One of the hurdles impeding health insurance reform is convincing those already with insurance that the changes will benefit them.
Indeed, according to most polls, more than 3 in 4 are satisfied with their own care, and according to The New York Times’ David Leonhardt, “Americans say they want change, but they also want to preserve their own status quo.”
But, the status quo cannot be preserved if we’re serious about controlling costs.
A recent editorial in the Washington Post shows the delicate situation facing the President. In his speeches, he glosses over what it means to cut costs, instead, referring to Matrix-like analogies of choosing the red pill or the blue pill when it comes to choosing medical treatments. But the situation is far more nuanced than that:
What if the pricey blue pill is actually better than the cheaper red one? What if it’s better but just a little bit? What happens when a yellow pill comes along, costing twice as much as the blue? What happens if there’s a new procedure that cures the ailment, but at an even bigger cost?
And there’s no doubt that cutting costs will require saying no, meaning the average patient will have to be affected. And that’s the conundrum facing reformers during this current iteration of reform.
In other words, having it both ways, wanting change yet maintaining the status quo, will be close to impossible if health care costs are truly to be contained.
Related posts:
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- Why price transparency won’t affect health care costs
- Without controlling costs, health coverage becomes unaffordable
- Do patient demands drive up health care costs?
- Cutting health care costs means reducing utilization
- AMA: Curbing the rise in health care costs is key to health-system reform
- "Socioeconomic status is the strongest predictor of health"
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Henry Blankett makes a very valid point. The way I see it, the idea of getting health care for everyone is a pipe dream because the supply of physicians is artificially limited. I’m a US citizen attending medical school in the Caribbean. In order to graduate, I have to pass Step 1, Step 2 and Step 2 CK. I have to go through residency training just like everyone else. Then I’ll have to pass step 3. After all of that, I’ll be eligible for a license in about 40 states. Why not 50? Because states have been lobbied by existing physicians to keep out competition.
Somehow, in medicine, the big boys get the government to keep out their competition. ~30 states have “certificate of need” laws requiring you to prove that you aren’t “duplicating services” if you want to open a hospital. Law prohibit people from buying insurance across state lines. Hospitals have to get the permission of the ACGME to increase the number of residents they hire. Everywhere, the big boys get protected and the patients get buggered. Now they want the government to get more involved? I can guarantee you that it won’t be patients OR doctors who benefit from this new scam.
Trenchdoc, I’ll give you a quote: “To each according to his needs, from each according to his abilities.” Sound familiar? This was tried for 70-odd years. Didn’t work too well.
Man has a right to the product of his labor, to appropriate that for the benefit of a few seems to me to be wrong. Government spending should benefit all: see spending on defense, highways, even (wince) the USPS. Redistribution of wealth is not the proper role of government.
Regarding “find the data” detailing outcomes differences between the UK and the US: this kind of data cannot be accomplished because the two types of health care systems are significantly different.
For example: you can go to the guidelines clearinghouse and find the statin guidelines for the UK. If you read them, you’ll discover that the UK universal coverage only covers a statin in the most dramatic of circumstances, compared to our NCEP guidelines. When the ENTIRE APPROACH to treatment of an illness differs, then direct comparisons of outcomes cannot be made.
We can look now at the CHD stats, and notice that the US has a slightly lower rate of CHD compared to the UK, yet the differences don’t appear to be large. (Figures available on Americanheart & UK heart websites.) You simply can’t use that as information to suggest there are no differences in outcomes. Our rates of obesity, diabetes, hypertension, etc. are higher than that in the UK, yet we are more proactive about treatment of hyperlipidemias. Considering these issues, there actually might be a huge disparity between UK and US outcomes–but you cannot appreciate these with direct comparisons. That’s an erroneous way to discuss this issue.
Same with Canada.
I feel a tad awkward saying that solutions ARE at hand and, further, they are NOT that difficult to comprehend or implement.
I invite interested persons to see two entries at http:doc2dochealthcarereform.com : They are “Successful Ideas” and “47M – 37M = 10M”. Together they inform that the problem is not as severe or as intractable as many want us to believe.
Healthcare resources are finite, demand for them can be practically infinite. Therefore there MUST be some sort of rationing. It will be either by market mechanisms or third-party authorities, probably government.
Here is an example to illustrate the difference:
You have a fatal condition. There is a certain cure. You will need quarterly doses for two years. Each costs $38,000. Which do you prefer:
1) You appreciate that you cannot afford it and either: a) get your affairs in order or b) initiate heroic efforts, including contacting all relatives and friends, holding raffles and bake sales, auctioning off “one year of (LEGAL) servitude”, borrowing from a bank – and raise the money for treatment.
— – — – OR — – —
2) You are told that, even if you happen to have or are able to raise the money, you CANNOT be treated because the cure has been determined illegal due to its high cost.
?????
OMG!!! — – It’s a no brainer to me.
PS – Do NOT write that these options will not work for the poor. That is elitist nonsense. Pilot programs have succeeded in the Medicaid population. (The money is granted to them, and more than made up through health care cost savings.)
I would like to see a break down of the stats shoing that 70% of Americans are satisfied with their coverage. What percentage of these had to use their insurance for significant health care problems? What percentage of people who had to use their insurance for significant problems are satisfied with their coverage (or were at the time of the problem)? What specific insurance coverage (i.e. Kaiser, United Health Care, Medicare A and B) most satisfied people who had to use it for serious medical problems?
Health Care Reform: American’s quit sitting on their fat asses, eating themselves to death, smoking, drinking to liver failure and stroking out on drugs. Or maybe just have the Govt not pay for treatment of conditions that are completely preventable. Medicare wants to not pay for “never events.” A similar approach to patients could (if the incentive actually motivated their lazy asses) results in both decreased costs AND improved health.
Win win win.
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