Wednesday, June 30, 2004
CDC report reveals lowest level of uninsured children since 1997
[Daniel Yee, "CDC: Uninsured Children Hits Lowest Level," Associated Press, New York Newsday, 30 June 2004.]
Expanded Medicaid coverage has led to a significant decline in the number of uninsured children since 1997:
Only 10.1 percent of U.S. children were uninsured last year, the lowest level ever recorded by the Centers for Disease Control and Prevention. In 1997, 13.9 percent were not covered by health insurance.
"We were surprised how dramatic the drop was in children," said Robin Cohen, CDC health statistician.
Around 2.6 million more children were insured last year than in 1997, the CDC said.
The increase was attributed to expanded state health insurance programs.
The CDC said the percentage of Americans overall without health insurance remained steady at 15 percent between 1997 and 2003.
But the percentage of working-age adults without coverage increased, from 18.9 percent in 1997 to 20.1 percent in 2003, the CDC said.
It is interesting to note how well HSAs and mandate-free policies might fit this population:
Most of the country's uninsured are single adults who work for companies too small to offer health insurance, said Kenneth Thorpe, chairman of Emory University's department of health policy and management.
"It's just unaffordable for most low- and moderate-income workers," Thorpe said. "That's the area where we haven't done anywhere near as well on the covered side."
[Daniel Yee, "CDC: Uninsured Children Hits Lowest Level," Associated Press, New York Newsday, 30 June 2004.]
Expanded Medicaid coverage has led to a significant decline in the number of uninsured children since 1997:
Only 10.1 percent of U.S. children were uninsured last year, the lowest level ever recorded by the Centers for Disease Control and Prevention. In 1997, 13.9 percent were not covered by health insurance.
"We were surprised how dramatic the drop was in children," said Robin Cohen, CDC health statistician.
Around 2.6 million more children were insured last year than in 1997, the CDC said.
The increase was attributed to expanded state health insurance programs.
The CDC said the percentage of Americans overall without health insurance remained steady at 15 percent between 1997 and 2003.
But the percentage of working-age adults without coverage increased, from 18.9 percent in 1997 to 20.1 percent in 2003, the CDC said.
It is interesting to note how well HSAs and mandate-free policies might fit this population:
Most of the country's uninsured are single adults who work for companies too small to offer health insurance, said Kenneth Thorpe, chairman of Emory University's department of health policy and management.
"It's just unaffordable for most low- and moderate-income workers," Thorpe said. "That's the area where we haven't done anywhere near as well on the covered side."
Monday, June 28, 2004
HSAs put consumers in control
[Julius A. Karash, "'I'm in control'," The Kansas City Star, 27 June 2004.]
This recent article from the Kansas City Star provides an excellent example of the potential benefits of Health Savings Accounts:
Michael J. Searcy, a fit 49-year-old, rarely needs health care beyond routine medical exams.
So it was highly unusual when Searcy, the head of an Overland Park financial services firm, drove himself to the St. Luke's South emergency room on a recent afternoon.
“I was doubled over,” Searcy recalled. “It was excruciating.”
The source of the agony was a kidney stone. Yet while Searcy's pain was searing, he didn't agonize over the emergency room bill. He felt confident that his needs would be covered by his high-deductible health insurance policy that's coupled with a new health savings account.
Health savings accounts represent the latest twist in what are known as consumer-driven health plans. As you might surmise, these plans are designed to save employers money and give employees incentives to control their health care spending.
Searcy wouldn't disclose exactly how much money he has in his account.
“It's enough to buy a modestly priced new car,” he said.
The money he puts in his account is tax-deductible. He pays no taxes on the accumulated savings or on money he takes out to pay for medical expenses. He can draw money from the account if he needs to or simply let it pile up.
“That's the beauty of this thing,” Searcy said. “If I want to dip into it, I can dip into it. If I want to write a check for part of it, I can. I'm in control.”
The problem arises when speculation begins about how the plans will only appeal to the "healthy and wealthy":
Randy McConnell, a spokesman for the Missouri Department of Insurance, said the department warns consumers to be wary.
He said health savings accounts are being pushed as a way to shift more health care costs to employees. He said the accounts “may be extremely good for someone who is a healthy young person and plans to remain that way. However, if you're in an accident or have a chronic illness that requires extensive medication, you will every year have to pay an extensive amount of money out of your own pocket.”
The reality is that HSAs can have great appeal to those who are less well-off and looking for a more cost-conscious alternative to traditional coverage. Depending on the structure of the HSA and high-deductible insurance plan, even those with ongoing illnesses can end up exposed to less out-of-pocket risk, while at the same time having greater control over their doctors and treatments.
[Julius A. Karash, "'I'm in control'," The Kansas City Star, 27 June 2004.]
This recent article from the Kansas City Star provides an excellent example of the potential benefits of Health Savings Accounts:
Michael J. Searcy, a fit 49-year-old, rarely needs health care beyond routine medical exams.
So it was highly unusual when Searcy, the head of an Overland Park financial services firm, drove himself to the St. Luke's South emergency room on a recent afternoon.
“I was doubled over,” Searcy recalled. “It was excruciating.”
The source of the agony was a kidney stone. Yet while Searcy's pain was searing, he didn't agonize over the emergency room bill. He felt confident that his needs would be covered by his high-deductible health insurance policy that's coupled with a new health savings account.
Health savings accounts represent the latest twist in what are known as consumer-driven health plans. As you might surmise, these plans are designed to save employers money and give employees incentives to control their health care spending.
Searcy wouldn't disclose exactly how much money he has in his account.
“It's enough to buy a modestly priced new car,” he said.
The money he puts in his account is tax-deductible. He pays no taxes on the accumulated savings or on money he takes out to pay for medical expenses. He can draw money from the account if he needs to or simply let it pile up.
“That's the beauty of this thing,” Searcy said. “If I want to dip into it, I can dip into it. If I want to write a check for part of it, I can. I'm in control.”
The problem arises when speculation begins about how the plans will only appeal to the "healthy and wealthy":
Randy McConnell, a spokesman for the Missouri Department of Insurance, said the department warns consumers to be wary.
He said health savings accounts are being pushed as a way to shift more health care costs to employees. He said the accounts “may be extremely good for someone who is a healthy young person and plans to remain that way. However, if you're in an accident or have a chronic illness that requires extensive medication, you will every year have to pay an extensive amount of money out of your own pocket.”
The reality is that HSAs can have great appeal to those who are less well-off and looking for a more cost-conscious alternative to traditional coverage. Depending on the structure of the HSA and high-deductible insurance plan, even those with ongoing illnesses can end up exposed to less out-of-pocket risk, while at the same time having greater control over their doctors and treatments.
Friday, June 25, 2004
Evidence of consumer driven health care success
["Whole Foods' Patient Power Health Plan," NCPA Daily Policy Digest, 25 June 2004.]
Here is a good real-life example of how people respond to the incentives of health savings accounts:
Whole Foods, the 159-store grocery chain, last year adopted a health plan that encourages its 30,000 or so workers to feel a bit of the pain every time a doctor sends out a bill. The new "consumer driven" medical coverage gives employees more of a financial stake in what they pay for medical care in hopes of slowing the growth in medical costs, say observers.
Key features of Whole Foods' "consumer driven" health-care plan:
- After a few months on the job, individual workers get free coverage; for workers with families, free coverage starts after about five years.
- There is a $500 for prescriptions and $1,000 for all other medical costs.
- However, Whole Foods contributes $300 to $1,800 per year, depending on an employee's length of employment, to help meet the deductible.
- Overall medical claims fell 13 percent in the first year and about 90 percent of employees had money left over to use next year.
The Whole Foods plan, which workers themselves chose over two competing plans after a series of votes last summer, has no premiums at all for many workers. But the deductible is a relatively hefty $1,500. Whole Foods each year puts money into an account for each worker to use for health-care expenses. If employees don't spend their money in one year, they get to carry it over to future years. After the deductible is reached, the plan operates more like a traditional one, picking up 80 percent of most medical expenses.
The hope is that once the money feels as though it belongs to them, people won't get an MRI when an X-ray (or an ice pack) might do.
["Whole Foods' Patient Power Health Plan," NCPA Daily Policy Digest, 25 June 2004.]
Here is a good real-life example of how people respond to the incentives of health savings accounts:
Whole Foods, the 159-store grocery chain, last year adopted a health plan that encourages its 30,000 or so workers to feel a bit of the pain every time a doctor sends out a bill. The new "consumer driven" medical coverage gives employees more of a financial stake in what they pay for medical care in hopes of slowing the growth in medical costs, say observers.
Key features of Whole Foods' "consumer driven" health-care plan:
- After a few months on the job, individual workers get free coverage; for workers with families, free coverage starts after about five years.
- There is a $500 for prescriptions and $1,000 for all other medical costs.
- However, Whole Foods contributes $300 to $1,800 per year, depending on an employee's length of employment, to help meet the deductible.
- Overall medical claims fell 13 percent in the first year and about 90 percent of employees had money left over to use next year.
The Whole Foods plan, which workers themselves chose over two competing plans after a series of votes last summer, has no premiums at all for many workers. But the deductible is a relatively hefty $1,500. Whole Foods each year puts money into an account for each worker to use for health-care expenses. If employees don't spend their money in one year, they get to carry it over to future years. After the deductible is reached, the plan operates more like a traditional one, picking up 80 percent of most medical expenses.
The hope is that once the money feels as though it belongs to them, people won't get an MRI when an X-ray (or an ice pack) might do.
Tuesday, June 22, 2004
Addressing the root causes of the uninsured
[Kristen Gerencher, "Middle class more vulnerable to care coverage lapses," Investor's Business Daily, 16 June 2004.]
Cato's Michael Cannon takes the position that the uninsured are a problem created by government intervention in this recent piece:
The uninsured problem is a result of the economic downturn and a government that has "fenced in" the health care system, allowing Americans to consider medical coverage an entitlement rather than a responsibility, argued Michael Cannon, director of health policy studies for the Cato Institute, a libertarian, free-market think tank.
"This survey indicates the failure of government intervention into the health care sector, rather than highlighting the need for more government involvement," Cannon claimed. "It highlights the opposite of what its authors want it to say."
For Cannon, health savings accounts are the most promising antidote to the uninsured. New this year, HSAs are meant to encourage employers who don't offer medical benefits to provide low-cost, high-deductible coverage.
Workers with a health plan that has an individual deductible of at least $1,000 a year or a family deductible of $2,000 could set aside that amount. The limit rises to $2,600 or $5,150 a year, respectively, if their deductibles are higher.
"As health savings accounts catch on, more and more people will start making more prudent decisions with their health care dollars," Cannon said, "and that will hold down health inflation, making insurance more affordable."
[Kristen Gerencher, "Middle class more vulnerable to care coverage lapses," Investor's Business Daily, 16 June 2004.]
Cato's Michael Cannon takes the position that the uninsured are a problem created by government intervention in this recent piece:
The uninsured problem is a result of the economic downturn and a government that has "fenced in" the health care system, allowing Americans to consider medical coverage an entitlement rather than a responsibility, argued Michael Cannon, director of health policy studies for the Cato Institute, a libertarian, free-market think tank.
"This survey indicates the failure of government intervention into the health care sector, rather than highlighting the need for more government involvement," Cannon claimed. "It highlights the opposite of what its authors want it to say."
For Cannon, health savings accounts are the most promising antidote to the uninsured. New this year, HSAs are meant to encourage employers who don't offer medical benefits to provide low-cost, high-deductible coverage.
Workers with a health plan that has an individual deductible of at least $1,000 a year or a family deductible of $2,000 could set aside that amount. The limit rises to $2,600 or $5,150 a year, respectively, if their deductibles are higher.
"As health savings accounts catch on, more and more people will start making more prudent decisions with their health care dollars," Cannon said, "and that will hold down health inflation, making insurance more affordable."
European waiting lists follow-up
["Patients face painful waiting lists," The Copenhagen Post, 18 June 2004.]
Here's another example of the often ignored costs of socialized health care, this time from Denmark:
Danish women concerned about suspicious breast lumps are often forced to wait weeks for a scan to determine whether or not they have cancer. And patients already diagnosed with cancer are waiting longer than recommended for potentially life-saving radiation treatments.
Daily newspaper Berlingske Tidende reported last week that an increase in patient volume has led to a backlog for two procedures central to cancer treatment and prevention - mammography and radiation treatment. The trend has led to calls for additional funding for cancer treatment, to increase capacity and maintain Parliament's treatment guarantees for public hospitals.
'It's very aggravating for patients to have to wait so long for an answer as to whether or not they have cancer. Waiting lists have got worse - we need a permanent expansion in capacity,' said Dr. Ilse Vejborg of Rigshospitalet's so-called mammo-radiological unit.
Dr. Vejborg's department currently has a 29-day delay for mammograms for women with palpable breast lumps, or other medically substantiated symptoms of breast cancer. Under Parliament's mandatory treatment guarantee, patients may wait no longer than two weeks.
The capital city's other major cancer treatment facility, Herlev Hospital, has a waiting list for mammograms of four to five weeks, and new figures indicate that the waiting list for radiation treatment has now reached five weeks.
["Patients face painful waiting lists," The Copenhagen Post, 18 June 2004.]
Here's another example of the often ignored costs of socialized health care, this time from Denmark:
Danish women concerned about suspicious breast lumps are often forced to wait weeks for a scan to determine whether or not they have cancer. And patients already diagnosed with cancer are waiting longer than recommended for potentially life-saving radiation treatments.
Daily newspaper Berlingske Tidende reported last week that an increase in patient volume has led to a backlog for two procedures central to cancer treatment and prevention - mammography and radiation treatment. The trend has led to calls for additional funding for cancer treatment, to increase capacity and maintain Parliament's treatment guarantees for public hospitals.
'It's very aggravating for patients to have to wait so long for an answer as to whether or not they have cancer. Waiting lists have got worse - we need a permanent expansion in capacity,' said Dr. Ilse Vejborg of Rigshospitalet's so-called mammo-radiological unit.
Dr. Vejborg's department currently has a 29-day delay for mammograms for women with palpable breast lumps, or other medically substantiated symptoms of breast cancer. Under Parliament's mandatory treatment guarantee, patients may wait no longer than two weeks.
The capital city's other major cancer treatment facility, Herlev Hospital, has a waiting list for mammograms of four to five weeks, and new figures indicate that the waiting list for radiation treatment has now reached five weeks.
Uninsured realities
[Phillip Brownlee, "At risk," The Wichita Eagle, 22 June 2004.]
One of today's editorials in the Eagle focuses on the crisis of the uninsured. This deserves two comments.
First, it is important to understand just who comprises the uninsured. As we have shown, the number of uninsured includes many who are able to afford insurance but choose not to nonetheless. Indeed, those at the upper end of the income scale have seen the largest increase in uninsured rates in recent years while those at the lower end have actually been on the decline.
Second, while it is often asserted that additional government assistance is needed to address the problem, it may actually be the case that less would be an improvement. State mandates for coverage increase the cost of insurance and thereby reduce affordability.
The Kansas Legislature passed the Business Health Partnership Act in 2000, and endorsed a non-profit agency to work on increasing insurance affordability. While the Kansas Health Partners Benefit Association has the authority to waive certain mandates, it does currently offer a low-cost insurance option that includes all state mandates.
With further efforts in this area and with the introduction of Health Savings Accounts, the uninsured need not be a crisis issue in Kansas.
[Matthew Hisrich, "Greatest increase in uninsured found among wealthy," The Flint Hills Center, 10 May 2004.]
[Phillip Brownlee, "At risk," The Wichita Eagle, 22 June 2004.]
One of today's editorials in the Eagle focuses on the crisis of the uninsured. This deserves two comments.
First, it is important to understand just who comprises the uninsured. As we have shown, the number of uninsured includes many who are able to afford insurance but choose not to nonetheless. Indeed, those at the upper end of the income scale have seen the largest increase in uninsured rates in recent years while those at the lower end have actually been on the decline.
Second, while it is often asserted that additional government assistance is needed to address the problem, it may actually be the case that less would be an improvement. State mandates for coverage increase the cost of insurance and thereby reduce affordability.
The Kansas Legislature passed the Business Health Partnership Act in 2000, and endorsed a non-profit agency to work on increasing insurance affordability. While the Kansas Health Partners Benefit Association has the authority to waive certain mandates, it does currently offer a low-cost insurance option that includes all state mandates.
With further efforts in this area and with the introduction of Health Savings Accounts, the uninsured need not be a crisis issue in Kansas.
[Matthew Hisrich, "Greatest increase in uninsured found among wealthy," The Flint Hills Center, 10 May 2004.]
Monday, June 21, 2004
Off the books health care costs
[Waldemar Ingdahl, "His Hip, Hooray!," Tech Central Station, 4 June 2004.]
Doing something and doing it well -- or in a timely manner -- can lead to very different outcomes. This is one of the basic issues that proponents of universal health care fail to acknowledge. It also creeps up as a problem in current health care delivery in progroms such as Medicaid where rich benefit packages do not square with the reality of what is available.
For instance, Medicaid reimbursement rates are set artificially low. Doctors and nursing homes still agree to work with these rates, but there is a cost. This cost can come in terms of the quality of care provided or in the form of rationing or waiting lists. In other words, there is no such thing as a free lunch.
Stories of waiting lines in countries with socialized medicine illustrate this point well. Here's a recent example from Sweden:
Sweden's prime minister, Göran Persson . . . . was diagnosed to need an urgent operation for his arthrosis in the hip [last year]. Persson has obviously been in great pain, walking with a limp, and he has reportedly been using strong painkillers.
Now, after waiting for more than eight months he finally received his operation yesterday (June 3rd).
Persson shares his hip troubles with many others of his age, but in Sweden a hip replacement is a very complicated affair, even if you are the prime minister.
Sweden's "egalitarian" health care system features the same serious problem as all other centrally planned systems: shortages, due to a culture of rationing. For an operation like hip replacement, a procedure that typically takes less than two hours, there is a waiting list ranging from a minimum of seven months to more than two years. More than 5,000 Swedes are estimated to be waiting in line for this procedure alone (not counting those that still have to get an examination from a doctor, and a diagnosis).
The problems of the Swedish health care system are well known in the country, and the fabled image of the welfare state, with the government providing for everything from cradle to grave, is gone. Or rather, we still pay the same high amount of taxes but we do not get the same amount of government services for them.
In public health care you pay for a queue line ticket, in private health care you pay for health care. All citizens have to pay taxes for the public health care (about 50-60 percent of your wage), and most cannot afford to pay again to get health care privately.
When the centre-right parties discuss reforms of the public health care system they always confine themselves to what appears today as politically possible. Those who concern themselves exclusively with what seems do-able in the existing state of opinion always find that even this becomes politically impossible as the result of changes in a public mood which they have done nothing to guide.
A truly radical alternative, contrasting to the old industrialist health care system, could inspire people to change. It would have to consider the introduction of new technologies and changes in people's preferences, towards less curative health care and towards more palliative health care. But it would also include dynamism and decentralization, putting the patient in the position to decide on his or her own health.
Until we see such a political alternative offered, we will have to wait in line for health care, just like Göran Persson. Or buy it abroad.
[See Brian Lee Crowley, "The Top Ten Things People Believe About Canadian Health Care, But Shouldn’t."]
Thanks to Benjamin Pratt for this story.
[Waldemar Ingdahl, "His Hip, Hooray!," Tech Central Station, 4 June 2004.]
Doing something and doing it well -- or in a timely manner -- can lead to very different outcomes. This is one of the basic issues that proponents of universal health care fail to acknowledge. It also creeps up as a problem in current health care delivery in progroms such as Medicaid where rich benefit packages do not square with the reality of what is available.
For instance, Medicaid reimbursement rates are set artificially low. Doctors and nursing homes still agree to work with these rates, but there is a cost. This cost can come in terms of the quality of care provided or in the form of rationing or waiting lists. In other words, there is no such thing as a free lunch.
Stories of waiting lines in countries with socialized medicine illustrate this point well. Here's a recent example from Sweden:
Sweden's prime minister, Göran Persson . . . . was diagnosed to need an urgent operation for his arthrosis in the hip [last year]. Persson has obviously been in great pain, walking with a limp, and he has reportedly been using strong painkillers.
Now, after waiting for more than eight months he finally received his operation yesterday (June 3rd).
Persson shares his hip troubles with many others of his age, but in Sweden a hip replacement is a very complicated affair, even if you are the prime minister.
Sweden's "egalitarian" health care system features the same serious problem as all other centrally planned systems: shortages, due to a culture of rationing. For an operation like hip replacement, a procedure that typically takes less than two hours, there is a waiting list ranging from a minimum of seven months to more than two years. More than 5,000 Swedes are estimated to be waiting in line for this procedure alone (not counting those that still have to get an examination from a doctor, and a diagnosis).
The problems of the Swedish health care system are well known in the country, and the fabled image of the welfare state, with the government providing for everything from cradle to grave, is gone. Or rather, we still pay the same high amount of taxes but we do not get the same amount of government services for them.
In public health care you pay for a queue line ticket, in private health care you pay for health care. All citizens have to pay taxes for the public health care (about 50-60 percent of your wage), and most cannot afford to pay again to get health care privately.
When the centre-right parties discuss reforms of the public health care system they always confine themselves to what appears today as politically possible. Those who concern themselves exclusively with what seems do-able in the existing state of opinion always find that even this becomes politically impossible as the result of changes in a public mood which they have done nothing to guide.
A truly radical alternative, contrasting to the old industrialist health care system, could inspire people to change. It would have to consider the introduction of new technologies and changes in people's preferences, towards less curative health care and towards more palliative health care. But it would also include dynamism and decentralization, putting the patient in the position to decide on his or her own health.
Until we see such a political alternative offered, we will have to wait in line for health care, just like Göran Persson. Or buy it abroad.
[See Brian Lee Crowley, "The Top Ten Things People Believe About Canadian Health Care, But Shouldn’t."]
Thanks to Benjamin Pratt for this story.
Off the books health care costs
[Waldemar Ingdahl, "His Hip, Hooray!," Tech Central Station, 4 June 2004.]
Doing something and doing it well -- or in a timely manner -- can lead to very different outcomes. This is one of the basic issues that proponents of universal health care fail to acknowledge. It also creeps up as a problem in current health care delivery in progroms such as Medicaid where rich benefit packages do not square with the reality of what is available.
For instance, Medicaid reimbursement rates are set artificially low. Doctors and nursing homes still agree to work with these rates, but there is a cost. This cost can come in terms of the quality of care provided or in the form of rationing or waiting lists. In other words, there is no such thing as a free lunch.
Stories of waiting lines in countries with socialized medicine illustrate this point well. Here's a recent example from Sweden:
Sweden's prime minister, Göran Persson . . . . was diagnosed to need an urgent operation for his arthrosis in the hip [last year]. Persson has obviously been in great pain, walking with a limp, and he has reportedly been using strong painkillers.
Now, after waiting for more than eight months he finally received his operation yesterday (June 3rd).
Persson shares his hip troubles with many others of his age, but in Sweden a hip replacement is a very complicated affair, even if you are the prime minister.
Sweden's "egalitarian" health care system features the same serious problem as all other centrally planned systems: shortages, due to a culture of rationing. For an operation like hip replacement, a procedure that typically takes less than two hours, there is a waiting list ranging from a minimum of seven months to more than two years. More than 5,000 Swedes are estimated to be waiting in line for this procedure alone (not counting those that still have to get an examination from a doctor, and a diagnosis).
The problems of the Swedish health care system are well known in the country, and the fabled image of the welfare state, with the government providing for everything from cradle to grave, is gone. Or rather, we still pay the same high amount of taxes but we do not get the same amount of government services for them.
In public health care you pay for a queue line ticket, in private health care you pay for health care. All citizens have to pay taxes for the public health care (about 50-60 percent of your wage), and most cannot afford to pay again to get health care privately.
When the centre-right parties discuss reforms of the public health care system they always confine themselves to what appears today as politically possible. Those who concern themselves exclusively with what seems do-able in the existing state of opinion always find that even this becomes politically impossible as the result of changes in a public mood which they have done nothing to guide.
A truly radical alternative, contrasting to the old industrialist health care system, could inspire people to change. It would have to consider the introduction of new technologies and changes in people's preferences, towards less curative health care and towards more palliative health care. But it would also include dynamism and decentralization, putting the patient in the position to decide on his or her own health.
Until we see such a political alternative offered, we will have to wait in line for health care, just like Göran Persson. Or buy it abroad.
[See Brian Lee Crowley, "The Top Ten Things People Believe About Canadian Health Care, But Shouldn’t."]
Thanks to Benjamin Pratt for this story.
[Waldemar Ingdahl, "His Hip, Hooray!," Tech Central Station, 4 June 2004.]
Doing something and doing it well -- or in a timely manner -- can lead to very different outcomes. This is one of the basic issues that proponents of universal health care fail to acknowledge. It also creeps up as a problem in current health care delivery in progroms such as Medicaid where rich benefit packages do not square with the reality of what is available.
For instance, Medicaid reimbursement rates are set artificially low. Doctors and nursing homes still agree to work with these rates, but there is a cost. This cost can come in terms of the quality of care provided or in the form of rationing or waiting lists. In other words, there is no such thing as a free lunch.
Stories of waiting lines in countries with socialized medicine illustrate this point well. Here's a recent example from Sweden:
Sweden's prime minister, Göran Persson . . . . was diagnosed to need an urgent operation for his arthrosis in the hip [last year]. Persson has obviously been in great pain, walking with a limp, and he has reportedly been using strong painkillers.
Now, after waiting for more than eight months he finally received his operation yesterday (June 3rd).
Persson shares his hip troubles with many others of his age, but in Sweden a hip replacement is a very complicated affair, even if you are the prime minister.
Sweden's "egalitarian" health care system features the same serious problem as all other centrally planned systems: shortages, due to a culture of rationing. For an operation like hip replacement, a procedure that typically takes less than two hours, there is a waiting list ranging from a minimum of seven months to more than two years. More than 5,000 Swedes are estimated to be waiting in line for this procedure alone (not counting those that still have to get an examination from a doctor, and a diagnosis).
The problems of the Swedish health care system are well known in the country, and the fabled image of the welfare state, with the government providing for everything from cradle to grave, is gone. Or rather, we still pay the same high amount of taxes but we do not get the same amount of government services for them.
In public health care you pay for a queue line ticket, in private health care you pay for health care. All citizens have to pay taxes for the public health care (about 50-60 percent of your wage), and most cannot afford to pay again to get health care privately.
When the centre-right parties discuss reforms of the public health care system they always confine themselves to what appears today as politically possible. Those who concern themselves exclusively with what seems do-able in the existing state of opinion always find that even this becomes politically impossible as the result of changes in a public mood which they have done nothing to guide.
A truly radical alternative, contrasting to the old industrialist health care system, could inspire people to change. It would have to consider the introduction of new technologies and changes in people's preferences, towards less curative health care and towards more palliative health care. But it would also include dynamism and decentralization, putting the patient in the position to decide on his or her own health.
Until we see such a political alternative offered, we will have to wait in line for health care, just like Göran Persson. Or buy it abroad.
[See Brian Lee Crowley, "The Top Ten Things People Believe About Canadian Health Care, But Shouldn’t."]
Thanks to Benjamin Pratt for this story.
Off the books health care costs
[Waldemar Ingdahl, "His Hip, Hooray!," Tech Central Station, 4 June 2004.]
Doing something and doing it well -- or in a timely manner -- can lead to very different outcomes. This is one of the basic issues that proponents of universal health care fail to acknowledge. It also creeps up as a problem in current health care delivery in progroms such as Medicaid where rich benefit packages do not square with the reality of what is available.
For instance, Medicaid reimbursement rates are set artificially low. Doctors and nursing homes still agree to work with these rates, but there is a cost. This cost can come in terms of the quality of care provided or in the form of rationing or waiting lists. In other words, there is no such thing as a free lunch.
Stories of waiting lines in countries with socialized medicine illustrate this point well. Here's a recent example from Sweden:
Sweden's prime minister, Göran Persson . . . . was diagnosed to need an urgent operation for his arthrosis in the hip [last year]. Persson has obviously been in great pain, walking with a limp, and he has reportedly been using strong painkillers.
Now, after waiting for more than eight months he finally received his operation yesterday (June 3rd).
Persson shares his hip troubles with many others of his age, but in Sweden a hip replacement is a very complicated affair, even if you are the prime minister.
Sweden's "egalitarian" health care system features the same serious problem as all other centrally planned systems: shortages, due to a culture of rationing. For an operation like hip replacement, a procedure that typically takes less than two hours, there is a waiting list ranging from a minimum of seven months to more than two years. More than 5,000 Swedes are estimated to be waiting in line for this procedure alone (not counting those that still have to get an examination from a doctor, and a diagnosis).
The problems of the Swedish health care system are well known in the country, and the fabled image of the welfare state, with the government providing for everything from cradle to grave, is gone. Or rather, we still pay the same high amount of taxes but we do not get the same amount of government services for them.
In public health care you pay for a queue line ticket, in private health care you pay for health care. All citizens have to pay taxes for the public health care (about 50-60 percent of your wage), and most cannot afford to pay again to get health care privately.
When the centre-right parties discuss reforms of the public health care system they always confine themselves to what appears today as politically possible. Those who concern themselves exclusively with what seems do-able in the existing state of opinion always find that even this becomes politically impossible as the result of changes in a public mood which they have done nothing to guide.
A truly radical alternative, contrasting to the old industrialist health care system, could inspire people to change. It would have to consider the introduction of new technologies and changes in people's preferences, towards less curative health care and towards more palliative health care. But it would also include dynamism and decentralization, putting the patient in the position to decide on his or her own health.
Until we see such a political alternative offered, we will have to wait in line for health care, just like Göran Persson. Or buy it abroad.
[See Brian Lee Crowley, "The Top Ten Things People Believe About Canadian Health Care, But Shouldn’t."]
Thanks to Benjamin Pratt for this story.
[Waldemar Ingdahl, "His Hip, Hooray!," Tech Central Station, 4 June 2004.]
Doing something and doing it well -- or in a timely manner -- can lead to very different outcomes. This is one of the basic issues that proponents of universal health care fail to acknowledge. It also creeps up as a problem in current health care delivery in progroms such as Medicaid where rich benefit packages do not square with the reality of what is available.
For instance, Medicaid reimbursement rates are set artificially low. Doctors and nursing homes still agree to work with these rates, but there is a cost. This cost can come in terms of the quality of care provided or in the form of rationing or waiting lists. In other words, there is no such thing as a free lunch.
Stories of waiting lines in countries with socialized medicine illustrate this point well. Here's a recent example from Sweden:
Sweden's prime minister, Göran Persson . . . . was diagnosed to need an urgent operation for his arthrosis in the hip [last year]. Persson has obviously been in great pain, walking with a limp, and he has reportedly been using strong painkillers.
Now, after waiting for more than eight months he finally received his operation yesterday (June 3rd).
Persson shares his hip troubles with many others of his age, but in Sweden a hip replacement is a very complicated affair, even if you are the prime minister.
Sweden's "egalitarian" health care system features the same serious problem as all other centrally planned systems: shortages, due to a culture of rationing. For an operation like hip replacement, a procedure that typically takes less than two hours, there is a waiting list ranging from a minimum of seven months to more than two years. More than 5,000 Swedes are estimated to be waiting in line for this procedure alone (not counting those that still have to get an examination from a doctor, and a diagnosis).
The problems of the Swedish health care system are well known in the country, and the fabled image of the welfare state, with the government providing for everything from cradle to grave, is gone. Or rather, we still pay the same high amount of taxes but we do not get the same amount of government services for them.
In public health care you pay for a queue line ticket, in private health care you pay for health care. All citizens have to pay taxes for the public health care (about 50-60 percent of your wage), and most cannot afford to pay again to get health care privately.
When the centre-right parties discuss reforms of the public health care system they always confine themselves to what appears today as politically possible. Those who concern themselves exclusively with what seems do-able in the existing state of opinion always find that even this becomes politically impossible as the result of changes in a public mood which they have done nothing to guide.
A truly radical alternative, contrasting to the old industrialist health care system, could inspire people to change. It would have to consider the introduction of new technologies and changes in people's preferences, towards less curative health care and towards more palliative health care. But it would also include dynamism and decentralization, putting the patient in the position to decide on his or her own health.
Until we see such a political alternative offered, we will have to wait in line for health care, just like Göran Persson. Or buy it abroad.
[See Brian Lee Crowley, "The Top Ten Things People Believe About Canadian Health Care, But Shouldn’t."]
Thanks to Benjamin Pratt for this story.
Friday, June 18, 2004
Charting a course toward cash for care
[Greg Scandlen, "Doctors And Patients Benefit When Insurers Are Bypassed," Health Care News, The Heartland Institute, 1 June 2004.]
In recent posts to this site, Flint Hills has reported on the growing trend of cash-basis health care. In this column, Greg Scandlen of The Galen Institute offers points physicians in the direction of resources on how to make the transition:
The magazine Medical Economics picks up on the fee-for-service trend in an article headlined, "No Coding, No Insurers--No Kidding." Senior Editor Robert Lowes writes, "It might be time to consider a cash-only practice. Your income may drop, but your overhead will decrease and your job satisfaction could soar."
The Nirvana is described as "No more arguing with insurance clerks about denied claims. No more fears of a Medicare audit." The article cites Dr. Rick Baxley of Orlando, who dropped all insurance contracts in 2000 and reports, "I earn roughly what I did back then, but I'm not working from 6 a.m. to 9 p.m. anymore. And I'm building relationships with patients, which is why I entered medicine in the first place."
Bethesda, Maryland internists Jane Chretien and Audrey Corson say they "have extended the length of the average visit from 8 minutes to about 25 minutes." They maintain, "When visits are longer, you get to know your patients. You can put their complaints in a bigger context."
Dr. Vern Cherewatenko, originator of the SimpleCare concept, is quoted as saying "a cash-only soloist probably can operate with just a receptionist and a medical assistant."
The article provides some advice for physicians thinking about moving in this direction: Cut ties with insurance companies gradually, starting with the worst payers; drop Medicare last, especially if you have a large number of patients on Medicare; and "be prepared to scramble initially to make ends meet."
[Greg Scandlen, "Doctors And Patients Benefit When Insurers Are Bypassed," Health Care News, The Heartland Institute, 1 June 2004.]
In recent posts to this site, Flint Hills has reported on the growing trend of cash-basis health care. In this column, Greg Scandlen of The Galen Institute offers points physicians in the direction of resources on how to make the transition:
The magazine Medical Economics picks up on the fee-for-service trend in an article headlined, "No Coding, No Insurers--No Kidding." Senior Editor Robert Lowes writes, "It might be time to consider a cash-only practice. Your income may drop, but your overhead will decrease and your job satisfaction could soar."
The Nirvana is described as "No more arguing with insurance clerks about denied claims. No more fears of a Medicare audit." The article cites Dr. Rick Baxley of Orlando, who dropped all insurance contracts in 2000 and reports, "I earn roughly what I did back then, but I'm not working from 6 a.m. to 9 p.m. anymore. And I'm building relationships with patients, which is why I entered medicine in the first place."
Bethesda, Maryland internists Jane Chretien and Audrey Corson say they "have extended the length of the average visit from 8 minutes to about 25 minutes." They maintain, "When visits are longer, you get to know your patients. You can put their complaints in a bigger context."
Dr. Vern Cherewatenko, originator of the SimpleCare concept, is quoted as saying "a cash-only soloist probably can operate with just a receptionist and a medical assistant."
The article provides some advice for physicians thinking about moving in this direction: Cut ties with insurance companies gradually, starting with the worst payers; drop Medicare last, especially if you have a large number of patients on Medicare; and "be prepared to scramble initially to make ends meet."
Highways and health care
[Michael Manville, "Review: Twentieth Century Sprawl by Owen Gutfreund," The New York Press, 16 June 2004.]
Here is an interesting review of the new book Twentieth Century Sprawl by Owen Gutfreund. What does it have to do with health care, you ask? Well, as the author explains, the system of partial federal funding encourages states to spend more than they otherwise would. This is as true for Medicaid (which has a 40/60 state/federal split) as it is for highways. Read the following with health care spending, insurance, and Medicaid in mind and note the similarities:
The highways themselves were inevitable, but for a time it seemed they would be paid for directly by drivers, through the now-reviled but eminently sensible system called tolls. We have no interstate tolls, however: not because they failed (no toll road has ever gone bankrupt), but because a consortium politely known as "the highway lobby" insisted that drivers should never pay directly for the freeways.
What the lobby called for and got was a system that Gutfreund calls "highway federalism." The federal government, using gas tax revenues which by law could only be spent on highway projects would pay for 90 percent of any interstate project. Whatever state the freeway ran through would kick in the remaining 10 percent.
On its face, this looked like a great deal for the states. In reality it has had regrettable and sometimes disastrous consequences. Ten percent of a highway construction project may be a small proportion of that cost, but in absolute numbers it was often a sizeable proportion of a state's budget - particularly in smaller states.
And yet the states could hardly walk away from the money on the table. One result of our federal system is that states compete, and if everyone else is adding more highway mileage, the question of whether your state actually needs more is, well, just missing the point. Once everyone else has it, then you most certainly need it.
We would use our roads more judiciously, and they would be in better shape, if we paid for them more directly. But we prefer not to do this. We choose instead to move their costs into the abstraction that we call the tax base, and then with all our might we do all we can to make that abstraction disappear. We put our public obligations in a box and then regularly elect people who say they can kick the box off the boat without making the boat sink. And so to the myth of unfettered mobility we add the myth of politics without consequences. Both are corrosive; both demand a corrective. Now as ever, too much public policy is predicated on the maintenance of agreeable fictions.
[Richard B. Warner, M.D., "The Real Culprit," The Flint Hills Center, 15 December 1997.]
[Michael Manville, "Review: Twentieth Century Sprawl by Owen Gutfreund," The New York Press, 16 June 2004.]
Here is an interesting review of the new book Twentieth Century Sprawl by Owen Gutfreund. What does it have to do with health care, you ask? Well, as the author explains, the system of partial federal funding encourages states to spend more than they otherwise would. This is as true for Medicaid (which has a 40/60 state/federal split) as it is for highways. Read the following with health care spending, insurance, and Medicaid in mind and note the similarities:
The highways themselves were inevitable, but for a time it seemed they would be paid for directly by drivers, through the now-reviled but eminently sensible system called tolls. We have no interstate tolls, however: not because they failed (no toll road has ever gone bankrupt), but because a consortium politely known as "the highway lobby" insisted that drivers should never pay directly for the freeways.
What the lobby called for and got was a system that Gutfreund calls "highway federalism." The federal government, using gas tax revenues which by law could only be spent on highway projects would pay for 90 percent of any interstate project. Whatever state the freeway ran through would kick in the remaining 10 percent.
On its face, this looked like a great deal for the states. In reality it has had regrettable and sometimes disastrous consequences. Ten percent of a highway construction project may be a small proportion of that cost, but in absolute numbers it was often a sizeable proportion of a state's budget - particularly in smaller states.
And yet the states could hardly walk away from the money on the table. One result of our federal system is that states compete, and if everyone else is adding more highway mileage, the question of whether your state actually needs more is, well, just missing the point. Once everyone else has it, then you most certainly need it.
We would use our roads more judiciously, and they would be in better shape, if we paid for them more directly. But we prefer not to do this. We choose instead to move their costs into the abstraction that we call the tax base, and then with all our might we do all we can to make that abstraction disappear. We put our public obligations in a box and then regularly elect people who say they can kick the box off the boat without making the boat sink. And so to the myth of unfettered mobility we add the myth of politics without consequences. Both are corrosive; both demand a corrective. Now as ever, too much public policy is predicated on the maintenance of agreeable fictions.
[Richard B. Warner, M.D., "The Real Culprit," The Flint Hills Center, 15 December 1997.]
Thursday, June 17, 2004
CBO acknowledges Medicaid's "crowding out" effect on long-term care insurance
[Financing Long-Term Care for the Elderly, Congressional Budget Office, April 2004.]
A recent report by the Congressional Budget Office takes a look at the troubles present and future in the long term care industry. Not only do the authors warn of the strain on its way as the baby boomers retire, but they also acknowledge how the relative accesibility of Medicaid reduces the likelihood of individuals providing for themselves:
Future demographic changes are likely to result in increased demand for long-term care, placing growing fiscal pressure on the public programs that pay for much of it today. Those changes may also indirectly affect informal care by reducing the number of people who might provide LTC services. In addition, the current financing structure creates incentives that discourage people from preparing to finance their own care, encouraging them to rely instead on public LTC insurance.
As Stephen Moses of the Center for Long Term Care Financing points out, the whole structure needs an overhaul:
Easy access to free or subsidized Medicaid and Medicare financing of nursing home and home health care for nearly four decades has anesthetized the public to the risk and cost of long-term care. Today, we're paying the price. We have a welfare-financed, nursing home based LTC system that is falling apart at the seams.
What's the answer? Target public LTC financing more narrowly to the genuinely needy and it will do a better job for fewer people. Everyone else will get the message, insure or use their home equity, and save the provider system by paying privately. Leave things as they are now, however, and the whole system will collapse when the boomers retire and approach senescence.
[See Stephen A. Moses, "Project Proposal: Controlling Medicaid Long-Term Care Costs," The Flint Hills Center.
Also, Matthew Hisrich, "Staying the Course: Medicaid Reform in Kansas," The Flint Hills Center.]
[Financing Long-Term Care for the Elderly, Congressional Budget Office, April 2004.]
A recent report by the Congressional Budget Office takes a look at the troubles present and future in the long term care industry. Not only do the authors warn of the strain on its way as the baby boomers retire, but they also acknowledge how the relative accesibility of Medicaid reduces the likelihood of individuals providing for themselves:
Future demographic changes are likely to result in increased demand for long-term care, placing growing fiscal pressure on the public programs that pay for much of it today. Those changes may also indirectly affect informal care by reducing the number of people who might provide LTC services. In addition, the current financing structure creates incentives that discourage people from preparing to finance their own care, encouraging them to rely instead on public LTC insurance.
As Stephen Moses of the Center for Long Term Care Financing points out, the whole structure needs an overhaul:
Easy access to free or subsidized Medicaid and Medicare financing of nursing home and home health care for nearly four decades has anesthetized the public to the risk and cost of long-term care. Today, we're paying the price. We have a welfare-financed, nursing home based LTC system that is falling apart at the seams.
What's the answer? Target public LTC financing more narrowly to the genuinely needy and it will do a better job for fewer people. Everyone else will get the message, insure or use their home equity, and save the provider system by paying privately. Leave things as they are now, however, and the whole system will collapse when the boomers retire and approach senescence.
[See Stephen A. Moses, "Project Proposal: Controlling Medicaid Long-Term Care Costs," The Flint Hills Center.
Also, Matthew Hisrich, "Staying the Course: Medicaid Reform in Kansas," The Flint Hills Center.]
The true value of prescription drugs
[Conrad F. Meier, "Medicines Are Worth The Price We Pay," Health Care News, The Heartland Institute, 1 June 2004.]
As Health Care News editor Conrad Meier points out in this column, while prescription drugs may only cost pennies to produce, much more goes into the final price than simply the costs associated with running an assembly line. This is even more so the case when the research-intensive nature of prescription drugs is taken into account. Add to this a high demand for their life-enhancing properties, and certain pills can become quite pricey. Does that mean that consumers are getting cheated out of something, though?
Companies fund research on future medicines and improvements to existing medicines with revenues from medicines currently in the marketplace. On average, and according to annually published shareholder data, one dollar out of every five earned in revenue is reinvested back into research and development.
Pharmaceutical companies are currently working on more than 1,000 new medicines--for Alzheimer's, stroke, cystic fibrosis, arthritis, and many other diseases. For cancer alone, more than 400 medicines are in the pipeline.
Focusing too narrowly on cutting the cost of prescription drugs may cause us to lose sight of their real and future value.
It's not always possible to put a price tag on the value of pharmaceuticals, but experts and patient organizations have calculated the cost of leading diseases. As the population ages, the costs of caring for people with these and other diseases yet unknown will escalate--unless we come up with more cures and better treatments.
Every government proposal that impacts health care policy should be judged carefully on whether it would nurture or hurt the environment needed to continue the remarkable progress brought about by drug research.
[Conrad F. Meier, "Medicines Are Worth The Price We Pay," Health Care News, The Heartland Institute, 1 June 2004.]
As Health Care News editor Conrad Meier points out in this column, while prescription drugs may only cost pennies to produce, much more goes into the final price than simply the costs associated with running an assembly line. This is even more so the case when the research-intensive nature of prescription drugs is taken into account. Add to this a high demand for their life-enhancing properties, and certain pills can become quite pricey. Does that mean that consumers are getting cheated out of something, though?
Companies fund research on future medicines and improvements to existing medicines with revenues from medicines currently in the marketplace. On average, and according to annually published shareholder data, one dollar out of every five earned in revenue is reinvested back into research and development.
Pharmaceutical companies are currently working on more than 1,000 new medicines--for Alzheimer's, stroke, cystic fibrosis, arthritis, and many other diseases. For cancer alone, more than 400 medicines are in the pipeline.
Focusing too narrowly on cutting the cost of prescription drugs may cause us to lose sight of their real and future value.
It's not always possible to put a price tag on the value of pharmaceuticals, but experts and patient organizations have calculated the cost of leading diseases. As the population ages, the costs of caring for people with these and other diseases yet unknown will escalate--unless we come up with more cures and better treatments.
Every government proposal that impacts health care policy should be judged carefully on whether it would nurture or hurt the environment needed to continue the remarkable progress brought about by drug research.
Wednesday, June 16, 2004
Bankruptcy and aging
[Timothy L. Takacs, "Bankruptcy Rising Among Elderly Americans," Elder Law FAX, 17 May 2004.]
Implications for Medicaid and other welfare programs abound in a recent study that shows a growing trend toward poverty among America's elderly. One key factor in debt levels was whether families had health insurance:
Although older Americans account for a small proportion of total personal bankruptcy filings, they are the fastest-growing group in bankruptcy. About 82,000 Americans 65 or older filed for bankruptcy in 2001, up 244% from 1991, according to the Consumer Bankruptcy Project, a study done at Harvard.
The United States Department of Justice, which runs the federal bankruptcy trustee program, released a study that painted a grim picture of the future for many older Americans.
According to the report, the average gross monthly income of an elderly debtor, $1544, is more than one-third below the average for Chapter 7 debtors ($2354). And for the average elderly debtor, Social Security benefits are the main source of income.
"Although the elderly are less likely to file chapter 7 bankruptcy than younger people, a significant number of them do file each year. The number of elderly filers is likely to grow in the coming years," the Justice Department report concludes.
The Justice Department found that most elderly debtors have very high concentrations of credit card debt -- not, as one might expect, high medical expenses.
A recent report from Demos, a New York-based public policy research group, found an alarming increase in credit card debt among older Americans.
"Conventional wisdom suggests that this segment of the population -- with lifetimes of financial experience, an over 80% homeownership rate and a generational ethos of thrift -- would be immune to the record debt increases of the 1990s," the report notes.
The Demos report, "Retiring in the Red," found that self-reported credit card debt among seniors age 65 and over increased 89% to $4041, between 1992 and 2001.
Among the report's other key findings:
* Having medical insurance -- or not having it -- made a major difference in credit card debt. Families in the 55 to 64 age range, for instance, had seen a credit card debt increase of 169% if they had no health insurance, but only 37% if they had health insurance.
[Timothy L. Takacs, "Bankruptcy Rising Among Elderly Americans," Elder Law FAX, 17 May 2004.]
Implications for Medicaid and other welfare programs abound in a recent study that shows a growing trend toward poverty among America's elderly. One key factor in debt levels was whether families had health insurance:
Although older Americans account for a small proportion of total personal bankruptcy filings, they are the fastest-growing group in bankruptcy. About 82,000 Americans 65 or older filed for bankruptcy in 2001, up 244% from 1991, according to the Consumer Bankruptcy Project, a study done at Harvard.
The United States Department of Justice, which runs the federal bankruptcy trustee program, released a study that painted a grim picture of the future for many older Americans.
According to the report, the average gross monthly income of an elderly debtor, $1544, is more than one-third below the average for Chapter 7 debtors ($2354). And for the average elderly debtor, Social Security benefits are the main source of income.
"Although the elderly are less likely to file chapter 7 bankruptcy than younger people, a significant number of them do file each year. The number of elderly filers is likely to grow in the coming years," the Justice Department report concludes.
The Justice Department found that most elderly debtors have very high concentrations of credit card debt -- not, as one might expect, high medical expenses.
A recent report from Demos, a New York-based public policy research group, found an alarming increase in credit card debt among older Americans.
"Conventional wisdom suggests that this segment of the population -- with lifetimes of financial experience, an over 80% homeownership rate and a generational ethos of thrift -- would be immune to the record debt increases of the 1990s," the report notes.
The Demos report, "Retiring in the Red," found that self-reported credit card debt among seniors age 65 and over increased 89% to $4041, between 1992 and 2001.
Among the report's other key findings:
* Having medical insurance -- or not having it -- made a major difference in credit card debt. Families in the 55 to 64 age range, for instance, had seen a credit card debt increase of 169% if they had no health insurance, but only 37% if they had health insurance.
Tuesday, June 15, 2004
When more is less: socialized health care
[Michael F. Cannon, "Free market is the answer," USA Today, 14 June 2004.]
Cato director of health policy studies Michael F. Cannon hits the nail on the head in this recent column. Politicians may never learn, but you can't fix problems spawned by bad public policy with more of the same...
The last thing patients need is for the government to inject more socialism into their health care in the name of expanding coverage. To borrow a phrase from President Reagan, government is not the solution to U.S. health care problems. It is the problem.
Most of America's health care is private, so many assume it operates as a free market. In truth, it is dominated by the government, resulting in high costs and stifling bureaucracy.
The federal government effectively socializes 86% of all health spending, a greater share than in 17 other industrialized countries, including Canada (though other features make these systems less free).
By discouraging individual responsibility, the government guarantees irresponsibility. We pay less attention to our health and demand more care — with little regard to the costs we impose on others or the rising prices that result. (Should it surprise us that health insurance is unaffordable for millions?) Those footing the bill — employers, insurers and the government — try to impose responsibility in ways both offensive and harmful (read: managed care).
Estimates by Harvard economist Martin Feldstein suggest that the federal government's quasi-socialization of private insurance alone will leave us nearly $200 billion worse off this year. Moreover, Chris Conover of Duke University estimates that health regulations will leave us $128 billion worse off. Taken together, that is more than what taxpayers will spend on Medicare or Medicaid in 2004. The only way to make health care affordable is to get the government out.
[Michael F. Cannon, "Free market is the answer," USA Today, 14 June 2004.]
Cato director of health policy studies Michael F. Cannon hits the nail on the head in this recent column. Politicians may never learn, but you can't fix problems spawned by bad public policy with more of the same...
The last thing patients need is for the government to inject more socialism into their health care in the name of expanding coverage. To borrow a phrase from President Reagan, government is not the solution to U.S. health care problems. It is the problem.
Most of America's health care is private, so many assume it operates as a free market. In truth, it is dominated by the government, resulting in high costs and stifling bureaucracy.
The federal government effectively socializes 86% of all health spending, a greater share than in 17 other industrialized countries, including Canada (though other features make these systems less free).
By discouraging individual responsibility, the government guarantees irresponsibility. We pay less attention to our health and demand more care — with little regard to the costs we impose on others or the rising prices that result. (Should it surprise us that health insurance is unaffordable for millions?) Those footing the bill — employers, insurers and the government — try to impose responsibility in ways both offensive and harmful (read: managed care).
Estimates by Harvard economist Martin Feldstein suggest that the federal government's quasi-socialization of private insurance alone will leave us nearly $200 billion worse off this year. Moreover, Chris Conover of Duke University estimates that health regulations will leave us $128 billion worse off. Taken together, that is more than what taxpayers will spend on Medicare or Medicaid in 2004. The only way to make health care affordable is to get the government out.
HSAs covered in The Wichita Eagle
[Phyllis Jacobs Griekspoor, "A healthy option for health plans," The Wichita Eagle, June 2004.]
Flint Hills is mentioned in this recent article on Health Savings Accounts in The Eagle. While we are planning a conference on the issue for this Fall, the October 13 event is actually another group's effort. The increasing interest in these tools is a testament to their potential:
There's a common message from Kansas businesses regarding health savings accounts, a health insurance product just now becoming widely available in the state.
That message is, "Tell me more."
"There's a lot of interest out there," said Cliff Somes with the Wichita Independent Business Association. "I anticipate that as more products become available and more vendors are out there, we'll hear a lot more about this."
HSAs are part of the ongoing "consumer-driven health care" trend, a movement intended to place more responsibility for paying for routine medical care on consumers.
[Phyllis Jacobs Griekspoor, "A healthy option for health plans," The Wichita Eagle, June 2004.]
Flint Hills is mentioned in this recent article on Health Savings Accounts in The Eagle. While we are planning a conference on the issue for this Fall, the October 13 event is actually another group's effort. The increasing interest in these tools is a testament to their potential:
There's a common message from Kansas businesses regarding health savings accounts, a health insurance product just now becoming widely available in the state.
That message is, "Tell me more."
"There's a lot of interest out there," said Cliff Somes with the Wichita Independent Business Association. "I anticipate that as more products become available and more vendors are out there, we'll hear a lot more about this."
HSAs are part of the ongoing "consumer-driven health care" trend, a movement intended to place more responsibility for paying for routine medical care on consumers.
Tuesday, June 01, 2004
Galen Institute to hold Consumer Driven Health Care briefing
While you might not be able to attend the briefing in person, it will be available online at www.kaisernetwork.org approximately 6 hours after the event:
Please join the Galen Institute for a briefing on Consumer Driven Health Care: Physicians Respond
Two trends are prompting physicians to re-think the way they practice medicine.
- The growing burden of regulations and the administrative hassles of third-party payment have left physicians frustrated and dissatisfied.
- The growing number of self-pay patients has made physicians realize they can serve patients independent of third-party payments.
These two developments have launched a new movement of independent and innovative medical practices that bypass the managed care bureaucracy and serve patients directly. This briefing will feature some of the pioneers in the movement, all of whom are taking different approaches to serving a new market.
Speakers:
Robert Berry, MD, PATMOS EmergiClinic, Greeneville, TN
Raymond Davies, PhD, AAPP/SimpleCare, Renton, WA
Alieta Eck, MD, Zarephath Health Center, Zarephath, NJ
David MacDonald, DO, Liberty Health Group, Edmonds, WA
Tom Reed, Personalized Physician Care, Naples, FL
Marcy Zwelling-Aamot, MD, FACEP, ChoiceCare and LA County Medical Association
Moderator:
Greg Scandlen, Director, Galen Institute's Center for Consumer Driven Health Care
Friday, June 18, 2004
2:00 - 4:00 p.m.
Barbara Jordan Conference Center
at the Kaiser Family Foundation
1330 G Street NW
Washington, DC
(one block west of Metro Center)
Please RSVP by June 15th or make inquiries to:
Jena Persico
jena@galen.org or 703-299-9204
While you might not be able to attend the briefing in person, it will be available online at www.kaisernetwork.org approximately 6 hours after the event:
Please join the Galen Institute for a briefing on Consumer Driven Health Care: Physicians Respond
Two trends are prompting physicians to re-think the way they practice medicine.
- The growing burden of regulations and the administrative hassles of third-party payment have left physicians frustrated and dissatisfied.
- The growing number of self-pay patients has made physicians realize they can serve patients independent of third-party payments.
These two developments have launched a new movement of independent and innovative medical practices that bypass the managed care bureaucracy and serve patients directly. This briefing will feature some of the pioneers in the movement, all of whom are taking different approaches to serving a new market.
Speakers:
Robert Berry, MD, PATMOS EmergiClinic, Greeneville, TN
Raymond Davies, PhD, AAPP/SimpleCare, Renton, WA
Alieta Eck, MD, Zarephath Health Center, Zarephath, NJ
David MacDonald, DO, Liberty Health Group, Edmonds, WA
Tom Reed, Personalized Physician Care, Naples, FL
Marcy Zwelling-Aamot, MD, FACEP, ChoiceCare and LA County Medical Association
Moderator:
Greg Scandlen, Director, Galen Institute's Center for Consumer Driven Health Care
Friday, June 18, 2004
2:00 - 4:00 p.m.
Barbara Jordan Conference Center
at the Kaiser Family Foundation
1330 G Street NW
Washington, DC
(one block west of Metro Center)
Please RSVP by June 15th or make inquiries to:
Jena Persico
jena@galen.org or 703-299-9204
