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POLICY: Free Market Healthcare – Fact or Fiction?By Eric Novack

THCB thanks guest poster Dr. Eric Novack for a great series of posts this week on the big issues facing the health care system.  Together with Mike Millenson and Maggie Mahar, Eric did a fantastic job of filling in for Matthew.  If you’d like to hear more from Eric, go have a listen to the Eric Novack show, which airs every weekend on KKNT 960 AM in Phoenix. Stay tuned for more from Eric in the weeks to come …

This week, in Matthew’s absence, we have debunked the low overhead of Medicare and engaged in an ongoing discussion about whether a society based upon freedoms ought to be able to compel its citizens to participate in government programs.  I am somewhat surprised to find few people have been tackling the ‘opt-out’ provision of my previous post.  My sense is that it is tough to argue on paper (electronic, of course) that the government can force everyone to join in, with no option of getting out.  Interestingly, this is at the heart of so many discussions about public education, where a growing segment of the population is demanding more choices, not fewer, for their children.

An issue we have tackled before, but is worth doing again, given the repeated references in the comments sections, relates to another of the great myths of American health care:  our ‘free market’ system. 

Fact: $2 trillion in total health care spending in 2006 Fact: direct government payments for Medicare and Medicaid in 2006 accounted for about $700 billion in 2006  Fact:  government spending on VA health care in 2006 exceeded $31 billion Fact: Department of Defense spending on healthcare in 2005 was $37 billion, though the number now is about 8% of the total defense budget for 2007 Fact:  The value of the ‘tax exclusion’ for employer sponsored benefits was nearly $190 billion in 2004 Fact: private insurers peg their reimbursement—no matter how much they would claim to the contrary—to the medicare fee schedule

And we have a ‘free-market’ healthcare system?  Like the editorial I posted previously says, “the least we can ask for is an honest comparison” of the different options for reform.

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Kiyoshi SakoCarlArrowv cifelloJim Newcomer Recent comment authors
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Kiyoshi Sako
Guest

KOMBUCHA (kind stocks) is SOLD. Kombuha is the healthy beverage which has been popular with New York. My Kombucha seems that is good to the CONSTIPATION. As for my Kombucha because it is difficut to drink vey, when Kombucha is drunk, directly please drink cola or juice. Drinking Kombucha, it seems that you can defecate after the 4-5 time.

Carl
Guest

Physician Compensation appears to be a point of concern and greatly misunderstood – and apparently, in the prior post, intentionally maligned. Physicians can be grouped as either public or private. Physicians can be further grouped as employees or owners of a private business. Finally, physicians can be grouped as Primary Care or Specialists. Public physicians are employed by the federal or state government and is either a state or federal employee. Physicians working for the Army, at a state financed medical school, under contract to an underserved area, or on staff with a regulatory agency would be in this category.… Read more »

Carl
Guest

Addendum:
How many motorized wheelchairs are in France and their percentage of use.
Regarding physician compensation:
*** How many HOURS per week do their physicians work & how many WEEKS per year do their physicians work versus their American counterparts???
More importantly, separate your physician statics. Don’t group surgeons with primary care physicians.
Primary care physicians & specialty care hours, expenses, compensation, and net revenue are significantly different.
Failure to account for these differences is statistical fraud.

Carl
Guest

Vive La France! What is missing from any discussion ANYWHERE on this site, is a separation of the cost and availability of health insurance, the utilization of health care services, the personal health habits of American citizens, personaland cultural behaviors, and the actual cost of providing health care services. What seems to prevail is a number of Chicken Littles screaming “The High Cost of Health Care”, figuring if they scream it loud enough and often enough there will be a groundswell of support for what they want – Universal Health Care – regardless of the facts. France to the rescue!… Read more »

Arrow
Guest

The proper income for a physician should be based on his ability to cure or prevent disease. If this paradigm was practiced the cost of healthcare would go way down since there is hardly a physician around that knows much about curing or preventing. The systems cost is largely controlled by the pharmaceutical and medical product companies and their ever increasing political lobby and control of medical schools. When doctors learn to disassociate themselves and practice true prevention and treatment and effort is placed on education of nutrition and natural modalities to the public, not dictated by the Health Department,… Read more »

v cifello
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v cifello

it is nice to see such an intelligent discussion. can someone point me to the educational materials that have culminated in such vast knowledge which has given some of you the ability to devine the proper income for a physician? i thought the politburo was disbanded

Jack Lohman
Guest

An interesting poll: Majority Back Health Care for All:
http://tinyurl.com/2x5asr and
http://tinyurl.com/2kymxr

Peter
Guest
Peter

I’m with Jack about health insurance companies offering nothing of real value in return for premiums. I would like to be able to deduct my healthcare costs off my income tax. I don’t get employer subsidized (non-taxed)insurance or tax funded medicare but have no way to offset costs like other taxpayers. But I think in absence of a single pay plan then Bush’s “plan” should also allow people to deduct health costs outside of the insurance industry. That might push insurance companies to get more competitive – HA! As with Jack, I don’t take anything Bush says with any kind… Read more »

Jack Lohman
Guest

And I’d add one more thing Jim. George W. does not do anything in the best interest of the public, but does indeed go our of his way to propose plans that benefit his contributors. And that comes from a liflong (though currently disgruntled) Republican that voted for W twice. Am I infallible? That should tell you no.

Jack Lohman
Guest

If you read my editorial you’ll see why I believe insurance companies are a waste of valuable resources that would otherwise be directed to patient care. I believe in a Medicare-for-all system, as do most phycisians with the one qualifier that reimbursements be more fair. Many managed care systems are pretty good, and many are pretty bad and limit choices. But making insurance an Option? Ask the folks in MA and CA about that. And ask those employees who are essentially forced into an HSA because the employer “opted” to provide HSAs.

Jim Newcomer
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Jim Newcomer

Jack: Thanks for the reply>>>>”I disagree, unless you are an insurance company exec.” However, your reply is puzzling. I think you are overlooking something or perhaps know something about the Bush plan that I don’t. As I understand it States that don’t wish to participate in the Bush Health Plan could simply opt out by enacting the same exemptions as the Federal. The Bush Plan is voluntary, no mandates, and states without income taxes are opted out from the git go. My state has a state monopoly on workers compensation insurance. There is also an effort to put a state… Read more »

Jack Lohman
Guest

>>> “I think the Bush plan has a great deal of merit…”
I disagree, unless you are an insurance company exec.
See: http://www.wisopinion.com/index.iml?mdl=article.mdl&article=6663

Jim Newcomer
Guest
Jim Newcomer

At the start of this thread Eric noted the value of 2004 tax exlcued benefits at 180 Billion which, if so ought to be at least $200 Billion today. Eric also calls for honest comparisons. I agree and feel the Bush Health Plan provides a baseline for comparing all other health reform proposals. Whether we end up with some kind of free market would in significant part depend on how each state chooses to allocate this new 200 billion which would be taxable at the state and local levels. By the ides of April we and all states will have… Read more »

Jack Lohman
Guest
Jack Lohman
Guest

An interesting article at http://tinyurl.com/yqf5n2