You don't say..
WaveCameCrashin
Posts: 2,929
http://www.politico.com/news/stories/0312/74119.html
President Barack Obama promised over and over during the health care debate that “if you like your health care plan, you can keep your health care plan.”
It turns out that, for a lot of people, that isn’t true.
A Congressional Budget Office report issued this week says that 3 to 5 million people could move from employer-based health care plans to government-based programs as the Affordable Care Act takes effect. And in the worst-case scenario, it could be as many as 20 million.
For Obama, it’s an inconvenient truth at a really inconvenient time — coming less than two weeks before the Supreme Court begins oral arguments on the law and just as the administration touts the law’s early benefits on its second anniversary.
And it’s not the only hard truth Obama and the law’s supporters are facing. No matter what they said about rising health care costs, those costs aren’t actually going to go down under health care reform. The talk about the law paying for itself is just educated guesswork. And people aren’t actually liking the law more as they learn more about it — and some polls show they are just getting more confused.
But it’s Obama’s signature promise — “If you like it, you can keep it” — that’s most likely to get thrown back in his face. Here are the four hard truths of health care reform as the law approaches its March 23 anniversary:
1) Some people won’t get to keep the coverage they like.
For Republicans, the CBO report is a giant “I told you so” moment — and they’re lining up to tell you so.
“President Obama repeatedly promised during the health care debate, ‘if you like your current plan, you will be able to keep it,’” House Energy and Commerce Committee Republicans said in a statement Friday. “Even under CBO’s ‘best estimate,’ President Obama will have broken his promise to 3 million to 5 million Americans each year, but unfortunately, that number could be much higher.”
Sen. Orrin Hatch (R-Utah) cited the 20 million figure, saying: “This law keeps getting worse and worse; it needs to be repealed.”
Supporters of the law say it’s not as bad as all that. The 20 million figure is the extreme scenario, they point out — CBO says that 3 million to 5 million is more likely. And that’s out of the 161 million Americans who would have had workplace health insurance before the law was passed.
Even there, the number is misleading, according to Topher Spiro of the Center for American Progress, because CBO says about 3 million wouldn’t be forced out. They would leave their workplace coverage voluntarily — possibly for better coverage, with subsidies, through the law’s new health insurance exchanges.
And for the rest, Spiro said, employers will have to take the responsibility for what happens — because they’ll still have plenty of incentives to offer coverage to their workers, especially once the individual mandate requires everyone to have it. “If they decide to drop coverage, that will be their decision, and they should not blame the health care law,” Spiro said.
But try explaining all that over the 30-second Republican campaign ads that are sure to come. And it’s not what Obama promised as he pushed for the new law two years ago.
“If you like your plan and you like your doctor, you won’t have to do a thing,” Obama promised at a press briefing in June 2009. “You keep your plan; you keep your doctor. If your employer’s providing you good health insurance, terrific. We’re not going to mess with it.”
The 3 to 5 million estimate is also a net figure, so it masks some bigger changes in both directions.
For one thing, CBO says 11 million Americans won’t get employment-based health insurance they would have had before the law — so they will be forced out (technically by their employer, not by the president, but the context will be the changes brought about by the health law). Another 9 million would gain coverage — but everyone who loses it will see their lives disrupted, and it will be used as more evidence of broken Obama promises.
But all of that assumes CBO is right. For the law’s supporters, the dream scenario is that employment-based coverage will go up — which is what happened in Massachusetts under Mitt Romney’s health care reform law, which (as his Republican rivals have been known to point out) also has an individual mandate. According to the state’s figures, the percentage of employers that offer health coverage has increased from 70 percent to 77 percent since 2005.
2) Costs aren’t going to go down.
The video released by the Obama campaign Thursday has a graph that shows health insurance premiums climbing and climbing — way above general inflation. Giving families and businesses relief was a big part of Obama’s sales pitch for health care reform.
“Health care costs had been rising three times the rate of inflation, crushing family budgets and choking businesses. And he knew that he couldn’t fix the economy if he didn’t fix health care,” narrator Tom Hanks says in the video.
But no matter what happens with the law, the line on that graph isn’t going to go down. If the law works as the administration hopes, premiums may not rise as fast. But they’re not going to plummet.
That’s because the main drivers of rising costs — including technology, expensive new drugs, an aging population, a surge in chronic diseases, and Americans’ propensity to use a lot more health care than many other countries even if it doesn’t make them any healthier — have nothing to do with the law.
It’s not clear whether a lot of people actually expected premiums to go down — but there’s already a perception that the law has increased the cost of insurance, which is feeding the negative attitudes. A Kaiser Family Foundation poll released this week found that 49 percent believe the law has “significantly increased the price of health insurance.”
That’s not true. An Aon Hewitt survey of health plans found that health insurance premiums on average rose 12.3 percent in 2011 — but only an average of 1.5 percent can be attributed to the health law. And health premiums had been rising for years before the law was passed.
But what is true is that what most people pay for their insurance — either through higher premiums or bigger co-pays and deductibles — aren’t rising more slowly. The law creates lots of experiments for delivering health care more efficiently, but those are just getting underway. If those don’t work, and costs keep rising, the law will get blamed for it.
3) It’s just a guess that the law can pay for itself.
The Obama administration insists that the health care law will actually reduce the deficit — which sounds like a fantasy to many people, since the law will clearly increase spending through insurance subsidies and an expansion of Medicaid.
But that’s what CBO says. And it’s because the budget office believes the law will pay for itself through cuts in Medicare payments and various new taxes, including fees that health insurers and medical device makers will pay.
Like everything else CBO does, though, those estimates are mostly educated guesses — and they assume Congress is actually going to let the Medicare cuts happen. For example, the law is supposed to save $157 billion over 10 years by increasing Medicare payments more slowly for inpatient hospital, home health and skilled nursing facility services. The law expects those providers to become more productive and more efficient. But watch for plenty of lobbying pressure on Congress to cancel those cuts.
4) “The more they know, the more they'll like it” isn’t happening.
When the bill passed, Democrats were convinced that Americans would like the health care reform law more once they were able to see its benefits. When then-House Speaker Nancy Pelosi said Congress had to “pass the bill so you can find out what is in it” — an inartful phrase that Republicans have happily quoted ever since — her aides insisted that’s what she meant: People would find out about its benefits once the controversy died down.
Except the controversy has never died down, and people don’t like the law any more now than they did then.
The latest Kaiser Family Foundation poll found that 41 percent had favorable views of the law, while 40 percent had unfavorable views. That’s down from the 46 percent who favored the law in April 2010, right after Obama signed it.
And people actually seem to know less about what’s in the law than they did then. Only 56 percent now know that people will get subsidies to pay for health insurance, compared to the 75 percent who knew in April 2010. Just over half of Americans knew that people with pre-existing conditions will be guaranteed coverage, compared to the 64 percent who knew it in 2010.
The part the most people knew about is the individual mandate — the least popular part of the law. And once the Supreme Court starts hearing the health care reform case on March 26, they’ll hear about that part even more.
President Barack Obama promised over and over during the health care debate that “if you like your health care plan, you can keep your health care plan.”
It turns out that, for a lot of people, that isn’t true.
A Congressional Budget Office report issued this week says that 3 to 5 million people could move from employer-based health care plans to government-based programs as the Affordable Care Act takes effect. And in the worst-case scenario, it could be as many as 20 million.
For Obama, it’s an inconvenient truth at a really inconvenient time — coming less than two weeks before the Supreme Court begins oral arguments on the law and just as the administration touts the law’s early benefits on its second anniversary.
And it’s not the only hard truth Obama and the law’s supporters are facing. No matter what they said about rising health care costs, those costs aren’t actually going to go down under health care reform. The talk about the law paying for itself is just educated guesswork. And people aren’t actually liking the law more as they learn more about it — and some polls show they are just getting more confused.
But it’s Obama’s signature promise — “If you like it, you can keep it” — that’s most likely to get thrown back in his face. Here are the four hard truths of health care reform as the law approaches its March 23 anniversary:
1) Some people won’t get to keep the coverage they like.
For Republicans, the CBO report is a giant “I told you so” moment — and they’re lining up to tell you so.
“President Obama repeatedly promised during the health care debate, ‘if you like your current plan, you will be able to keep it,’” House Energy and Commerce Committee Republicans said in a statement Friday. “Even under CBO’s ‘best estimate,’ President Obama will have broken his promise to 3 million to 5 million Americans each year, but unfortunately, that number could be much higher.”
Sen. Orrin Hatch (R-Utah) cited the 20 million figure, saying: “This law keeps getting worse and worse; it needs to be repealed.”
Supporters of the law say it’s not as bad as all that. The 20 million figure is the extreme scenario, they point out — CBO says that 3 million to 5 million is more likely. And that’s out of the 161 million Americans who would have had workplace health insurance before the law was passed.
Even there, the number is misleading, according to Topher Spiro of the Center for American Progress, because CBO says about 3 million wouldn’t be forced out. They would leave their workplace coverage voluntarily — possibly for better coverage, with subsidies, through the law’s new health insurance exchanges.
And for the rest, Spiro said, employers will have to take the responsibility for what happens — because they’ll still have plenty of incentives to offer coverage to their workers, especially once the individual mandate requires everyone to have it. “If they decide to drop coverage, that will be their decision, and they should not blame the health care law,” Spiro said.
But try explaining all that over the 30-second Republican campaign ads that are sure to come. And it’s not what Obama promised as he pushed for the new law two years ago.
“If you like your plan and you like your doctor, you won’t have to do a thing,” Obama promised at a press briefing in June 2009. “You keep your plan; you keep your doctor. If your employer’s providing you good health insurance, terrific. We’re not going to mess with it.”
The 3 to 5 million estimate is also a net figure, so it masks some bigger changes in both directions.
For one thing, CBO says 11 million Americans won’t get employment-based health insurance they would have had before the law — so they will be forced out (technically by their employer, not by the president, but the context will be the changes brought about by the health law). Another 9 million would gain coverage — but everyone who loses it will see their lives disrupted, and it will be used as more evidence of broken Obama promises.
But all of that assumes CBO is right. For the law’s supporters, the dream scenario is that employment-based coverage will go up — which is what happened in Massachusetts under Mitt Romney’s health care reform law, which (as his Republican rivals have been known to point out) also has an individual mandate. According to the state’s figures, the percentage of employers that offer health coverage has increased from 70 percent to 77 percent since 2005.
2) Costs aren’t going to go down.
The video released by the Obama campaign Thursday has a graph that shows health insurance premiums climbing and climbing — way above general inflation. Giving families and businesses relief was a big part of Obama’s sales pitch for health care reform.
“Health care costs had been rising three times the rate of inflation, crushing family budgets and choking businesses. And he knew that he couldn’t fix the economy if he didn’t fix health care,” narrator Tom Hanks says in the video.
But no matter what happens with the law, the line on that graph isn’t going to go down. If the law works as the administration hopes, premiums may not rise as fast. But they’re not going to plummet.
That’s because the main drivers of rising costs — including technology, expensive new drugs, an aging population, a surge in chronic diseases, and Americans’ propensity to use a lot more health care than many other countries even if it doesn’t make them any healthier — have nothing to do with the law.
It’s not clear whether a lot of people actually expected premiums to go down — but there’s already a perception that the law has increased the cost of insurance, which is feeding the negative attitudes. A Kaiser Family Foundation poll released this week found that 49 percent believe the law has “significantly increased the price of health insurance.”
That’s not true. An Aon Hewitt survey of health plans found that health insurance premiums on average rose 12.3 percent in 2011 — but only an average of 1.5 percent can be attributed to the health law. And health premiums had been rising for years before the law was passed.
But what is true is that what most people pay for their insurance — either through higher premiums or bigger co-pays and deductibles — aren’t rising more slowly. The law creates lots of experiments for delivering health care more efficiently, but those are just getting underway. If those don’t work, and costs keep rising, the law will get blamed for it.
3) It’s just a guess that the law can pay for itself.
The Obama administration insists that the health care law will actually reduce the deficit — which sounds like a fantasy to many people, since the law will clearly increase spending through insurance subsidies and an expansion of Medicaid.
But that’s what CBO says. And it’s because the budget office believes the law will pay for itself through cuts in Medicare payments and various new taxes, including fees that health insurers and medical device makers will pay.
Like everything else CBO does, though, those estimates are mostly educated guesses — and they assume Congress is actually going to let the Medicare cuts happen. For example, the law is supposed to save $157 billion over 10 years by increasing Medicare payments more slowly for inpatient hospital, home health and skilled nursing facility services. The law expects those providers to become more productive and more efficient. But watch for plenty of lobbying pressure on Congress to cancel those cuts.
4) “The more they know, the more they'll like it” isn’t happening.
When the bill passed, Democrats were convinced that Americans would like the health care reform law more once they were able to see its benefits. When then-House Speaker Nancy Pelosi said Congress had to “pass the bill so you can find out what is in it” — an inartful phrase that Republicans have happily quoted ever since — her aides insisted that’s what she meant: People would find out about its benefits once the controversy died down.
Except the controversy has never died down, and people don’t like the law any more now than they did then.
The latest Kaiser Family Foundation poll found that 41 percent had favorable views of the law, while 40 percent had unfavorable views. That’s down from the 46 percent who favored the law in April 2010, right after Obama signed it.
And people actually seem to know less about what’s in the law than they did then. Only 56 percent now know that people will get subsidies to pay for health insurance, compared to the 75 percent who knew in April 2010. Just over half of Americans knew that people with pre-existing conditions will be guaranteed coverage, compared to the 64 percent who knew it in 2010.
The part the most people knew about is the individual mandate — the least popular part of the law. And once the Supreme Court starts hearing the health care reform case on March 26, they’ll hear about that part even more.
Post edited by Unknown User on
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Comments
Godfather.
Hopefully one day people will wake up godfather. People need to realize that the majority of politicians don't give a shit about us. All they care about is power and getting re-elected. It doesn't matter what side your on,bcos when these utopian statist are in control our lives ,our children and grandchildren are all going to be negatively effected in more ways than just healthcare.
If the Individual Mandate is not ruled to be unconstitutional it will be the final nail in Americas coffin.
You aren't getting any responses here because liberals already hate the healthcare bill. It isn't at all what they wanted. It doesn't go nearly far enough. And it just makes more money for the insurance companies. But no one is responding to your post because like most Americans, you don't have any clue where your problems even start.
"Hear me, my chiefs!
I am tired; my heart is
sick and sad. From where
the sun stands I will fight
no more forever."
Chief Joseph - Nez Perce
This seems very true much of the time. I have friends who would say this is a good argument for anarchy (as in elimination of government authority). The only problem with this is that there are too many people who would still exercise power and control for their own benefit and there are too many adults (at least in our society) who are infused with apathy.
So what alternatives do we have (except to sing for a rock 'n roll band
-Eddie Vedder, "Smile"
Does he mention the law doesn't even come into effect for another two years?
sorry I didn't mean to be disrespectful I agree with you 100%, I have felt a bad feeling about the current president as many have about some of the past presidents and the more I read about the health care deal the more I feel like "I thought so"
Godfather.
Dude I could really care less if I get a response especially from guys like you. And you say it doesn't go far enough? Really how much further would you like it to go ? Is forcing us to buy ins ie the individual mandate not far enough? Does it even occur to you that everything our federal gov touches goes to shit. There's not one gov program that's not in the red. So instead of trying to insult me why don't you educate yourself for once in your life and read what doctors are saying about this bill.
By Richard Amerling, MD
In his latest book Ameritopia, Mark Levin discusses utopian “masterminds” who make promises of “heaven on earth” that are never possible to deliver. Attempting to create utopia leads to disruptions in the status quo, always making it worse. In order to pursue their agenda, utopians must ignore history, current realities on the ground, facts, science, and human nature. They must also turn a blind eye to the human suffering their efforts cause. They must lie and misinform on a massive scale to convince citizens they live in misery and should give up their liberty for false promises. In medicine we have terms to describe such thought processes—delusional, sociopathic, and schizophrenic!
Look at the current administration’s energy policy, such as it is. It is based on the absurd ideology that considers carbon dioxide, a gas we all exhale and which feeds plants, a pollutant. Thus, carbon-based energy sources are to be shunned and billions of taxpayer subsidies thrown at so-called green technologies that cannot make it in the marketplace. Rounded to the nearest whole number, the total contribution to world energy made by wind power is zero. We are blocked from developing national sources of oil and gas, and allowing a pipeline to be built from Canada. Coal-fired electricity plants are being closed, and energy prices are climbing. This affects us all, and ultimately makes us poorer. But the utopians are impatient to implement their policies now, ignoring the obvious fact that we are dependent on fossil fuels and will be for the foreseeable future.
Government Run Healthcare is the ultimate utopian delusion. As Levin points out, control of medicine has been a key element of utopian schemes dating back to Plato’s Republic. Government Healthcare depends on an unconstitutional mandate for all individuals to purchase health insurance, for the “greater good” of universal health care. This ignores the obvious fact that for young and healthy people what is called insurance is a really bad deal. These folks will be forced to subsidize care for others who may be better off than they are themselves. The utopians claim the free-market system has failed. Actually, it is government policies and mandates that drove costs through the roof.
Government Healthcare “invests” heavily in preventive care with little evidence such measures actually work. Funds for this come largely from half a trillion dollars cut from Medicare, that is, from care for the elderly and disabled. This is not to defend Medicare, which is a bankrupt bureaucratic nightmare. But current beneficiaries have paid into the system and will not benefit from “preventive care”; they already have all the diseases associated with aging. Never mind. Their care will be strictly rationed by the Independent Payment Advisory Board, an unelected and unaccountable group of “experts” who will decide what services will and won’t be paid for.
Fee-for-service practice, which is all that currently assures promptness of care, will be phased out in favor of the managed care du jour, the Accountable Care Organization (ACO). In this utopian fantasy doctors and administrators will receive a fixed sum for each enrolled patient and will then work harmoniously to provide high quality care, keeping whatever money is left over. There is absolutely no chance that ACOs will work, unless they severely restrict care and/or cherry pick their members.
ACOs and all physicians will be coerced into following “practice guidelines,” issued by “expert panels.” This one-size-fits-all approach to medicine will inflict incalculable harm on patients. The notion that a handful of elites can tell doctors working in the trenches how to treat their patients is pure utopianism.
Ah, but they will be armed with the ultimate utopian tool: the electronic health record. Your brand new, government-certified, “meaningful use-capable,” EHR will give the feds access to all your confidential patient encounters and information. The EHR, through embedded algorithms, will “guide” your decision-making along approved, cost effective paths. The potential to inflict harm across such a platform is greatly magnified.
The utopian conceit that a small group of elites can effectively manage something as complex as the practice of medicine will lead to failure, dislocations, and suffering on a massive scale. It must be turned back.
http://www.aapsonline.org/
Richard Amerling, MD is a nephrologist practicing in New York City.
He is an Associate Professor of clinical medicine at Albert Einstein College of Medicine in New York, and the Director of Outpatient Dialysis at the Beth Israel Medical Center. Dr. Amerling studied medicine at the Catholic University of Louvain in Belgium, graduating cum laude in 1981. He completed a medical residency at the New York Hospital Queens and a nephrology fellowship at the Hospital of the University of Pennsylvania. He has written and lectured extensively on health care issues and is a Director of the Association of American Physicians and Surgeons. Dr. Amerling is the author of the Physicians' Declaration of Independence.
And when I tell you "not far enough" you bring up the mandate again. You haven't a clue. I would want to eliminate insurance companies altogether. It's called a single payer system. Maybe you've never heard of it. But it doesn't matter, your back ass country will never figure it out.
I agree that insurance is a god damn joke the way it is set up now, but there are a lot of jobs that people won't have if we move to a single payer system. Also, that has got to be a substantial tax revenue to the system, how will the government get the money to pay for it if we suddenly and very publicly lose a ton of jobs because of the single payer system?
It is terrifying when you are too stupid to know who is dumb
- Joe Rogan
"Well, you tell him that I don't talk to suckas."
"Well, you tell him that I don't talk to suckas."
It isn't just the people who work in the insurance industry that will be affected by this, I guess I should have extrapolated that out further. The entire healthcare industry would have be changed...it is a huge can of worms to say something as simple as "single payer system"...there... healthcare solved...I think it is the most economical way of doing it, but I don't think anyone can begin know what would happen if we truly did go to the single payer system.
who knows...I just can't help but wonder if the unintended consequences wouldn't be worse than the system we already have...
It is terrifying when you are too stupid to know who is dumb
- Joe Rogan
what are you but my reflection? who am i to judge or strike you down?
"I will promise you this, that if we have not gotten our troops out by the time I am president, it is the first thing I will do. I will get our troops home. We will bring an end to this war. You can take that to the bank." - Barack Obama
when you told me 'if you can't beat 'em, join 'em'
i was thinkin 'death before dishonor'
chances were high considering hes a lawyer AND a politician.
take a good look
this could be the day
hold my hand
lie beside me
i just need to say
You are absolutely right. It would likely be extremely difficult. Difficult even with everyone on board. And I really don't think it would ever happen. There is far too much money imbedded in the heath care system. And those with that flow of money steaming to them will fight like hell to hold on to it. So far all they've had to do is spend a bit of that money to dupe people like the OP into thinking they have the best system and that all others are bad.
Could there be some negatives involved in eliminating insurance companies from the health care system? Most likely. But I am absolutely sure the positives would outweigh the negatives.
A couple questions for you mike or any other Americans who may have health insurance. How much are your monthly premiums? And if you do have insurance, how much are your co-pays for a regular doctor visit or a trip to the emergency room after a minor injury like a broken ankle? Do you have to pay when you visit the doctor and then get reimbursed from the insurance company?
I only pay 40 a month for my premiums...but my employer kicks in around 300 monthly. but that is just for me. If my wife and child were on my insurance instead of her own it would be 447 a month from me and who knows how much from my employer.
I have 15 co-pays but utilize flex spending benefits for that stuff. My emergency room co-pay is 100. My wife and daughter don't have any co-pays for regular doctor's visits and pay 10 for a co-pay at urgent care and 50 at the emergency room.
And no, generally you don't have to pay out of pocket and get reimbursed but there are some plans that operate that way. It is a strange system there is no doubt about that...
Some day the transition will be made, probably not in my lifetime and it will probably only be after we resemble Freedonia, but it will happen.
It is terrifying when you are too stupid to know who is dumb
- Joe Rogan
Why wouldnt I he's a doctor who knows what he's talking about.And not to mention his credintals. This is one of tens of thousands that are against this bill. What, i should take advice form someone like you that doesnt practice medicine and obvoiusly only knows how to insult people ?
We can"t just get rid of the ins companies, What we would do with all those employed people with famalies ? just tell them oh well tough shit and add to our already high unemployment ? You obviously dont understand
that our Federal Gov screws up practically everything they touch. Maybe if you actually studied and did a little research you might understand.
http://freemarketcure.com/singlepayermyths.php
Myth No. 1: Everyone has access to health care a single-payer system.
Everyone in a single-payer system has health insurance, not necessarily health care.
While the government in a single-payer system will pay for everyone's health care, it limits the access to health care. In a single-payer system, citizens often believe that "the government" is paying for their health care. When people perceive that someone else is paying for something, they tend to over-use it. In a single-payer health care system, people over-use health care. This puts strain on government health care budgets, and to contain costs governments must ration care.
Governments in a single-payer system ration care using waiting lists for surgery and diagnostic procedures and by canceling surgeries. As the Canadian Supreme Court said upon ruling unconstitutional a Quebec law that banned private health care, "access to a waiting list is not access to health care." [Back to Top]
Myth No. 2: Claims of rationing are exaggerated.
Jonathan Cohn, author of Sick, wrote that the "stories about [rationing in] Canada are wildly exaggerated." Yet advocates of single-payer never say what they mean by "exaggerated."
The fact is that people often suffering great pain and anxiety while they spend months on a waiting list for surgery. Others spend months waiting for a surgery, only to have it cancelled, after which they will spend even more time waiting for another surgery. Sometimes people even die while on the waiting list.
Media in foreign nations are full of stories about people suffer while on a waiting list. In Canada, Diane Gorsuch twice had heart surgery cancelled; she suffered a fatal heart attack before her third surgery. In Great Britain, Mavis Skeet had her cancer surgery cancelled four times before her cancer was determined to have become inoperable. In Australia, eight-year-old Kyle Inglis has lost 50 percent of his hearing while waiting nearly 11 months for an operation to remove a tumor in his ear. Kyle is one of over 1,000 children waiting over 600 days for ear, nose and throat surgery in Warnbro, a suburb in Western Australia.
These are not mere anecdotes. Much academic literature has examined the impact of waiting lists on health. A study in the Canadian Medical Association Journal found that 50 people died while on a wait list for cardiac catheterization in Ontario. A study of Swedish patients on a wait list for heart surgery found that the "risk of death increases significantly with waiting time." In a 2000 article in the journal Clinical Oncology, British researchers studying 29 lung cancer patients waiting for treatment further found that about 20 percent "of potentially curable patients became incurable on the waiting list." [Back to Top]
Myth No. 3: A single-payer system would save money on administrative costs.
Single-payer advocates often claim that the U.S. private sector health care system is wasteful, spending far more on administrative costs than do government-run single-payer systems. According to single-payer advocates David Himmelstein and Steffie Woolhandler, "Streamlining administrative overhead to Canadian levels would save approximately $286.0 billion in 2003, $6,940 for each of the 41.2 million Americans who were uninsured as of 2001."
Yet comparisons of private sector administrative costs with those of government are misleading. Many government administrative expenses are excluded in such comparisons, such as what it costs employers and government to collect the taxes needed to fund the single-payer system, and the salaries of politicians and their staff members who set government health-care policy (the salary costs of executives and boards of directors who set company policy are included in private sector administrative costs).
But even if the U.S. would save money on administrative costs by switching to a single-payer system, the savings would prove temporary. The main cause of rising health care costs is not administrative costs, but over-use of health care. A single-payer system would not solve that problem. Indeed, it would make it worse. [Back to Top]
Myth No. 4: Single-payer will provide fair and quality care for everyone.
Leftist Dave Zweifel claims that the U.S. "could make the system so much more fair by enacting a national single-payer health plan." Jonathan Cohn, when asked why he had faith that the government could run the health care system for all when it didn't do it very well for the poor, responded, "My answer is that they do it, and do it well, abroad."
Well, no they don't. According to Canada's Fraser Institute:
... a profusion of research reveals that cardiovascular surgery queues are routinely jumped by the famous and politically-connected, that suburban and rural residents confront barriers to access not encountered by their urban counterparts, and that low-income Canadians have less access to specialists, particularly cardiovascular ones, are less likely to utilize diagnostic imaging, and have lower cardiovascular and cancer survival rates than their higher-income neighbours.
It isn't much better in Great Britain. Take a look at the Saga 'Good Hospital Guide' for British hospitals. Compare the ones in Inner London, which tend to be in wealthier areas, to the ones in Outer London, which tend to be in poorer areas. You'll notice that in general, the ones in Inner London have more doctors and nurses per bed, shorter wait times for MRIs and hip replacements, and lower mortality ratios. [Back to Top]
Myth No. 5: A single-payer system will leave medical decisions to a patients and his or her doctor.
According to Physicians for a National Health Program (PNHP), a group pushing for a single-payer system in the U.S.:
There is a myth that, with national health insurance, the government will be making the medical decisions. But in a publicly-financed, universal health care system medical decisions are left to the patient and doctor, as they should be. This is true even in the countries like the UK and Spain that have socialized medicine.
Yet PNHP seems to be talking out of both sides of its mouth. Here is how PNHP addresses the question of how to keep doctors from doing too many procedures in a single-payer system:
[Doing too many procedures] is a problem in systems that reimburse physicians on a fee-for-service basis. In today's health system, another problem is physicians doing too little for patients. So the real question is, "how do we discourage both overcare and undercare"? One approach is to compare physicians' use of tests and procedures to their peers with similar patients. A physician who is "off the curve" will stand out. Another way is to set spending targets for each specialty. This encourages doctors to be prudent stewards and to make sure their colleagues are as well, because any doctor doing unnecessary procedures will be taking money away from other physicians in the same specialty.
In practice what this will mean is medical decisions will be left up to you and your doctor as long as your doctor isn't doing too many (or too few) procedures and is within a spending target.
The truth is that single-payer systems often interfere with treatment decisions. For example, most single-payer systems have bureaucracies that delay the approval of new drugs, preventing patients from using them. Alice Mahon, a former member of the British parliament, needed the drug Lucentis to slow her macular degeneration. Because of delays due to the National Health Service not yet having approved Lucentis at the time of her diagnosis, Mahon lost much of the sight in her left eye.
In 1999, Canadian patient Daniel Smith, a cystic fibrosis sufferer, and his doctors agreed that he needed a lung transplant. But his surgery was cancelled by administrators because an open hospital bed could not be found.
So much for medical decisions being left to patients and their doctors. [Back to Top]
Myth No. 6: Single-payer systems achieve better health outcomes.
Most single-payer advocates point to life expectancy and infant mortality as evidence that single-payer systems produce better health outcomes than the U.S. And, indeed, the U.S. has lower life expectancy and higher infant mortality than many nations with a single-payer system.
The problem is that life expectancy and infant mortality tell us very little about the quality of a health care system. Life expectancy is determined by a host of factors over which a health care system has little control, such as genetics, crime rate, gross domestic product per capita, diet, sanitation, and literacy rate.
The primary reason is that the U.S. has lower life expectancy is that we are ethnically a far more diverse nation than most other industrialized nations. Factors associated with different ethnic backgrounds -- culture, diet, etc. -- can have a substantial impact on life expectancy.
A good deal of the lower life expectancy rate in the U.S. is accounted for by the difference in life expectancy of African-Americans versus other populations in the United States. Life expectancy for African-Americans is about 72.3 years, while for whites it is about 77.7 years. What accounts for the difference? Numerous scholars have investigated this question. The most prevalent explanations are differences in income and personal risk factors. For example, one study found that about one-third of the difference between white and African-American life expectancies in the United States was accounted for by income; another third was accounted for by personal risk factors such as obesity, blood pressure, alcohol intake, diabetes, cholesterol concentration, and smoking and the final third was due to unexplained factors.
Infant mortality is also impacted by many of the same factors that affect life expectancy -- genetics, GDP per capita, diet, etc. -- all of which are factors beyond the control of a health care system. Another factor that makes U.S. infant mortality rates higher than other nations is that we have far more pregnant women living alone; in other nations pregnant women are more likely to be either be married or living with a partner. Pregnant women in such households are more likely to receive prenatal care than pregnant women living on their own.
Perhaps the biggest drawback of infant mortality is that it is measured too inconsistently across nations to be a useful measure. Under United Nations' guidelines, countries are supposed to count any infant showing any sign of life as a "live birth." While the United States follows that guideline, many other nations do not. For example, Switzerland does not count any infant born measuring less than 12 inches, while France and Belgium do not count any infant born prior to 26 weeks. In short, many other nations exclude many high-risk infants from their infant mortality statistics, making their infant mortality numbers look better than they really are.
In areas where a health care system does have an impact, such as treating disease, the U.S. outperforms single-payer systems. For example, the U.S. has a higher five-year survival rate for victims of heart attacks than Canada, due to the fact that we do more bypass surgeries and angioplasties in the U.S. Hospitals in the U.S. also commit fewer errors than hospitals in countries with single-payer systems like Australia, Canada, New Zealand, and the United Kingdom. [Back to Top]
Myth No. 7: The U.S. systems also engages in rationing - 18,000 people die each year due to lack of insurance.
According to PNHP, "Rationing in U.S. health care is based on income: if you can afford care you get it, if you can't, you don't. A recent study by the prestigious Institute of Medicine found that 18,000 Americans die every year because they don't have health insurance."
The Institute of Medicine study purporting to show that 18,000 people die each year due to a lack of health insurance is actually a "meta-analysis," a study that summarizes the results of other studies. Yet many of the studies the Institute relied on have some rather odd results. One study in the New England Journal of Medicine found that women with private insurance were more likely to survive breast cancer than those uninsured. However, data in the study also showed that those who were uninsured had a higher survival rate than women covered by Medicaid. This suggests that factors other than health insurance, like education and income, were at play in determining breast cancer survival.
Furthermore, everyone in the U.S. can get care regardless of income. In 1986 the U.S. Congress passed the Emergency Medical Treatment and Active Labor Act. This requires emergency rooms to treat any person who shows up seeking medical treatment, regardless of their ability to pay. [Back to Top]
Myth No. 8: A single-payer system will not hamper medical research.
The PNHP claims:
Medical research does not disappear under universal health care system. Many famous discoveries have been made in countries that have national health care systems. Laparoscopic gallbladder removal was pioneered in Canada. The CT scan was invented in England. The new treatment to cure juvenile diabetics by transplanting pancreatic cells was developed in Canada.
While it is true that medical research will not "disappear," it will surely decline. Consider what has happened to pharmaceutical research in single-payer systems, where the government imposes price controls on prescription drugs. A study (PDF) conducted by U.S. Commerce Department found that drug price controls in other nations reduced annual investment in pharmaceuticals by $5-8 billion, resulting in 3 to 4 fewer drugs being launched each year. The Boston Consulting Group found (PDF) an even bigger effect of price controls, showing a loss of $17-22 billion annually in pharmaceutical research resulting in the loss of 10 to 13 new drug launches.
In a free market, producers make a profit by providing services that consumers find useful. Profits also act as a signal to research - research dollars go toward services that make more profit. This is desirable because services that make more profit are the ones that consumers find most useful. Medical services that make profit -- i.e., the ones that patients find most useful -- will attract more research dollars.
In a single-payer system, government sets the prices for medical services. Since government is not good at setting prices, it inevitably over-pays for some services. Research dollars will go not necessarily toward the services that patients find most useful but toward the services that government over-pays since those will be the ones that will be most profitable. [Back to Top]
Myth No. 9: Single-payer will save money because patients will seek care earlier (since they will no longer face financial barriers to health care) when it is easier and more affordable to treat diseases.
This assumes that patients will be able to get access to health care easily in a single-payer system. But as nations with single-payer have shown, even the most basic health care, like routine doctors visits, are rationed. According to a report by Statistics Canada:
Despite the fact that most individuals had a regular family doctor, almost one in five individuals of those who required routine care experienced difficulties accessing care. The rates were significantly lower in Saskatchewan (12%), Alberta (13%) and British Columbia (12%), and significantly higher in Newfoundland and Labrador (20%) and Quebec (19%).
The top two barriers to receiving routine or on-going care were difficulties getting an appointment, and long waits for an appointment.
Overall, 16% of Canadians who had required health information or advice indicated that they had experienced difficulties accessing care. The rates were significantly lower in Saskatchewan (13%) and Alberta (13%), and significantly higher in Ontario (18%).
Seeking care earlier will make little difference if patients have trouble getting a routine appointment with a doctor. [Back to Top]
Myth No. 10: The free market in health care has failed in the U.S.
What has failed in the U.S. is government micromanagement of the health care system. Over the past 40 years government's role in the health care system has continually expanded, from programs like Medicare, Medicaid and SCHIP, to regulations like HIPPA and COBRA. Like most government interventions, it has only made the problem worse.
The fact is we do not have a free market in health care in the U.S. Ask yourself: How many markets in the U.S. do you get a tax break for buying a product, but only if you buy it through your employer, as we do with health insurance? In how many markets are you prohibited from purchasing a product out of state, as we are with health insurance? In how many markets are employers prohibited from providing bonuses to employees for improving quality and productivity, as hospitals are prevented from doing with doctors? If government policy inhibited other markets that way, those markets would be dysfunctional too.
The solution to our health care problems is to reduce the role of government, not increase it by switching to a single-payer system. [Back to Top]
The reason I asked how much premiums and co-pays were, is I was trying to equate if it would be anywhere near what the potion of taxes I pay that contributes to our healthcare. It's pretty tough to figure out exactly. But I do find it really awful that even after making monthly payments that you Americans still have to pay any amount when visiting the doctor.
I pay about $460 a month plus a $15 co-pay per visit for myself wife and son, my wifes apendix burst a few years back and she had to spend 1 night and 1 day in the hosiptal so they hit me with a $75 emerengcy room co-pay plus $360 for the over night stay at the Kaiser bed and breakfast, kaiser is a better deal then the 20/80 deal with most insurance companys so we actually saved a bunch of money,anyway hope that can give you some idea what cost is. (this insur. is thru my work) out side for 3 you can pay as much as $6 to $7oo a month.
Godfather.
That's absolutely criminal!! There is no way you get what you pay for. My best guess is that if I earn $60,000 a year, about $350-$400 a month of my taxes goes towards our healthcare. And I NEVER pay anything for doctors visits or overnight stays in the hospital...NEVER. The only thing I ever have to pay out of my own pocket is ambulance rides and prescription medications.
yea we get hosed for sure, if we had your deal in the states our government would dip into the medical fund and our tax's would increase every other year or so.
Godfather.
ever do your own research instead of regurgitating dubious links
I know what you mean about hockey skates and weird feet. I have those same odd bumps on the top of my feet. That shit is weird. But I guess it is what we get for jamming our feet into the smallest skates possible.
I skate sockless to get another half size down...
I don't know. It may have cost you a lot, it may not have depending on the state you live in. Mn has an emergency medical plan and most if not all of the hospitals offer huge discounts for people with use of a sliding fee scale based on income, dependents, etc...
But ultimately, this bill that was passed into law is a gold mine for the insurance companies. It will do nothing to help stem the rising premiums or the rising cost of healthcare in general. Too bad really, the dems had a chance to do something they have always wanted with a super majority in the senate and a majority in the house and couldn't get it done. The whole bill reeks of politicians trying to preserve their jobs.
it is funny, above I read comments that progressives aren't happy with it, then why did the senate and house approve it in the first place? Is it really that necessary? is it solving the main problem? Who knows how much it will cost in the end, but I think if you look at it objectively you almost have to come to the conclusion that it isn't a good piece of legislation...but then again, I am sure some will say my bias is showing.
It is terrifying when you are too stupid to know who is dumb
- Joe Rogan
when it comes to this type of issue, as is done here in this thread.
The US is three times as large in population... not counting the illegal immigrants
which surely have an effect on our healthcare system.
The US has more than three times as many on aid
that the government pays for their healthcare etc already.
The US has a much different position in the world arena also.
My opinion what works for Canada probably wouldn't for the US due to the sheer numbers
of those in need. The feasibility is not that of our northern neighbors.
No such easy answer for us as Canada enjoys, this a complex issue with corporations and money
the driving force.
I don't blame our President and won't blame future Presidents it's the basis of the
system we the people allow. Compromise must be met here on health as with all our issues
but when big money leads the way there is no compromise in my opinion.
when health care is done in the interests of public interest and not profiteering ... it's a different model altogether ...
great post Pandi !
Godfather.
I just said I was glad I didn't have to worry about stuff like this because I'm from Canada. I didn't offer any commentary on it, nor did I make any comparisons.... Of course, maybe if the billions and billions and billions and BILLIONS of tax dollars that go to paying for military actions and wars overseas that no one agrees with weren't getting spent, there would be plenty of money to put towards universal health care in America no matter what the population is. Plus, there are plenty of countries with larger populations that Canada's with systems where people don't go broke from being sick. The US is the only modern country where people can get rich directly from denying health care. Just sayin'.