Rx for Health Care: Pain

Runaway spending is a symptom of the biggest problem which his described here:
http://www.scragged.com/blogs/scragged/archive/2007/08/28/the-only-health-care-question.aspx
Unless this question is answered, debate is futile.

Mr. Samuelson accurately states that ???runaway health spending??? is our biggest health care problem. His statement that doctors profit from this is inaccurate. Medicare is still paying physicians the same rate as six years ago, even though the costs to run a practice have increased 18% over that period. To make matters worse, Medicare plans to cut its payments to doctors by 10% on Jan. 1, 2008 and 40% over the next nine years. Last year Congress stopped a planned 5% cut at the last minute, but there was no increase. Meanwhile, for each of the 5.6 million Medicare enrollees in managed care, Medicare spent an average of $922 more per year than it would have for regular fee-for-service Medicare. This money went to the health insurance companies, not to physicians who are struggling to remain in business. Malpractice insurance premium costs in many states continue to skyrocket, since Congress has failed to pass any bill to reform the system. Physicians??? organizations have repeatedly offered long term solutions for these problems without being heard. Many physicians in suburban and rural areas have already had to close their offices. If the Medicare cuts take place and the malpractice system is not made rational, many more will follow.

We may do well to look at the infrastructure of the individual corporations. Their lust for the bottom line is erroding the quality of care. There are viable reasons for the ever increasing costs of health care and include rising staff turnover rates, increased length of stay and insurance companies who continue to run amok.

I keep wondering about the many sugestions that the health care situations should be discussed. During the same time we can be sure that millions will die due to a lack of proper medical care. I feel the fact that we have so many people in this Country without health care paints us as a strange bunch of Christians.

Dan Kanoza

Hooray for Robert Samuelson for calling for an in depth discussion of the health situation. Problem is he doesn't go nearly far enough. From Edwards Deming we have learned that fixing problems after they occur is incredibly expensive. Better to prevent the problems from happening in the first place.
Sadly our entire "health" system is built on fixing problems after they occur. Given the size and economic power of the major players--HMOs, pharmaceuticals, insurance companies, big hospitals, the AMA, et al.--nothing is going to change, since all the money is in fixing problems after they occur.
In actuality we do not have a health care system; rather we have a sickness management system. Until we have the political will to invest in prevention, all the cost-cutting schemes are merely flimsy band-aids on a gaping wound. And the costs will continue to skyrocket
elder1737

Hooray for Robert Samuelson for calling for an in depth discussion of the health situation. Problem is he doesn't go nearly far enough. From Edwards Deming we have learned that fixing problems after they occur is incredibly expensive. Better to prevent the problems from happening in the first place.
Sadly our entire "health" system is built on fixing problems after they occur. Given the size and economic power of the major players--HMOs, pharmaceuticals, insurance companies, big hospitals, the AMA, et al.--nothing is going to change, since all the money is in fixing problems after they occur.
In actuality we do not have a health care system; rather we have a sickness management system. Until we have the political will to invest in prevention, all the cost-cutting schemes are merely flimsy band-aids on a gaping wound. And the costs will continue to skyrocket.
Alan Gilburg
agilburg@comcast.net

I have been following health care issues at www.polijam.com Samuelson is right by saying that we must cut hidden costs present in the current health system. Cutting out unnecessary procedures (which incidentally increase both risk and cost) and reducing costs of procedures that are performed, will inherently cut the overall costs of health care. But as long as some sort of insurance covers most of the costs, even if the cost of insurance is borne directly by individuals, rather than employers or government, the ???tragedy of the commons??? will prevail. Individual health care will continue to be paid for by ???others,??? namely an anonymous insurance plan.

Unfortunately, not only are the costs hidden, but the medical and pharmaceutical establishments have convinced Americans that more procedures and medications are to be equated with premium care and better health. Clearly, as Samuelson points out, when people begin to recognize the costs of health, some may choose to be more discriminating when using health care resources. But until people begin to recognize that more and expensive health care does not necessarily equate with better health care, I am afraid that overall costs will not be reduced.

Cant post long comments here.

Many problems cause the high costs of healthcare. No one solution that will bring down the costs. Only dividing the problem into smaller pieces will we be able to see potential solutions. The cause for high drug prices is not the same cause for high prices for office visits. Different problems need different solutions.

First, lets realize that because someone does not have insurance does not mean that they don't get medical treatment. In fact, these individuals are responsible for a big increase in costs for those with insurance. We also must realize that the Federal Government has never managed anything effectively, either from a cost or service stand point. If you want to bring costs down, remove Medicare and Medicaid and cap what doctors and hospitals can charge. The article proposes to simple change the bandaid of the current system instead of curing the problem. Privatize all insurance, (including social security while we are at it), so that the patient can shop for the best price (if things aren't capped) and service.