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POLICY/INTERNATIONAL: John Cohn puts the boot in….nicely

I told John Cohn a while back that he was just too nice, and that he shouldn’t engage in the pointless argument with the free-marketeers about whether we treat cancer better or worse than the Europeans—especially as we do so much worse on many other measures. But John doesn’t listen to me—instead he takes the cancer argument and uses it to stamp all over the free-marketeers. At some point the referee should step in and stop this fight…

Meanwhile here’s the real problem. Next to John’s article on the CBS site is a video of Bush, and this is the text below it:

CBS News RAW: President Bush announced new proposals for the tax code intended to improve health care. His ideas counter Democratic proposals to nationalize the system.

Please could someone at CBS or anywhere else find me an example of a democrat wanting to “nationalize” the system. “Nationalize” means the government owning the production/service a la the Post Office or UK NHS. Not even Dennis Kucinich seems to be in favor of that. So what the hell are they talking about? I don’t know but neither do they. And, as they’re controlling a major news organization’s output, that is the problem.

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sonomabev M.D.BerryBarry Caroljane blow Recent comment authors
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Peter
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Peter

Sonoma, you’ll find usage in universal/single-pay countries also rising and their HC costs going up as well, but not at the rate of U.S. HC. They put there private sector under sufficient pressure by cost controls – something the U.S. has not discovered yet.

sonoma
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sonoma

Well, if we had Chinese doctors fly en masse to the US to work for $100 a month, the cost would come down. But, the service sector dosen’t work that way. You missed the first part of my argument, which is that HC consumers are using more HC, so the cost per unit treated probably hasn’t gone up that much, if such a thing could be measured. So, combine better quality, more quantity, and a low elasticity of supply, and you’ve got your explanations. Now, I’m not saying that efficiency couldn’t improve. It could, and the private sector will help… Read more »

Peter
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Peter

“Why do we not measure quality improvements in HC as we do in other sectors (computer technology, cell phones, TV’s, software, etc.).”
Sonoma, the problem with your comparison is the cost of those items comes down as technology improves. Ever see the cost (to the patients/policy payers) of healthcare come down?

Peter
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Peter

“I think it is quite possible and even likely that the combined lobbying clout of all of these employer purchasers of health insurance could more than counteract the lobbying power of hospitals, doctors, drug companies and other beneficiaries of the current system.” Barry, it would be great if that kind of balance existed, but it seems that even the healthcare cost problems of the big three auto companies is not enough for their execs. to “in effect” go against their pals at the country club and sell out to the “socalists” for universal/single pay. This point was raised a while… Read more »

sonoma
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sonoma

The real problem is the old 80/20 rule, whereby 20% of patients consume 80% of HC dollars. MH: as to your argument about real wages: the median worker is much older now than, say, 20 years ago. He consumes more HC and, more importantly, he understands that he will need more HC from here on out. So, yes, he’s paying more and it has come out of real wages, but he’s willing to pay more because he is or will be using more HC. One other bit: the quality of HC is much better than in the past. Think of… Read more »

bev M.D.
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bev M.D.

Sonoma;
Another weakness in that argument is that you may be a well-insured, middle class person TODAY and be an uninsured or unemployed person TOMORROW – literally. (Even as a retired M.D. under 65, I am currently experiencing the joys of individual health insurance.)
The current system is unsustainable no matter how you look at it – financially, patient safety-wise, continuity of care, access, whatever. Americans are famous for not seeing beyond the end of their individual-rights noses, but it will only take one good economic downturn with ensuing layoffs to change things….

Matthew Holt
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sonoma. The lose lose is that the increased cost of health care has represented ALL the growth in real income for most American workers in the last 30 years. It’s been a straight transfer payment to the health care industry.
If health care was cheaper, real wages would be much higher. and it would be cheaper if the uninsured were in one big pool with everyone else because there would be no “saftey valve”.
That’s the message that’s been rolled over by the industry’s trojan horse.

sonoma
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sonoma

Interesting piece in the Politico today: http://www.politico.com/news/stories/0707/5184.html Gist is, “reform” HC at your own political peril. As we have learned in Massachusetts, HC resources are limited. Are you, the middle class suburban voter with good health care coverage, prepared to share your doctor, your surgeon, your hospital, your nurses, your pharmacist, your PT, etc. with the uninsured? Universal HC is a lose-lose for the well-insured American. Why? It requires that he pay to subsidize the invasion of his own waiting room. If, somehow, the “reformers” succeed in this effort to seriously degrade the health coverage and access of middle-class suburban… Read more »

bev M.D.
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bev M.D.

Peter; The answer to your question about black women and breast cancer is “both, sort of.” That is, due (presumably) to lower socio economic status they tend to present at later stages, but, when compared to white women stage for stage and given the same treatment, tend to have poorer prognosis anyway. So there is something qualitatively different with at least some black women’s cancers. (I’ll find a reference on that sooner or later.) And that’s a good argument for carefully designed clinical trials in medicine which don’t mix apples and oranges – similar to the finding that women and… Read more »

Barry Carol
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Barry Carol

Peter, There are, I believe, between 150 and 160 million people who currently get their health insurance through their employer in the U.S. By contrast, there are, perhaps, 15 million people or so who work in the healthcare field. As the rapidly rising cost of health insurance moves to the top of the priority list for more and more employers (including state and local government employers), I think it is quite possible and even likely that the combined lobbying clout of all of these employer purchasers of health insurance could more than counteract the lobbying power of hospitals, doctors, drug… Read more »

Peter
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Peter

Mr. Bawer’s reference to breast cancer mortality in the U.S. does not show what the mortality rate is for low income women. From what I’ve been able to find black women’s mortality is about 34%. So is that due to relative low economic status or the types of cancer they get. I wonder what the survival rate of medicaid patients is? “What’s different is that Americans are keenly aware of their system’s problems, are arguing vigorously about those problems, and are trying to decide how best to fix them.” I see, those countries with single pay are not aware and… Read more »

Peter
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Peter

Posted by: jane blow “Didn’t you learn in kindergarten to ignore such people, not stoop to their level?” Was that a “rude” commentary on Stuart Browning? Most people have learned that a rational conversation cannot be had with Mr. Browning as he is trapped in is own ideology – or the ideology of the people he serves . But I think it important to answer him at least once in a while to uncover his agenda and counter his points, if his red-baiting can be called “points”. Rush Limbaugh learned quickly that a good buck could be had by being… Read more »

matt
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matt

Of course, there’s absolutely, positively nothing to learn from any of the 25 nations with superior health systems than ours if there’s anything wrong with any of them.
Perhaps people of other nations are less aware of the problems with their health coverage because they actually have health coverage.

sonoma
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sonoma

Conservative gay American expat writer Bruce Bawer talks about the HC system in Norway, where he lives: “Norwegians boast of their system’s “total coverage” – but total coverage doesn’t mean guaranteed care, or care on demand. Far from it. Even the media here, which generally push the official line that Norway’s system is far superior to its U.S. counterpart, run occasional stories about Norwegian children who’ve been turned down for life-saving medications, who’ve had to fly to the U.S. to get the care they needed, or who’ve died while waiting for treatment. In America 20% of women with breast cancer… Read more »

bev M.D.
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bev M.D.

Matthew’s case is interesting, because if that occurred in the U.S., the treating oncologist would be accused of treating her only for his own profit.