Bush addresses the nation on the economy and the stock market tanks. Irony

[sdnativeson]

Cyphire, medicare? efficient? I seriously have a hard time accepting that- it’s been a pretty hot topic for quite a while. I haven’t heard much, if anything positive.

I only “parroted” what I read in the news and other blogs etc, as I said to PC – I don’t spend a lot of time thinking about healthcare programs, I admit I’m not the most well informed.

Heres an excerpt from an interview with David Walker our comptroller (Hey! this is just a sample before I get jumped on with my earlier opinion about his latest talk)

“What would happen in 2040 if nothing changes?

“If nothing changes, the federal government’s not gonna be able to do much more than pay interest on the mounting debt and some entitlement benefits. It won’t have money left for anything else – national defense, homeland security, education, you name it,” Walker warns.

Walker says you could eliminate all waste and fraud and the entire Pentagon budget and the long-range financial problem still wouldn’t go away, in what’s shaping up as an actuarial nightmare.

Part of the problem, Walker acknowledges, is that there won’t be enough wage earners to support the benefits of the baby boomers. “But the real problem, Steve, is health care costs. Our health care problem is much more significant than Social Security,” he says.

Asked what he means by that, Walker tells Kroft, “By that I mean that the Medicare problem is five times greater than the Social Security problem.”

The problem with Medicare, Walker says, is people keep living longer, and medical costs keep rising at twice the rate of inflation. But instead of dealing with the problem, he says, the president and the Congress made things much worse in Dec. 2003, when they expanded the Medicare program to include prescription drug coverage.

“The prescription drug bill was probably the most fiscally irresponsible piece of legislation since the 1960s,” Walker argues.

Asked why, Walker says, “Well, because we promise way more than we can afford to keep. Eight trillion dollars added to what was already a 15 to $20 trillion under-funding. We’re not being realistic. We can’t afford the promises we’ve already made, much less to be able, piling on top of ’em.”

With one stroke of the pen, Walker says, the federal government increased existing Medicare obligations nearly 40 percent over the next 75 years. ”

I agree it’s a serious issue. I admitted I am not all over the topic so it is entirely possible that I am talking out my ass but, I don’t think I am that far off base.

I’ve only had first hand experience with emergency rooms three times in the U.S. Once the wait was two and a half hours (at 2 in the morning!) the other times pretty quick response, the staff did a good job. But I know the point you are making.

I do not believe that our health care system is the laughing stock of the world. Don’t construe that statement as meaning there isn’t room for serious improvment. As I said earlier lets reign in the TLA first.

I still equate it to Socialized medicine. Bureaucracy, the governmental version of anarchy.

[cyphire]

The funding problem of Medicare is accurate – but has nothing to do with how the program runs…

Basically – it works – and it doesn’t cost a lot to administer. Our current system is one of increasing costs, obscure rules, arbitrary decisions, all motivated by greed and profit. Also – as to the prescription benefit… We pay huge prices for drugs, so our drug companies can give discounts to every other country. The lobbyists say that without America paying full price for drugs, the drug companies wouldn’t be able to develop new drugs…. Wow…

Anyway the thrust of your response was about the funding of Medicare, and the prescription problem… My point is that Medicare runs efficiently, (like most single payer systems)… The American people are being effectively robbed by big Health Care – and they lies they express which are parroted…

By the way sdnative… “I still equate it to Socialized medicine. Bureaucracy, the governmental version of anarchy.” But the point is that it works far better for other countries than our system is working for us… Too bad most Americans don’t actually look at the scorecard in almost every category to see that we are getting a horrible, raw deal. When you say “Socialized medicine” most people (me included) have been taught to look at that as a terrible thing… It’s advertising… Actually socialized medicine works far better than the system we have here.

I would also like ANYONE else to comment about Emergency rooms…. Please chime in… I’ve been to about 10 in my life, 8 were horrific. I hear stories all the time… Anyone? Have a good experience with Emergency rooms?

[cyphire]

The funding problem of Medicare is accurate – but has nothing to do with how the program runs…

Basically – it works – and it doesn’t cost a lot to administer. Our current system is one of increasing costs, obscure rules, arbitrary decisions, all motivated by greed and profit. Also – as to the prescription benefit… We pay huge prices for drugs, so our drug companies can give discounts to every other country. The lobbyists say that without America paying full price for drugs, the drug companies wouldn’t be able to develop new drugs…. Wow…

Anyway the thrust of your response was about the funding of Medicare, and the prescription problem… My point is that Medicare runs efficiently, (like most single payer systems)… The American people are being effectively robbed by big Health Care – and they lies they express which are parroted…

By the way sdnative… “I still equate it to Socialized medicine. Bureaucracy, the governmental version of anarchy.” But the point is that it works far better for other countries than our system is working for us… Too bad most Americans don’t actually look at the scorecard in almost every category to see that we are getting a horrible, raw deal. When you say “Socialized medicine” most people (me included) have been taught to look at that as a terrible thing… It’s advertising… Actually socialized medicine works far better than the system we have here.

I would also like ANYONE else to comment about Emergency rooms…. Please chime in… I’ve been to about 10 in my life, 8 were horrific. I hear stories all the time… Anyone? Have a good experience with Emergency rooms?

[cyphire]

The funding problem of Medicare is accurate – but has nothing to do with how the program runs…

Basically – it works – and it doesn’t cost a lot to administer. Our current system is one of increasing costs, obscure rules, arbitrary decisions, all motivated by greed and profit. Also – as to the prescription benefit… We pay huge prices for drugs, so our drug companies can give discounts to every other country. The lobbyists say that without America paying full price for drugs, the drug companies wouldn’t be able to develop new drugs…. Wow…

Anyway the thrust of your response was about the funding of Medicare, and the prescription problem… My point is that Medicare runs efficiently, (like most single payer systems)… The American people are being effectively robbed by big Health Care – and they lies they express which are parroted…

By the way sdnative… “I still equate it to Socialized medicine. Bureaucracy, the governmental version of anarchy.” But the point is that it works far better for other countries than our system is working for us… Too bad most Americans don’t actually look at the scorecard in almost every category to see that we are getting a horrible, raw deal. When you say “Socialized medicine” most people (me included) have been taught to look at that as a terrible thing… It’s advertising… Actually socialized medicine works far better than the system we have here.

I would also like ANYONE else to comment about Emergency rooms…. Please chime in… I’ve been to about 10 in my life, 8 were horrific. I hear stories all the time… Anyone? Have a good experience with Emergency rooms?

[sdnativeson]

Cyphire, point taken, two different issues. I stand somewhat
corrected (not going to capitulate completely or immediately, I want/need more info). Still, I appreciate both the information and perspective.

True, Walker did explicitly mention the prescription benefit as a primary culprit.

As it all comes down to cost, isn’t that the issue (main issue) with our current system? After fraud (maybe before) what would be the next greatest expense? I’ll postulate lawsuits, if I’m wrong correct me. The problem with emergency rooms (wait, expense ?)I can see where the expense might be controlled but the wait is more of a supply issue isn’t it?

I agree it’s ludicrous that the drugs we develop here are cheaper in other countries, so we subsidize their prescription costs at the expense of our citizenry’s ability to obtain the same.

I appreciate the insight, you’ve given me something more to think about (gee, thanks) and a possible opportunity to only be mumbling out of my ass instead of talking from it
(at least on this topic).

[sdnativeson]

Cyphire, point taken, two different issues. I stand somewhat
corrected (not going to capitulate completely or immediately, I want/need more info). Still, I appreciate both the information and perspective.

True, Walker did explicitly mention the prescription benefit as a primary culprit.

As it all comes down to cost, isn’t that the issue (main issue) with our current system? After fraud (maybe before) what would be the next greatest expense? I’ll postulate lawsuits, if I’m wrong correct me. The problem with emergency rooms (wait, expense ?)I can see where the expense might be controlled but the wait is more of a supply issue isn’t it?

I agree it’s ludicrous that the drugs we develop here are cheaper in other countries, so we subsidize their prescription costs at the expense of our citizenry’s ability to obtain the same.

I appreciate the insight, you’ve given me something more to think about (gee, thanks) and a possible opportunity to only be mumbling out of my ass instead of talking from it
(at least on this topic).

[sdnativeson]

Cyphire, point taken, two different issues. I stand somewhat
corrected (not going to capitulate completely or immediately, I want/need more info). Still, I appreciate both the information and perspective.

True, Walker did explicitly mention the prescription benefit as a primary culprit.

As it all comes down to cost, isn’t that the issue (main issue) with our current system? After fraud (maybe before) what would be the next greatest expense? I’ll postulate lawsuits, if I’m wrong correct me. The problem with emergency rooms (wait, expense ?)I can see where the expense might be controlled but the wait is more of a supply issue isn’t it?

I agree it’s ludicrous that the drugs we develop here are cheaper in other countries, so we subsidize their prescription costs at the expense of our citizenry’s ability to obtain the same.

I appreciate the insight, you’ve given me something more to think about (gee, thanks) and a possible opportunity to only be mumbling out of my ass instead of talking from it
(at least on this topic).

[cyphire]

It’s a tough call – but I think the basic problem is that we are the only first world country to not actually provide healthcare to it’s citizens. We have been programmed to believe that if its the government it’s bad. Problem is that the free market system, which also controls our political will (the people are sheep – the lobbyists win) – doesn’t really efficiently handle social issues like health care.

You are correct – the supply problem in the ER is that the uninsured must be taken whether or not they can pay. If they added more ER’s and more doctors, the wait wouldn’t go down, it would just get more volume. This is the fundamental breakdown in the system. If even illegals had access to health care (I’m not advocating it one way or another, just a point) then the ER’s wouldn’t be so crowded. If doctors offices operated like any other business, they wouldn’t have bankers hours (funny – but even banks are open till 7pm and on Sat and Sun – Dr’s shut down at 4pm on Fridays.

We need a socialized health care system. We need to start removing the private element from health care. They are delivering a crap product at the highest price on the planet. And the quality of care sucks. We are ranked 34th in health care for a reason….

To me the biggest crime (I just sold my company in pharma) is that our drug companies hide their profits, go offshore, take illegal tax breaks, lie about their cost and profit percentages as a relation to geography, and give huge discounts to all the other countries except ours (they are the best at paying off our corrupt thieving politicians.)

As long as Canada gets our drugs at 1/2 price and we are paying full we have a lot to be ashamed about.

[cyphire]

It’s a tough call – but I think the basic problem is that we are the only first world country to not actually provide healthcare to it’s citizens. We have been programmed to believe that if its the government it’s bad. Problem is that the free market system, which also controls our political will (the people are sheep – the lobbyists win) – doesn’t really efficiently handle social issues like health care.

You are correct – the supply problem in the ER is that the uninsured must be taken whether or not they can pay. If they added more ER’s and more doctors, the wait wouldn’t go down, it would just get more volume. This is the fundamental breakdown in the system. If even illegals had access to health care (I’m not advocating it one way or another, just a point) then the ER’s wouldn’t be so crowded. If doctors offices operated like any other business, they wouldn’t have bankers hours (funny – but even banks are open till 7pm and on Sat and Sun – Dr’s shut down at 4pm on Fridays.

We need a socialized health care system. We need to start removing the private element from health care. They are delivering a crap product at the highest price on the planet. And the quality of care sucks. We are ranked 34th in health care for a reason….

To me the biggest crime (I just sold my company in pharma) is that our drug companies hide their profits, go offshore, take illegal tax breaks, lie about their cost and profit percentages as a relation to geography, and give huge discounts to all the other countries except ours (they are the best at paying off our corrupt thieving politicians.)

As long as Canada gets our drugs at 1/2 price and we are paying full we have a lot to be ashamed about.

[cyphire]

It’s a tough call – but I think the basic problem is that we are the only first world country to not actually provide healthcare to it’s citizens. We have been programmed to believe that if its the government it’s bad. Problem is that the free market system, which also controls our political will (the people are sheep – the lobbyists win) – doesn’t really efficiently handle social issues like health care.

You are correct – the supply problem in the ER is that the uninsured must be taken whether or not they can pay. If they added more ER’s and more doctors, the wait wouldn’t go down, it would just get more volume. This is the fundamental breakdown in the system. If even illegals had access to health care (I’m not advocating it one way or another, just a point) then the ER’s wouldn’t be so crowded. If doctors offices operated like any other business, they wouldn’t have bankers hours (funny – but even banks are open till 7pm and on Sat and Sun – Dr’s shut down at 4pm on Fridays.

We need a socialized health care system. We need to start removing the private element from health care. They are delivering a crap product at the highest price on the planet. And the quality of care sucks. We are ranked 34th in health care for a reason….

To me the biggest crime (I just sold my company in pharma) is that our drug companies hide their profits, go offshore, take illegal tax breaks, lie about their cost and profit percentages as a relation to geography, and give huge discounts to all the other countries except ours (they are the best at paying off our corrupt thieving politicians.)

As long as Canada gets our drugs at 1/2 price and we are paying full we have a lot to be ashamed about.

[patientrenter]

Cyphire, I’d like to be guaranteed good health care. I’d also like to be guaranteed good food, good housing, good…. In fact, much of my life is spent trying to achieve these security goals, so my comments on this are far from flippant or unsympathetic.

I think it’s interesting that one of the largest well-off nations on the planet also has an unusual arrangement for the health care of its residents. When I was growing up in a society with a lot of these guarantees, I noticed the US seemed to have more economic drive and success than we did. Could it be that the effort I now expend to achieve this economic security is shared by many others here? Could it be that it’s one of the reasons why the US does as well as it does economically (and examining the record over very long time horizons)? I don’t know, but it’s worth some fairly deep reflection as part of any debate on our future health care system.

I see horrible waste in our health care system here, but my impression is that first began to be serious in the 1960’s. When primary responsibility for almost all payments for medical goods and services are handed over to a weak 3rd party, Medicare or a private insurer, logic would say costs would start to escalate. I suspect that the cumulative health cost inflation we’ve experienced since 1960 is the biggest contributor to poor health care today.

There is more than one solution to the cost inflation. One solution is to put an all-powerful “dictator” in charge of the health care system – a European-style government health agency. They can then impose cost controls through price orders and rationing. We do it for other things, like physical security. It seems to work OK in Europe. But I wonder if it’s also possible to cure most of the unaffordability problem by removing much of the 3rd party management.

If most patients and doctors had to come to an agreement on prices and services without a 3rd party, I suspect prevailing prices would be dramatically lower. If I only had to pay $25 for a doctor’s visit, then even when I’m pretty poor I’m likely to go when I really need it. And most communities would have doctors who would occasionally forgive the bills for their poorest and most deserving patients.

I agree we have the worst of both worlds now. But I just think that there may be more than one solution to this.

Patient renter in OC

[patientrenter]

Cyphire, I’d like to be guaranteed good health care. I’d also like to be guaranteed good food, good housing, good…. In fact, much of my life is spent trying to achieve these security goals, so my comments on this are far from flippant or unsympathetic.

I think it’s interesting that one of the largest well-off nations on the planet also has an unusual arrangement for the health care of its residents. When I was growing up in a society with a lot of these guarantees, I noticed the US seemed to have more economic drive and success than we did. Could it be that the effort I now expend to achieve this economic security is shared by many others here? Could it be that it’s one of the reasons why the US does as well as it does economically (and examining the record over very long time horizons)? I don’t know, but it’s worth some fairly deep reflection as part of any debate on our future health care system.

I see horrible waste in our health care system here, but my impression is that first began to be serious in the 1960’s. When primary responsibility for almost all payments for medical goods and services are handed over to a weak 3rd party, Medicare or a private insurer, logic would say costs would start to escalate. I suspect that the cumulative health cost inflation we’ve experienced since 1960 is the biggest contributor to poor health care today.

There is more than one solution to the cost inflation. One solution is to put an all-powerful “dictator” in charge of the health care system – a European-style government health agency. They can then impose cost controls through price orders and rationing. We do it for other things, like physical security. It seems to work OK in Europe. But I wonder if it’s also possible to cure most of the unaffordability problem by removing much of the 3rd party management.

If most patients and doctors had to come to an agreement on prices and services without a 3rd party, I suspect prevailing prices would be dramatically lower. If I only had to pay $25 for a doctor’s visit, then even when I’m pretty poor I’m likely to go when I really need it. And most communities would have doctors who would occasionally forgive the bills for their poorest and most deserving patients.

I agree we have the worst of both worlds now. But I just think that there may be more than one solution to this.

Patient renter in OC

[patientrenter]

Cyphire, I’d like to be guaranteed good health care. I’d also like to be guaranteed good food, good housing, good…. In fact, much of my life is spent trying to achieve these security goals, so my comments on this are far from flippant or unsympathetic.

I think it’s interesting that one of the largest well-off nations on the planet also has an unusual arrangement for the health care of its residents. When I was growing up in a society with a lot of these guarantees, I noticed the US seemed to have more economic drive and success than we did. Could it be that the effort I now expend to achieve this economic security is shared by many others here? Could it be that it’s one of the reasons why the US does as well as it does economically (and examining the record over very long time horizons)? I don’t know, but it’s worth some fairly deep reflection as part of any debate on our future health care system.

I see horrible waste in our health care system here, but my impression is that first began to be serious in the 1960’s. When primary responsibility for almost all payments for medical goods and services are handed over to a weak 3rd party, Medicare or a private insurer, logic would say costs would start to escalate. I suspect that the cumulative health cost inflation we’ve experienced since 1960 is the biggest contributor to poor health care today.

There is more than one solution to the cost inflation. One solution is to put an all-powerful “dictator” in charge of the health care system – a European-style government health agency. They can then impose cost controls through price orders and rationing. We do it for other things, like physical security. It seems to work OK in Europe. But I wonder if it’s also possible to cure most of the unaffordability problem by removing much of the 3rd party management.

If most patients and doctors had to come to an agreement on prices and services without a 3rd party, I suspect prevailing prices would be dramatically lower. If I only had to pay $25 for a doctor’s visit, then even when I’m pretty poor I’m likely to go when I really need it. And most communities would have doctors who would occasionally forgive the bills for their poorest and most deserving patients.

I agree we have the worst of both worlds now. But I just think that there may be more than one solution to this.

Patient renter in OC

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