Exploding Myths About The Costs of Healthcare

I caught this the other day from Ezra Klein at TPM Cafe and thought it was worth discussing here. You know all of those stories Republicans tell us about why American healthcare is so expensive? You know, malpractice awards are too high, that we don't ration our healthcare, that our healthcare infrastructure is just better, etc, etc. Well, according to an extensive study published last year in the journal Health Affairs, those stories are (surprise, surprise) not true.

Average malpractice awards domestically are lower than in Canada, the UK, or Australia (has it occurred to anyone else that if there is indeed an epidemic of defensive medicine -- which I don't believe, but nevertheless -- that the fault probably lies on conservative- created hysteria about malpractice awards and American litigiousness?), and the whole malpractice "industry" amounts to less than one half of one percent of spending (for a very comprehensive takedown of all aspects of the medical malpractice myth, go here). That's just not the stuff our health spending is made of.

As for supply constraints, the researchers checked out the 15 procedures that account for the bulk of wait times in foreign lands. They make up 3 percent of our total spending. In addition, health spending in the twelve countries with waiting lists was $2,366 per capita. In the seven without, it was $2,696 per capita. In America, it was $5,267 per capita. So sorry, no answers there, either.

And to burst another bubble, we don't get more resources than folks in other countries. Indeed, our per capita hospital beds, CT scanners, physicians and nurses were lower than the OECD average. Ouch.

Long story short, not one of the "market based" ideas Republicans have been peddling for so long now are actually meant to do anything to lower the cost of healthcare in America. They'll just line the pockets of the wealthy at the expense of those who can least afford it.

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Will Health Care In The U.S. Improve? Ever?

The day I first met Howard Dean I didn't know much about him. He hadn't broken into double digits in the polls yet but he had offered to make it real easy for me by coming to my house for breakfast. He understood why half a papaya with blueberries, pecans and flaxseeds were way better for him than pancakes and a slab of bacon. And he told me something that turned me into a Deaniac on the spot. He told me why he got into politics and what he wanted to accomplish in politics-- basically the same thing. As an M.D., Dean was more aware of the shortfalls in the American medical system and the medical insurance system than any politician I had ever spoken too and when he talked about fixing it he talked about what he knew. Now all moderates and even relatively reactionary politicians are giving at least lip service to his ideas. But Bush neither fits "moderate" nor "relatively" reactionary.

According to my doctor, almost 50% of Americans living today will be diagnosed with cancer at some  point in their lives. The day that happens is a really scary one-- as bad as looking up and seeing a stewed and cockeyed Dick Cheney lunging at you with a 28-gage shotgun. Today I still had Dick "above-the-law" Cheney on the brain when I abandoned my computer and headed out into the world. Randi Rhodes wasn't on yet so I tuned in KCRW, the local NPR affiliate, and I heard a story worse than Dick Cheney's murderous shooting rampage.

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The Push For HSAs Is On

What better place for a Republican to kick off a healthcare campaign than at the corporate headquarters of a fast food restaurant? It speaks volumes, no? Well, today Bush brought his traveling roadshow to a more respectable venue, the Department of Health and Human Services.

Having personally been under the impression that Bush was going to make the pitch during the State of the Union for transitioning the healthcare system away from group insurance towards private Health Savings Accounts, I've already done a lot of writing on the topic. Obviously, I think it's a terrible idea.

But beyond the economics of HSAs and the disastrous effects of pulling healthy, young people out of risk pools, I think the thing that bothers me most about this proposal is the fact that it demands even more sacrifice from the sick. This isn't something that Bush hides from. In fact, he brags about it. Clearly, he just doesn't get what this system would mean for the average American.

"When somebody else pays the bills, rarely do you ask price or ask the cost of something," the president said during a panel discussion on his health care initiatives at the Department of Health and Human Services. "The problem with that is that there's no kind of market force, there's no consumer advocacy for reasonable price when somebody else pays the bills. One of the reasons why we're having inflation in health care is because there is no sense of market." ...

"When you go buy a car you're able to shop and compare," he said. "And yet in health care that's just not happening in America today."

George W. Bush is a son of privilege. I don't care that he wears a cute little cowboy hat while he "ranches" and "clears brush." At the end of the day, he's still the Connecticut-born scion of one of America's most prominent political families. His life was a series of failures and bail-outs, with Poppy's friends always waiting with kind words and big checks.

This is Medicare Part D, writ large over the entire American healthcare system. It's just so easy for Bush to talk about the American people comparison shopping in a magical "healthcare marketplace." But it's not so easy for the average working person to actually go out and do that. Not only do we lack the resources, we lack the time. Of course, the wealthy will have an army of lawyers and health advisers holding their hands and walking them through the ins and outs of the system. But what about those less fortunate? And yet they wonder why there's an increasing sense that the GOP just doesn't care about everyday people.

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Have YOU had Enough yet???

I had the privilege of being on a live blog for the first time last night and I enjoyed the insightful tough questions and comments that were directed at the person who was the focus of the live blog.  Some of those comments were directed at me as well.    The event was very interesting and I was delighted to meet other bloggers too.  Some of the comments provided a look at the issues from a different perspective and I appreciated the frustration and anger that were clearly issues for all but especially to others and I am well aware and share perspectives of other issues as well.


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Bush on The Marketplace, Oil, Healthcare, and Cost Cutting

Some days, the President actually makes my brain hurt. I'm not talking simple headache here. I'm talking full-on, forehead clutching agony. Let me give you an example.

George W. Bush on Health Savings Accounts, January 26, 2005:

"A health savings account enables a person to be in charge of his or her own health care decisions.... Our view is, is that if you're a consumer of health care and you're in the marketplace making health care decisions, it is more likely that there be more cost control in health care..."

George W. Bush on Record Oil Company Profits, February 1, 2006:

"I think that basically the price is determined by the marketplace and that's the way it should be.... There is a marketplace in American society."

So let me see if I've got Bush's economics lesson straight. Health Savings Accounts will help control the cost of healthcare because that's the way "the marketplace" works. But record high fuel prices coupled with record high oil industry profits shouldn't get anybody down because that's the way "the marketplace" works. In other words, leaving the cost of anything -- like healthcare -- to "the marketplace" is in no way, shape, or form a guarantee that prices will actually come down.

Anybody have any Excedrin?

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