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Tag: Policy

POLICY: Why Is Fixing American Health Care So Difficult?

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Das KapitalABC News is running a special on health care this week and they asked two bloggers to stick in our 2c.  I’m up asking Why Is Fixing American Health Care So Difficult? David Williams from The Health Business Blog pens an article about IT and transparency that is slightly more optimistic.

Feel free to come back here and comment.

Almost all the problems with the American
health care system boil down to two questions. How do we create a
system that ensures that all citizens, and perhaps residents, have
access to health insurance? And how do we contain the huge cost
increases?

Of course, behind these questions lies the question of how to reform
the nation’s largest industry that serves and richly rewards many
powerful interests. Continue.

POLICY: Healthcare by Lobbyist By Eric Novack

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Das Kapital
Place this in the ‘toot my own horn’ category. And in the ‘you really ought to listen to The Eric Novack Show’ at www.ericnovack.com‘ category.

From the Wall Street Journal October 10, 2006 edition:

Competition is an issue that many patient-advocacy groups wrestle with as they struggle to raise funds for research, attract greater interest in their diseases, and speed up the search for a cure.

The article ostensibly discusses how there are over 140 advocacy groups for brain tumors alone— and how they actively compete against each other for members, funding, and the ear (and hopefully pocketbooks) of elected officials.

As we give more and more power over the administration, funding and regulation over to unelected bureaucrats appointed by our ever campaigning politicians, we head toward the only guaranteed outcome of ‘single payer’, ‘single pool’, ‘national’ healthcare:  the protected by law, expanded by lawsuit, and guarded by lobbyists development of healthcare-by-lobbying.

In the world of healthcare-by-lobbying, heart disease advocates fight against Alzheimer’s groups, child advocates fight against the AARP, hip replacement makers fight against pacemaker manufacturers.

There is no free market-no free market of ideas, no free market for patients, no free market for doctors. And busy legislators find themselves uncertain about what the greatest need is for patients because each group emphasizes different issues or aspects of the disease.

There is also recognition that as cancer research increasingly focuses on using costly, cutting-edge technology to identify genes and cellular changes as an avenue to new treatments, progress is going to take huge sums of money that small patient-advocacy groups are unlikely to be able to raise on their own.

I have yet to ever hear an argument from the single payer advocates how this can be prevented.  Rather, it appears as if this is an essential part of their plan.

Proof- spend 10 minutes reading the single payer bill vetoed by Governor Schwarzenegger in California last month.  80+ pages of committees and  bureaucracy.

POLICY: Aetheist pokes fun at religious institution not offering much charity

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Yup I’m at up at Spot-on talking about the nun who lost her health insurance. It’s called Get cancer? Get fired, become homeless and lose your health insurance!. As ever you can come back here to comment.

Here’s to the new road to ruin in America. Got cancer? Now you can get
fired, become homeless and lose your health insurance, and therefore
all your money too! Statistically, it’s unlikely to happen. But it’s
perfectly legal if your employer has very few scruples.

Being a member of one of America’s most despised minorities – atheists (or secular humanists as we’re now calling ourselves) – and being none too impressed with the New York Times in recent years with both its reporting of Iraq and its continued insistence on writing rubbish about how we get the health care system we want, I have been doubly gratified by a current Times series
on the unfair privileges which religious institutions receive in the
U.S. It illustrates, in passing, an important point about the
relationship between health insurance and employment – for the worse,
I’m afraid. Continue

PHARMA/POLICY: When off-label drug use attacks! (Pharma profits, that is)

The NEJM, in an article called The Price of Sight — Ranibizumab, Bevacizumab, and the Treatment of Macular Degeneration catches up with a THCB contributor from 4 months ago. The issue is that Genentech has a new and to the unwashed un-sophisticates (i.e. me and apparently most opthamologitsts) seemingly identical drug (Lucentis) for which it wants to charge 20 times the amount of Avastin, when Avastin works fine or better. Although of course Avastin hasn’t had a clinical trial for exactly that indication, and Genentech is apparently restricting supplies of Avastin in order to force you and me (the taxpayer) to cough up for Lucentis instead (and for the poor patient who must pay 20% of a much bigger number than if they’d paid out of pocket for Avastin.

Genetech does appear to be gilding the lilly here. I mean seriously who ever heard about a drug company complaining about un-promoted off-label use of its product? Unless of course, the off-label use cuts into the sales of a much more expensive version of the same thing!

On the other hand if someone can explain if there’s a justifiable difference, you know where the comments button is.

POLICY/POLITICS: Econ 101

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I’m up at Spot-on taking explaining very basic economics to the unwashed masses in a piece called Back To School, Business Week and no I didn’t get to choose the title. The main point is that health care is not infrastructure nor is it manufacturing. It’s a service industry, like teaching English Lit.  Come back here to comment.


There’s been a lot of fuss in the last week about the BusinessWeek article that suggested that all employment growth in America in the last year had come in the health care sector.
Well that’s not too surprising. The money pouring into health care has
been going up at more than 10% a year since 2000 while the rest of the
economy has been relatively stagnant (at least compared to
historical growth rates). The non-employment sector of the economy
(i.e. corporate profits) has been growing much faster than the labor
sector. Health care, though, is a labor intensive business – you need
those nurses, techs, and even doctors to look after patients. Continue …

POLITICS/POLICY: Shock-Horror–I almost agree with Arnold Kling

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Arnold Kling responds to Moulitas’ (DailyKos) overture to the Libertarians in a piece called Dear Libertarian Democrats… The only slight flaw in all this is that there aren’t very many libertarians, but then again we don’t need too many Republican voters to change sides!

Kling proposes running school choice in a few states and single payer health care in a few states. The only flaw here is in thinking that they’re much different. After all single payer health care in the usual American sense means putting all the money in one social insurance pool and allowing people to choose which doctors and hospitals they go to. As far as I can see school choice in Kling’s version is the same: creating one pool of all K-12 education dollars and letting kids/parents choose the schools they want to go to. In both cases everyone needs to be in the same pool, and the money follows the choice of the individual. I don’t understand how the libertarians can decry one as evil socialism while being OK with the other, unless they really favor repealing universal compulsory education. But maybe they do!

As for the health experiment, it probably depends where they run single payer. But the likelihood is that a really effective single payer plan run across state lines would be a wash. It would attract old school industry (autos) who would get rid of their “obligations” on the state, but it would also attract entrepreneurs suffering from job lock. It might lose jobs from employers with younger than average workforce, but theoretically it’ll be a wash. While single payer may not be the best option for financing health care delivery, and while a universal voucher scheme like educational choice may work too, a compulsory universal single insurance pool is by far the best option.

 

 

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