5 Myths About Health Care Around the World

[HAL 9000 96]

And yet the complains cease when a Republican is in office. Yeah... real inefficiency.

[one...two...tree 2,762]

And yet the complains cease when a Republican is in office. Yeah... real inefficiency.

Imagine if they were for once honest about SS and Medicare...they'd have to stop being fascist ideologues and start realizing realizing that government and the private sector can coexist and actually work together for a better tomorrow.

[Danno 1,228]

Very good summary. Unfortunately, the fact that our health care system is far from the best in the world will fall on deaf ears in this great country of ours. Despite the overwhelming evidence to the contrary, too many Americans have allowed themselves to be manipulated into believing that only the absence of government will produce the best result. It's almost like a religion.

LOL...No, those of us that have dealt with the Government all our adult lives have come to our own conclusions!

You liberals frame everything in the same way when you just can't understand why everyone doesn't see your distoreted point of view, there must be something wrong with us; we are manipulated, etc.

It's the "guns'n religion" stuff straight from the far lefty Obama......So you know what's wrong with us, do you MrBig? We're just not as astute and wordly as person such as yourself?

Every time you flush the toilet, you should be thanking government, you unappreciative government leech. I suggest you disconnect from the grid. Cancel your water, sewage and trash. Build a wall around your house and a helicopter landing pad on your roof since you won't want to be using those public roads. Also, stop using the internet, because all your ranting against government as incapable of doing anything good while relying on government for your daily life makes you out to be one lame-azz hypocrite.

Steven, serious Dude, you have got to get out of the Burbs once in a while, you falling victim to the old.... "Because I live this way, everyone does" mentality.

Such as.. you do realize a sizable population do not use city water or sewer.

You might also be startled to know the number of people who get their power from a co-opt or private utility service. Their gas from a local guy and their trash picked up by a company.

Certainly there is nothing wrong with city services, in some areas they not only make sense they are needed but there is life outside this bubble.

And did you know everytime someone buys gas, they pay a road tax.... so they have every right to drive on the road.... though the roads are often bumpy due to some of the Road-tax money being stolen to fund "pet projects".

You see Steven in my "perfect world"... we could all decide which area we wanted to live in.... Some people like a lot of Gov and others don't.

And I am glad we live in a country which affords both extremes ..lots of Gov or a little gov, depending on where you live.

Now you live in Ca. .....and they are bankrupt .......and will need the other states to bail them out but you don't see this as unfair,

what you see as "unfair" are people who want to limit gov so we don't all go bankrupt.

Edited October 27, 2009 by Danno

[Mr. Big Dog 10,747]

Very good summary. Unfortunately, the fact that our health care system is far from the best in the world will fall on deaf ears in this great country of ours. Despite the overwhelming evidence to the contrary, too many Americans have allowed themselves to be manipulated into believing that only the absence of government will produce the best result. It's almost like a religion.

LOL...No, those of us that have dealt with the Government all our adult lives have come to our own conclusions!

The fact of the matter is that there is ample evidence both within the US as well as in other comparable countries that government works better than private for profit enterprise in creating effective and efficient ehalth care systems. Again, Medicare outranks private insurance in service, coverage and cost. The health care systems of comparable countries outrank the US system in effectiveness, efficiency and overall health outcomes. The only item where we rank way on top is cost. Nothing to be proud of.

The evidence that government does a better job of organizing health care is on the table. Your "conclusions" are based on ideology rather than reality.

I'm not taking the bait on this because I know that you can produce stats that back you up and I'm 100% I can find stats that back my contentions up.

Please do, I'd love to see that.

[Mrs.J06 4]

Very good summary. Unfortunately, the fact that our health care system is far from the best in the world will fall on deaf ears in this great country of ours. Despite the overwhelming evidence to the contrary, too many Americans have allowed themselves to be manipulated into believing that only the absence of government will produce the best result. It's almost like a religion.

LOL...No, those of us that have dealt with the Government all our adult lives have come to our own conclusions!

The fact of the matter is that there is ample evidence both within the US as well as in other comparable countries that government works better than private for profit enterprise in creating effective and efficient ehalth care systems. Again, Medicare outranks private insurance in service, coverage and cost. The health care systems of comparable countries outrank the US system in effectiveness, efficiency and overall health outcomes. The only item where we rank way on top is cost. Nothing to be proud of.

The evidence that government does a better job of organizing health care is on the table. Your "conclusions" are based on ideology rather than reality.

I'm not taking the bait on this because I know that you can produce stats that back you up and I'm 100% I can find stats that back my contentions up.

Please do, I'd love to see that.

nothing yet?

[mRx 16]

The fact of the matter is that there is ample evidence both within the US as well as in other comparable countries that government works better than private for profit enterprise in creating effective and efficient ehalth care systems. Again, Medicare outranks private insurance in service, coverage and cost. The health care systems of comparable countries outrank the US system in effectiveness, efficiency and overall health outcomes. The only item where we rank way on top is cost. Nothing to be proud of.

The evidence that government does a better job of organizing health care is on the table. Your "conclusions" are based on ideology rather than reality.

You have no evidence to support your claim that the government can create and maintain cost-effective health care systems.

Medicare--the example of your claim--is insolvent. Medicare, as you must know, is financed through taxes that are deposited into a HI Trust Fund. The funds are then invested into non-marketable government securities that collect interest. We Americans make non-voluntary contributions to this trust fund monthly, and we are in turn to believe that at age 65 we can be sustained on our matured contributions in the trust fund. This trust fund is the funding source of Medicare. As with any trust fund, they are managed by trustee(s). In the US, the Board of Trustees is required, by law, to provide statistics to the public. Here's what the Board of Trustees had to say this year:

As was true in 2008, Medicare's Hospital Insurance (HI) Trust Fund is expected to pay out more in hospital benefits and other expenditures this year than it receives in taxes and other dedicated revenues.

This means that the marvelous government Medicare system that is more cost-effective than private insurance has the problem of expenditures exceeding revenues (translated: losses). So, how will these losses be made up?

The difference will be made up by redeeming trust fund assets.

Oh, lovely. So current contributors are now paying current beneficiaries, instead of investing into their own future benefit (Note: we put a man in prison for 150 years for running a similar system). Oh, it get's better:

Growing annual deficits are projected to exhaust HI reserves in 2017

This well-organized system that the government has so thoughtfully given us is starting to sound like it's consuming itself (going bankrupt). When a private business is confronted with such a situation where revenue cannot cover expenditures, they must scramble to liquidate assets to pay obligations. But, fear not, the government will not be selling off any Federal buildings.

The drawdown of Social Security and HI Trust Fund reserves and the general revenue transfers into SMI will result in mounting pressure on the Federal budget. In fact, pressure is already evident. For the third consecutive year, a "Medicare funding warning" is being triggered, signaling that non-dedicated sources of revenues—primarily general revenues—will soon account for more than 45 percent of Medicare's outlays

So, they will just roll the losses of the efficient Medicare into the nearly $2 trillion dollar general deficit, which will in turn need to be paid for (that means printing more paper money, lest President Obama reneges on his tax pledge).

It's easy to see now that a public option, government-financed/organized health care is not more efficient than private insurance; They merely have the luxury of consistently spending more than they take in, and confiscating wealth produced in America if necessary. Private businesses are not permitted by law to steal in order to stay afloat.

Either way, private insurance is not so private at all. Consider this article describing some of the regulations that have led to the outrageous premiums. The way our health insurance market operates (heavily regulated/controlled) can easily be contrasted with the way our auto insurance market operates (relatively freely). If you crash your car into a tree, and don't have insurance, you cannot purchase auto insurance thereafter to pay for the damages. But, with health insurance, the government has mandated that private insurers accept such "pre-existing" conditions. With auto insurance, a driver who's been in no accidents will have much lower premiums than a driver with many accidents. Your premiums are dictated by your "risk pool". But, with health insurance, the government has mandated regulations that don't allow insurers to charge based on risk-potential, so "wreckless drivers" and "safe drivers" are in the same community pool.

The linked article does a better job explaining the regulation imposed upon health insurers which help explain the outrageous premiums, but the bigger issue is the cost of what is being insured; health care. In my last post, I detailed the monopolistic traits of the health care industry. This is the true problem with our health care system.

When industry-wide costs are high, changing the payer of these costs (public option, nationalization) does nothing to lower those costs.

Address the costs of health care by shedding the web of regulation that restricts supply and monopolizes profits for the health and Pharm industry, and prices will fall.

Otherwise, we are doomed to the fate described by the Board of Trustees...

[scandal 951]

3. Foreign health-care systems are inefficient, bloated bureaucracies.

Much less so than here. It may seem to Americans that U.S.-style free enterprise -- private-sector, for-profit health insurance -- is naturally the most cost-effective way to pay for health care. But in fact, all the other payment systems are more efficient than ours.

This point I can personally attest to and confirm to be true.

I've lived, and partaken in health delivery services, in 3 countries: Canada, Israel, the USA.

On this particular point - the paperwork and forms which need to be processed for every doctor or ER visit - the US is mind bogglingly inefficient. Every doctor's office in the country needs to keep track of all possible combinations of insurance carriers they contract with, and patient records and pre-approval forms. It's simply insane the amount of overhead a simple doctor's office needs to deal with, rather than delivering medical services. It does not need to be this way. I've personally seen and benefited from systems where it's not this way. And I don't consider the alternatives "free". I paid for my Kupat Holim coverage in Israel, just as I pay for my PPO here through my payroll. The difference is streamlined point-of-service delivery and billing. The system here is designed to protect the jobs of thousands of insurance company clerks filing mountains of paperwork but providing no other tangible benefit.

[mRx 16]

Just realized what I wrote was pretty long-winded. Lest my efforts to articulate my point be in vain...

Here's the short version:

The US government has proven that they are no better at managing US health care costs than private insurance (as evident by the statistical summary provided by the board of trustees who manage Medicare funds: (here).

Therefore, comparisons of government-run health systems of foreign countries to the system of the US are entirely moot.

There is a core problem with the cost of health care in the US. The exorbitant cost of health care can only be logically blamed on the regulations that have monopolized the US medical industry.

Abolishing the regulations, commissions, administrations, bureaus, associations, and legislative acts that control the supply and price of health care is the only real way to lower the costs of health care. Such a restrictive regulatory body exists in no other health care system in the world. This correctly accounts for why health care is far cheaper in countries with and without government-provided health care/insurance alike; because the health care industries of those countries are not monopolized like that of the US.

[one...two...tree 2,762]

Here's the short version:

The US government has proven that they are no better at managing US health care costs than private insurance (as evident by the statistical summary provided by the board of trustees who manage Medicare funds: (here).

Matt, Medicare is proven more efficient than private insurance.

(the following is a little long, but I've highlighted important points in red)

POLICY: Why Medicare is More Efficient

Than Private Insurers

By Maggie Mahar

I found Eric's Novack's June 13 post, "The Three Percent Myth," provocative, though I'm afraid I can't agree. Medicare is, in fact, more efficient than private insurers.

In his comment on the post, Rick underlines a key difference: In contrast to private insurers Medicare doesn't have to spend millions on marketing, advertising, and Washington lobbyists. On top of that, private insurers must generate profits for their shareholders. In 2003, the HMO industry as a whole reported total earnings of $5.5 billion—up 83 percent from $3 million in 2002 , according to Weiss Ratings, a firm that assesses the financial strength of banks and insurance companies.

In 2004 the industry's profits jumped another 10.7 percent to $11.4 billion, and in the summer of 2005 industry leader WellPoint told investors that it expected its profits to continue to levitate by an average of 15 percent a year for the next five years. That same week Wellpoint announced its plans to boost average premiums by 16.6 percent in 2006.

In my 2006 book, Money-Driven Medicine: The Real Reason Health Care Costs So Much, I quote Weiss vice-president Melissa Gannon, who is remarkably candid about the impact the insurance industry's fat profit margins have on society:

"While this bodes well for the industry's overall health, rising premiums have forced many consumers to select more restrictive health plans or opt not to purchase insurance entirely."

But it's not just the cost of marketing, advertising, lobbying and providing profits for investors that makes a private insurer's overhead so much higher. Insurers also have higher administrative costs because they are constantly enrolling and disenrolling customers as people change plans. (The average turnover in an employer-sponsored insurance plan is 20% to 25% a year. By contrast, Medicare patients stay put. Even if they could switch, most prefer Medicare's coverage to the coverage they had under a private insurer.)

In Money-Driven Medicine, I quote former Medicare chief Bruce Vladeck who points out that:

". . . even very efficient insurers must spend roughly 5 percent of their premiums just to enroll and disenroll customers . . . . This is why, when I was in Washington, some of us talked about giving people age 55 to 65 the opportunity to voluntarily enroll in Medicare –letting them pay premiums to the government in exchange for full Medicare coverage . . Donna Shalala, who was Secretary of Health and Human Services at the time, said to me, 'You really want to compete with the insurance companies, don't you?'

And I said, 'You bet," Simply because our costs were so much lower, I knew I could beat them.'"

In his post, Eric also argues that Medicare is less efficient because its oversight is lax, and thus millions are lost to fraud. But if you look at cases where healthcare providers like National Medical Enterprises cheat insurers, you'll find that they are just as likely to bilk private insurers.

If anything, private insurers may be more laid-back because they can "pass the costs associated with fraud on along their customers in the form of higher premiums," notes The Wall Street Journal, quoting Louis Parisi, director of the New Jersey Insurance department fraud division. (Medicare has a harder time finding funds to cover fraud.)

In the same story, the Journal quotes the medical director of an NME hospital saying that when he tried to inform the Prudential Insurance Company of possible fraud, company executives merely laughed, saying that for them, large bills meant large premiums and big bonuses.

Eric goes on to suggest that Medicare's voluminous rules create "hidden overhead" for healthcare providers who must spend hours deciphering the coding. But Jonathan is right in pointing out that private insurers also create "hidden overhead": for doctors who must deal with the 12 different sets of forms form 12 different insurers—all designed to make it difficult for the doctor to be reimbursed.

While interviewing doctors for my book, I found that the vast majority found Medicare's paper-work far simpler. They also liked the fact that Medicare does not try to micro-manage their practice by forcing them to call and ask permission to keep a patient in the hospital an extra two days, or to perform a certain procedure. Medicare simply publishes a list of what it will and won't cover—and that's that. When dealing with private insurers, by contrast, physicians spend hours on the phone.

What's interesting is that, in the course of interviewing doctors for Money-Driven Medicine, I found that the majority preferred Medicare—even when it paid less—because it was so much less hassle. As The New York Times. recently pointed out, private insurers make a game out of delaying reimbursement, and designing the forms so that the doctor leaves out one detail, he or she won't be paid.

Finally, I agree with John when he points out in his comment that even if we switched to Medicare-for-All ( a bill now in Congress that would let people 55-65 and those under 20, voluntarily switch to Medicare, paying Medicare rather than a private insurer for coverage) ---and even if Bruce Vladeck is right that because Medicare's administrative, marketing, advertising and lobbying costs are so much lower, and because it doesn't have to generate profits, Medicare could provide more coverage for less—this still doesn't solve the larger problem of health care inflation of 8% a year. After a couple of years, inflation would exceed the lower administrative costs—then what?

Ideally, if more people were on Medicare, Medicare would begin to exercise its clout as the nation's largest payer—the way other governments do—negotiating with drugmakers and device-makers for lower prices. (The high cost of drugs and devices is a major reason why our hospital bills are so high—drugs and devices account for 15% of the $2 trillion-plus that we spend on healthcare each year. Private insurers are less likely to bargain because they can always pass the cost along to their customers—and they do just that.. In just the last five years the cost of an average insurance premium has risen 75%.)

Of course drugmakers and device-makers argue that Americans need to pay twice what patients in other countries pay for their products in order to cover the high cost of research.

This is simply not true. Analysis by Families USA, a non-profit consumer group, shows that drugmakers spend roughly twice as much on advertising, marketing and administration as they spend on research.

Moreover, from 1995 to 2002, drugmakers took top prize as the nation's most profitable industry, showing profit margins of 13 percent to 18.6 percent of sales each and every year. (In 2004, they fell to third place, but still posted profits equaling 16 percent of sales.) Meanwhile, in recent years, device makers have boasting profits margins as high as 20%.

There is no reason for drug makers and device-maker to make so much more money than other industries—especially when those industries are going broke trying to cover the high cost of healthcare for their employees. Investors needed to be rewarded for taking a risk, but there's just not that much risk when you invest in Pfizer or Johnson and Johnson.

Even on Wall Street, health care analysts say, that that if you cut profit margins in these industries—and cut back on excessive marketing, advertising and lobbying--- and drug-makers and device-makers could roll back prices without making a dent in their research budgets.

http://www.thehealthcareblog.com/the_healt...y_why_medi.html

....

And one more caveat - you know which private insurance company is the most efficient in this country? Kaiser-Permanente...and they are a non-profit. Contrary to what you think, non-profit health insurance is much more efficient than for profit insurance.

Edited October 29, 2009 by Col. 'Bat' Guano

[mRx 16]

Here's the short version:

The US government has proven that they are no better at managing US health care costs than private insurance (as evident by the statistical summary provided by the board of trustees who manage Medicare funds: (here).

Matt, Medicare is proven more efficient than private insurance.

If rising premiums were endemic to private insurance companies, then why does the Medicare Board of Trustees report on the third consecutive "Medicare funding warning"? Why would the HI trust fund, for which we all contribute, be exhausted by 2017? Why would an immediate and 75-year long 134% Medicare tax increase be necessary to bring about balance for Medicare? (I'm not making any of this up, I assure you. It's all right here.)

The truth is, Medicare is in no better shape to cover these monopolized costs than private insurers. Private insurers must raise premiums, and Medicare must raise taxes. The effect is the same.

Insurance is not the problem; Health care is. This isn't ideology or theory. These are facts. The condition of Medicare is proof.

[PlatyPius 5]

Well, I agree Danno that the author of this report was clearly biased toward one end...which is not the way to sway people affectively. However, you have to admit that the article makes some good points?

How is it okay that millions are without insurance and that thousands go bankrupt from medical bills every year?

It's ok because Danno and his a$hole friends don't give a flying shît about anyone else.

Edited October 29, 2009 by PlatyPius

[britty 1]

Just realized what I wrote was pretty long-winded. Lest my efforts to articulate my point be in vain...

Here's the short version:

The US government has proven that they are no better at managing US health care costs than private insurance (as evident by the statistical summary provided by the board of trustees who manage Medicare funds: (here).

Therefore, comparisons of government-run health systems of foreign countries to the system of the US are entirely moot.

There is a core problem with the cost of health care in the US. The exorbitant cost of health care can only be logically blamed on the regulations that have monopolized the US medical industry.

Abolishing the regulations, commissions, administrations, bureaus, associations, and legislative acts that control the supply and price of health care is the only real way to lower the costs of health care. Such a restrictive regulatory body exists in no other health care system in the world. This correctly accounts for why health care is far cheaper in countries with and without government-provided health care/insurance alike; because the health care industries of those countries are not monopolized like that of the US.

Exactly !! why don't some people get this?

[Mr. Big Dog 10,747]

The fact of the matter is that there is ample evidence both within the US as well as in other comparable countries that government works better than private for profit enterprise in creating effective and efficient health care systems. Again, Medicare outranks private insurance in service, coverage and cost. The health care systems of comparable countries outrank the US system in effectiveness, efficiency and overall health outcomes. The only item where we rank way on top is cost. Nothing to be proud of.

The evidence that government does a better job of organizing health care is on the table. Your "conclusions" are based on ideology rather than reality.

You have no evidence to support your claim that the government can create and maintain cost-effective health care systems.

Why would I have to have supporting evidence for a claim I did not make? My claim is that that government has proven to do a better job - not perfect, just better - than private insurance in containing cost, maximizing coverage and delivering service. Evidence of that claim? Well, take a quick look at OECD data in terms of coverage and satisfaction rates. The US ranks at or near the bottom. Look at outcomes and the US ranks near the bottom. Look at the data in terms of cost, however, and you'll find the US way on top. Efficient health care? Not around here. So internationally, we're failing compared to health care systems in terms of coverage, cost and service.

Looking at national data, Medicare per enrollee spending over the last three decades vs. that of the private insurance shows that within those 30 years, per enrollee spending has risen about 45% more under the latter vs. the former. And that despite the fact that Medicare doesn't get to cherry pick it's enrollees and gets to pay for that part of the population that tends to consume the most care - the elderly. Patient satisfaction, on the other hand, is better for Medicare than for private insurers.

Consider for a second that the private insurance segment of the health care accounts for roughly 55% of the total health care outlays - that's about 1.3 trillion of the 2.4 trillion dollars as of 2008. Had the private insurance been able to achieve the same cost growth as Medicare, that 1.3 trillion dollars in outlays would only be about 900 billion and the total health care spending would be 2 trillion i/o 2.4 trillion - 17% less than what it is today.

Does that mean that the cost growth path that Medicare is on is sustainable? No, it doesn't. Does it mean that Medicare has been more effective in controlling cost than the private insurance industry? Absolutely.

[Mr. Big Dog 10,747]

Here's the short version:

The US government has proven that they are no better at managing US health care costs than private insurance (as evident by the statistical summary provided by the board of trustees who manage Medicare funds: (here).

Matt, Medicare is proven more efficient than private insurance.

If rising premiums were endemic to private insurance companies, then why does the Medicare Board of Trustees report on the third consecutive "Medicare funding warning"? Why would the HI trust fund, for which we all contribute, be exhausted by 2017? Why would an immediate and 75-year long 134% Medicare tax increase be necessary to bring about balance for Medicare? (I'm not making any of this up, I assure you. It's all right here.

When was the Medicare rate last raised? Right, in 1986. When did private health insurance last go up? Right, this very open enrollment period. And the last one. And the one before. And the one one before that. Well, you get the idea. Private insurance has gone up well over 134% since 1986 and it will continue to go up year after year while the Medicare trustees state that the system would need a one time rate increase - the first in over a quarter century - that would then carry the system through the next 75 years. In other words, a single rate increase in a century.

When the private insurance companies match that, I'll be all ears.

[mRx 16]

You may be forgetting the crucial fact that Medicare is payed for by everyone (155,500,000 people) and provided to only a certain group (45,000,000 people.) Excluding the premiums Medicare charges to it's recipients, over 3 people are funding 1 person to be on Medicare, and it's still unsustainable.

A system that takes funding from 3 and provides to 1 can never be considered cost-effective. It also can never be considered more cost-effective than 1 for 1 private insurance (no matter how horrible and costly they are), because at least two-thirds of those funding Medicare receive a cost, but no effect.

Nevertheless, as I've already stated, the problem is not insurance, it's health care. My aim was never to make a case defending private insurance, but merely illustrate that it doesn't matter who pays. The costs are astronomical, whether payed by all Americans collectively, or separately via individual plans. Therefore, high hopes of a public plan making health care cheaper are lost.