Silly Megan, all we need to do is establish a VAT tax. (/snark)
Want to actually reduce health care costs? Repeal the 16th Amendment.
That would help in so far as the messed up 3rd party payment system is a tax dodge. 3rd party payment for routine medical care is a big part of the price problem.
Indeed, and the mess that the health care system became in the USA even prior to Obamacare was a direct result of the wage and price controls of FDR. Companies still needed a way to attract and keep good employees, and health insurance was the way around wage controls.
The 16th, 17th, and 18th amendments were mistakes. It took less than a generation to rid America of the 18th, but those other two are tenacious, like ticks burrowed deep. Getting rid of both would go a long way to reversing the dangerous course America is on now. I’d repeal the 17th outright and revert to having senators selected by state legislatures. For the 16th, repeal and replace with something that says each state should decide how to generate revenue (sales taxes, royalties on natural resources, income taxes, lotteries, whatever – it would be up to each state), and then each state would fund the federal government according to population fraction (a state with 2% of the population would fund 2% of the federal budget). That would make the Treasury department significantly smaller – the IRS branch would be gone altogether.
Single payer might not be the solution that its advocates want it to be but we might be able to learn something about health and health care from our British cousins. A number of years ago (5, 6, 7) I read in The Economist a report on a research study that compared the health and costs of health care in Britain and the United States. That report noted than the British smoke a bit more than average than Americans and also drink alcohol a bit more than average than Americans. The report also noted that Americans spend twice as much per capita on health care as the British. The British were somewhat healthier and lived somewhat longer than Americans did. That raised some interesting questions in my mind.
More recently someone in this country told me that we spend half of our medical dollars in the last six months of a person’s life. If true, that raises some interesting questions about our culture. I do know I loved my mother with all my heart and mind. I did tell the assisted living place where I had to put Mom during her final years to take no extraordinary measures at the end. If more Americans made my choice, would things be better in this country regarding medical expenses? I would like to know.
Before you talk about the wonders of the NHS, you might want to Google ‘liverpool care pathway’.
As you say, healthcare costs are significantly lower if you kill the old farts rather than try to keep them alive.
Oldest trick in the book – statistics collected by those with an interest in skewing them one way or another.
If you actually ever meet a British person, you’ll see with your own eyes how “healthy” they are.
Trent, I have British cousins who live in Nottingham. I have lots of friends in the UK through science fiction and artistic and Hash House Harrier connections and more. I have spent so much time in the UK that I am not allowed to give blood in this country because of fears of mad cow disease.
My British friends and relatives seem to be as healthy as my American friends and relatives. The Economist, in case you don’t know it, leans toward the conservative side in UK politics. It might not be perfectly conservative, but it is hardly a Communist rag. That report got my attention to some extent. When I heard in this country from an American that we spent lots of money on people who were dying it got my attention.
Health care is not top of my list of things I pay attention to. I do try to pay attention to others. When I hear the words “democratic socialist” I think this is a person with whom I might have some significant disagreements as well as some agreements. That is the way it has been with my British and American friends who vary widely in their political and social views. They do, however, tend to be open minded, good people who think for themselves.
Oh — you might find it amusing that I have actually been treated by the NHS. It was a minor running injury. I have had a number of them in the United States as well. The free market treatment was pretty much the same as the NHS treatment was.
I’ve never received worse health care than when I was sick in London. As I understand it, the country areas get better general health care but suffer the same as the city folks when it comes to surgery (weeks waiting to move from queue to queue). Every sick person I’ve known in the UK had a “waiting to die” attitude.
Every time an American tells me that they went to the emergency room because they had the sniffles I ask them why they didn’t go see their GP and they just stare at me blankly. I put it down to me not asking the right question.
I’ve watched as the Australian health care system has gotten progressively worse over my lifetime, while my own health care has gotten better as I made better decisions – essentially, you get what you pay for.
“More recently someone in this country told me that we spend half of our medical dollars in the last six months of a person’s life. If true, that raises some interesting questions about our culture. ”
If our culture is what it should be, it wouldn’t raise any questions because people would be left to decide what’s best for them, instead of decision by government Dikktat
Regarding Britain’s NHS: Here are 3 headlines from Drudge you may want to check out. The first being an article about the component of US “NHS” that already exists:
Doctor Shortage Feared as Medicaid Rolls Swell…
300 PATIENTS A DAY HAVE SURGERY AXED IN UK…
Operations cancelled as National Health Service runs out of beds…
That happens a lot in some health care systems. To save costs on space the hospitals try to reduce the number of beds as much as possible. Quite often you will find out the surgeries that were delayed were surgeries for things which do not cause fatalities like surgery on varicose veins.
“Quite often you will find out the surgeries that were delayed were surgeries for things which do not cause fatalities like surgery on varicose veins.”
I hope our standards never drop so low that you will only receive care if it is life threatening and then add in a bunch of caveats to determine if anyone cares if your life is threatened.
Did you read McArdle’s article, and the earlier ones she referenced? Summary: There is no good reason for thinking that changing to a different health care system would save the US money. It is possible, with difficulty, to avoid new growth of health care costs. It is politically completely impossible to decrease them once they are there. Neither the US _nor any other country_ has managed to bring down whatever costs they have. The US costs are not growing faster than other countries; they are about the same. The difference is for several decades we paid our health care providers much better than other countries, and our facilities (hospitals) are more spacious and more expensive. Those things aren’t going to be rolled back.
And yet the average life expectancy in the US is lower. Figure that.
There are lots of reasons for that that have nothing whatsoever to do with health care. Including comparing apples to eggs.
That’s an absurd comment. The murder rate is higher! Also, life expectancies in the US includes prenatals who die, which is not counted in most countries. But the US has some of the most cutting-edge prenatal care, saving younger premies than almost anywhere else – but some of them die, so that counts against. And a number of other reasons. Apples and oranges.
The right way to do the comparison is look at outcomes on particular health issues. Survival rate from such-and-such type of heart bypass. Survival rate from colon cancer… And so forth. The United States tends to be among the best in all such measures.
“The difference is for several decades we paid our health care providers much better than other countries, and our facilities (hospitals) are more spacious and more expensive. Those things aren’t going to be rolled back.”
Just wait. Private practices are being gobbled up. I wouldn’t be surprised at all to see hospitals closed down, aside from rural facilities which are already feeling the strain.
“I did tell the assisted living place where I had to put Mom during her final years to take no extraordinary measures at the end. If more Americans made my choice, would things be better in this country regarding medical expenses? I would like to know.”
What was Mom’s take on all of this?
A person placed in your position often has to make such decisions, and a person is often just placed in this situation without much training or guidance or preparation. And long-term care facilities often urge you to sign do-not-recusitate orders on behalf of your family member. Quoting Trotsky, you may not be interested in one of these advanced orders, but orders are interested in you!
But we are still making decisions by proxy for another person. I also have a sense, having observed the end-of-life process here and over by one of our Major Industrial Trading Partners, call it how a cancer was managed for two brothers, that we are considerably more compassionate.
Paul,
Mom is the only person I have had to make that decision for. By that point in her life she was not able to make decisions for herself.
I have read and heard about how the last few months especially can be very difficult for everyone. I haven’t heard from relatives or friends about the end of life in Britain. I can say my mother had as best last few months as were possible. Keeping a woman I truly loved going a few more months with extraordinary treatments — some of which can cause real pain — didn’t seem like the right thing to do.
“Keeping a woman I truly loved going a few more months with extraordinary treatments”
Extraordinary treatments can be expensive but most illnesses are just managed, which can be expensive but not extraordinarily so. The real cost concern isn’t from extraordinary treatments but just from paying for assisted living and more managed care. This eats up savings very fast.
Fun fact: Vermont dropped its plans for single-payer when projections showed that it would require higher taxes than the governor and legislative leaders considered possible. The source of those projections? None other than Jonathan Gruber.
So Gruber consulted to build the system, then consulted again to dismantle the system? I can see why he says people are stupid.
By definition, half the population has a double digit IQ.
Not necessarily. 100 is the average IQ, not the median. They coincide only in a normal distribution, which IQ may be, but is not necessarily. So it’s not clear what percentage of the populace has a two-digit IQ.
He consulted to model proposals, and generate cost forecasts. He didn’t build the system (or the ACA, for that matter), he acted as a source of expertise and information for the decision makers. The information he provided to Vermont convinced Vermont’s policy makers that they couldn’t afford the system they’d hoped to build.
“He didn’t build the system (or the ACA, for that matter)”
Uhh, that is right, he didn’t build it but he did help design it. Obama, Pelosi, numerous other Democrats, and Gruber himself have all referred to Gruber as one of the most important and influential Obamacare architects. Is there anyone else that has been more widely used or paid more by Democrats or governments for work on the ACA? This guy is a multimillionaire thanks to his work designing and implementing Obamacare.
“The information he provided to Vermont convinced Vermont’s policy makers that they couldn’t afford the system they’d hoped to build.”
That’s silly. How did they know he wasn’t just making a speako? I guess when he recanted his other stated policy advice, he didn’t recant his views on Vermont. But maybe his assessment of Vermont was wrong just like his speakos? I guess he could have been telling the truth to Vermont and in his speakos but then that would mean he and Obamacare defenders would be lying now and we know that would never happen…
Silly Megan, all we need to do is establish a VAT tax. (/snark)
Want to actually reduce health care costs? Repeal the 16th Amendment.
That would help in so far as the messed up 3rd party payment system is a tax dodge. 3rd party payment for routine medical care is a big part of the price problem.
Indeed, and the mess that the health care system became in the USA even prior to Obamacare was a direct result of the wage and price controls of FDR. Companies still needed a way to attract and keep good employees, and health insurance was the way around wage controls.
The 16th, 17th, and 18th amendments were mistakes. It took less than a generation to rid America of the 18th, but those other two are tenacious, like ticks burrowed deep. Getting rid of both would go a long way to reversing the dangerous course America is on now. I’d repeal the 17th outright and revert to having senators selected by state legislatures. For the 16th, repeal and replace with something that says each state should decide how to generate revenue (sales taxes, royalties on natural resources, income taxes, lotteries, whatever – it would be up to each state), and then each state would fund the federal government according to population fraction (a state with 2% of the population would fund 2% of the federal budget). That would make the Treasury department significantly smaller – the IRS branch would be gone altogether.
Single payer might not be the solution that its advocates want it to be but we might be able to learn something about health and health care from our British cousins. A number of years ago (5, 6, 7) I read in The Economist a report on a research study that compared the health and costs of health care in Britain and the United States. That report noted than the British smoke a bit more than average than Americans and also drink alcohol a bit more than average than Americans. The report also noted that Americans spend twice as much per capita on health care as the British. The British were somewhat healthier and lived somewhat longer than Americans did. That raised some interesting questions in my mind.
More recently someone in this country told me that we spend half of our medical dollars in the last six months of a person’s life. If true, that raises some interesting questions about our culture. I do know I loved my mother with all my heart and mind. I did tell the assisted living place where I had to put Mom during her final years to take no extraordinary measures at the end. If more Americans made my choice, would things be better in this country regarding medical expenses? I would like to know.
Before you talk about the wonders of the NHS, you might want to Google ‘liverpool care pathway’.
As you say, healthcare costs are significantly lower if you kill the old farts rather than try to keep them alive.
Oldest trick in the book – statistics collected by those with an interest in skewing them one way or another.
If you actually ever meet a British person, you’ll see with your own eyes how “healthy” they are.
Trent, I have British cousins who live in Nottingham. I have lots of friends in the UK through science fiction and artistic and Hash House Harrier connections and more. I have spent so much time in the UK that I am not allowed to give blood in this country because of fears of mad cow disease.
My British friends and relatives seem to be as healthy as my American friends and relatives. The Economist, in case you don’t know it, leans toward the conservative side in UK politics. It might not be perfectly conservative, but it is hardly a Communist rag. That report got my attention to some extent. When I heard in this country from an American that we spent lots of money on people who were dying it got my attention.
Health care is not top of my list of things I pay attention to. I do try to pay attention to others. When I hear the words “democratic socialist” I think this is a person with whom I might have some significant disagreements as well as some agreements. That is the way it has been with my British and American friends who vary widely in their political and social views. They do, however, tend to be open minded, good people who think for themselves.
Oh — you might find it amusing that I have actually been treated by the NHS. It was a minor running injury. I have had a number of them in the United States as well. The free market treatment was pretty much the same as the NHS treatment was.
I’ve never received worse health care than when I was sick in London. As I understand it, the country areas get better general health care but suffer the same as the city folks when it comes to surgery (weeks waiting to move from queue to queue). Every sick person I’ve known in the UK had a “waiting to die” attitude.
Every time an American tells me that they went to the emergency room because they had the sniffles I ask them why they didn’t go see their GP and they just stare at me blankly. I put it down to me not asking the right question.
I’ve watched as the Australian health care system has gotten progressively worse over my lifetime, while my own health care has gotten better as I made better decisions – essentially, you get what you pay for.
“More recently someone in this country told me that we spend half of our medical dollars in the last six months of a person’s life. If true, that raises some interesting questions about our culture. ”
If our culture is what it should be, it wouldn’t raise any questions because people would be left to decide what’s best for them, instead of decision by government Dikktat
Regarding Britain’s NHS: Here are 3 headlines from Drudge you may want to check out. The first being an article about the component of US “NHS” that already exists:
Doctor Shortage Feared as Medicaid Rolls Swell…
300 PATIENTS A DAY HAVE SURGERY AXED IN UK…
Operations cancelled as National Health Service runs out of beds…
That happens a lot in some health care systems. To save costs on space the hospitals try to reduce the number of beds as much as possible. Quite often you will find out the surgeries that were delayed were surgeries for things which do not cause fatalities like surgery on varicose veins.
“Quite often you will find out the surgeries that were delayed were surgeries for things which do not cause fatalities like surgery on varicose veins.”
I hope our standards never drop so low that you will only receive care if it is life threatening and then add in a bunch of caveats to determine if anyone cares if your life is threatened.
Did you read McArdle’s article, and the earlier ones she referenced? Summary: There is no good reason for thinking that changing to a different health care system would save the US money. It is possible, with difficulty, to avoid new growth of health care costs. It is politically completely impossible to decrease them once they are there. Neither the US _nor any other country_ has managed to bring down whatever costs they have. The US costs are not growing faster than other countries; they are about the same. The difference is for several decades we paid our health care providers much better than other countries, and our facilities (hospitals) are more spacious and more expensive. Those things aren’t going to be rolled back.
And yet the average life expectancy in the US is lower. Figure that.
There are lots of reasons for that that have nothing whatsoever to do with health care. Including comparing apples to eggs.
That’s an absurd comment. The murder rate is higher! Also, life expectancies in the US includes prenatals who die, which is not counted in most countries. But the US has some of the most cutting-edge prenatal care, saving younger premies than almost anywhere else – but some of them die, so that counts against. And a number of other reasons. Apples and oranges.
The right way to do the comparison is look at outcomes on particular health issues. Survival rate from such-and-such type of heart bypass. Survival rate from colon cancer… And so forth. The United States tends to be among the best in all such measures.
“The difference is for several decades we paid our health care providers much better than other countries, and our facilities (hospitals) are more spacious and more expensive. Those things aren’t going to be rolled back.”
Just wait. Private practices are being gobbled up. I wouldn’t be surprised at all to see hospitals closed down, aside from rural facilities which are already feeling the strain.
“I did tell the assisted living place where I had to put Mom during her final years to take no extraordinary measures at the end. If more Americans made my choice, would things be better in this country regarding medical expenses? I would like to know.”
What was Mom’s take on all of this?
A person placed in your position often has to make such decisions, and a person is often just placed in this situation without much training or guidance or preparation. And long-term care facilities often urge you to sign do-not-recusitate orders on behalf of your family member. Quoting Trotsky, you may not be interested in one of these advanced orders, but orders are interested in you!
But we are still making decisions by proxy for another person. I also have a sense, having observed the end-of-life process here and over by one of our Major Industrial Trading Partners, call it how a cancer was managed for two brothers, that we are considerably more compassionate.
Paul,
Mom is the only person I have had to make that decision for. By that point in her life she was not able to make decisions for herself.
I have read and heard about how the last few months especially can be very difficult for everyone. I haven’t heard from relatives or friends about the end of life in Britain. I can say my mother had as best last few months as were possible. Keeping a woman I truly loved going a few more months with extraordinary treatments — some of which can cause real pain — didn’t seem like the right thing to do.
“Keeping a woman I truly loved going a few more months with extraordinary treatments”
Extraordinary treatments can be expensive but most illnesses are just managed, which can be expensive but not extraordinarily so. The real cost concern isn’t from extraordinary treatments but just from paying for assisted living and more managed care. This eats up savings very fast.
Fun fact: Vermont dropped its plans for single-payer when projections showed that it would require higher taxes than the governor and legislative leaders considered possible. The source of those projections? None other than Jonathan Gruber.
So Gruber consulted to build the system, then consulted again to dismantle the system? I can see why he says people are stupid.
By definition, half the population has a double digit IQ.
Not necessarily. 100 is the average IQ, not the median. They coincide only in a normal distribution, which IQ may be, but is not necessarily. So it’s not clear what percentage of the populace has a two-digit IQ.
He consulted to model proposals, and generate cost forecasts. He didn’t build the system (or the ACA, for that matter), he acted as a source of expertise and information for the decision makers. The information he provided to Vermont convinced Vermont’s policy makers that they couldn’t afford the system they’d hoped to build.
“He didn’t build the system (or the ACA, for that matter)”
Uhh, that is right, he didn’t build it but he did help design it. Obama, Pelosi, numerous other Democrats, and Gruber himself have all referred to Gruber as one of the most important and influential Obamacare architects. Is there anyone else that has been more widely used or paid more by Democrats or governments for work on the ACA? This guy is a multimillionaire thanks to his work designing and implementing Obamacare.
“The information he provided to Vermont convinced Vermont’s policy makers that they couldn’t afford the system they’d hoped to build.”
That’s silly. How did they know he wasn’t just making a speako? I guess when he recanted his other stated policy advice, he didn’t recant his views on Vermont. But maybe his assessment of Vermont was wrong just like his speakos? I guess he could have been telling the truth to Vermont and in his speakos but then that would mean he and Obamacare defenders would be lying now and we know that would never happen…