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.
"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!