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Title: America’s broken health insurance system (MALKIN ON MD HEALTH INSURANCE IN 2004)
Source: michellemalkin.com
URL Source: http://michellemalkin.com/2004/08/2 ... roken-health-insurance-system/
Published: Aug 27, 2004
Author: Michelle Malkin
Post Date: 2007-10-10 14:55:18 by aristeides
Keywords: None
Views: 949
Comments: 33

America’s broken health insurance system

By Michelle Malkin • August 27, 2004 07:29 AM

Paul Krugman has a column in today’s New York Times decrying America’s health care system. He supports–surprise!–a single payer approach.

I have commented before on the problems with central planning in health care. I certainly am not convinced that a government-run system is the answer, but I do agree with Krugman that there are serious problems with our health insurance system, particularly in the market for individually-purchased (non-group) coverage.

After my husband quit his job earlier this year (to become a full-time stay-at-home dad), we had a choice. We could either buy health insurance from his former employer through a program called COBRA at a cost of more than $1,000 per month(!) or we could go it alone in Maryland’s individual market. Given our financial circumstances, that “choice” wasn’t much of a choice at all. We had to go on our own.

We discovered that the most generous plans in Maryland’s individual market cost $700 per month yet provide no more than $1,500 per year of prescription drug coverage–a drop in the bucket if someone in our family were to be diagnosed with a serious illness.

With health insurance choices like that, no wonder so many people opt to go uninsured.

In the end, we decided to purchase a very high-deductible plan (sold by Golden Rule Insurance Co.) coupled with a tax-sheltered Medical Savings Account (MSA). We couldn’t qualify for the preferred rate because Golden Rule says I am underweight. Hmph! In any case, while Krugman and most Democrats don’t seem to like MSAs, in our case we were glad they were an option.

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#4. To: aristeides (#0)

Are these people nuts?

Look at the goob's VA system if you'd like a preview of more goob health care.

Lod  posted on  2007-10-10   15:13:47 ET  Reply   Untrace   Trace   Private Reply  

Look at the goob's VA system if you'd like a preview of more goob health care.

Government-administered medical care is very different from government-provided medical insurance.

The National Health Service they have in Britain is government-administered medical care. The private medical care provided through government insurance they have in France and Germany is very different.

They all cost about half as much as ours, in terms of percentage of GDP. And they all result in a higher life expectancy than in this country.

aristeides  posted on  2007-10-10   15:18:05 ET  Reply   Untrace   Trace   Private Reply  

They all cost about half as much as ours, in terms of percentage of GDP. And they all result in a higher life expectancy than in this country.

As usual you talk through your hat about universal health care.

a. You might want to read this summary article about an MD who has actually worked in "the system" - Dr. David Gratzer, Cdn trained physician:

www.investors.co m/editorial/editorialcontent.asp? secid=1502&status=article&id=270338135202343

"A Canadian Doctor Describes How Socialized Medicine Doesn't Work" 07/26/07

...And now even Canadian governments are looking to the private sector to shrink the waiting lists. In British Columbia, private clinics perform roughly 80% of government-funded diagnostic testing.

This privatizing trend is reaching Europe, too. Britain's Labour Party — which originally created the National Health Service — now openly favors privatization. Sweden's government, after the completion of the latest round of privatizations, will be contracting out some 80% of Stockholm's primary care and 40% of its total health services.

Since the fall of communism, Slovakia has looked to liberalize its state-run system, introducing co-payments and privatizations. And modest market reforms have begun in Germany.

Yet even as Stockholm and Saskatoon are percolating with the ideas of Adam Smith, a growing number of prominent Americans are arguing that socialized health care still provides better results for less money...

...One often-heard argument, voiced by the New York Times' Paul Krugman and others, is that America lags behind other countries in crude health outcomes. But such outcomes reflect a mosaic of factors, such as diet, lifestyle, drug use and cultural values. It pains me as a doctor to say this, but health care is just one factor in health.

Americans live 75.3 years on average, fewer than Canadians (77.3) or the French (76.6) or the citizens of any Western European nation save Portugal. Health care influences life expectancy, of course. But a life can end because of a murder, a fall or a car accident. Such factors aren't academic — homicide rates in the U.S. are much higher than in other countries.

In The Business of Health, Robert Ohsfeldt and John Schneider factor out intentional and unintentional injuries from life-expectancy statistics and find that Americans who don't die in car crashes or homicides outlive people in any other Western country.

And if we measure a health care system by how well it serves its sick citizens, American medicine excels. Five-year cancer survival rates bear this out. For leukemia, the American survival rate is almost 50%; the European rate is just 35%. Esophageal carcinoma: 12% in the U.S., 6% in Europe. The survival rate for prostate cancer is 81.2% here, yet 61.7% in France and down to 44.3% in England — a striking variation.

Like many critics of American health care, though, Krugman argues that the costs are just too high: health care spending in Canada and Britain, he notes, is a small fraction of what Americans pay. Again, the picture isn't quite as clear as he suggests. Because the U.S. is so much wealthier than other countries, it isn't unreasonable for it to spend more on health care. Take America's high spending on research and development. M.D. Anderson in Texas, a prominent cancer center, spends more on research than Canada does.

That said, American health care is expensive. And Americans aren't always getting a good deal. In the coming years, with health expenses spiraling up, it will be easy for some to give in to the temptation of socialized medicine. In Washington, there are plenty of old pieces of legislation that like-minded politicians could take off the shelf, dust off and promote: expanding Medicare to Americans 55 and older, say, or covering all children in Medicaid.

But such initiatives would push the U.S. further down the path to a government- run system and make things much, much worse. True, government bureaucrats would be able to cut costs — but only by shrinking access to health care, as in Canada, and engendering a Canadian-style nightmare of overflowing emergency rooms and yearlong waits for treatment..."

b. regarding myths about international life expectancy studies...

www.freemarketcure.com /singlepayermyths.php

"The 10 Myths of Single-Payer Health Care"

Myth No. 6: Single-payer systems achieve better health outcomes.

Most single-payer advocates point to life expectancy and infant mortality as evidence that single-payer systems produce better health outcomes than the U.S. And, indeed, the U.S. has lower life expectancy and higher infant mortality than many nations with a single-payer system.

The problem is that life expectancy and infant mortality tell us very little about the quality of a health care system. Life expectancy is determined by a host of factors over which a health care system has little control, such as genetics, crime rate, gross domestic product per capita, diet, sanitation, and literacy rate.

The primary reason is that the U.S. has lower life expectancy is that we are ethnically a far more diverse nation than most other industrialized nations. Factors associated with different ethnic backgrounds -- culture, diet, etc. -- can have a substantial impact on life expectancy.

A good deal of the lower life expectancy rate in the U.S. is accounted for by the difference in life expectancy of African-Americans versus other populations in the United States. Life expectancy for African-Americans is about 72.3 years, while for whites it is about 77.7 years. What accounts for the difference? Numerous scholars have investigated this question. The most prevalent explanations are differences in income and personal risk factors. For example, one study found that about one-third of the difference between white and African-American life expectancies in the United States was accounted for by income; another third was accounted for by personal risk factors such as obesity, blood pressure, alcohol intake, diabetes, cholesterol concentration, and smoking and the final third was due to unexplained factors.

Infant mortality is also impacted by many of the same factors that affect life expectancy -- genetics, GDP per capita, diet, etc. -- all of which are factors beyond the control of a health care system. Another factor that makes U.S. infant mortality rates higher than other nations is that we have far more pregnant women living alone; in other nations pregnant women are more likely to be either be married or living with a partner. Pregnant women in such households are more likely to receive prenatal care than pregnant women living on their own.

Perhaps the biggest drawback of infant mortality is that it is measured too inconsistently across nations to be a useful measure. Under United Nations' guidelines, countries are supposed to count any infant showing any sign of life as a "live birth." While the United States follows that guideline, many other nations do not. For example, Switzerland does not count any infant born measuring less than 12 inches, while France and Belgium do not count any infant born prior to 26 weeks. In short, many other nations exclude many high-risk infants from their infant mortality statistics, making their infant mortality numbers look better than they really are.

In areas where a health care system does have an impact, such as treating disease, the U.S. outperforms single-payer systems. For example, the U.S. has a higher five-year survival rate for victims of heart attacks than Canada, due to the fact that we do more bypass surgeries and angioplasties in the U.S. Hospitals in the U.S. also commit fewer errors than hospitals in countries with single-payer systems like Australia, Canada, New Zealand, and the United Kingdom.

c. Regarding high costs of medicine in the USA as opposed to other Western nations, I'd suggest that tort reform in the USA would bring down the costs substantially. Oddly enough, whenever I hear "folks" talking about implementing the single payer "good stuff" insurance program that "other countries" have, these same folks never talk about the fact that "other countries" don't allow the ambulence chasing lawyers to run their insurance programs into the ground with frivolous malicious lawsuits.

scrapper2  posted on  2007-10-11   0:13:19 ET  Reply   Untrace   Trace   Private Reply  

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