View Story | 176 comments
Comments: Expand Shrink Hide (Always) | Indented Flat (Always)
Europe is working on a reform to allow patients to be taken care of in another EU country if there are undue delays in care in their own country - and still keep their full domestic healthcare coverage (ie not pay for it)
European Tribune / The Oil Drum / EA2020
by Jerome a Paris on Sat Dec 22, 2007 at 12:45:03 PM PDT
This is exactly the kind of story that needs to be disseminated here so that people can see how much better it can be, not theoretically in some parallel univers, but here and now. Cheers to all over at the ET.
"Time to focus on McCain and kicking his McAss." Angry Mouse
by NearlyNormal on Sat Dec 22, 2007 at 12:47:34 PM PDT
[ Parent ]
..I was wondering how your son was doing just the other day.
Jerome, a very happy holiday to you and your family. And while I am at it , to everyone here at Dkos.
open-source: Environmental Americanandnetrootsdaily.com
by NetRootsDaily on Sat Dec 22, 2007 at 12:59:37 PM PDT
A happy holiday season to the "a Paris" family, and to all Kossacks!
"Do not forget that every people deserves the regime it is willing to endure." -- White Rose letter no. 1
by keikekaze on Sat Dec 22, 2007 at 02:50:18 PM PDT
I hope and pray your son will be okay.
"There is one man who knows in his heart that we have to build one America - not two - and that man is Barack Obama." John Edwards 5/14/08
by TomP on Sat Dec 22, 2007 at 12:57:07 PM PDT
I've added a clarification in the body of the diary that the time references were written back in April - the exam in May was positive, and so have all more recent MRIs and quarterly exams.
He still has continuous physical reeducation, but no other requirement for any medical procedure at this point - and we hope it will stay that way!
by Jerome a Paris on Sat Dec 22, 2007 at 01:43:52 PM PDT
I'm very glad for you. What a relief.
by TomP on Sat Dec 22, 2007 at 01:52:05 PM PDT
because whenever I write these diaries, I'm always tempted to write as the very last line, "I wonder what Jerome would say?"
Thank God you don't live with a system as cruel and depraved as ours.
Tell your healthcare and insurance horror stories at Guaranteed Healthcare
by nyceve on Sat Dec 22, 2007 at 12:59:53 PM PDT
for this excellent discription of how a real health care system operates. We keep getting told about bureaucracies and other crap from our information oligopoly. Good to have real facts.
by DaleA on Sat Dec 22, 2007 at 01:03:06 PM PDT
I'm appalled, as a human being, and outraged as a politically aware person (and would be as a citizen if it were my country).
Of course, in my specific case, I can' help wonder - what if we had been in that system? Would we be bankrupt? Would treatment have been denied? And I am terrified every single time.
by Jerome a Paris on Sat Dec 22, 2007 at 01:06:00 PM PDT
Your costs would probably be in the millions of dollars by this point. Even if you had insurance, it probably would have been canceled long ago.
If you still had insurance, you would be spending massive amounts of time fighting with infuriating profit-driven bureaucracies, who would make the treatment decisions instead of your doctors.
And you'd probably be harassed mercilessly by bill collectors, creditors, and other leeches.
You'd probably end up on public welfare, which means every facet of your lives would be scrutinized to make sure you were destitute enough to receive help.
Thanks for contrasting the two healthcare systems. I really don't think our system will ever be as good as yours, because ours is driven by profit, not medicine.
by Pompatus on Sat Dec 22, 2007 at 01:37:25 PM PDT
...if it were run by the government", or at least that's what they like to tell us...
-5.12, -5.23
We are men of action; lies do not become us.
by ER Doc on Sat Dec 22, 2007 at 03:35:17 PM PDT
(In my best Samuel L. Jackson, Pulp Fiction voice)
Allow me to retort! If the frakkin' French government can do a more than adequate job of health care administration, surely ours could do even better?
Oh, and don't forget that if we could reduce our Defense Dept. budgets, where we spend more than every other country combined (is that a true stat? or was it just more than the other top 3 or 4? I'll look it up later...) we could actually provide health care and still reduce our taxation? Hmmm?
Need something new here... This Space for Rent! (Keith? Your name could be here!) (-4.88, -4.15)
by DrSpalding on Sat Dec 22, 2007 at 04:49:40 PM PDT
bit better? Could you provide a link either in English or French?
It sounds pretty frightening but probably because it reminds me of a re education camp.
Let's support our candidate in the primary and if he/she loses, let's think of John Roberts and Sam Alito when we think of John McCain.
by Dave from Oregon on Sat Dec 22, 2007 at 01:44:31 PM PDT
and kinesitherapy and associated disciplines - just the long term treatment+exercise to catch up any physical handicap or other similar condition.
by Jerome a Paris on Sat Dec 22, 2007 at 01:58:00 PM PDT
. . . "rehabilitation". :)
The French can sometimes be a bit literal. I recently read a funny article in the NYT, about how an American lady living there got "re-education" of her privates, after the birth of her child. She highly recommends it, but "reeducation" does sound. . . odd to the American ear. . .
What would Gandhi do? "The cause of liberty becomes a mockery if the price to be paid is the wholesale destruction of those who are to enjoy liberty."
by Robespierrette on Sat Dec 22, 2007 at 02:06:46 PM PDT
very brilliant and angelic daughter got lyme's disease on a trip to the East Coast. It took her five years to get her West Coast doctors to admit she had it (lyme, at the time wasn't on the west coast) and another year and half to get even basic treatment.
In the interval her condition (which she had diagnosed accurately herself in the first year) left her at 90 lbs., bed-ridden, repeated seizures and collapses, and loss of mental faculties.
The treatment they gave her was a protocol for someone who had recently been infected, apparently the progression of the disease being determined by the date the medical establishment there acknowledged it. Of course, it was inadequate to the purpose. Nonetheless their documents said this treatment cures this condition so therefore no more treatment for this was available.
That took a year to fix.
Fortunately, an angel has arrived, and she, after another two years has gone from the edge of death to actually taking short jaunts with friends, and writing and singing again. If not for that lucky break...
I could tell you stories... it's the one reason I usually don't have the nerve to read most of nyceve's diaries.
At this point I'd favor a law that would at it's start require, first, that all the medical related board members, and a good sprinkling of doctors be lined up, and second the ability to count to ten.
Until we break the corporate virtual monopoly on what we hear and see, we keep losing, don't matter what we do.
by Jim P on Sat Dec 22, 2007 at 09:24:52 PM PDT
Yes, but to get that kind of care you have to live in France! How awful that must be! Mon Dieu!
"I think we need a president who isn't afraid to say, 'I'm gonna change my mind. I made a mistake.'" --George McGovern, 1972
by darrelplant on Sat Dec 22, 2007 at 01:04:36 PM PDT
b'rer fox.
by NearlyNormal on Sat Dec 22, 2007 at 01:11:01 PM PDT
9/11 changed everything. And we're gonna change it back.
by perro amarillo on Sat Dec 22, 2007 at 01:30:07 PM PDT
And ordinary people get to drink wine at lunch. On a workday. Appalling.
"Surrendering and fearful: that's the face of the Democratic Party. It's how they show they're not weak." -- Glenn Greenwald
by expatjourno on Sun Dec 23, 2007 at 05:59:22 AM PDT
Actually giving a damn about the plight of some citizen who is ill and actually giving a damn, that they can move to another country in the EU, for the treatment! You Europeans are actually a community. What! No Rugged Individualism? What No Forcing People to pull themselves up by their bootstraps? I must tell Sean/Rush/Glenn/Medved about this atrocity or it may spread here to the fruited plain
America, They were yours, Honor Them, Do Not forget them-IGTNT.
by Mr Stagger Lee on Sat Dec 22, 2007 at 01:32:22 PM PDT
It's hard to tell where Hollywood ends and the d.t.'s begin ~ W.C. Fields
by va dare on Sat Dec 22, 2007 at 02:25:41 PM PDT
...and I just happen to have it bookmarked:
"Great men do not commit murder. Great nations do not start wars". William Jennings Bryan
by ImpeachKingBushII on Sat Dec 22, 2007 at 03:53:35 PM PDT
Would that our People in America could experience such Humanity. It's so hard when you consider how many have died and are currently suffering, in America, just because they are in poor health. Many Blessings to you, your wife, and your son. Thanks So Much!
by leonard145b on Sat Dec 22, 2007 at 02:29:01 PM PDT
Nice diary. I remember it from before :-)
by Plutonium Page on Sat Dec 22, 2007 at 02:29:24 PM PDT
Does the health care system in Amsterdam differ much from the one Jerome has in Paris?
NFTT Progressively supporting the troops
by Timroff on Sat Dec 22, 2007 at 09:30:25 PM PDT
Everyone gets healthcare, but it's privatized, which is a little worrying, because the insurance companies are getting more and more control.
by Plutonium Page on Sun Dec 23, 2007 at 02:50:16 AM PDT
(joint,ligaments and meniscus) badly and after undergoing surgery developed a staph infection, had to go back to clean it out, then developed clots in her lung, etc. What should have taken a week or two spread into months. The whole situation was a nightmare because the HMO(insurance) tried frantically to control her costs at every turn. But, the worst things was watching the doctors trying to serve two masters, the patient and the company. As a health care professional it was painful to watch.
Those who can make you believe absurdities, can make you commit atrocities-Voltaire
by hairspray on Sat Dec 22, 2007 at 02:55:04 PM PDT
But I agree with the sentiment.
Insurance should be willing to pay for more of what they call experimental surgery if it is a standard, even if somewhat risky, practice. And the universal health care system in France is a far more equitable system than the already, but increasingly more absurd, US system, as nyeve's pieces show.
But you, and nyeve and everyone else, seems to be making the argument that if the US had an equitable, universal care system like the rest of the industrialized world, cases like natalie's would not occur.
That's simply not true, and it's better state the fact than overlook it.
It is just as likely the same cases happen in Europe, even France, just as often as they do here, if not more so. More equity does not translate into more supply of care. No one involved in policy research on either side of the Atlantic has ever made that claim. No research says that the supply of care is greater in France than in the US -- just that it is more equitably distributed. That's economics.
The difference for someone like Natalie is that more people pay into the system to cover expenses like hers. But there is no real evidence that natalie ever would have gotten what she needed if she were in France. Experimental procedures are restricted in your land too. Maybe by different criteria, but the restrictions still exist and are based, hopefully, on some sort of evidence-based strategy that the doctor in nyeve's piece complains about.
Also, the private insurance company blame for US health care woes is, if not misplaced, at least disengenous. Although insurance company admin costs may well be much higher than public systems, especially if the 8% expected return on capital profit is taken into account, those costs and profits are not increasing, so they cannot be the cause of the high cost of health care.
What is increasing? Well, lots of provider-level expenses, for one thing. US doctors earn over twice as much, on average,as French doctors do, and, unlike insurance company profit margins, their earnings are increasing, as are all provider expenses.
The letter from the doctor on nyeve's current piece is even more disengenous. Why couldn't the hospital and doctor's cough up for the procedure instead of the insurance company which was following its (agreeably absurd) evidence-based medicine procedures, like all universal systems, including France's, do. France won't pay for every treatment a doctor dreams up, either. But since its doctors pay is not dependent upon performing procedures (or am I wrong on this regarding France?), isn't it probable that they simply don't suggest possibilities that don't exist to sick and grieving patients?
by eastsidedemocrat on Sat Dec 22, 2007 at 06:44:00 PM PDT
eastsidedemocrat:
"What is increasing? Well, lots of provider-level expenses, for one thing. US doctors earn over twice as much, on average..."
What REALLY is increasing is the HMO's CEO's and other officers' SALARIES. I read on Kos that United Health Care's CEO received a bonus of roughly half a BILLION (yes, with a B) dollars and benefits in 2005. Not believing it, I Googled it, and the information was verified.
Half a billion would pay for a lot of medical treatment.
and...
"Why couldn't the hospital and doctor's [sic] cough up for the procedure..."
The hospital's BUSINESS is to provide a facility for doctors to provide treatment. The doctor's BUSINESS is to provide said treatment. The insurance company's BUSINESS is to PAY FOR THAT TREATMENT. That is their PRODUCT -- it's called COVERAGE.
The insurance industry is, generally, one of the most corrupt of all industries, and is responsible for much of the attacks on and opposition to social progress legislation. It pays so much money for lobbyists and 527s and direct contributions to every politician with a pulse - with very few exceptions -- that every politician is scared to death to call it to task for its policies. This goes back generations. I for one would dearly love to see it nationalized. Any apologist -- even a partial -- for the insurance industry has been brainwashed by corporate America. IMO...
Kick apart the structures.
by ceebee7 on Sat Dec 22, 2007 at 09:40:37 PM PDT
I hate 'em too. Unfortunately, facts are facts. Medical insurance profit rates are 8% and have been for years and years, just like most every other mature industry.
That United CEO? That was options, not cash. They're not worth that anymore and will be much less still when he can finally cash them in. He's still filthy rich, and insurance is still really corrupt -- no argument there. But all the crap they do just doesn't account for the financial side of the health care crisis. (Other than the lobby to keep things this way: you're right on target there.) But there's just not enough money in the 8% margin to make up for the trillion dollar increase in costs over the last decade.
There is enough money to account for a trillion dollars if you look at the increase in hospital, clinic, doctors earnings, and other provider cost increases.
It all means that if we do someday get a single- payer plan, doctors are going to go on strike (like they do at times in Europe and Canada), because its their pay that will get re-distributed to patients, like the case in every other industrialized country.
by eastsidedemocrat on Sat Dec 22, 2007 at 11:02:37 PM PDT
what has been rising are the exec salaries, posher accomodations and perqs for managment level employees, PR and marketing to increase share of market -- eg bodies -- us to pay the and more. Physician compensation has been static.
Add in the amount of time and staff required of the doctors to deal with the requirements on the insurance co/HMOs and you have a big reason for the increase in costs. Add in huge rises in medication costs.
Bush and McCain and their Social Security Privatization Plan.
by samddobermann on Sun Dec 23, 2007 at 05:21:10 AM PDT
and overhead, which have not been increasing, so, as absurdly high as they may be for some CEO's they just aren't a significant part of total health care costs. They can't explain the cost increases. A few hundred million, or even a few billion, out of a two trillion dollar budget just doesn't explain much.
Even the marketing and PR and other administrative overhead costs have not been increasing as a percentage of insurance premiums, even though premiums have been increasing, so they don't explain much of it either.
Problem with private insurance is that they're doing a lousy job of controlling costs, so, under single payer, we propose to have the government do a better job of it through legal coercion to force providers to reduce their earnings and distribute it in the form or more care for the currently underserved population. It's not any more complicated than that. But it ain't going to be doctor-friendly either for many physicians.
by eastsidedemocrat on Sun Dec 23, 2007 at 08:05:18 PM PDT
after salaries and fancy perqs are paid. Profits go to shareholders unless are retained for future operating costs in case of shortfall and capital equipment and buildings.
There are many ways to reduce costs but the pay for procedures system is a major part of problem. That's why surgeons and radiologists make way more than primary care and pediatricians and psychiatrists.
You need to read some reports. too tired to dig now but the census has some good stuff
by samddobermann on Wed Dec 26, 2007 at 04:06:33 AM PDT
Well,since you are obviously fact challenged, how about if I give you a few:
A 2003 study in The New England Journal of Medicine estimated that administrative costs took 31 cents out of every dollar the United States spent on health care, compared with only 17 cents in Canada. (Source: Paul Krugman)
And how about this:
McKinsey & Company, the consulting firm, recently released an important report dissecting the reasons America spends so much more on health care than other wealthy nations. One major factor is that we spend $98 billion a year in excess administrative costs, with more than half of the total accounted for by marketing and underwriting - costs that don't exist in single-payer systems. And this is just part of the story. McKinsey's estimate of excess administrative costs counts only the costs of insurers. It doesn't, as the report concedes, include other "important consequences of the multipayor system," like the extra costs imposed on providers. The sums doctors pay to denial management specialists are just one example. Incidentally, while insurers are very good at saying no to doctors, hospitals and patients, they're not very good at saying no to more powerful players. Drug companies, in particular, charge much higher prices in the United States than they do in countries like Canada, where the government health care system does the bargaining. McKinsey estimates that the United States pays $66 billion a year in excess drug costs, and overpays for medical devices like knee and hip implants, too. To put these numbers in perspective: McKinsey estimates the cost of providing full medical care to all of America's uninsured at $77 billion a year. Either eliminating the excess administrative costs of private health insurers, or paying what the rest of the world pays for drugs and medical devices, would by itself more or less pay the cost of covering all the uninsured. And that doesn't count the many other costs imposed by the fragmentation of our health care system. Source: Krugman
McKinsey & Company, the consulting firm, recently released an important report dissecting the reasons America spends so much more on health care than other wealthy nations. One major factor is that we spend $98 billion a year in excess administrative costs, with more than half of the total accounted for by marketing and underwriting - costs that don't exist in single-payer systems.
And this is just part of the story. McKinsey's estimate of excess administrative costs counts only the costs of insurers. It doesn't, as the report concedes, include other "important consequences of the multipayor system," like the extra costs imposed on providers. The sums doctors pay to denial management specialists are just one example.
Incidentally, while insurers are very good at saying no to doctors, hospitals and patients, they're not very good at saying no to more powerful players. Drug companies, in particular, charge much higher prices in the United States than they do in countries like Canada, where the government health care system does the bargaining. McKinsey estimates that the United States pays $66 billion a year in excess drug costs, and overpays for medical devices like knee and hip implants, too.
To put these numbers in perspective: McKinsey estimates the cost of providing full medical care to all of America's uninsured at $77 billion a year. Either eliminating the excess administrative costs of private health insurers, or paying what the rest of the world pays for drugs and medical devices, would by itself more or less pay the cost of covering all the uninsured. And that doesn't count the many other costs imposed by the fragmentation of our health care system. Source: Krugman
Facts are fact, troll. EVERY OTHER industrialized country IN THE WORLD provides better health care at a lower cost that the U.S.
by expatjourno on Sun Dec 23, 2007 at 06:29:31 AM PDT
also point out that those costs have not been increasing as a percentage of total costs. That means it is impossible that they are the reason that our health care costs are increasing. The same McKinsey document he cites research that clearly shows that reducing the admin costs would be a one-time benefit -- our bills would go back to say, 2003 levels, and then start increasing again at the same rate they are now. Although Krugman doesn't specifically say it in that article, he is also well aware that doctors are also profit-seekers as much as insurance companies. That's the problem with American health care -- profit-seeking is the problem, not just insurance companies.
Krugman's valid point is that problem is not any one insurance company, it's the whole system. It's not that insurance companies are bad, it's that both insurance and doctors are profit-seeking instead of seeking better health outcomes, and they will be punished by market forces if they do otherwise.
Which is why the doctors shouldn't be let off the hook any more than the insurance company in Natalie's tragic case.
by eastsidedemocrat on Sun Dec 23, 2007 at 08:26:10 PM PDT
It's the insurance companies that are responsible for compensating doctors and hospitals. They create the economic incentives for doctors. They ARE "the whole system" when it comes to who gets paid what. And their ONLY interest is profit.
Doctors, whatever conflicts of interest they might have, do at least have interests that conflict. Plenty of people still go into the field of medicine because they want to help people.
On the other hand, administrative costs, including salaries for the armies of people employed to do screen potential patients before letting them sign up, salaries for the armies of people employed to deny claims, salaries for top management, profits for shareholders and the salaries for all of the people employed at every medical practice just to field all of the paperwork from insurance companies, all add up to about 30 cents on the health care dollar.
Taking insurance companies out of the picture is a one-time benefit, sure, but it takes cost back a bit farther that to 2003. Plus, those costs rise just like any others, top management salaries faster than anything. In fact, the total compensation of the top hundred managers at all of the health insurance companies adds up to a couple of hundred billion dollars a year that's not going into patient care.
Then there is the efficiency drain from having so many people forced to use hospital emergency rooms for their primary care simply because they can't afford to pay for a simple visit to a primary care physician. Hospital emergency rooms don't deliver that kind of care very efficiently.
There's just no getting around the fact that the very existence of private, for-profit insurance companies is an enormous efficiency drain. Millions of people employed in an industry that not only adds no value but makes every single step of delivering a service less efficient. It's an astonishing testament to their lobbying power, the corruption of the U.S. Congress and the incompetence of Hillary Clinton that the system still exists.
There is simply no economic justification for having a private insurance industry instead of a public one.
Then there is the fact that pharmaceutical companies are allowed to charge American much more for prescription drugs that they are able to charge anyone else in the world. And drugs are a bigger part of the health care bill than fees for doctor visits.
You say facts are facts, but you seem to ignore the whopping fact that every single industrialized country in the world delivers health care to all its citizens at 30 to 50 percent lower cost, with better or results in virtually every statistical measure than the U.S. does. And if you look at the EU, not counting the recent entries from eastern Europe that I'm not sure about, the U.S. is even farther behind in results while spending more money.
by expatjourno on Sun Dec 23, 2007 at 09:49:35 PM PDT
Not quite right. This is the incentive structure in health care:
Providers are paid, not for the health of the patient, but instead by the number and dollar value of the procedures they perform. The only role of insurance is to be a check on what doctors prescribe in order to keep them honest and to pool risk for catastrophic health emergencies.
Providers are profit-incented to prescribe treatments. Provider's employment of armies of administrators to try to get paid is at least as morally hazardous in terms of patient care as the armies of administrators employed to deny treatment. Why? Because lots of treatments are risky, costly, and unnecessary. Quackery still exists in high-tech medicine, so there will always be a role for denial of treatment -- just like in Medicare today.
Actually, no. Administration costs and insurance corporate profits have NOT risen as a percent of health care premiums. But provider payments have. That's how we know that providers are driving health care costs higher. Also, Krugman says that we pay 14% more on administration that Europe and Canada do. 14% is just under two years of health care cost increases. So, It's not bringing us back to 2003 like I originally mistyped. It would only take us back to our health care premiums of 2005. Something other than administration and insurance profits must be driving the costs. Nothing else is mathematically possible.
You're absolutely right about the inefficiencies of the current system. Where you, and many others here, are missing something is in your concept of the policy space of health care:
Millions of people employed in an industry that not only adds no value but makes every single step of delivering a service less efficient. It's an astonishing testament to their lobbying power, the corruption of the U.S. Congress and the incompetence of Hillary Clinton that the system still exists.
Insurance is only one-half of the coalition that prevents reform. Providers are the other half and their lobbying is at least as intense, which is why doctors that did not offer to work on Natalie pro bono are being disingenuous about the evil CIGNA insurance companies role in her death. They could have operated without pay to save her life. And they could offer to give up some of their high incomes, along with those of insurance execs, to help us all achieve better care in the US. Equity: that is really what single payer is about.
by eastsidedemocrat on Sun Dec 23, 2007 at 10:30:42 PM PDT
In someone's garage?
A transplant isn't like pulling a tooth.
And as for what providers are charging, much of the cost of doing business for any physician is having people on the payroll to handle the paperwork from insurance companies. So increasing fees from providers are also the fault of insurance companies.
I don't know what the 14% figure refers to, but insurance companies put less than 30 cents of each premium dollar into health care. Call that 30% whatever you want, but it's not 14%, not by a long shot.
Moreover, even if that 30% stays where it is, it's still going to be 30% of a bigger bill every year. Which is why it's simply incorrect to talk about getting rid of health insurance companies as a one-time gain. It's one time for the 30 percent and then forever eliminating the cost increases from rising health insurance company premiums.
In Medicare, no one is incentivized to the tune of tens of millions of dollars in their personal bank accounts to deny care. No one gets bonuses for thinking up excuses to deny care. And Medicare's administrative costs are, unsurprisingly, lower.
And don't forget about prescription drug costs, which for most people are their biggest costs. So, no, it's not only insurance companies that are causing the runaway costs, it's also the drug companies.
I agree that in the past physicians have fought "socialized medicine" tooth and nail. Now that HMOs have created a system that's just as unpleasant and unprofitable, not so much.
by expatjourno on Mon Dec 24, 2007 at 07:35:15 AM PDT
From your first comment to me:
Administration costs in US: 31% of total costs Administration costs in Canada: 17% of total costs
Difference = 31% - 17% = 14% That's how much more we spend on admin and profits than Canada's single payer. That eliminates 1 1/2 years of health care increases in a single lump sum, putting as back to 2005. I'd take it in a heartbeat anyway, but it won't solve the rising cost problem going forward because admin isn't increasing -- provider charges are.
Medicare doesn't have armies of people around denying care, because they have a relatively immutable list of things they don't cover, and prices they won't pay. Providers insist that Medicare doesn't cover their costs, so they charge much higher prices to non-Medicare, including private insurance and the uninsured. That's called the provider profit incentive, and that is what is driving costs, according to virtually every study done, including by single-payer supporters. (That's why single payer includes global budgeting for hospitals, for example, instead of fee for service.)
If you read the pieces I cited at the beginning of this thread, you'll see that admin costs and prescription drug costs did not go up at all from 2004-2006 as a percentage of premiums in the Minnesota study, while doctors, hospitals, and clinics all increased by over 10% per year.
Regarding the failure to operate on Natalie, doctors AND the hospital AND other requisite supporting providers should have provided the operation if they really felt it was what she needed. What killed Natalie was not just the insurance company, it was an unwillingness to provide urgently needed care by everyone involved because some people felt they were not going to get paid (!!) -- both CIGNA and the providers. That's reprehensible on both sides.
by eastsidedemocrat on Mon Dec 24, 2007 at 10:15:39 AM PDT
I'd take it in a heartbeat anyway, but it won't solve the rising cost problem going forward because admin isn't increasing -- provider charges are.
This is just false. Admin costs aren't frozen. They may not be going up as a percentage of health care costs, but they are going up just like everything else. So throwing insurance companies off the sled isn't just a one-time gain.
As for Canada, their admin costs may well be too high as well.
But I get the feeling we're just quibbling about how big a waste insurance companies are and how badly Americans are being overcharged for drugs. I do agree that provider charges are part of the problem (especially for-profit hospitals), though you seem to ignore how much of that is due to the hoops that they have to jump through for insurance companies. And I think defensive medicine is probably also a part of the problem. Sweden has very good health care but they don't do anything like the kind of routine testing that U.S. practitioners do.
Katie Couric's husband dies of colon cancer so now everyone over 50 is supposed to get an annual colonoscopy? Please. There are older, cheaper tests that don't involve high-tech equipment and that can screen out almost all colon cancer.
And I think that taxpayers should probably heavily subsidize medical education so that we'd have a lot more doctors and nurses who would not be burdened by ginormous student loans.
Finally, Americans have to get over the fact that people do, in fact, get old and die. There are heroic, against-all-odds treatments for elderly an terminally ill people that we just shouldn't be wasting limited resources on.
So yes, there's more to it than parasitic health insurance companies. They just happen to be the single largest money pit and the single greatest cause of inefficiency, so that's where I'd start.
And yes, assuming the doctors were correct in their assessment, the hospital should have gone ahead and arranged the surgery for Natalie if a donor had become available.
by expatjourno on Mon Dec 24, 2007 at 04:10:03 PM PDT
wide narrow
View Story | 176 comments