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I've been reading a lot about the efforts of some states, like Pennsylvania, to preserve some kind of middle class in the face of what seems like a corporate sponsored war on people's security.

There's a catch. Its a big one. The various Democratic "plans" that all pointedly ignore the lessons learned elsewhere in the world- can't save money.

Real restrictions on cost are necessary to prevent what we have here, now. To roll back prices to an affordable level. (They lied to us- covering up the need for that) Getting affordable healthcare, is impossible using the Massachusetts model, public interests OPTIONAL. The insurers can charge whatever they want. That weakness dooms any of them. Even if a public plan (one that would not try to dump sicker people)- was started alongside them. They will be forced to pay unaffordable "competitive" prices, while having their profitable customers cherry picked away, leaving the public plan with huge losses.

That is the insurers bulletproof strategy. As long as the government has committed to forcing America to keep them in the game, they win.

That is just one of the many compelling reasons why none of the structures the Obama administration and the Senate have allowed to be discussed can save any real money. As long as cost control is prevented and prices propped up, as long as we require that insurers remain in the game, nomatter what, we can't win. Even if there is a public plan, it won't be affordable, and it will rapidly fall victim to the death spiral effect.

Look at the latest news from Massachusetts.. The governor is begging for emergency authority to stop the huge premium hikes.

A similar dynamic exists with drug prices, where we pay as much as FOUR TIMES MORE than norms for other developed countries, like France.

Read this paper on cost control and the box the Obama industry and the insurance administration  have created to prevent it.

From:  The Obama Administration's Options for Health Care Cost Control: Hope vs. Reality -- Marmor et al., -- Annals of Internal Medicine

"The Obama team's approach to health reform does not, however, fully embrace the central lesson of international cost-control experience. Effective cost control requires strong government leadership to set targets or caps for spending in the various sectors of medical care (hospital, pharmaceutical, and physicians), either directly or through insurers. The targets may not always be binding, and these caps would be on total expenditures, not services. But without explicit targets and continual efforts to enforce them, no health care system can control costs. That lesson is evident in countries ranging from Canada, Sweden, and the United Kingdom to France, Germany, and Japan (34). In Germany, for example, caps adopted in 1986 had a dramatic effect on spending for physician services. Some analysts stress other, less reliable lessons about how other countries have controlled costs (41). These arguments often confuse association with cause. For example, other nations do indeed use electronic health records (EHRs) more widely than the United States, but use of EHRs is not why they spend less on medical care. These countries had much better cost control than the United States long before the spread of EHRs (34). No studies have identified different levels of use of health information technology as a primary explanation for why U.S. health care costs exceed those of other nations.

Similarly, the United Kingdom has a National Institute for Health and Clinical Excellence (NICE), and health care costs in the United Kingdom are much lower than in the United States. But these facts are not causally related. The NICE makes recommendations about covering new medical technologies and interventions on the basis of cost-effectiveness principles (and is often cited as a model by American advocates of comparative effectiveness research) (42). However, NICE's main aim has been to rationalize decision making about coverage decisions rather than to constrain spending; it has not operated as an instrument of cost control. Indeed, since NICE's establishment in 1999, spending in the National Health Service has dramatically increased (from 7.2% of gross domestic product in 2000 to 8.4% in 2006) as the British government sought to meet the European Union norm and satisfy long-standing demands for improved, more accessible medical services (43).

In short, if medical costs are to be controlled, no substitute exists for constraining prices and capping expenditures. Frank talk about these cost-control realities, however, is politically difficult. It immediately elicits alarms from the medical care and insurance industries about "rationing" (ignoring the fact that the United States could realize significant savings from lower prices and administrative costs). Others, particularly the pharmaceutical industry, raise alarms about the effect that cost control would have on the pace of medical innovation. In addition, spending targets constrain medical providers' income and thereby prompt intense political struggles. The Obama team's limited treatment of cost-control realities—including the absence of global budgets and spending targets or caps—seems to reflect a desire to avoid such political controversies.


We write this essay, then, as a cautionary tale. Claims of savings from health information technology, prevention, P4P, and comparative effectiveness research are politically attractive. Their political appeal lies largely in the embrace of widely supported goals, including better health and improved quality of medical care. In theory, these reforms—more research, more preventive screenings, and better organized patient data—sound like benign devices to moderate medical spending. For many purposes, such reforms are substantively very desirable. But these reforms are ineffective as cost-control measures. If the United States is to control health care costs, it will have to follow the lead of other industrialized nations and embrace price restraint, spending targets, and insurance regulation. Such credible cost controls are, in the language of politics, a tough sell because they threaten the medical industry's income. The illusion of painless savings, however, confuses our national debate on health reform and makes the acceptance of cost control's realities all the more difficult."

These warnings are real. The Obama administration and their friends in the increasingly superficial parties dumb and dumber hands-off approach to healthcare are clearly to please their sponsors, and keep prices high for Americans, who are being thrown to a pack of hungry wolves.

Single payer is the ony way to make healthcare affordable, and the everybody in approach will make healthcare free and pay for it by taxes, allowing STRONG price negotiation leverage as single payer also means single customer. That would lower prices, it always does. They have no choice. But, special interests have the upper hand and would not have supported Obama - so real change is off his table. His goal seems to be to confuse the issues and keep prices high.

So the paid bloggers marching orders this week are trying to confuse that issue with a bocage of single payer look alikes.. "public option" of course, but also "medicaid buy in" plans, etc.

None of them will save any money.. they can't as long as they are forced to compete on a level playing field with cherry picking private plans, and be self sustaining, which really means to force sick people to pay money they don't have or not get care.

Shame on them!

Originally posted to Andiamo on Wed Feb 10, 2010 at 06:48 AM PST.


Is the Obama administration and the Senate's refusal to enact cost controls as practiced by developed nations preventing affordable quality health care in the USA?

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Comment Preferences

  •  Tip Jar (7+ / 0-)
    Recommended by:
    ybruti, Fabian, splashoil, xaxado, J M F, Losty, MariaWr

    WHAT exactly do insurers give us? (besides denying care) What value do they add BESIDES raising prices SO high that THEY exist? Please, WHAT?

    by Andiamo on Wed Feb 10, 2010 at 06:48:20 AM PST

    •  There is lots more on cost control issues (0+ / 0-)

      At the Columbia Journalism Review site, where Trudy Lieberman has written an excellent series of articles about the healthcare problems in the United States.

      The Obama administration really should be considered to be taking a center right position on these issues, really, arguing for the corporate viewpoint. But, Americans absolutely cannot afford that.

      Nobody in Washington except the progressive members of the House, are taking the people's side here.

      Health "reform" that can't, that won't lower prices is not health reform. We are better off going back and starting from scratch. They need to keep at it until they get it right, absolutely no concealment of built-in problems through delay can be allowed. No DELAYS because if the Dems dont lose, the bill itself will crash.. a delay is meant to extend the looting four more years.

      There is also a good series of blog posts at on the cost control failures of the various approaches that Obama HAS allowed discussion of.

      WHAT exactly do insurers give us? (besides denying care) What value do they add BESIDES raising prices SO high that THEY exist? Please, WHAT?

      by Andiamo on Wed Feb 10, 2010 at 08:21:41 AM PST

      [ Parent ]

  •  Yes, but.... (4+ / 0-)
    Recommended by:
    splashoil, xaxado, J M F, Wom Bat

    ...the fight to face these realities was lost before the current HCR kabuki theater even began last year.

    Single payer will never be taken seriously so long as progressive voters fail are willing to vote for candidates--especially presidential candidates--who don't take single payer seriously.

    Not a single, serious presidential candidate in 2008 was willing to put single payer on the table. Not a one.  Progressives eagerly backed one of these anti-single payer candidates, Barack Obama. And it was clear that for another four (likely eight) years at least, we wouldn't face up to any of the realities in this diary.

    The first step to even seriously discussing single payer is to identify and groom someone who supports single payer and is a credible candidate for president. And to start working for him or her NOW, with an eye to 2016....or perhaps 2012.

    Stop Obama's Wars Now! Bring the Troops Home!

    by GreenSooner on Wed Feb 10, 2010 at 07:02:44 AM PST

    •  Well, there was this guy from Ohio.. (3+ / 0-)
      Recommended by:
      Andiamo, J M F, Wom Bat

      But he talks funny, and he's short..

      •  Exactly (0+ / 0-)

        For better or for worse, Kucinich was NOT a credible presidential candidate.

        There really is no substitute for charisma.

        That sucks, but it's true.

        Stop Obama's Wars Now! Bring the Troops Home!

        by GreenSooner on Wed Feb 10, 2010 at 07:07:59 AM PST

        [ Parent ]

        •  Oh, I don't know.. (3+ / 0-)
          Recommended by:
          Gooserock, Andiamo, J M F

          I think being RIGHT has it's own appeal..

          Imagine that,

          Remember 9 years ago when we went for the more "Charismatic" person?  The person we want to have a beer with?

          How'd that Charisma work out for you?

          •  Well We Had 200 Years of Elections and Alas (2+ / 0-)
            Recommended by:
            GreenSooner, J M F

            your view while not invariably rejected has not generally prevailed.

            We are called to speak for the weak, for the voiceless, for victims of our nation and for those it calls enemy.... --ML King "Beyond Vietnam"

            by Gooserock on Wed Feb 10, 2010 at 07:19:48 AM PST

            [ Parent ]

          •  Being right doesn't win presidential elections. (0+ / 0-)

            And anyone who hasn't figured that out yet isn't likely to win presidential elections, either.

            Remember 9 years ago when we went for the more "Charismatic" person?  The person we want to have a beer with?

            I remember that he got to serve two terms as president. That really, really sucks. But it's still true.

            Stop Obama's Wars Now! Bring the Troops Home!

            by GreenSooner on Wed Feb 10, 2010 at 07:20:25 AM PST

            [ Parent ]

            •  And you'd think we'd learn from that.. (1+ / 0-)
              Recommended by:

              But if the Vast Majority of Americans want to be THAT stupid, What can we do?

              I seem to remember a line:

              Those who don't learn from History are doomed to repeat it..

              Again, And Again, And Again..

              Would we have voted for FDR if we knew about the Polio?  "He can't stand without help, he can't lead."


              •  Maybe they wouldn't have voted for him.... (0+ / 0-)

                ...if they knew of his disability (they did know he'd had polio).

                My conclusion: good thing they hid it from the public.

                Yours seems to be: f**k 'em if they can't handle the unvarnished truth.

                Stop Obama's Wars Now! Bring the Troops Home!

                by GreenSooner on Wed Feb 10, 2010 at 07:35:04 AM PST

                [ Parent ]

                •  No, its that the truth is important (0+ / 0-)

                  I'll take a normal looking truthful person over a flashy, well dressed liar any day.

                  We need that test that can find narcissistic people by their brain activity, and we need to use it to screen politicians for narcissistic personality disorder.

                  WHAT exactly do insurers give us? (besides denying care) What value do they add BESIDES raising prices SO high that THEY exist? Please, WHAT?

                  by Andiamo on Wed Feb 10, 2010 at 07:51:17 AM PST

                  [ Parent ]

                  •  Its easy to try to change the subject (0+ / 0-)

                    MUCH easier than admitting that we need to change course now- before we commit national suicide economically.

                    Single payer doesn't just work, it eliminates a huge source of waste, the denial system that adds absolutely no value.

                    It eliminates a 50% black hole we are puring money into.

                    It ALSO allows the government to negotiate STABLE prices on services and globally competitive prices on drugs. Changes that add to the savings.

                    The change suddenly makes healthcare affordable for everybody. At a far lower total cost than we are paying now for abysmally bad health care.

                    WHAT exactly do insurers give us? (besides denying care) What value do they add BESIDES raising prices SO high that THEY exist? Please, WHAT?

                    by Andiamo on Wed Feb 10, 2010 at 05:05:14 PM PST

                    [ Parent ]

                •  So his Charisma wouldn't trump it? (0+ / 0-)

                  OR was it that he was right?

                  Being right may be a little important, eh?

                  Maybe we can look past the flash and go for the person who happens to be RIGHT..

                  OR at least doesn't continue policies of the people who are WRONG..

          •  Kucinich couldn't even convince... (0+ / 0-)

            ...people who agreed with him on the issues to vote for him in the primary.

            A successful progressive presidential candidate would need to win the votes not only of those who agree with him, but those who don't.

            That's just a political fact.

            Stop Obama's Wars Now! Bring the Troops Home!

            by GreenSooner on Wed Feb 10, 2010 at 07:23:13 AM PST

            [ Parent ]

            •  INSTANT RUNOFF VOTING (0+ / 0-)

              an idea whose time has COME

              WHAT exactly do insurers give us? (besides denying care) What value do they add BESIDES raising prices SO high that THEY exist? Please, WHAT?

              by Andiamo on Wed Feb 10, 2010 at 07:52:13 AM PST

              [ Parent ]

              •  Finally, you are for something that CAN be done! (0+ / 0-)

                Color me shocked.

                I am fully in support of IRV; if it were in place we would not have to make many of the compromises we have to make to get incremental change.

                Freedom of speech does not mean the freedom to lie without consequence; unless, apparently if you're a right wing talk-radio host.

                by Whimsical on Wed Feb 10, 2010 at 09:03:10 AM PST

                [ Parent ]

    •  I, still, didn't expect Obama to be so Republican (1+ / 0-)
      Recommended by:

      in his outlook and embracing of the Establishment. Almost any "reasonable" Republican proposal is listened to and frequently incorporated in a bill - while actual Progressive proposals are either not listened to, rejected out of hand or eliminated later.

      Hate to say this but - in my view from my political awareness beginning in 1968 - I consider Obama to be a Moderate Republican - and I was a Republican for much of this period. Those policies are a failure and will be the demise of the middle class - as it has been and even to some extent exists today. Embrace the New Feudalism - serfs.

      That is the message I hear from mainstream Democrats, based on a continually right ward shift in economic policies over these many years...

      •  Very few people realize what was going to happen (1+ / 0-)
        Recommended by:
        J M F

        very few people have experience with this particular kind of extremely skillful manipulator.

        WHAT exactly do insurers give us? (besides denying care) What value do they add BESIDES raising prices SO high that THEY exist? Please, WHAT?

        by Andiamo on Wed Feb 10, 2010 at 07:54:25 AM PST

        [ Parent ]

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