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Thursday, April 06, 2006

One of These Things Just Doesn’t Belong (The Health Care Edition)

I’ve been thinking about health care recently because with the job change came the health care change came all the options and choices and paperwork that accompanies moving from one bureaucratic system into another. That started me thinking about the percentage of our economy that goes to fund health care expenditures (a percentage that is already higher than most other developed nations and promises to go even higher as the boomers retire and our government expands the social programs to fund old folks’ drug habits) and why our system truly is screwed up.

Consumers demand:

  1. Access to unlimited drug benefits.
  2. Easy access to (and availability of) the latest and most expensive technology.
  3. Portability.
  4. Choice.
  5. Expanding coverage.
  6. All of the above at little or no cost to themselves.

It is understandable that we would demand great health care with a trusted physician of our choosing and coverage for all the ailments at which you can shake a pointed stick. That all makes sense.

Demanding it all for a $5 co pay with no limits on services, though, is ridiculous. We consumers are demanding an awful lot without wanting to shoulder much of the burden for the attendant costs.

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Solution, please? hmmm

on Apr 06 2006 @ 10:32 AM

I’m workin’ on it, I’m workin’ on it…

(Predictably, any solution that I would suggest would have less gov’t funding, less gov’t regulation, and more personal responsibility and choice.)

on Apr 06 2006 @ 10:42 AM

What do you think this is, Masschusetts?

on Apr 06 2006 @ 11:16 AM

We need to add price signalling back into the system.  (That is, “What David said.") This inherently requires that we increase the pain (cost) of getting health care.  If there is no difference in consumer pain (in the form of cost, usually) associated with increased underlying costs, there is no incentive to signal that the prices have risen beyond reason.  If there is no price signalling, there is no real market.

TW: wrong.  I think not.

on Apr 06 2006 @ 12:16 PM

You know, David… You pretty much described the Medicare system in a nutshell. And we all know how well that works in the end.

on Apr 06 2006 @ 02:25 PM

I linked a quote from this in my Spectator column today. Link through if y’all get a chance.

on Apr 06 2006 @ 09:35 PM

Hey, Spectator readers, this here is a great blog and you should be reading it every day. And that also goes for the blogs over there on the right sidebar.

Especially the ones with hyphenated names that begin with “Y”. Not sure why that’s true, but it is.

on Apr 07 2006 @ 06:22 AM

I have not ever seen a $5.00 co-pay, maybe $15.00. I think Americans are willing to pay more. Medicaid is more closer than what you describe than Medicare. You do have a monthly premium with Medicare and they do some rationing. I know this from experience.
I just became aware of this site. http://www.citizenshealthcare.gov/
It is the Congress’and President’s Citizens’ Health Care Working Group Web site. It invites the public to participate. I don’t know if the public will really effect any changes in legilation.

on Apr 07 2006 @ 10:16 AM

I don’t think consumers necessarily demand easy access to the latest technology. Rather, industry and physicians push new technology because you can charge more for something new - the 3d ultrasound for babies, for instance, when a traditional ultrasound would do just fine. If it were put to consumers, I think they’d forego the latest cutting edge technology if something more traditional did the job. I don’t know that most consumers actually get any say in what new-fangled CAT Scan, MRI, etc. gets done.

Further, as others noted, I’m not sure I’ve ever met anyone who demanded all those things at a $5 co-pay with no limitations. Many consumers have already accepted HMOs and PPOs. I think what consumers would really like is some honest price structure that returns a reasonable profit to the health care providers while curbing ridiculous inflation in the industry.

on Apr 09 2006 @ 06:08 PM

Bryan, I’m going to do my best to have a proper response to your comment tomorrow evening. I think it requires something thoughtful and respectful in dissent.

on Apr 09 2006 @ 08:18 PM

That’s fair. I would also hope you’d add in that consumers (and their employers) pay *more* than the co-pay through their monthly premiums. Honestly, I think there’s a lot of truth in what you are saying. the actual costs of health care are hidden through a wide variety of means (by cost-shifting at hospitals, “write-offs” of huge bills through insurance, etc.) I think you’d find, though, that if the market for health care was actually healthy, it would cost a lot *less.* There’s every incentive in the current structure for people to gouge the system.

What you seem to want to do (I may be misreading this, btw) is shove all the responsibility off on those darned consumers who want all the latest whizbang medical gizmos at no cost. But I think that’s a very simplistic assumption when you have at least three huge industries (pharmaceuticals, medical professionals and insurance companies) making enormous profits off these consumer “demands.”

Why do people want the “little purple pill” or the ED medications or whatever latest drug? It’s an elemental statement of advertising - “create a need and fill it.”

I look forward to reading your response.

on Apr 09 2006 @ 08:37 PM

A little late to the party…

I pay a $100 a month towards my low-level health plan, my employer pays $220. My Co-pay is $30 per office visit. I have a $2000 deductable and a $500 prescription deductable. My copay on non-generic prescriptions is $50-$80 per prescription, per month. Co=pay at the emergency room is $1000.

I think I am kicking out plenty of cash (and so is my employer) to expect a little bit more. But the coverage is weak at best.

We sat at home one night and did the math...for my partner, it would be cheaper to forego employer’s health inusrance, if this year’s health issues are anything like the last ten years, and pay straight cash for the few visits a year that he sees the doctor. But try getting a doctor to see you sans insurance! Now, MA requires everyone to have it, even.

It’s all screwed up, and consumers have a right to feel fried about it.

on Apr 12 2006 @ 10:22 AM
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