” the result of reaching across the aisle and working with the democrats.

That bill was bipartisan, but as you have just done, the Republicans and compassionate, conservative President Bush will be forever tagged with the blame for the “massive increase in socialized entitlements.”

So, if you are soooo unhappy with the drug benefits, wait til you see what the democrats did alllllll by their selves.

Like or Dislike: 0  0

@mata:

There are important differences between the US system for people who have private health insurance and who are under 65 and the more fortunate residents of France and Germany and Japan. The largest segment of personal bankruptcies in the USA are people with catastrophic health care expenses and who HAVE health insurance. This is because of limitations in payouts with US private health insurance and no safety net for insured people with catastrophic illnesses which exceed these limits. The French and German systems are superior, because they provide equivalent flexibility and choice, while having safety nets, which prevent the personal bankruptcies.

The implication that the care in Veterans Affairs hospitals is “substandard” is a shot which is both cheap and undeserved. It is a fact that problems with VA health care are widely publicized, because public sector health care is transparent, while the private sector buries its mistakes — both figuratively and literally. I’m curious, also. You are perhaps suggesting that the private sector would provide better health care to native Americans than does the US Public Health Service (of which I am a Lt Cmdr in the Inactive Reserve)?

I agree with your statement that the comparison between uninsured Americans and residents of Cambodia is odious.

I favor a system which provides universal coverage for all, with the option of a concierge level of service for those employers or individuals who wish to purchase it, and a safety net for all, to eliminate health care expense related bankruptcies. This is the essence of the French/German/Japanese systems, which produce equal or superior health care outcomes, at less total cost, and which provide universal coverage.

I’ll say it again, the GOP had its chance and all it could get done was a massive increase in socialized entitlements, which was the biggest giveaway of taxpayer money to private lobbyists in my lifetime, in a massive expansion of the socialized sector of US healthcare. Interestingly, though, I don’t hear any call from anyone to “save” tax dollars by repealing this socialized expansion. It’s because the socialized expansion, like socialized Medicare itself, is a wildly popular and strongly supported program. Which is the case of all the “socialized” health care systems of Western Democracies.

By the way, I agree that Obamacare is a down payment on a future program, which will end up looking a whole lot like the French/German/Japanese systems.

- Larry Weisenthal/Huntington Beach, CA

Like or Dislike: 0  0

Interesting, Larry. As an outspoken supporter of French health care, and one who speaks unfavorably of both Canada and Britain, one would think that the US system would shine in your opinion when reading Reid’s few “quotes” in the article.

i.e. those under 65 are similar to Germany, France of Japan. Well news bulletin… most insured under 65 are in private insurance plans.

For the Native American community and military/veterans… they are already on a socialized health plan similar to Britain or Cuba. And like Britain and Cuba, this socialized plan is bankrupt and is renowned for it’s substandard treatment. But then, for the desperate uninsured, perhaps substandard treatment looks inviting… at the beginning, anyway.

For the seniors, it’s Canada since those with extra income can go the route of Medicare Advantage… a program that the occupant of the Oval Office is busy gutting, and slashing the basic Medicare on-the-verge-of-bankruptcy budget. However those with extra money cannot opt out of Medicare and save the system $1.5 bil annually unless they also walk away from all the cash the government has stolen from them since social security was implemented. Rock? Hard place? Geee… lemme think…

As far as that “45 million uninsured”… we already know that’s a bogus and inflated number. And quite frankly – despite never visiting Cambodia or the others – I’m dead certain that no one in Cambodia, rural India or Burkina Faso can walk into a state of the art ER and get treated… despite their insured status. That’s another bogus piece of BS.

Lastly, I’d like to point out that the words you quote from the article… save the actual Reid quotes… are those of the WaPo reporter, and not that of Reid.

All in all, what’s your point with the article, Larry? Seems like it is diametrically opposed to every point you’ve ever made about health care, plus drags in a few progressive talking points (from the article) to drag America’s health care into the financial and quality gutter with the rest of these systems.

Like or Dislike: 0  0

There’s a new book on the health care debate, just out, written by TR Reid. I think it’s an original “take” on the issue.

He points out that the USA doesn’t just have a private health care system, it’s got a cornucopia of systems.

http://www.reuters.com/article/smallBusinessNews/idUSTRE59S3FX20091029

T.R. Reid, a long-time Washington Post correspondent, lays out those details in a fascinating new book, “The Healing of America.” Reid worked in Post bureaus in London and Tokyo, and he and his family had received health care under the British and Japanese systems. During his research, he traveled to many other countries seeking treatment for a bum shoulder he had seriously injured years earlier while in the Navy.

The result is a tale that highlights the positive and negative aspects of other systems. By almost every measure, the healthcare outcomes are better in other developed countries than in the United States, while the costs are lower.

None is perfect. They all face the problem of rising costs. But all other developed countries essentially provide care for everyone.

“For most working people under 65, we’re Germany or France or Japan,” Reid writes. “For Native Americans, military personnel and veterans, we’re Britain, or Cuba … For those over 65, we’re Canada … For the 45 million uninsured Americans, we’re Cambodia, or Burkina Faso or rural India.”

People in the latter group get care if they can pay the bill out of pocket. The United States, however, is like no other country because it “maintains so many separate systems for separate classes of people, and because it relies so heavily on for-profit private insurance plans to pay the bills,” Reid says.

Some opponents of healthcare reform complain that the focus is on extending coverage to the uninsured, which will be expensive, rather than on ways to control costs. There’s some truth to that, but extending coverage is the far more critical step. Other changes to control costs can come in turn.

Reid notes that on average, U.S. health insurance companies pay out in claims only about 80 percent of what they collect in premiums. The rest goes for marketing, underwriting and administration, with what’s left, for profit.

- Larry Weisenthal/Huntington Beach, CA

Like or Dislike: 0  0