Why is it that cutting costs and increaseing efficiency always is only directed at health care providers?
Where is the cost cutting and efficiencies from the insurance companies? They are posting record profits, while eating up half of every health care dollar. Why are they gettting a free ride, yet hospitals are closing and squeezing every dollar they can? This country should be absolutely outraged that it costs the same amount of money to actually care for a sick person as it does to process their insurance paperwork.
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Getting Real About Health Care
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We need more realism on health care. The trouble with casting medical-care as a "right" is that this ignores how open-ended the "right" should be and how fulfilling it might compromise other "rights" and needs. What makes people healthy or unhealthy are personal habits, good or bad (diet, exercise, alcohol and drug use); genetic makeup, lucky or unlucky, and age. Health care, no matter how lavishly provided, can only partially compensate for these individual differences.
There is a basic moral and political dilemma that most Americans refuse to acknowledge. What we all want for ourselves and our families—access to unlimited care paid for by someone else—may be ruinous for us as a society. Sensible limits must somehow be imposed. The crying need now is not to insure all the uninsured. This would be expensive (an additional $123 billion a year, estimates the Kaiser study) and would provide modest health gains at best. Two fifths of the uninsured are young (19 to 34) and relatively healthy. The compelling need now is to limit the runaway increases in spending that make private and government insurance more expensive and may not deliver significant health improvements.
Both McCain and Obama have health-care proposals that, though radically different, are impractical or undesirable. And both largely ignore the massive health-care challenge already sitting in the government's lap: Medicare. By some studies, 30 percent of Medicare spending may go to unneeded services that do not enhance recipients' well-being. Medicare is so large and influential that by altering how it operates, government can reshape the entire health-care system. This would require changes in rules and reimbursements to encourage more electronic record-keeping, better case management, fewer dubious tests and procedures, and a fairer sharing of costs between the young and the old. The work would be unglamorous and probably unpopular. But if the next president won't—or can't—do it, his presidency will fail in one fateful way.
© 2008
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