Robert Samuelson on the Real Health Care Debate
Ronald Bailey | December 6, 2007, 11:56am
Invaluable Washington Post columnist Paul* Robert Samuelson today discusses the dishonesty that pervades the health care debate. He points out that the uninsured are NOT the chief problem with health care in the U.S. The uninsured do get health care and uncompensated care amounts to about 3 percent of all health care expenditures. So what is the main problem?
We need to have a candid debate about health care in 2008, but the odds are against it. The fact that covering the 47 million uninsured already looms as the centerpiece of this debate is a warning sign that it won't be serious. We're told that the uninsured are our biggest health-care problem, but they aren't. Runaway health spending is. Although politicians pay lip service to that, what they really enjoy is increasing spending.
Why do health care costs keep rising so steeply? Because nobody has a direct interest in keeping them low. As Samuelson points out:
Neither the government nor the private sector has succeeded in controlling health spending. From 1970 to 2005, average spending per Medicare beneficiary rose 8.9 percent a year. For similar services, spending for Americans with private health insurance rose 9.8 percent annually over the same period. The small difference may reflect cost shifting. When Medicare imposes price controls, doctors and hospitals increase prices for privately insured patients...
The politics of health care rests on a mass illusion: Most Americans think that someone else pays for their care. Workers with employer-provided insurance believe that their companies pay. Retirees and the poor think that the government, through Medicare (retirees) and Medicaid (the poor), pays. No one has an interest in controlling spending, because everyone believes that it burdens someone else. Naturally, the health-industrial complex -- doctors, hospitals, drug companies -- has no interest. Higher health spending raises their incomes and profits.
In practice, the costs are mostly disguised. Because employer-paid insurance is not counted as income for tax purposes, most workers don't realize what they're getting. Companies now pay about $9,000 for a family policy. That limits wage and salary gains. From 2000 to 2006, average compensation for full-time workers rose by $3,500 after inflation, says Brookings Institution economist Gary Burtless. But $1,045 went to health insurance. Similarly, Medicare and Medicaid's effects get buried in the larger budget; since 1990, they've gone from 12 percent to 21 percent of federal spending.
What's Samuelson's solution? He proposes either a dedicated health care tax or the elmination of employer-based health insurance which would require workers pay out of pocket for their health care. In both cases, the public would experience cost increases directly and thus be encouraged to control costs. Actually his proposed health tax would still obscure costs unless it was imposed as a fixed percentage of everyone's incomes and even then the incentive to control costs would be weaker than having individuals pay out of pocket.
Whole Samuelson column here.
My proposal for universal mandated private health insurance here. The Cato Institute's critique of health insurance mandates here.
*oops. Paul and Robert obviously stored in the same malfunctioning brain cell.
jacksmith | December 6, 2007, 4:04pm | #
The #1 cause of injury, disability, and DEATH in America is, Health Care. More people die now from contact with the American Medical Health Care system than from any other cause of death. More than from Cancer, Heart disease, or Stroke. More than any other country in the world. Many times more than any other people in the world. This fact is a catastrophic indictment of the entire US Health Care System.
Driven by greed. And a rush to profit. Thousands of Americans are killed, and injured daily in America. By compromised health care. Cutting corners. Over, and under treatments. And poisonings with all manor of toxic, poisonous pharmaceuticals. Especially the children. America only makes up 2-4% of the world population. But Americans buy, and consume 50% of all pharmaceuticals world wide.
But the tide has turned. I can see it. Hear it. And feel it. The message is getting out. And taking hold about the fact that we have a very serious, and major health care crisis going on in America. Hurting everyone. Especially our precious little children. Rich, and poor alike. And most all Americans seem to understand now that "HR 676 Not For Profit Single Payer Universal National Health Care For All (Medicare For All)" is the way to go. Like all the other developed countries have done. I have seen numbers as high as 90% of Americans want government managed health care Now. Medicare for all. Like other developed countries have. And like older Americans have now.
BRAVO!!! America. YOU GET IT! YOU REALLY GET IT! See sickocure.org.
It's NOW TIME to bring out the BIG GUNS!! The BIG GUNS!! are you. The American people. And anyone else that wants to help. From now until HR 676 is passed into law. I want every person to reach out and touch their fellow Americans every day if you can. I want you to take a phone book. And call at least one of your fellow Americans every day. And ask them to pickup the sword of HR 676 Single Payer Not For Profit Universal Health Care For All (Medicare For All).
Call more than one each day if you can. And ask them to do the same as you are doing if they can. And also to put maximum pressure on their politicians to get HR 676 done. And to make sure their politicians support HR 676. Accept no substitute. HR 676 is a no-brainer. It's the best way to go on health care. It's the only moral, and ethical way to go. That is why every other developed country has done it. Most did it years ago.
I know that many of you have been doing a fabulous job of spreading the word by talking it up with family, friends, and co-workers. And putting pressure on the politicians to get HR 676 done ASAP. The phone calls to your fellow Americans will increase the pressure. And grow the movement at an astonishing, and exponential rate. And I know many of you have been wanting to do something more to help. The phone calls to your fellow Americans is something you can do every day to help.
Trust me. It will be something to see. But you have to keep the focus, and pressure on getting HR 676 passed pronto. They will try to distract you. With all manor of other crises, and catastrophes. And other plans. Don't be distracted. HR 676 Single Payer Not For Profit Universal Health Care is the #1 concern of the American people. Thousands of Americans are dieing daily now. And you or your loved ones could be next.
There is no good reason HR 676 cannot be passed into law well before the coming elections. Do not tolerate delays. If it is not passed before the coming elections. All America will know which politicians are on the side of the American people. And which are not when they vote. Well before the elections.
Everyone can do this. Most of you are well informed about HR 676. This truly is one of those no-brainers. Be considerate of your fellow Americans when you call. But be comfortable about calling. These are your fellow Americans. Some will be receptive. And some will not be. Some maybe rude, and mean. Just thank them, and move on to the next. Most will be with you. And if you get a call from one of your fellow Americans about HR 676. Let them know you are already on board. And thank them for calling. Build them up. And keep them strong. They are fighting for all of us.
I will try to make a second post with just a few of the reasons everyone with 2 working brain cells agrees HR 676 is the best way to go. But you can also look them up for your-self. And read some of the positive informed post on many of the message boards too.
Lastly, I am sick and tired of hearing how the candidates, and politicians health care plans are going to protect, and preserve the private for profit health insurance companies that have been killing, and ripping off the American people. And now the politicians want to mandate (require) that every American has to support the private for profit insurance company's that have been killing, and ripping you off. Or you will be fined, and PENALIZED. Thats right. PENALIZED. Ridiculous! The politicians really think you are all detached idiots. CASH COWS! To lead to the slaughter. Don't put up with that.
So get on it America. Get those phones going. Chat it up! Save some lives. You want all of America talking about HR 676 becoming law, Now! Before more die needlessly. Make it happen. And to my fellow cyber warriors. You have been doing great! I see it! Keep it up. 1 of 2 post...
Below are a few reasons why "HR 676 Single Payer Not For Profit Universal Health Care For All (Medicare For All) is a no-brainer. And some reasons why private for profit health insurance is a stupid idea, and injuring, and killing you and your loved ones.
Medicare cost 2-3% to administer. Private insurance cost 30% to administer.
Under HR 676 everyone would be covered from birth to death. No co-pays. No-deductible. No out of pocket cost. Plus Dental. And Vision. For less cost than we pay now under private health insurance.
With private insurance. You have 47 million Americans with no insurance.
And 89 million Americans that had no insurance part of the time from 2006-2007.
And over a 100 million that are under insured.
18-30 thousand Americans that die each year from lack of health care.
Health Care bills as the #1 cause of personal bankruptcy. And loss of homes.
Under HR 676 health care is moral, and ethical.
Private for profit insurance is immoral. And unethical.
Profit is the primary motive of the private insurance companies.
They make profit by charging needy, vulnerable, sick Americans as much as they can charge them.
Then they make more profit by denying them care when they most need it. And are most vulnerable and unable to fight back. When they are sick. Or trying to recover from major illness.
Yep! I know you are getting angry. I'm sorry. But I have to continue.
Under HR 676: we will save 300 billion dollars in administrative cost each year.
With private insurance: we spent more per capita on health care than any other country in the world. Over twice as much as most other developed country's. Yet we have 47 million with no health care.
We rank at the bottom in quality of health care #37.
Americans have a shorter life expectancy than people from all other developed countries. We rank # 42 in life expectancy. Down from #1.
For the first time in American history. The life expectancy of American children is less than that of their parents. American children are dieing at a record rate. And are in terrible health generally.
People from other country's enjoy a much higher level of general health than the best privately insured Americans.
Americans are also shrinking. We used to be the tallest people in the world. Now we are down to # 10.
People from other country's never have to worry about going bankrupt, or loosing their homes over medical bills if they get sick.
Maybe you should go take a break for a while before I go on. I know this must be upsetting. But this is just a small part of the sad truth about private health insurance that HR 676 can fix.
Under HR 676: Health care will be based on need. Not on profit. And high standards, and quality will be enforced, and patients protected by the Government through a dedicated civil service. With the power, and resources to rain in abuses of patient care. Like they do with Medicare now.
With private insurance: Medical care is base on ability to pay. And profit. Tens of thousands of patient are killed, and millions are injure, crippled, and mutilated each year under private for profit health care, and insurance.
By insurance companies denying needed care to increase their profits.
By hospitals cutting corners. And using the cheapest least experienced personnel, equipment, and standards they can get away with.
By doctors that over treat, and under treat. Who injure, mutilate, and kill patients with unnecessary test, procedures, surgery, and invasive diagnostic test for profit. Who poison, kill, and injure millions of Americans with all manor of unnecessary pharmaceuticals for profit. Men, Women, Children, and babies.
Americans makeup 2-4 % of the world population. But Americans buy, and consume 50% of all pharmaceuticals world wide. This is a monstrous evil. And immorality.
And lastly, by politicians that take blood money from all these despicable groups and turn blind eye's to this slaughter of the American people. And the slaughter of their own loved ones. And them-self.
Well I could go on. And on. But I think this is enough to get you started making your daily phone calls to your fellow Americans to support HR 676. And to help them understand how important it is that each of them join the fight. And bring the MAXIMUM pressure to bear on all individuals, parties, and especially your politicians, and Representatives. To get HR 676 passed into law immediately.
This is an emergency. America is in a crisis. More Americans have died from this health care crisis than have died in all the wars in US history. Do your best. Millions of Americans lives are counting on each of you. Including your own life. Remember, you are Americans. You know how to fight for your country when you have too. The whole world is in your blood. I'm with you.
All the best... 2 of 2
LarryA | December 6, 2007, 8:23pm | #
JUST MAKE the GOVERNMENT PAY FOR ALL HEALTH COSTS.
Sorry. The government has no money. They’ll bill the taxpayer. (You.)
The major problem for most uninsured is that they either don't have a job or work for a company too small to negotiate an affordable plan. The stupid part is that Congress "fixes" this by mandating more and more coverage through employers.
Unlike members of Congress, people out in the real world switch jobs and even careers regularly. Every time they do they have to start over with a new plan, if one is available.
What if people could go to almost any organization and get health care plans with the same tax benefits they have with employers?
I could join the National Rifle Association plan, or ride on my wife's National Federation of Press Women plan, or the United Methodist Church, or Wells Fargo Bank, or a plan set up for residents of Kerrville, Texas, all of which we've belonged to for far longer than either of us have stayed with any employer. (25 to 50 years and counting.)
These are big organizations, able to look insurance companies in the eye and say, "Show us your best." I get even more choice, since I can shop among the five organizations' offerings, or any of the other organizations we belong to.
Minority discrimination? Let AARP, NOW, LULAC, and the NAACP step up. The latter two could demand plans that address racially prevalent health patterns. I presume NOW wouldn't have to cover Viagra, and AARP would skip birth control.
Competition is what we need.
PS: A lot of the rise in health care costs occurs simply because there's more stuff to buy. Anyone guess what was spent on CAT scans in 1972?
Zero. They hadn't been invented yet.
We can say we "spend more on" CAT scans today, hundreds of thousands of dollars. But they aren't "more expensive" than when no one could get one.
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