Health Debate: Costs and Benefits
The New York Times
Letters
August 4, 2009
To the Editor:
Universal coverage and cost control are not conflicting aims.
Canada spends 10 percent of gross domestic product on health care, and everyone is covered. The United States spends 16 percent of G.D.P., but tens of millions lack coverage. The cost difference is almost entirely due to higher administrative costs and higher prices, which are directly related to the economics of a multi-payer system.
The lessons from Canada and other countries are clear. If you focus on cost control, you will fail. If you cover everyone because itās decent and just, you will also achieve economic sustainability.
America, itās time to do the right thing and then reap the rich rewards of moral public policy.
Michael M. Rachlis
Toronto, Aug. 2, 2009
The writer, a doctor, is a health policy consultant.
http://www.nytimes.com/2009/08/05/opinion/l05health.html?ref=opinion
And…
U.S. Health Spending Breaks From the Pack
By Catherine Rampel
Economixl
The New York Times
July 8, 2009
The following graph shows that the United States is the only nation that has failed to slow the growth in health care costs in spite of also being the only nation of those listed that has not provided universal coverage.
health spending per capita in US 2000 PPP dollars, OECD countries
If there is no image in this message, the graph can be accessed at this link:
http://economix.blogs.nytimes.com/2009/07/08/us-health-spending-breaks-from-the-pack/
And…
Senators Closer To Health Package
By Shailagh Murray and Lori Montgomery
The Washington Post
August 6, 2009
The emerging Finance Committee bill would shave about $100 billion off the projected trillion-dollar cost of the legislation over the next decade and eventually provide coverage to 94 percent of Americans, according to participants in the talks. It would expand Medicaid, crack down on insurers, abandon the government insurance option that President Obama is seeking and, for the first time, tax health-care benefits under the most generous plans. Backers say the bill would also offer the only concrete plan before Congress for reining in the skyrocketing cost of federal health programs over the long term.
Spurred by the CBO director’s startling assertion last month that measures drafted by other committees would not bend the “cost curve,” negotiators on the finance panel are also studying a plan to fine insurance companies that do not pay providers electronically, a plan to reduce payments to providers to force them to increase efficiency and a plan to study the comparative effectiveness of various medical treatments.
http://www.washingtonpost.com/wp-dyn/content/article/2009/08/05/AR2009080503996.html?hpid=topnews
Once again. The stated goals of health care reform are 1) to cover everyone, and 2) to slow the growth in health care costs so that health care is affordable. So what is Congress doing?
The Senate Finance Committee now would leave 6 percent without coverage, and none of the other bills are truly universal either. Based on the policies contained in the bills, it is likely that the estimates of individuals that would be left out are very conservative, and many more will remain uninsured. So much for universal coverage.
What about bending the cost curve? Most of the legislative measures are aimed at controlling federal spending on health care. Very few of the policies would have any real impact on slowing the growth of our total national health expenditures. This means that more health care costs will be shifted from the government to individuals and employers. Bending the cost curve of the federal budget is of no value if the cost curve of our national health expenditures continues on its current trajectory.
Will private insurance reform slow cost increases? All Congress is asking of the insurance industry is that they guarantee the availability and renewability of insurance coverage. That can have no impact whatsoever on total health care costs, but it does increase health insurance premiums since those high-cost individuals who are currently shut out would then be allowed to purchase coverage in the private plan risk pools. Higher private insurance premiums is not exactly what most Americans want.
Michael Rachlis is right. Look at the curves. Every other nation has adopted health care financing systems – social insurance programs – which have allowed them to moderate the trajectory of health care spending, while providing universal coverage. The United States remains the outlier on both counts.
The members of Congress are diddling with policies that they wish would control costs, but at best will only sanitize the federal budget, while they insist in leaving in place our unique, American-style multi-payer system that can never provide affordable health care for all of us.
An improved Medicare-for-all program would bend our cost curve into the sustainable path shared by all other nations, and would take care of all of us. Let’s go for it!