Yessssssssss. We want the last dollar!
Paul Krugman writing in the New York Times has a great article about the supposed benefits of the private health insurance industry. Ostensibly as part of defense of the movie Sicko, it’s a very good read.
The persistence of that myth puzzles me. I can understand how people like Mr. Bush or Fred Thompson, who declared recently that “the poorest Americans are getting far better service” than Canadians or the British, can wave away the desperation of uninsured Americans, who are often poor and voiceless. But how can they get away with pretending that insured Americans always get prompt care, when most of us can testify otherwise?A recent article in Business Week put it bluntly: “In reality, both data and anecdotes show that the American people are already waiting as long or longer than patients living with universal health-care systems.”
A cross-national survey conducted by the Commonwealth Fund found that America ranks near the bottom among advanced countries in terms of how hard it is to get medical attention on short notice (although Canada was slightly worse), and that America is the worst place in the advanced world if you need care after hours or on a weekend.
Hip replacement surgery in the US is more available than in Canada. But, there’s a little catch you probably didn’t know.
On the other hand, it’s true that Americans get hip replacements faster than Canadians. But there’s a funny thing about that example, which is used constantly as an argument for the superiority of private health insurance over a government-run system: the large majority of hip replacements in the United States are paid for by, um, Medicare.
That’s right: the hip-replacement gap is actually a comparison of two government health insurance systems. American Medicare has shorter waits than Canadian Medicare (yes, that’s what they call their system) because it has more lavish funding – end of story. The alleged virtues of private insurance have nothing to do with it.
Here’s one of his examples of health-care treatment through an insurance company;
This can lead to ordeals like the one recently described by Mark Kleiman, a professor at U.C.L.A., who nearly died of cancer because his insurer kept delaying approval for a necessary biopsy. “It was only later,” writes Mr. Kleiman on his blog, “that I discovered why the insurance company was stalling; I had an option, which I didn’t know I had, to avoid all the approvals by going to ‘Tier II,’ which would have meant higher co-payments.”
He adds, “I don’t know how many people my insurance company waited to death that year, but I’m certain the number wasn’t zero.”
One of the little discussed issues with private health insurance discussed is the cost it adds to businesses in the US. Countries with state health care allow businesses to pocket that expense directly, or add a supplementary insurance option for things that are not covered via universal coverage. In Soviet Cannuckistan, my employer offers medical benefits of pharmaceuticals and dental care. All my other needs are met by the universal medical care. And those costs are a fraction of the cost of complete health care. How much does a business save when they don’t have to foot the bill the government could and probably should? You may not like this source, but the facts are strong.
In 1988, Chrysler’s CEO Lee Iacocca reported that each car his company produced in the U.S. cost $700 in health benefits alone, while the same car produced in Canada by Chrysler cost only $233 in health benefits.
The situation hasn’t changed much since then. In 2005, General Motors of Canada’s CEO Michael Grimaldi reported that each U.S.-produced car cost $1,500 in health benefits, compared to less than $500 in Canada. And in 2006, the Conference Board of Canada reported that in the U.S., health care and pensions add between $1,400 and $1,800 to the price of each vehicle – a major reason Toyota cited for building its newest plant in Ontario.
The carmakers aren’t the only ones bearing the burden. Wal-Mart’s annual bill for health benefits is $1.5 billion, even though fewer than half of the company’s 1.3 million U.S. employees are actually insured.
One of the top advocates for public health care in the U.S. is Howard Schultz, the chairman of Starbucks. He has been outspoken about the “moral responsibility” of businesses to provide health coverage. But he also knows that this is one of the best ways for companies like his to retain employees. Given that 45 million people in the U.S. have no health coverage whatsoever, even a low-paid job slinging coffee is desirable if it includes health benefits.
“How much does a business save when they don’t have to foot the bill the government could and probably should?”
So where exactly did the government get the money to foot that bill in the first place? Hint: “from the Free Money Fairy” is not the correct answer.
I love that the first answer is always “let the government take care of it,” when half of the problems are most likely caused by the government to begin with. Interestingly, I’ve even seen it suggested that seemingly unrelated things like our farm subsidy programs are major contributors to rising healthcare costs, since the cheap and readily available corn based sweeteners that are in nearly everything we eat contributes to obesity, which is a major factor in adult-onset diabetes, which is the single largest area (and growing) of annual healthcare treatment expenditures.
And yet, we just can’t seem to push national health care through in our demented society. Even many people on this very blog site are against it. Why??!!?
Remember, when the Kool-Aid smells like almonds, don’t drink it.
BTW, how many out there are aware that the CEO of United Healthcare makes $100,000,000/yr? Think that might be a factor in the cost of health care in this country? Not alone perhaps. But I’m sure others in high office are also dramatically overpaid. Obviously though, that’s just a piece of our puzzle.
#1 – Sea Lawyer,
Yes, the government is the problem here … for not implementing nationalized health care!!
1,
There are some schools of thought that if you spread the costs out over a larger base, you get a larger benefit for less per unit input. Also, a healthier population costs less to maintain.
Here’s a question. How much does company funded health care cost an employee per year, and how much would it cost per year for state funded health care? And if US care is the best and cheapest, why are there so many US seniors crossing the border to buy pills in Canada?
If you want to see an example of government run health care, be sure to look at the Walter Reed scandal.
5,
Doesn’t count. They’re soldiers. They have no rights unless the army explicitly grants it as the White House has clearly demonstrated.
#5
I’d call that duhbya run health care.
#4, I’m not saying or implying that the U.S. is the best in this area. Giving pain killers to a cancer patient doesn’t cure the cancer, and putting a rose on top of shit still leaves you with a big pile of shit.
But go ahead, create another government program. Maybe in twenty years we can amuse ourselves analyzing all of the secondary and tertiary effects that you didn’t plan for or even think about when instituting what was expedient today. That’s is inevitably the problem with all of these “government is the answer” types – they are only concerned with achieving their immediate goals, and give very little thought to the long term side effects they will be causing down the road.
Shane P. Brady
Walter Reed’s in-patient care is excellent. The issue was/is the out sourced out-patient care. Private contractors handle the housing and administration of out-patients; precisely where the abominable failures occurred. That said, no military officer should be forgiven for dereliction of duty in assuring quality at all stages for America’s wounded… unless, of course, under orders from on high to ‘over look’ the unconscionable out sourced out-patient care .
By the way, NIH is also government run as is NCI. Both do a splendid job even though the current administration has quietly devastated their funding.
Call it what you want, but it wasn’t all Bush that caused the problems. Look at this quote from the Wash. Post articles:
“the despair of Building 18 symbolizes a larger problem in Walter Reed’s treatment of the wounded. The typical soldier is required to file 22 documents with eight different commands – most of them off-post – to enter and exit the medical processing world, according to government investigators. Sixteen different information systems are used to process the forms, but few of them can communicate with one another. The Army’s three personnel databases cannot read each other’s files and can’t interact with the separate pay system or the medical recordkeeping databases.” [6] This complicated system has required some soldiers to prove they were in the Iraq War or the War in Afghanistan in order to obtain medical treatment and benefits because Walter Reed employees are unable to locate their records.”
It’s unlikely any of that is the result of Bush policies.
#1 – There’s a big difference between the government arbitrarily subsidizing certain businesses because of campaign contributions and managing social services. One functions because of corrupt politicians. The other functions because government employees do their job without any incentives to maximize profits.
It’s actually a very similar distinction to private and public health care. One sucks because money gets in the way. To other doesn’t. In fact, from a certain point of view, maintaining the broken health care system is also a case of subsidizing corporations who give large campaign contributions. The subsidies are just in the form of allowing them to scam citizens.
In general the government shouldn’t be playing favorites to private institutions (businesses, religious institutions, etc.). It *should*, however, be involved in providing social services for it’s citizens that the citizen’s themselves can’t provide easily for themselves (that was actually the original purpose of corporations before corruption allowed them to do whatever they wanted). Health care has proven to be one of those services.
#9
The “outsourcing” didn’t start until February 4th of 2007, just two weeks before the Post stories came out. So unless you’re talking about something other than the IAP contract, I’m not sure what you’re talking about.
#12, what points of mine are you addressing exactly?
Misanthropic Scott,
Don’t forget Bill ‘I am an egomaniac’ Maguire’s $1.6 billion stock options when he retired.
#8 – This is the same kind of lame argument that makes the US look like idiots when it comes to even believing in global climate change, let alone doing something about it. There are very clear benefits to having universal health care. There are also many examples around the world of it succeeding, and for the most part the citizens of the implementing countries are very happy with it.
To say we aren’t going to do something that has clear benefits just because there could be an any number of unknown negative consequences that we can’t predict is just an excuse to do nothing. If we had that attitude about everything, people wouldn’t take drugs, get surgery, or walk to school.
My daughter could become an axe murderer. Does that mean I shouldn’t raise her? Maybe I should just let her die because I can’t predict what evil things she might do later in life. Yes that’s an extreme example, but hopefully it illustrates how silly that line of reasoning is. If there are clear negative consequences (or ways to determine possible negative consequences), then take that into account. If not, it’s reprehensible to let your contrived paranoia get in the way of your humanity.
>>It’s unlikely any of that is the result of Bush policies.
Not sure I get your point. Why is it “unlikely”?? Dumbya has fucked up everything else he’s touched ever since he legacied himself out of Yale, why not this?
And before 2000, I was hearing lots of positive things about the VA medical system. Only since he started “supporting our troops”, have all these scandals come to light.
Jeez, if he doesn’t want to give them sufficient armor to keep them from getting blown up, the least he could do is make sure they get decent medical care when they come home.
#15 – You were trying to suggest that government is bad, and as an example you called up government subsidies of industry. I tried to make the point that government subsidies are indeed a bad idea, but that that is a completely different situation from government-run social services. Not everything the government does is good, but it does tend to run social services rather efficiently.
#17, If you decide to do something, it will likely only affect you. When the U.S. government decided to do something, 300 million people are affected, and those effects are seldom fully realized until many years later. It’s prudence, not paranoia, that rules over my, as you put it, sense of humanity.
I don’t believe in limited government because I don’t care about others, I believe in it because government is too dangerous to let its power be misused buy people who can’t think beyond today.
#20 – Like I said, if you have concrete concerns that should be taken into account, fine. That’s prudence. But to say that there *could* be any number of unknown consequences that we *can’t predict* just to avoid doing anything, that’s unfounded paranoia. I want government decisions to be made on sound evidence, not speculation.
Did Krugman make any mention of the trillions of dollars Medicare needs to stay solvent? Hmm. That;s funny. I wonder why he didn’t make mention of the fact that the government doesn’t pay for physicals through medicare, or that they entire system will collapse (just like the beloved Social Security Moore holds up as an example of perfection) in our lifetimes?
Mister Mustard: The problems at Walter Reed have been building for decades. Unless Bush was president in the late 70s, through the 80s and all the way up to today…well, that’s just stupid, obviously. Bush didn’t cause Walter Reed’s issues. He did nothing to help, but he was not the cause.
For the record, when you make insane accusations like that, it makes it hard to get people to take *real* criticism of the President seriously.
>>I don’t believe in limited government because I don’t care about
>>others, I believe in it because government is too dangerous to let
>>its power be misused buy people who can’t think beyond today.
I think we all believe in “limited government”, counselor. And the more sensible among us think that government should be limited to providing services, protection, and a decent quality of life to its citizens. That includes basic health care.
Spying on citizens, warrantless wiretapping, starting wars based on bullshit so your handler can make billions on his Halliburton stock options, subverting the criminal justice system, emasculating the Constitution, eviscerating the (former) scientific and medical excellence of the country….?? Not so much.
One of Dumbya’s (many) failed legacies was supposed to be handing over Social Security to the same profit-mongers who now pay CEOs in the Health Care Denial industry hundreds of millions of dollars in salary every year (not to mention the billion dollar golden parachutes) to fuck over the rubes who pay their monthly health insurance premiums, stupidly assuming that they have “health care coverage”. And this is supposed to be a model we use for seniors’ retirement? Gak.
#22 – I won’t deny that SS has a problem with solvency since it’s basically a Ponzy scheme. That said, Moore was using it as an example of good administration efficiency, not as an example of a program with a sound financial plan. Universal health care would be a horrible program financially as well if all you care about is whether the government will have to find some way to pay for it. But if that’s the case, the you should be out of your mind enraged about the military. And yet we somehow find a way to pay for the occupation of two countries and hundreds of military bases world wide. It’s all about priorities. Even SS could be financially sound if we acknowledged it’s inherent problems and simply budgeted for it.
#22 – I won’t deny that social security has a problem with solvency since it’s basically a Ponzy scheme. That said, Moore was using it as an example of good administration efficiency, not as an example of a program with a sound financial plan. Universal health care would be a horrible program financially as well if all you care about is whether the government will have to find some way to pay for it. But if that’s the case, the you should be out of your mind enraged about the military. And yet we somehow find a way to pay for the occupation of two countries and hundreds of military bases world wide. It’s all about priorities. Even social security could be financially sound if we acknowledged it’s inherent problems and simply budgeted for it.
#20 – Sea Lawyer,
When the government decides not to do something it also affects millions. When you do the math on the differences in our infant mortality versus the next worst developed democratic nation, and multiply that by the number of births, those dead babies are the price of not having nationalized health care.
How’s that almond flavored Kool-Aid going for you? *
BTW, no country in the world provides 100% perfect health care to all of its citizens. In every other developed democratic nation, the decision of who falls through the cracks is generally made by a careful cost benefit analysis of each procedure. In the U.S., we just say screw the working class poor, the ones that don’t get medicaid and don’t have coverage. Still happy with your sense of humanity?
* Almond Kool-Aid may be an obscure reference. Cyanide smells like almonds (actually, it’s really the other way around as wild almonds actually are full of cyanide). Other than that, It’s a standard Jim Jones reference, though I just checked wikipedia and found that it was actually Flavor Aid, a competing product.
http://en.wikipedia.org/wiki/Jim_Jones
Before you prattle on about this, go research the difference between HOW the numbers for most of the rest of the world and how the infant mortality numbers for the US are calculated. Learn the difference, then see if you can spot the flaw in your own reasoning.
#21, You are the one suggesting I just don’t want to do anything. In reality, I’m much more interested in looking at the mountains of policies over the years that have caused things to be where they are now. Not only in why the services cost so much, but why we seem to need so much more of them. What I don’t want to do is simply slap a different color of paint on this house and expect that to solve the problems with the rotted foundation.
Malren – Funny that the “problems have been building” at Walter Reed. for thirty years, but nobody said anything until it was on Dumbya’s watch.
I don’t know too much about Walter Reed specifically, but I DO know about the VA medical system. And up through Clinton, it was just getting better and better. In Dumbya’s seven purloined years of “leadership”, the whole thing has gone to hell in a fucking handbasket.
As to the “trillions” of dollars Medicare needs to stay solvent, could you provide a link to that? Is that over the next 200 years, or what? Best estimates are that Medicare costs a couple of hundred billion. Hey, we cancel a few more trophy wars, and we’ve got it covered. After all, what’s more important – sending ill-equipped soldiers to Iraq to get blown up (and come home to shitty health care), or taking care of our citizens? And if you don’t like Medicare, what’s your alternative? To set the wolves of the Health Care Denial industry free on senior citizens??
26,
Why don’t you explain the supposed discrepancy? Our infant mortality rates are abysmal.
>>go research the difference
Who the fuck are you? Plato? You answer every question with a request that the poster go do some research, as though you know the answer and it will be a fun pedagogical exercise for someone else to go look it up.
Guess what, Malren. You DON’T know the answers, and you’ve BEEN BUSTED, dude.
I agree with Smartalix; either explain why US infant mortality rates are so bad, or STFU.
#23, you don’t believe in limited government; you just don’t want it to be nosy while it’s serving as your provider. All I can do is smile.