Quote of the Day
| Tue Oct. 27, 2009 7:16 AM PDT
From Jon Kingsdale, director of the Massachusetts health insurance exchange, on reining in healthcare spending in America:
If you're going to do health-care cost containment, it's going to have to be stealth. It's going to have to happen before any of the players understand what's happening.
Well, either stealth or main force, anyway. If the former doesn't work, eventually we'll resort to the latter whether anyone likes it or not.
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Comments
No shit, Sherlock. We call
Submitted by Another Brad (not verified) on Tue Oct. 27, 2009 7:42 AM PDT.
No shit, Sherlock. We call that "rationing." You know, that thing liberals keep swearing will never ever happen nuh uh not ever?
Massachusetts sure has done
Submitted by James2 (not verified) on Tue Oct. 27, 2009 7:52 AM PDT.
Massachusetts sure has done a brilliant job of controlling costs...
Rationing
Submitted by Walker (not verified) on Tue Oct. 27, 2009 7:55 AM PDT.
You know, that thing liberals keep swearing will never ever happen nuh uh not ever?
No, it is the thing that already happens in the US, and the conservatives are in denial about.
Actually, Another Brad, we
Submitted by Anonymous (not verified) on Tue Oct. 27, 2009 8:13 AM PDT.
Actually, Another Brad, we call it "evidence based medicine". Did you know that right now Medicare won't pay for "routine lipid screening" or flexible sigmoidoscopy more than every 5 years, or yearly Dexascan bone density screening in people who don't have osteoporosis? That's a good thing and more aggressive money saving guidelines could easily be implemented -- with no decrease in quality of care.
If Medicare says to me, you can only order a Dexa every two years (or five years or even no repeats ever would probably be adequate), then I would be protected from malpractice suits, if I only ordered it on a rational basis and a hip fracture happened. That would remove my financial motivation for ordering CYA Dexas. Having good, strong guidelines would help a lot.
No one has ever shown that doing repeat CTs for lung nodules prevents death from lung cancer. If I don't order those repeat scans and someone gets lung cancer even many years later, I get sued (ask me how I know!) If Medicare/private insurance/public option won't pay for those tests, I'm going to stop ordering them. There will be no change in lung cancer survival, even if we "ration" those tests.
If Medicare says to me that they won't pay for Pap smears in women over 65 with no history of cervical dysplasia, then I won't be tempted to do them. (I've had my head bitten off one too many times to be particularly aggressive about telling women they don't need the damn tests -- now they snarl "So this is Obamacare!" -- people love their tests)
Good, clear guidelines from a single source would go a long way toward reducing over-testing. Right now I have to weigh guidelines from various different sources and the nebulous "community standards" against my risk of being sued. It would simplify my life, decrease my liability, and NOT CHANGE OUTCOMES, if Medicare would "ration" a little more aggressively.
It's going to have to happen
Submitted by Anonymous (not verified) on Tue Oct. 27, 2009 9:14 AM PDT.
It's going to have to happen before the Supreme Court uses Citizens United v. Federal Election Commission to declare restrictions on direct electoral spending by corporations unconstitutional.
Fixed that for you.
Convoluted Costs
Submitted by Sam Gamgee (not verified) on Tue Oct. 27, 2009 9:14 AM PDT.
NPR recently had an excellent show during This American Life, called "More Is Less", that describes some of the convoluted causes of health care costs. While it tamped down some of my exasperation with the Insurance industry, it reinforced my belief of the Rube Goldberg build of the health care market. The incremental build-up over 80+ years by various market and government groups, with their own agendas, is an absurd way for something this comprehensive and costly to be built.
Link for the show.
http://www.thisamericanlife.org/Radio_Episode.aspx?sched=1320
Stealth or Force
Submitted by Trashhauler (not verified) on Tue Oct. 27, 2009 9:34 AM PDT.
Does that essentially give the game away on most things that statists want, whether they be from the Left or Right? In every case, they are the Vanguard, protecting us from ourselves.
The state of Mass. is the
Submitted by MacGruber on Tue Oct. 27, 2009 9:36 AM PDT.
The state of Mass. is the paragon of the folly of government health care. What a debacle. Can't wait for that to go national.
In other news, progressives have been caught lying again (shocker). This time, about the so-called obscene profits from the health insurance industry:
http://apnews.myway.com/article/20091025/D9BI4D6O1.html
2.2% profit margin? Evil cretins!
Heavens to Betsy! They
Submitted by spork_incident (not verified) on Tue Oct. 27, 2009 9:49 AM PDT.
Heavens to Betsy! They might have to reduce executive compensation or eliminate lobbying and campaign bribes!
Or even jack up premiums another 30%! (But I'm sure that will only be as a last resort.)
.
Yawn. Get me a talented
Submitted by Art Eclectic on Tue Oct. 27, 2009 10:23 AM PDT.
Yawn. Get me a talented accountant and a tax lawyer and I'll show you 0% profits.
Of course, I'm allowed give a completely different number to my shareholders to justify my bonus and 20 mil per year salary.
If we would just do what the UK did - only allow one number. Not one number to the IRS and a different number to shareholders....
Single payer equals 50%
Submitted by evdebs on Fri Oct. 30, 2009 10:11 AM PDT.
Single payer equals 50% costs savings, no one dies for lack of access to medical care, ability to take comfort in the knowledge that the people who process and serve you your food have access to adequate medical care, it will costs the same to build a car in the US as it does in Canada, middle class Americans won't live in constant fear that a catastrophic illness will ruin them financially, average life span will increase by three or four years, quality of life will increase exponentially, ....
Check it out!
Profit is exactly the point.
Submitted by BlueGreen55 (not verified) on Fri Oct. 30, 2009 5:36 AM PDT.
Profit is exactly the point. One either believes it's moral or immoral to make a profit at the expense of care receivers. I believe it is immoral by definition to make profit that way. Paying doctors, nurses, techs, etc. gets no argument. 1 million persons a year declaring bankruptcy because they can't pay medical bills is OUTRAGEOUS! Single payer now!!!
