Although there are some positive provisions in the current House Tri-Committee bill – including insurance for all and payment reform demonstration projects – the proposed legislation misses the opportunity to help create higher-quality, more affordable health care for patients. In fact, it will do the opposite.
In general, the proposals under discussion are not patient focused or results oriented. Lawmakers have failed to use a fundamental lever – a change in Medicare payment policy – to help drive necessary improvements in American health care. Unless legislators create payment systems that pay for good patient results at reasonable costs, the promise of transformation in American health care will wither. The real losers will be the citizens of the United States.
114 Comments
Excellent article by Mayo’s Cortese and Korsmo in the Chicago Tribune about the need for a “value index” factor in Medicare payments.
I would also add that tort reform needs to be part of this health care cost reduction mix. How come the trial lawyers are conspicuously absent from the table? A reduction in the number of procedures and tests ordered that do not make a difference to the management of the case could have a beneficial effect on costs of care.
great. Now nothing will happen in DC except our premiums and copays will continue going up at 15% a year, meanwhile 46 million americans won’t have insurance at all (and counting)
Exactly! These Medicare payment “formulas” are helping to drive up costs in the first place. So they want to apply similar policies across the board to help lower costs? I guess that only makes sense to people in Washington.
It just smacks of the idea that every profession must pay almost nothing, or else be a “money-grubbing” parasite on society’s back. The plan is clearly to pay less for low-grade treatment, and to thus make the government plan “competetive” enough to cut out enough people from other plans more or less to drive those plans out of business. And while they may not go completely out of business, what probably will happen is they’ll “restructure” (downsize) and go into a secondary “supplemental” insurance market for the wealthy. The real losers? The middle class who currently have good coverage.
Mayo has a point, but the clinic needs to offer constructive criticism not just criticism.
So, Mayo how about it? Can you offer detailed specifics to Congress, or not?
It’s troubling to realize that such respected medical organizations while saying that reform is needed and costs must be brought under control find it to their benefit to upset the progress of change. Is Mayo as guilty as the entrenched insurance carriers?
So, can anybody out there bring some substance to this debate? If there is a better way or that the policies are not in ALL our best interest give some alternatives with detail. PLEASE
Congress is exempting itself from its healthcare plan and crippling private insurance http://www.investors.com/NewsAndAnalysis/Article.aspx?id=482329.
A comprehensive, free market plan exists that transitions those on government programs to a new plan while private business builds what those on Medicare, Medicaid, and SCHIP need.
The plan is catastrophic care that is means-tested with a prevention focus. It would be open to all citizens while more private plans are created. That will happen because regulations are drastically reduced and plans sold across state lines. Private plans also get tax credits to enroll the poor and the sick.
The government plan pays for itself and is phased out in favor of private ones.
Unlike ALL the UHC plans, ways to get more doctors and nurses is included without bankrupting people.
Please check it out:
http://www.modernconservative.com/freeandfair.php
To helen: You seem to have forgotten that only 9-11 million of the 46 million uninsured will be covered in this giant leap further into socialism. And it seems you’ve not thought about all those who can afford to pay for their own health care and choose (sic) not to purchase insurance: Also that most likely, 90% of the rest are here in our country illegally and are therefore not deserving of health care paid for by our hard working citizens.
“…the proposed legislation misses the opportunity to help create higher-quality, more affordable health care for patients. In fact, it will do the opposite.”
Let’s skip the political propaganda, shall we. In fact, you have no idea whether the legislation will or won’t improve affordability or quality (the public plan should certainly do the former). You just lost any credibility you ever had with anyone who understands science, public policy, or political rhetoric.
To Rob: Here is some substance for you, okay? Folks in countries with socialism health care have to come to America to have their medical needs met. That should tell you that, while our heath care might not be perfect, it is the best in the world.
Why, then would you want our system to become like those that aren’t working in socialist countries?
Providing insurance does not provide better healthcare or any healthcare.
So many people in rural America the real issue is accessibility to healthcare. You can provide all the insurance you want, but for millions of people, traveling on rural roads for a couple of hour is not a priority until they get sick.
A simple yet inexpensive procedure like teeth cleaning substantially reduces health risk, yet millions of people don’t have access to routing dental care due to the reasons I’ve stated
Preventative medicine reduces the cost of healthcare by lowering risk of disease. Where is that in the bill?
Hello shepherdwong, and Rob. You are obviously unable to read the other options for reform that are out there. You seem to only be reading liberal articles. Why don’t you educate yourself on the other options you say don’t exist. I seem to be able to find 3 ways other than the current bill, but that does take reading views you may not agree with. I am not going to spoon feed you on the other options either, like you expect people to do.
Rob asks about providing alternatives. He is certainly correct about this.
The Mayo Clinic has a well deserved reputation for quality, but not necessarily at a higher cost.
In many cases the best healthcare in our country is not the most expensive.
For example the leading healthcare institutions tend to operate differently. Best practices in areas ranging from sterilization techniques to pre and post operation processes can deliver better quality of healthcare at a lower cost.
I would challenge Mayo (and others) to build a medical online community to share best practices, mentoring, etc. among all other institutions.
“Folks in countries with socialism health care have to come to America to have their medical needs met. That should tell you that, while our heath care might not be perfect, it is the best in the world.”
Rich folks come here (in extremely small numbers) to have their medical needs met while those who live in this country die because they are denied coverage by insurance companies seeking to increase profits and executive pay. The net result is that we have the highest cost per person in the industrialized world (at least double) and yet some of the highest infant mortality and shortest life expectancy rates. “Best in the world” is just more insurance industry propaganda.
I am one of the moderators for this blog, responding to Rob. Check out this link: there are several suggestions from Mayo Clinic http://www.mayoclinic.org/healthpolicycenter/pdfs/perspective.pdf
Thanks for your interest, and engaging in the discussion.
When has the government ever reduced the cost of anything?
“When has the government ever reduced the cost of anything?”
Again, for those who learned everything they know about public policy and government from Limbaugh and Hannity: corporate run health care in the US has the highest cost per person in the industrialized world (at least double) and yet some of the highest infant mortality and shortest life expectancy rates in the industrialized world. What you are really saying is that every other industrialized nation can provide health care to all of their citizens with better outcomes at a lower cost but the United States can’t.
I don’t get this criticism at all. The Tri Committee bill does include results oriented reforms. JaneJ if you mean just using the blunt instrument of cutting Medicare payments across the board how does that stop the local hospital in my area from giving everyone a chest x-ray no matter what they’re being treated for? They’re still going to do them at 70% payscale unless those extra tests are pinpointed for elimination.
A beefed up MEDPAC under the health care commissioner will be able to mandate best practices and a good open source universal records keeping system such as the VA VistA will allow the kind of data mining it takes to make those recommendations. And they’ll be able to say, “fine, give every one of your patients an unneeded chest x-ray, but we’ll re-imburse you 0% on each one.”
Janej:
Thanks for the link.
In regard to your quote: “Mayo Clinic alone lost $840 million last year under Medicare.”
Just curious as to how Mayo recouped this amount, or did it come from its endowments?
If nothing changes how long before Mayo will not accept Medicare patients? 1 year – 10 years??
Will Mayo be adding to the discourse of Sen Conrad’s co-op plan by offering what it thinks ought to be considered, or is Mayo just going to suggest exploring?
“The Medicare payment system must be reformed to pay for value rather than pay for volume.”
Does Mayo have a solution?
See, this is what I mean. Lots of broad criticisms that make sense, but then no substance. No detailed logic to provide a considered discourse as to EXACTLY HOW to solve the problem.
Further, we all might want to start with this simple premise:
Citizens want affordable health care
Doctors want to provide this health care
Doctors and the facilities they require to provide health care have to be (reasonably) compensated – no one works for free.
Financial/insurance industries can provide the service to assure that patients get properly treated and pay their share, and the medical professions are reasonably compensated for doing so. At the same time insurers need to be regulated so they cannot game the system.
Now, is time for the policy wonks to get to basics and for the medical services industry to scrap the old and craft a new business model that is fair to ALL.
This is simple logic. Us citizens are sick and tired listening to corporations and institutions (and their shills in Congress) blather on and on about policy and ethics and moral commitment. but since when did a non-human entity (corporations/institutions) have morals or ethics – it’s all about shareholders returns or contributors demands, and this years bonuses; and for the Congressional shills remaining in office).
It would be a breath of fresh air if Dr Cortese et al could provide their “personal” prospectives and not that of an endowed institution that needs to placate its board. And, while the Mayo Clinic Health Policy Center may feel insulted by such criticism these policy wongs need to get back to being more pragmatic and practical. High-minded policies need to be replaced by action by concerned individuals with integrity, not a soulless committee.
Rich folks come here (in extremely small numbers) to have their medical needs met…
Rich folks? Do you have any idea how many ordinary, middle-class people cross the border from Canada to get treatment here in the US? Hospitals along our northern border are filled with Canadians fleeing the glory of single-payer care.
Rob:
You ask excellent questions. Mayo Clinic alone doesn’t have all the answers, but the link I provided has some very real ideas for how change can begin. The strength of real reform will be carried out at many levels, with many unique and creative solutions that work for local communities and patients. The principles must be consistent, but the solutions must be flexible enough to accommodate variation across the country.
It is important that everyone involved in health care, especially patients and families, have a voice at the table.
Just a point of clarification; the recommendations of the Health Policy Center represent a consensus of more than 2,000 people who have participated with the Health Policy Center over the past three years — not just the voice of Mayo Clinic. And we try to be very specific when we speak as to whether it is the Health Policy Center or Mayo Clinic, fully realizing this sometimes gets lost in the translation. We are a nonpartisan center, representing these viewpoints.
We believe that the health care delivery system needs to change — and that includes Mayo Clinic. While we feel we do many things well, we know we need to get better at many things and that change will cost us — but it is necessary to change if we are going to provide affordable accessible health care for everyone.
“Do you have any idea how many ordinary, middle-class people cross the border from Canada to get treatment here in the US? Hospitals along our northern border are filled with Canadians fleeing the glory of single-payer care.”
Sorry, I don’t drink Kool-Aid anymore (I grew up). Here’s something more nutritious:
http://content.healthaffairs.org/cgi/content/full/21/3/19?
And since you are undoubtedly unwilling to do any real research which might conflict with your indoctrinated beliefs, here’s the money graph:
Might I add whenever Canadians come across the border for healthcare they do so with the checkbook of the Canadian healthcare system in hand. It’s cheaper for Canada to send some to the Mayo Clinic or Cedars Sinai than it is to train up a bunch of say heart surgeons and pay them to relocate to Thunder Bay.
Shepherdwong:
Yes the paper does recognize that the raw number of Canadians who routinely cross the border for medical treatment unavailable or delayed in Canada is small compared to the number of those Canadians who receive treatment under the national health system. But to note that the Canadian system cannot effectively treat all its citizens is hardly drinking Kool-Aid. PS the “money paragraph” uses the following language: “Canadians routinely coming across the border seeking health care”. It’s not surprising that the number “routinely” seeking health care is low. That’s not the point. What matters most is the availability of services for those in immediate need, and/or where the service cost is high (cancer, for example)–in other words, the “non-routine” stuff. If the system cannot take care of those patients it is essentially abandoning the neediest, and that’s just plain wrong–and that ain’t Kool-Aid speaking.
Further PS to Shepherdwong. The sampling was done in ’98-99 if I read the article correctly. One must wonder if the data (anecdotal as it was) is still accurate today, when the Canadian system is more taxed (economically and in terms of personnel) and even the the architect of the Province of Quebec’s program (Claude Castonguay) now says the system is a failed one.
“What matters most is the availability of services for those in immediate need, and/or where the service cost is high (cancer, for example)–in other words, the “non-routine” stuff. If the system cannot take care of those patients it is essentially abandoning the neediest, and that’s just plain wrong–and that ain’t Kool-Aid speaking.”
Couldn’t agree more. Just don’t forget to include the 50 million Americans who have to go to an emergency room for just about anything, and face personal bankruptcy as a result, and the rest of the insured population who pay for that stupidity through ever increasing insurance premiums and who always face the possibility of winding up in the same exact circumstances if they lose their job or an insurance company decides they’re too expensive, when you apply your standard to an honest comparison.
“One must wonder if the data (anecdotal as it was) is still accurate today…
The only data I’m concerned with are the ones that show that we pay two to four times what anyone else pays and get poorer health and economic loss as a result. Every other argument against real reform of the corporate insurance monopoly seems to amount to little more than data dredging or anecdotal “evidence”. FYI, the Katz paper used sampling not anecdote.
Thank you to those at Mayo who continue true to the wisdom expressed by WJ Mayo in 1921
in JAMA: “Medicine’s place is fixed by its
services to mankind; if we fail to measure
up to our opportunity it means state medicine,political control, mediocrity, and
loss of professional ideals.”
The impending disaster of government medicine is a consequence of an evil moral code. Altruism holds the ultimate virtue an action which provides no benefit for the actor and worse, no interest in any benefit for himself whatsoever. No moral code could be more viciously Un-American and anti-human life.
America was founded on a moral principle, Individual Rights, the right of every individual to his life, liberty and the pursuit of his own happiness. That is his life belongs to himself and his actions properly accrue to himself. He has no obligation for the lives of others except for the chosen obligation for his children until they are able to care for their own lives.
America is under the sway of the collectivist notion that we are our brothers keepers, that we are the property of the collective and have a moral responsibility for the dolts, the bums on the street, the deliberately lazy, and the incompetent.
Men need a new moral code and we are fortunate to have the insight of Ayn Rand who expounded a new rational code of morality based on the objective reality of the requirements of man’s life when living in society with other men. Its essence is the prohibition of the initiation of force by one man against another and the government the agent to protect those rights by responding with force to stop and punish those who violate the rights of others and nothing else.
Her wisdom is available to all in her book “The Virtue Of Selfishness” and her other non-fiction writings as well as her famous works of fiction, “The Fountainhead” and “Atlas Shrugged”.
“Every other argument against real reform of the corporate insurance monopoly seems to amount to little more than data dredging or anecdotal “evidence”. FYI, the Katz paper used sampling not anecdote.”
Obviously, I was wrong about that. There’s at least one other argument in favor of corporate hegemony over American health care: base selfishness dressed up as moral clarity.
Rob said:
“Mayo has a point, but the clinic needs to offer constructive criticism not just criticism.”
No they don’t. I’m really tired of comments like this. If something is BAD, it needs to be criticized.
You know, it is entirely possible that the US health-care system can be “fixed” with no government action at all. Did you ever consider that?
Stop dismissing their valid criticisms just because they aren’t saying what you want to hear.
Mayo Clinic Rebukes Obamacare, How Will Media Respond?
http://newsbusters.org/blogs/noel-sheppard/2009/07/20/mayo-clinic-rebukes-obamacare-how-will-media-respond
“You know, it is entirely possible that the US health-care system can be “fixed” with no government action at all. Did you ever consider that?”
Weeee! Never mind that the Mayo Clinic’s criticism is because they don’t think there is enough government action to control costs in the bill. Never mind that the current players have had decades to fix it themselves and chose instead to bilk us all for personal profit.
I don’t get it. Why does Healthcare Reform have to add a single payor system? Indigents and illegal aliens are not denied healthcare today – they get free healthcare via Public Healthcare clinics, Emergency Rooms, etc. that we pay for. There are also many charities that subsidize preventative care for the poor, homeless, illegal aliens, etc. What does that have to do with Insurance? In the 60s and in many rural parts of this country, people trade products and services with doctors for healthcare. They have Catastrophic coverage but not HMO type coverage. Young people choose NOT to pay for Healthcare Insurance (like they choose not to save in Retirement Funds). WHY do we keep talking about the “uninsured”? It’s not like they don’t have access to care… and we already pay for them.
And, Oh By the Way, given government performance with education, stimulus, spending, post office, etc. why in the name of all that is holy would we want them to manage our healthcare? They can’t even manage to read a bill before voting on it…
If it is such a good plan. the President, Senate and Congress should go under the health plan with all of America.
JohnJ
You are wrong about me not hearing what I wanted to hear therefore the rant. What I was stating was all those who find fault with Congress’s approach might want to come to the aid of us all by offering up other fresh approaches rather than just saying NO, their ideas will not work; or this approach is too expensive, or whatever – just an endless debate that goes nowhere and offers no solution or it’s too expensive (no liver transplant for you – insurance will not cover it because you have a less expensive plan – like what we do with our ill pets).
I keep looking for substance from ALL of the involved parties – left – right, medical – patient.
Meanwhile a standard group HMO policy from Anthem in California for someone aged 62 is $9,900 a year with a $1500 deducible, plus one has to get certain procedures approved by some unqualified Anthem staffer using some computer model to deny coverage.
Further, I never said that the government should be in the game. I don’t care one way or the other. If it can be fixed without them fine.
What sets me off is the bureaucracy of the system. As an example, there is a fairly large doctor-owned medical group I go to. They have excellent medical professionals, but the administration is horrible. There are 90 healthcare professionals and 510 staff! When quizzed about this ratio the group says that this is the amount of staff they need to handle the insurance and government payment system. These terrible inefficiencies exist because the insurance providers’ poorly thought-out plan and administration methods and implementation (or possibly done intentionally it confuse and cloud the procedure payment models). This is perhaps the major problem.
So, my rant to Mayo was from a gut-full of frustration and a feeling of doom that not even the Mayo Clinic could offer up a clear and cogent view and solution. Medicare is breaking them they say – will they drain their endowments or start refusing care to Medicare patients and is that medically ethical? A bit scary, is it not?
If they cannot provide clearer and more exact guidance based on their collective experience then who can?
In any event they are to be commended for the effort. I just like to see more flesh on the bones from all quarters rather than all of these lofty pronouncements of what will or will not work.
President Obama and the Congress are pushing for reforms that will move the US health care system closer to a nationalized system like that of Canada or Great Britain. If this is successful, you will have fewer health care choices and your access to care will be more limited. The government, not you and your doctor, will be responsible for determining whether you receive care. You will be “wait listed” for critical diagnostic tests. You may wait two or three years for surgery. You may not have access to life-saving cancer and other drugs. Yet, you will pay higher taxes.
You can help stop this government takeover of health care. Send a message by signing the petition at http://www.freeourhealthcarenow.com
The government wants to provide healthcare (socialized medicine) for all, but if you look back at the other two government healthcare programs (Medicare & Medicaid) they are flawed and need reform. So what is the government thinking about when they want to provide healthcare for all when they cannot even run their other two programs effectively.
http://ecireport.wordpress.com/2009/07/20/healthcare-reform-what-about-medicare-medicaid/
…also, Yaron Brook just came across a very scary addition in the new Health Care Bill. On pg. 16 is a provision that it will outlaw individual private coverage. Under the Orwellian header of “Protecting The Choice To Keep Current Coverage,” the “Limitation On New Enrollment” section of the bill clearly states:
“Except as provided in this paragraph, the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day” of the year the legislation becomes law.”
Therefore you will not be permitted to make any changes to your exisiting private health plan after the bill’s effective date. So you are stuck with your plan unless you drop it and take the general plan that the government will offer you…
WOW!
“If this is successful, you will have fewer health care choices and your access to care will be more limited.”
Yes, of course, that’s what I’m going to miss, all the access and choices. What was I thinking?
@shepherdwong – I would rather drink Kool Aid and live happily ever after without government interference into my life, than drink the hard liquor you seem to be drinking and wake up with a massive hangover in 4 or 5 years!!! I happen to be working for a non for profit HMO and, ironically, am a legal immigrant from an Eastern European Country that is still using a government run, single payer Health Care system. Believe me when I say that every day, the media in that country reports about the ineffectiveness of the system, about the corruption and the low level of health care. Believe me when I am saying that daily, the media is saturated with requests for humanitarian help to collect money for people needing treatment/surgery in US, England, Austria, Germany, France, just to name few. Believe me when I am saying that I saw first hand, the benefits of a single payer system, the benefits of socialism/comunism mentality that is slowly creeping into this great country. The problem with our system is not regulation, because health care is probably one, if not the most regulated businesses in America. HMO’s have to be accredited by several National Bodies and follow the rules and regulations created by several governmental agencies. The problem is strictly the higher cost of health care, and that is not driven by the HMO’s but by the patients and doctors. Patients tend to abuse the system, going to the doctor for even the simplest of the colds and are expecting to be tested and treated with the latest medicine or equipment. On the other hand, doctors have high stakes in the new equipment they purchased and they want to have the highest possible ROI. The vast majority of the doctors forgot they should be doctors first than businessmen. And to give you a perfect example. My wife gave birth to a boy in one of the hospitals here. Of course she is covered under my insurance plan. The hospital made a mistake and billed her as uninsured – $8,700. After I called the hospital and corrected the insurance problem we got a new bill – $7,500, out of which we had to pay our co-payment of 10%!!! Do the math and tell me what is wrong there and who is trying to keep the costs under control?!??! On the other hand, there were 12 doctors and nurses present in the delivery room, for a normal, no risks, planned C Section. Don’t you think it is a waste of resources and a rip off? I do my friend!!! That is what needs to be fixed. And your new government run health plan that will become a single payer system will not fix it. Just think of the total overhead of administrative costs that will be necessary to provide service for over 300 millions!!! The sky will be the limit! Look at the current Medicare and Medicaid riddled with fraud and admin costs and than try to picture the same folks administering a single payer system for everybody! I’m having nightmares already!!! Wake up before it is too late and stop this socialist nonsense.
The number 46 million/47 million gets thrown around as for uninsurd, virtually unchanged since the Clintons tried this power grab.
Here’s the dirty little secret: the plurality of those 46 million or 47 million are … illegal aliens. Most of the rest are young adults who choose not to buy health insurance for a variety of reasons.
It’s my responsibility to pay for health insurance for Jose the illegal alien? Or some yuppie who chooses to buy a 60-inch plasma TV? I don’t think so.
Perhaps if the government would start putting a limit in LAWYERS and LAWSUITS that are ruining our country, then we might have affordable healthcare for all. No one has brought up this very real problem. The MAIN reason our healthcare premiums and healthcare itself costs so much is because of frivolous (and warranted) lawsuits about everything. There should be a cap on medical malpractice (and other lawsuits for that matter) since people should be compensated for wrongdoing, but who should get two million dollars because someone made a mistake??? The lawyers continue to strip the American public through the ever-increasing power of the judicial branch. Put the checks and balances created in the Constitution back in place and it would also help our economy, including the cost of healthcare. Then others WOULD be able to afford stuff, not just high priced attorneys.
Sonya Haskins
As usual our “representatives” are not serious about fixing anything other than their bank accounts. Every doctor in America would start with fixing the Medicare payment system and tort reform. Instead the Obama system leans more heavily on the broken Medicare structure and totally ignores tort reform in a blatant nod to their big money donors in the Trial Lawyers Assoc.
The whole pitch on Health Reform is a lie.
You all seem so sincere. Why then instead of using natural and affordable remedies that actually reverse the root cause of disease, that you all push the overpriced, deadly and ineffective big Pharma offerings?
Why is the Autism rate up to 2% for vaccinated boys and virtually nil in unvaccinated children? Yet there is no proof that vaccines are causing great harm to this generation of children and you Pediatricians still advise to vaccinate.
I cant feel sorry you Doctors that push pills that are destroying America and help to suppress anything that isnt taught in med school by the Drug comanies. You are greedy. miseducated drug pushers only concerned about making money at the expense of our health. Wake up to this or rot in hell…
to shepherdwong, US infant mortality rate is calculated differently than most other countries. Any live birth in the US is counted as a live birth. This is not the case in other countries–hence our infant mortality rates look worse. We have decreased life expectancy because we have higher death rates of younger people for non-medical reasons. Try comparing life expectancies of those in their 50s or 60s vs other countries.
as for the money aspect, the cost per patient of Medicare is rising higher than traditional insurance. The US has for years subsidized the socialized care of other countries. Healthcare technology and pharmaceutical advances that come out of the US are not reimbursed at the same level in other countries due to socialized medicine. The result–costs here are higher so that private companies and continue to do their research and development. Now you may not like capitalism, but without it, we wouldn’t have the majority of advances in medical care that we’ve had over the past 30-50 years. Sure, we could save a lot of money if we go back to a 1960s level of care. But then you’d see our life expectancies go down even further. The US has the highest cancer survival rates. Why is that if we have such a bad system?
This is the point many of us have been making for many months, there is nothing in the legislation that does anyhting to control costs, but rather expands coverage and lowers some costs for the Federal govenrment via cost shifting to the private sector.
For more of my view on health care reform visit http://www.quinnscommentary.com
Is this the official Mayo Clinic position on the bill? Two paragraphs without an author?
“Now you may not like capitalism, but without it, we wouldn’t have the majority of advances in medical care that we’ve had over the past 30-50 years.”
Oh, please. If you understood or cared about the power of markets, you’d be lobbying for a single-payer system where health care providers could compete on a level playing field for customers and thereby improve quality and affordability over time. No market on earth is more skewed, distorted and corrupted than the heath care market created and maintained by corporate insurers. And those for-profit, capitalist advances in medical care have led to millions of deaths and injuries from poorly tested pharmaceuticals, 100,000 preventable deaths from medical errors, 50 million uninsured, personal and small business bankruptcy, etc., etc. Once more for the lucid: in our for-profit “capitalist” insurance industry created model, we pay two to four times what anyone else pays with some of the worst health care outcomes in the industrialized world.
The real details of any plan always seem to come out after the fact, when it’s too late. So far, I don’t see any major changes in what has been communicated through the media– just more complications and higher overall cost. I was an insurance agent for 17 years and stopped selling health insurance after about 10 because I was thoroughly disgusted. “Sell the sizzle, not the steak” was what the marketing departments told us to do! Give me a simple, single payer plan any day! I lived half my life in Canada and would love to have that coverage again.
again shepherdwrong, the best cancer survival rates overall in the world.
and a single payer government system will only dramatically reduce payments to providers, while at the same time massively increasing the government bureaucracy. just look at HR3200 and the flow chart as an example. all the new government departments and/or agencies that would be formed.
take the policy decisions away from businesses and away from the government, and let the people determine what coverage they want. let them ration their own care instead of the government doing it for them.
I’ll give you credit though. You’ve got the leftist talking points thoroughly down
“You’ve got the leftist talking points thoroughly down”
They’re called facts – in stark contrast to your industry propaganda dressed up as personal conjecture – I’m shocked, just shocked that you can’t tell the difference.
I must say, shepherdwong, you are appropriately named. Talk about truth in advertising… oh, wait, that’s “wong,” not “wrong.” Sorry. Never mind.
If you want to rant at the Mayo Clinic, you need to come here with facts. For example — FACT: On average, hospitals only recover about half of the expenses they bill. They provide so much emergency care for people that can’t afford it (or people without insurance, often people that are here illegally) that they’re forced to raise prices on everything for those who CAN pay and CAN afford insurance. That’s why “we pay two to four times what anyone else pays.” And if you really think we have “some of the worst health care outcomes in the industrialized world,” you have absolutely no understanding of the health care industry in this country.
Of course, it’s possible that you don’t really think that, and you’re just a propaganda machine. I’d buy that too.
Here’s another. FACT: Only 17% (approximately) of Americans under the age of 65 have no health insurance. Of that 17%, 53.3% of them CHOSE to refuse coverage. They didn’t want to spend the money on it, because that might force them to buy a smaller TV or a less expensive car.
If people would focus on providing for their needs instead of their wants, they’d be amazed at what they could afford for themselves.
One more. FACT: The health care bill currently proposed by the House would make it ILLEGAL for insurance providers to provide health insurance to individuals. That means that even if someone WANTS to spend the money on an individual health insurance policy (e.g., if someone is in between jobs and wants better coverage), this bill would make it ILLEGAL for such people to do that. That choice would no longer exist.
“I’d buy that too.”
Not too surprising since you’re buying a system where we pay two to four times what we need to pay so we can send millions of Americans to the emergency room when they get the flu and then pay for it through astronomical insurance premiums that probably won’t pay for our own care when we need it. There’s a sucker born every minute.
On more thing, you’ll need to do a little better than simply say something is a “fact” before you’ll get any credulity from me. I’ve seen enough “conservative” “facts” turn out to be lies to fill every hospital in America.
In fact, that’s how I got here in the first place, re: “In fact, it will do the opposite.” I’m just plain sick and tired of “conservative” lies dressed up as fact.
“On more thing, you’ll need to do a little better than simply say something is a “fact” before you’ll get any credulity from me. I’ve seen enough “conservative” “facts” turn out to be lies to fill every hospital in America.”
First of all, “credulity” means a state of willingness to trust someone or something too quickly or easily, so if you need mountains of evidence to be convinced, nobody’s going to get any credulity from you. You may have been looking for “trust” or “belief,” or even “reliance.” Either way, if you’re trying to use impressive words so people think you’re smart, make sure you know what they mean first.
Second, there’s a different between conservative and, as you put it, “conservative.” The Republican party, as a whole, hasn’t been truly conservative for quite some time. But if you think Republicans are the only ones spreading half-truths and lies, you need to take off those periwinkle-colored glasses.
“…there’s a different between conservative…”
I meant “difference,” of course.
“…so if you need mountains of evidence to be convinced, nobody’s going to get any credulity from you….”
Not really much of an issue yet since you haven’t offered any evidence so far, just a bunch of right-wing claptrap. Vall it “conservative”, Republican, whatever, it’s all the same demonstrably false industry propaganda.
“Vall it “conservative”, Republican, whatever, it’s all the same demonstrably false industry propaganda.”
If it’s “demonstrably false,” as you claim, why don’t you actually demonstrate how it’s false instead of merely asserting (without any basis or support) that it’s propaganda?
“If it’s “demonstrably false,” as you claim, why don’t you actually demonstrate how it’s false instead of merely asserting (without any basis or support) that it’s propaganda?”
Sorry, it doesn’t work that way. You have to support your own argument (though I can see why you wouldn’t want to try), it’s not my job to disprove it before you’ve made a plausible fact-based case. Besides, most of this stuff is so full of holes, you could easily disprove it yourself if you wanted to. But, just in case you haven’t replaced your intellect (and moral compass) with comforting right-wing dogma, this should get you started:
http://www.denverpost.com/recommended/ci_12523427
When the Mayo Clinic claims to have lost $840 million dollars to Medicare, I don’t think you’re telling the whole story.
I come from “not-for-profit” health care and some of the dirty little secrets are that:
A. “Not-for-profit” just means you spend all that comes in and you don’t have stockholders.
B. You bill Medicare at high rates, accept the Medicare payment and call the difference a contractual allowance or LOSS. It isn’t a loss. You discount to all kinds of groups.
What’s worse, typically, “not-for-profits” call this faux loss “charity” and use it to justify paying no taxes.
I commend the Mayo Clinic for giving an honest negative assessment of the Obama Health reforms. We have some of the best doctors and facilities in he world and why would we want the Government to regulate our care in the face of a serious illness? While I understand there could be some improvements, the President is going too far, too fast, and could not be that knowledgible about running a healthplan. Why shouldn’t the insurance companies make money? Yet, it is OK for politicans to make money?? I would be frightened to death if everything he proposes goes through.
I’m confused. This response by the Mayo Clinic was included as a link in an article in the New York Times, yet it’s not quite clear whose opinion it represents. This is a blog, isn’t it? Does this opinion, which is very disappointing to those of us who would like very much to see health care reform with a strong public option, represent the views of all of the doctors at the Clinic, or all of the administrators? The Mayo clinic has such an outstanding reputation; it would be helpful if you would help the rest of us achieve meaningful reform. Personally, I have been very fortunate in that I have had insurance coverage all my adult life. But many people are not so fortunate. My friend and neighbor took care of her husband who had Alzheimer’s at home, and didn’t have insurance after he died. She had pre-existing conditions and fell thorough all the cracks in our system. Her doctor kept urging her to have a surgery she had no insurance for, and she was afraid of losing her home, her only real asset. She decided to wait until she was 65 and could get Medicare but she didn’t make that birthday. Right now, right here, in our country, impossible situations like that are taking place. President Obama is working very hard to bring us health care reform. I understand that there are differences of opinion on specific approaches, (I’ve watched some of the House and Senate committee meetings on C-SPAN) but we have to take action. Can we build on the positive improvements that we can all agree upon? Thank you.
A few questions I’d look to throw out there to make this dialogue a little more granular and less ideological…
When I lived in London, I was horrified to learn (from colleagues) that if you didn’t have an NHS or private insurance card, you would NOT BE TREATED in an ER. So in other words, NO ILLEGALS are given even emergency care. (And likewise, my colleagues were equally shocked to learn in the US, the “uninsured” receive lots of ER and inpatient services. ER’s are a major drain on the system.
Could someone please confirm with any statistics?
Also interested to know how this holds for Canada, France, etc.?
I also understand that knee/hip replacements aren’t covered in these countries (deemed elective), yet are covered by Medicare. Again, any stats on that would be interesting.
A friend of mine just had an emergency C-section at a public NY hospital…the cost: $57,000. I think 20% of births or so result in C’s… and regardless of insurance those are covered by the overall system. We must be able to bring that cost down. Shouldn’t this reform have specific changes with input from the specialties themselves?
It seems with a few tweaks we could do a whole lot:trim some excessives (marginally effective treatments like high cost drugs or extraordinary efforts to prolong life) and make some fundamental changes around pre-existing conditions and who is covered by Medicaid, tackle tort reform, and we are good?
It seems we are trying to do too much too fast, without an understanding of the whole system….
Here’s a thought! If government has to be involved in health care reform, let’s do it this way. Let’s require that everyone have health insurance coverage, but it’s not provided by any employers. It’s like car insurance. You can buy basic coverage or the full boat, but it’s an individual, guaranteed issue policy.
If you can’t afford the premiums because of your income level, you will receive vouchers, tax credits or some other form of assistance.
If you’re unemployed and receiving unemployment benefits, you also receive basic health insurance coverage.
If you’re in this country illegally, you don’t qualify.
Those $840 million losses the Mayo cites are recouped by “overcharging” those patients with insurance. One of the reasons insurance premiums are so high is insurance pays for those who don’t have it.
Not all insurance companies are for-profit. There are a number out there that are non-investor owned (they still pay taxes in the states they operate in). They are owned by the people that they cover. When your members own you, you do your best to keep costs down. Believe it or not, a lot of people who work in the insurance industry do so because they actually like helping other people!
This country was founded on certain principles and certain freedoms were supported. Socialism isn’t one of those principles, yet socialism is what has been taught in public schools for decades as well as in higher education.
Schools are run by unions. Try to find someone teaching in a university that would be considered even moderate, let alone conservative (that means fiscally responsible by the way). Our kids have been fed socialist tripe for decades. It’s no wonder our friend Sheperdwong holds his points of view. He can’t help it!
Don’t get me wrong, Sheperdwong. I imagine you’re a great guy and would probably be a friend of mine (I have many liberal friends). I consider myself a moderate politically. I agree with many things that both parties espouse.
On health care, I don’t agree with what is currently proposed and I have read all 1,018 pages. I have lots of ideas on how to fix health care in this country, but they won’t listen to me (or to you). They only listen to us when they want to get re-elected. Washington is a circus and I’m afraid of clowns!
“It seems with a few tweaks we could do a whole lot:trim some excessives (marginally effective treatments like high cost drugs or extraordinary efforts to prolong life) and make some fundamental changes around pre-existing conditions and who is covered by Medicaid, tackle tort reform, and we are good?”
It seems we are trying to do too much too fast, without an understanding of the whole system…”
—
“On health care, I don’t agree with what is currently proposed and I have read all 1,018 pages. I have lots of ideas on how to fix health care in this country, but they won’t listen to me (or to you).”
Look, if we were going about creating the most cost-effective national heath care system possible, we’d design an elegant single-payer system, tell the insurance giants to live with their other products, and be done with it. We’re not. This is an exercise in selective ox-goring, which is why Mayo has staked out a political position which can’t be reconciled with any known facts other than what they think will translate positively to their bottom line. The only people with pure (partly-selfish) motives here the people who want a system that allows them to get the health care they need and doesn’t bankrupt them in the process. Unfortunately, they don’t have $millions to lobby their so-called representatives in Congress or a patina of credibility in the Village to promote their parochial interests.
FYI on shepherdwong:
His obvious bias to left leaning liberal opinions is not disguised. On top of that he seems to be pretty narrow minded, demonstrated by his wide sweeping generalizations of the right wing.
It’s people/organizations/legislators like this that impede our path to a truly successful discussion on healthcare.
People want choices and fair rates in health care. Doctors want good compensation for their service. The only “fair” healthcare system involves capitalism, not the government.
No system that requires a 3rd party to regulate and choose for other parties is ever a success. In time both parties become frustrated by their lack of control in the agreement.
When a 3rd party runs an agreement without THEIR OWN money or participating in the service, they have no skin in the game. The 3rd party will choose the cheapest equipment, and facilities and cut corners to make “their books” look better. There is NO chance for success in that model.
On the other hand the natural ebb and flow of supply and demand always self corrects – WHEN there are no outside forces involved (Gov’t)
All politics aside, this is purely an economic view.
I’m sure corruption, hand-shake deals and some right wing comment is forthcoming.
Corruption is better dealt with though by the parties with something to lose, not a “regulator”
“His obvious bias to left leaning liberal opinions is not disguised.”
Gosh, Jake, thanks for that. As all rational, thinking people understand, reality also has a strong liberal bias. Speaking of “bias” rational people also know that markets can’t exists in the first place without government regulation, no less “always” automatically regulate “the natural ebb and flow of supply and demand.” Unless your planning to get your health care at a yard sale, please save the “free-market” dogma for your “conservative” friends.
I agree with the Mayo Clinic that the government is totally discounting the fact that if proper reimbursements are not made to doctors, a number of there proposals are moot. I believe private statewide pooling is a better option. http://brillsdiscontent.wordpress.com
Any plan which by amendment excludes those who impose it is immoral,betrays the trust we often misplace in or elected officials.
If a public option is such a good idea, why won’t Congress participate in it themselves? They have the best coverage our money can buy. Also, why did the Democrats in the House Ways and Means Committee vote against an amendment requiring proof of citizenship in order to get free insurance? It looks like we will be buying insurance for 12-20 million illegal aliens! What’s the price tag for that?
“If a public option is such a good idea, why won’t Congress participate in it themselves? They have the best coverage our money can buy.”
Asked…and answered.
“It looks like we will be buying insurance for 12-20 million illegal aliens! What’s the price tag for that?”
Much less than paying for when they finally show up at the public hospital when they’re on death’s door. Think of it as a surcharge on your $2/head lettuce and $3/lb. hamburger.
shepherdwong: “rational people also know that markets can’t exists in the first place without government regulation”
The popularity and success of craigslist may refute this statement. Independent buyers and sellers negotiate cash for merchandise, unfettered by government interference.
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Well, since the Obama administration has been touting the clinic as a model for health care hopefully they have been offering their constructive ideas in those behind-closed-doors meetings that the administration has been having (remember – the ones he promised during the campaign would be on C-Span…everyone at the table in unprecedented transparent negotiations) – the attendees of which he refuses to reveal.
Having been a recipient of government run health care (in the military and as a member of a federally recognized Indian tribe), I can say that I wouldn’t wish government run health care on anyone. I’m just glad to see that it would appear that this most recent stab at universal health care won’t be the last. There’s no way HR 3200 is going to be what ends up on the books. Not only is that wonderful in and of itself, but what a wonderfully rich conversation is finally taking place in this country around the topic. Prior to this many people blindly advocated for “free health care for all.” I think everyone’s fairly clear now that nothing is free…regardless of what a politician might have told you in order to get elected.
When did a politician known anything but making a deal to better their own career.They are voting on finances when most don’t know how to balance a check book. Now they are experts in health care telling the people of this country how we will be taken care of or being taken.
“The popularity and success of craigslist may refute this statement. Independent buyers and sellers negotiate cash for merchandise, unfettered by government interference.”
It might, if we were still living in the nineteenth century. Even so, we’d probably be trading in canned food, bullets and gasoline, rather than Treasury-printed and guaranteed cash, if it weren’t for government. Eh, if “conservatives” have their way, we may still.
Thank you for being a voice of common sense in this crazy debate . As a physician I’m proud that finally a group of health providers have spoken the truth , this plan is not what needs to be done is a mess of bureaucracy and half baked ideas that if anything will make things worse.
Yeah, let’s take our cues from a nice impartial rag like “Health Affairs”. It might as well be published at 1600 Pennsylvania Ave., Washington DC — given the cast of characters who run it. All nice liberals, one and all, toeing the party line and spewing the talking points.
How about an indisputable fact, the NHS in the UK is the largest employer in the EU. The bureaucracy in the UK system is stunning…the cost of actual health care may be lower in the UK, but the cost of the administration of the system is astronomical. And the bureaucracy in the UK will be dwarfed by that proposed in the tr-committee legislation. But let’s not let facts get in the way of a good ideological tirade.
Ask yourself a simple question: If I were to get sick ANYPLACE on Earth, where would I wish it to be? If you reply anywhere other than the US, then you’re either a fool or a damn liar.
The health care system can be easily fixed with:
Tort reform,
Medicare overhaul,
Insurance de-regulation (so that universal plans may be purchased cross-state borders),
Efficacy-based incentive payments to physicians,
and Mandatory participation in catastrophic health insurance at the state level.
And I don’t see any of these measures included in the proposed legislation. It makes you wonder why the rush to yoke us with this new system?!!?
The government has no place making heath care a right or regulating the bejeesus out of the system to placate powerful constituencies and special interests. Health care is a service, and last time I read it the CONSTITUTION doesn’t mandate services as rights. But this won’t stop the socialists presently in power from ignoring the wisdom of the founders.
We need common sense and simplicity rather in our health care system than the nightmare that Obama and the Dems are trying to foist upon us.
BTW, I think the Mayo Clinic’s observations are spot on!
Helen # 2 response. I don’t like 15% increases either for premiums and I agree we need to do something about health care but pushing it too fast in a few years we won’t have any health care insurance at that price. We need to work on streamlining paper compliance,better communication and quality before we can pass a trillion dollar health care bill that very few have even read.This is so critical to our nation that we have only one chance to get it right because it is so big so we need to take the time to understand it before we pass it. Look at Massachusettes which is now unable to pay for their government run health care.Government is the answer for some things but definetly not Health care. Look at the Veterans system of health care and you will find veterans not getting the health care they need because of rationing. If any group of people deserve the best health care in the world it is our servicemen and women and they are not getting it.
A newswire article in the St. Louis Post-Dispatch about two weeks ago quoted the CEO of Aetna Insurance, stating that group insurance contains a 12% premium to cover the cost shifting that happens because so many people are unable to pay their bills. Presumably this means that everyone covered by private insurance would see a substantial rate decrease if everyone were insured. My concern is that without a public insurance option, for-profit insurance carriers would keep premiums level and rake in billions of additional, unearned profit. I don’t see insurers lowering premium out of the goodness of their corporate hearts! Do any of you?
P.S. I was an insurance agent for 17 years!
I’m reading down this blog and an aweful lot of commentators are using the terms health insurance and health care interchangeably. I’m an insurance agent; my sister is a nurse. There is a big difference! When Congress is talking about mandating health insurance and buying insurance coverage for the poor– using our taxes to engorge insurance company income statements– that isn’t the same as providing health care. If a person lives in rural America, 2 hours away from the nearest health care specialist, it really doesn’t matter whether or not that person is insured. Health care reform MUST be more than just making sure everyone has insurance.
SParis wrote: “When the Mayo Clinic claims to have lost $840 million dollars to Medicare, I don’t think you’re telling the whole story.”
I had a similar thought. Couldn’t we also write, “The Mayo Clinic wanted to overcharge Medicare by $840 million for standard procedures, but Medicare refused.”? Maybe the Mayo Clinic’s rates are a bit too high?
a lot of good points have been made in this blog–from many perpsectives.
The “process” of health care reform needs to be addressed imo. This administration is using a “ram and jam” approach to legislation. Aside from the campaign promises which are being thrown to the wind, the reality is that health care by itself is unbelievably complex, which contributes to cost and delivery frustration.
What should happen on such an important issue is a bi partisan coalition be formed and work on this as a longer term project-at least longer than a few weeks.
A poor process wil result in poor health care reform, just like the TARP last year, and stimulus this year, and cap and trade so far.
Its the process–we all should be working towards the combination of constantly improved healthcare delivery for more people and at a better cost.
We also need to remember we have technoology that costs a bundle that was invented here–there is a cost to that. How do we value that.
just my two cents worth. In a forum that cannot address the complex issues.
What do you guys think of concierge/boutique based medicine where you pay a premium of a few thousand dollars a year to get more personalized care?
Several large institutions are looking to move to this model. I imagine Mayo and others will be looking to get some easy cash from all of those who are scared of rationed health care or a government controlled system.
Do you think it is fair for wealthy people to have this kind of access? Do you think there will be a rush of doctors/clinics moving to conceirge/boutique medicine if we move to a single payer system or government option? Do you think the liberal government will come in and try and prevent it from expanding as it will further reduce the number of available physicians willing to accept reduced compensation? I’m sure they could probably come up with some Patriot Act -like justification to prevent doctors from doing concierge medicine.
Look forward to the ‘healthy’ discussion.
@Tyler Durden: I expect that most doctors and hospitals will continue to treat both the privately insured (yes, there will be Cadillac plans, mostly for the wealthy and they should be able to buy what they want) and people on the public plan, much as they do Medicare patients (don’t forget, most of this stuff is proposed to phase in over years so there’s no need for any rush). If the insurance industry were worried that all the medical talent would flee the public plan they wouldn’t be flooding the halls of Congress with campaign cash to try to kill it. And what is this “liberal government” you speak of?
SCARY BILL
There is no way any senator or congressman has read and understood the implications of this bill. It’s way too complex and shrouded in minutia. In addition to the bill being over 1000 pages (though large font and well spaced), most of it reads like the text below. There is about 25 pages dedicated to changes in medical residencies and for the life of me I can’t figure out what it means. Anyone?
“a) IN GENERAL.—Section 1886(h) of the Social Security Act (42 U.S.C. 1395ww(h)) is amended— 7 (1) in paragraph (4)(F)(i), by striking ‘‘paragraph (7)’’ and inserting ‘‘paragraphs (7) and (8)’’;
9 (2) in paragraph (4)(H)(i), by striking ‘‘paragraph (7)’’ and inserting ‘‘paragraphs (7) and (8)’’;
11 (3) in paragraph (7)(E), by inserting ‘‘and 12 paragraph (8)’’ after ‘‘this paragraph’’; and
13 (4) by adding at the end the following new 14 paragraph:”
“There is no way any senator or congressman has read and understood the implications of this bill.”
Here’s a news flash for you: they never do. That’s what their staffs are for.
Could someone at Mayo Policy Center please explain what section “TITLE V—MEDICARE GRADUATE MEDICAL EDUCATION” is all about? It clearly has to do with the way that funding is calculated to staff and pay medical residents, but hard to figure out what it actually means…
(shepherdwong -snarky predictable replies are not helpful and should be deleted from the blog)
Read my thoughts on this issue:
http://silencedogood2.wordpress.com/
@drswife: Actually, I’m completely serious. You really didn’t know?
The only simple health plan is single payer system. If everyone was covered by something like Medicare, regardless of employment status, health and age, we wouldn’t have much to talk about. Seniors have had 45 years of experience with it; so have medical care providers. I hear more complaints from seniors about the new Medicare Advantage plans that came out this decade than basic Medicare. There are problems with Medicare– so Congress, fix them and then let the rest of us buy in!
Here is a little basic education for those who are really interested: modern health insurance contracts don’t meet the textbook definition for insurance. They are maintenance contracts! So think auto insurance from your agent versus the extended warranty being sold by your car salesperson. Health insurance contracts are not actuarially sound; corporate bureaucrats are estimating costs based on computer models but it’s like building a house on sand! Health insurance contracts are one way to pay for health care but they aren’t a very efficient way!
I find it ridiculous how many of these commentators endorse the Obama plan, and decry Mayo’s stance against it. The Mayo clinic is universally regarded as one of the greatest health care institutions in the entire world. Obama even believes this to be the case. Obama, however, isn’t a physician, nor does he work in health care, and has absolutely no idea what it takes to offer high-quality health care. He will no doubt ignore Mayo’s objection to his plan, however, and keep with his ivory-tower rhetoric.
I guarantee, however, that he and his buddies in Congress will find all sorts of ways to circumvent public insurance for themselves. Just as Obama opposed school vouchers in Washington, but sends his daughters to fancy private schools that serve Filet Mignon for lunch, he and his Washington buddies will find ways to sidestep the disaster that is single payer healthcare for themselves.
Ms. janej,
I see that you suggest that Obama and his party have ‘failed to use the Medicare payment policy lever’.
Are you suggesting that the major attempt at redistribution of wealth, the socialist instrument that Medicare is, should be taking away even more money and freedom from America’s most productive workers and companies in order to offer the ‘have nots’ even more unearned health care services and service levels?
A former insurance agent comments: There seems to be a lot of socialism going around– or the fear thereof! Insurance companies don’t want to insure old people! Seniors are expensive and unprofitable, unless insurers get a sweatheart deal from our government: the Medicare Advantage program for example. Insurers receive 12%-17% more from the Health Care Finance Administration than it costs the HCFC for regular Medicare patient cost. It sounds like a “no bid” contract to me. Why did the Bush administration and the Republican Congress set up such an expensive corporate welfare plan? It’s our money and the most cost effective way should be used to provide health care, not the most expensive way. If private, for-profit insurers have the lowest cost, let’s use them. But if government can provide the same coverage for less money, that’s what we should do. Right now, Medicare is less expensive than Medicare Advantage. Call it socialism if you want– our military is also a government program and I don’t here anyone shouting socialism there– as long as my money is spent wisely. Medicare has big problems because it isn’t structurally and actuarially sound. The issue is adverse selection: when all the high cost customers end up on one plan. Congress should have planned better in 1965 when Medicare was created. Insurers gladly went along when all the sick, elderly and poor ended up in a government plan, leaving the insurers to cover the young, affluent, healthy and employed folks. Medicare needs to be fixed or scrapped! As for Mayo Clinic not approving the current reform plans, more power to them. So far I see more expense and little real reform. So far I see more health insurance reform and very little health care reform. President Obama is pushing a government option and saying that if I’m happy with my coverage, I can keep it. The flip side to that worries me: if I am unhappy with my group coverage, I may be forced to keep it!
Dear shepherdwrong,
“As all rational, thinking people understand, reality also has a strong liberal bias.”
Funny!
” Speaking of “bias” rational people also know that markets can’t exists in the first place without government regulation,”
Governments regulate pre-existing markets. They don’t create and then regulate markets. If you check a history book you’ll find that the American federal government didn’t create the medical market. Believe it or not before and without government involvement people made, bought, sold, and traded medical products and services. But congrats on lying big – Goebbels would be proud.
” no less “always” automatically regulate “the natural ebb and flow of supply and demand.” ”
Right, so all of the producers, middlemen, and consumers can’t all think, choose, and act of their own accord based upon the many different factors and variables that concern them, but a government bureaucracy can plan and control all of these people, products and services, and factors and variables? The Austrian school of economics has thoroughly proven the fallacy of central planning. See Hayek, Mises, Rothbard.
“Unless your planning to get your health care at a yard sale, please save the “free-market” dogma for your “conservative” friends.”
Statism kills.
“Let’s skip the political propaganda, shall we. In fact, you have no idea whether the legislation will or won’t improve affordability or quality (the public plan should certainly do the former). You just lost any credibility you ever had with anyone who understands science, public policy, or political rhetoric.”
Wow, what a two faced disingenuous slick snake you are! You should run for office and help finish the looting of America.
Janej’s comments about the shortcomings of the Health Care reform bill working it’s way through Congress…Is she speaking for the Mayo Clinic? Or is this her personal take on the plan?
Sheperdwong, you are well-informed and a voice of reason among the cacacophy of Fox News-informed (MISinformed, that is) comments in this thread. Thanks for doggedly trying to inform those who want to believe the Hannity/O’Reilly/Limbaugh lies. Ignorance and/or just plain stupidity put this country in the mess it’s in right now, with voters opting for Bush and then re-upping in 2004,with all evidence to his administration’s kowtowing to the rich being washed–brain-washed away by the Fox News and hate radio combo. Money well spent by their wealthy sponsors, sadly.
MAYO IS NOT A MEDICARE PROVIDER, SO THEN YOUR SUPPLEMENT INS. WILL NOT PAY. THIS IS DISCRMINATION AGINST THE ELDERLY, OVER 65..TO BAD
A couple points to answer some previous questions on the blog.
I am a Mayo Clinic employee who works in the Mayo Clinic Health Policy Center. The statement above — and all posts contained in the blog — are posted on behalf of the Mayo Clinic Health Policy Center. This is not my personal analysis, but rather represents the position of the Mayo Clinic Health Policy Center. I am one of the administrators of the blog.
Also, in response to Lars — a correction, Mayo Clinic is the largest Medicare provider in the United States when looking at all three Mayo Clinic campuses combined as well as just Mayo Clinic in Rochester, Minnesota.
For more detail about Mayo Clinic Health Policy Center recommendations for reform, I would refer you to our main Web site: http://www.mayoclinic.org/healthpolicycenter . I would also encourage you to view subsequent posts on this blog.
In particular, I would encourage you to view http://www.mayoclinic.org/healthpolicycenter/pdfs/MC-Response-to-Expanding-Coverage-Final.pdf and http://www.mayoclinic.org/healthpolicycenter/pdfs/MC-Response-Senate-Finance-Committee-5-13.pdf .
And thanks to everyone for continuing the absolutely critical discussion that will lead to much needed health care reform.
I know people that have money and last thing they want to spend it on is health care – that’s nuts – they want it for free…..
Insurance (any kind) is unique because it completely defies normal economic supply/demand curves. The principle of “Adverse Selection” says that the risk spreading mechanism itself is damaged by low-risk people who opt out. In essence, young healthy people say, “I’m young and healthy… I’d rather just NOT participate and keep my money, but thanks anyway.” And the market is left full of high risk participants.
Now I pose the question: Should anyone be able to opt out of paying for roadways? (Highly socialized…except in Orlando and a few other places where there is a toll booth every 50 feet. Last time I traversed the city I wanted to shoot myself. Thanks so much, Mickey Mouse).
Should anyone be able to opt out of paying for police, fire departments, or military? (Much like health insurance, all risk spreading mechanisms. All incredibly socialized).
People with families should not have to work for large companies (groups) to attain low cost coverage. That effectively dampens job liquidity and hinders broader economic markets. What happens when GM closes down a plant and 800 workers find themselves constrained to working for another big company in order to find health care comparable to what they had before for their family? (Ever notice how manufacturing plants are often planted in small towns where there aren’t a lot of other big companies?)
Job liquidity demands that job decisions be completely separable from the health coverage decisions. So the current system patently discourages broader free markets and discourages massively liquid value flows rather than encourages them.
There has not been enough head-on discussion of “Adverse Selection” and the underlying economics involved. “High Risk” pools are not going to get the job done.
Nice post, thanks for sharing this wonderful and usefull information with us.
Green Tea
Great stuff. (sorry for the ridiculously short comment, but what else was I supposed to say?)
Praying For Dollars,
Paying Christians Health Care Dollars.
ahhh, well for give me but first before I address this,
I wish to say thank you to President Obama and the Obama Administration for being the first Government Officials that have created the first Anomaly, in all of U.S. History. Has this Health Care issues reached desperate measures by Government Officials offering money to Christians to pray for the sick, welllll.
I see what this is, but I must share the truth, it is a 21st. Century Of Caging. The same {two step shuffle} used to gain political support in a issue that has lost its value.
This anomaly has grown beyond your control Mr. Obama, as over 173 million American People see for the first time the truth and lies , the good and bad within this Bill to Law. Thousands of Companies seek to move out of the U.S.A., or just close up shop, people are Boycotting this Bill to Law.
Yea, it would be safe to say that 173 million people are just shaking their heads. As a father would when his child has done something stupid.
President Obama stated that he has got a lot of letters from people who are sick and as of yet he has not seen what is within the hearts of the American People. You already have a Medicare or Medicate tax forum in place, but according to insurance companies it is to base payments according to where you live. To stand with the people to build a Health Care Forum within our Government is a concept of freedom of choice. To bring companies into the forum to Rebuild America,is to say that the people will not allow any company to faultier, that stands with the people, to build the most powerful Health Care Reform ever seen.. And all Government Officials had to do is ask and millions of people would step forward.
As the news of a Boycott grows it only widens the size of this anomaly. But no ! You all are still running around like the chickens after a little bug. Well….I did warn you that I have this little Health Care Bug in my hands.
As the last 27 pages are posted at our site, people will see all the issues under one web site, as stated before, the good the bad and the ugly…..the last pages from page 49 to 100 will place 173 million people and their views as one voice. I did state that I would do this and I Know that I put a smile on Government Officials face, so allow me to show you how i did it, I used the Artificial Intelligence of the Internet. To build a Health Care Forum by the People in or Against the Bill.
Out of all of the Government Officials only one opened a blogged at
The American Spectator . This company posted http://www.fascmovement.mysite.com on the net and Congressman Ryan dropped off his little blog.
But anyway, what we are dealing with is that some Officials think that because I lack the ability to stand before them as a Kindred Intellect that what I write does not hold truth, well, thats ok, All Good Things Come To Those Who Wait. And I assure you that this anomaly is not going away any time soon. But I do offer my congratulations again to the Obama Administration and theses Law Makers In And for The People Of The United States Of America.
As this fight grows and the issues of the Bill come to light for people to read, so it is true that the moral building block is lost to the value of the $100 Trillion dollar Health Care Forum that Government Officials wish to Force Pay and also tax that system. Oooops, is this the first time this amount was brought up, $100,Trillion Dollars that the States fight over.
You see Government Officials do not have a clue of what the people intend to do, the phone call I got yesterday, there is a Boycott about to take place and as of now it is over 45 million people strong. This Bill has failed because it lack a moral foundation.
My My My, To build a United Health Care Forum you must unite all the people as one. I once wrote to President Obama and stated to take the words of 250 million people of what Health Care should do for them, and place this before all on tv, remove this force pay concept, the pick and choose the best and dump the rest, all issues that are not of a moral building block of Bill To Law.
But to do this you must step out side of the Artificial Intelligence within Government of what the dollar is next to the needs of a people. It must be known that the tax against the health care system is because it is a $100 trillion dollar package.
I see something and it starts with Health Care vs. The People vs. The Dollar and it grows,
I have weighed this issue Health Care Bill vs. Constitution, and if a Political Party Gains control over a people because of the Health Care Tax Dollars, then it is laws with out moral value.
You see when tobacco companies became under fire the laws were based on a moral value because of the issues within.
The moral building blocks from Bill to Law is not supported because these Laws are for increase taxes and force pay against the people and a increase tax forum in a wide coverage stated to be in the best interest of the Country.
I dont see the moral building block of which the words for Health Care stands for. It is Health care vs. the dollar. Such issues as Health Care dollars for killing yourself, ideas of DNA tasting to be able to get Health Care “to pick the best and dump the rest, implants to get Health Care and so on. Welcome to the 21st century of Health Care Reform.
exmp.,
So this is Health Care Reform at its best, please allow me to share a concept that will open your mind in a way never thought of for a United Health Care Forum Concept. At first I stood alone and I wrote my first blog and little did I know that thousands of people and companies stood by it,
I have waited to see the issues of tax increase and health care, something that may be wrote by President Obama,
You see a lot of what I write, is in fact that, I do not seek Political support because I do not belong to any party. As for President Obama and theses 60 people that hold seat of Government who wish to build 1900 page of law to Govern this system because of this Health Care dollar. I watch them stumble about without a clue of how to fix this failed system. To see into this failure, you must allow this system to be seen as a forum for dollars of taxes created as a constant as a yearly figure. This prediction of dollar for the future, is in fact what I call Artificial Intelligence built on the hope that taxes will stay a constant figure. Our tax system today is also a failure and to build more Tax Laws against the Health Care issue will only bring cost up no matter what Government Officials state.
To state it simple if Health Care Insurance Companies Unite and hand over this issue then the Officials of Government, then they will have have no choice but to turn their eye to the companies of medication and medical supplies and hospitals and Doctors who charge cost that is the cause and effect of this failure within this system.
This Health Care Forum we offer is built on a moral value, a strategic forum to place issues to work ,that offers freedom to be a part of it or not. This force pay against companies, force pay against VETS, and so on, shows the lack of a moral building block within this Health Care Reform.
What we offer is that, will, Lets use the AARP Health Care Insurance Company, and lets say that they have 30 million members. To show that this company can earn $150 million dollars per month and be released from the burden of medical cost, by what we wish to show as kind of Health Care Tax Forum that covers the needs of the people and much more. And a freedom of choice for a pay in to a forum to a Insurance Company for people who do not trust this system within The United States Government. A tax forum forces the Government system to work for the people and at the same time forces Government Officials to work for the people within this forum against unjust cost.
To reach out to a company and sit down with them to build something never attempted in order to rebuild lives and the National Security of The United States as a moral building block without laws to Govern, but to protect this system from crime is what a moral law use to stand for.
To show a $100 trillion dollar strategic building block by companies of freewill that step forward to help rebuild America. To build the most powerful anti war / crime forum ever conceived by such as I a nobody that only seek to only go back to work as a painter and rebuild his little company dream.
As stated at first I stood alone against so many and I have found the uniting of people of different faith that seeks the same as I do. What makes FASC Concepts different, we do not ask for money and we opened a door for people to put their faith into themselves as a person and not what we say, to build on this and protect it under the concepts of law such as the Patriot Act. {A Moral Concept}. I do ask only this, please allow yourself to see into my mind of what I see that is needed………
There is a day coming that Officials of Government will see that the Laws built against God and Country was the first steps of the United States Of America headed for failure because it lacks moral value. This is what our enemies see, a Country of Laws that should of never been created by few against so many people of the USA.
Is it so hard to see a concept for a Health Care Stimulus Package that builds jobs and life within a anti war / crime forum ? But it was the war and the crimes committed after 9/11/2001 of how I was allowed to see into the basic tax forum failure. And to rebuild the security within the Country. This tax forum against the Health Care Dollars is chump change and so is this $100 trillion dollars, when it is stood up next to the people. The true back bone of America is the people and their ideas to rebuild America in a effort to ready ourself against the next attacks on our land.
I see something and I am that little dyslectic kid that finds it hard to write what I see, but as of yet I still have my hand raised high in hopes that the teacher with let me share.
Henry Massingale
FASC Concepts in and for Pay It Forward
found on google.com. And yahoo look for page 1 american dream offical site.
The current proposal in Congress does not address any of the most meaningful issues in health care:
1) The need for single-payer insurance Multi-payer systems inflate health care costs and give 8-12% of total health system costs to private insurers in system waste
2) True universality of coverage in a plan that doesn’t create a second-class citizenry of the insured Congressional plans still leave 10-15% of our country insured and create a second-class system of the poor insured that will place them below Medicaid recipients with respect to stigma and prioritization of care
3) The crisis of doctor shortages and primary care deficits in American medical care Doctors are retiring at record rates and they are only being replaced at 75-85% rate because of a monopoly and market-control of the MD control by the AMA. Also, we have a 2/3 primary care / specialist ratio and 40% less per-capita doctors than the best European and Scandinavian countries. We have plenty of dermatologists and radiologists but not enough doctors to complete basic screenings and offer fundamental preventative care
4) Tax shortages for the Federal government and a lack of funding for the Medicare (and Social Security) trust funds With a $13 trillion deficit and annual budget deficits of greater than $500B, our country and our entitlement programs are heading for bankruptcy without a 7% across the board tax cut. The idea of providing greater benefits without tax hikes is a myth impossible through policy
5) Tort reform and the end of defensive medicine The featured research section of my website discusses the true costs of defensive medicine, which are high and staggering. Most studies that indicate these costs are 0.5% of total system costs are flawed econometric studies that poorly measure true indirect effects on health care costs within our American system
My website addresses these issues, and many more, as they related to health policy, comparative health systems and public health. I encourage you to all check the site out and appreciate your visits. Every visit also raises money that goes 100% to charity to fight disease.
The url is: http://www.satvathealthcare.com
Thanks,
Amir Satvat
MBA in Health Care Management, The Wharton School
MPA in Health Policy and Management, New York University
Former Health Care Investment Banker, Goldman Sachs
2/24/2010
Will, I did try to tell everybody that this was for the tax dollar and now the big IT has shown its true nature. What is lost to understand that the tax forum for S.S. and income tax is all ready in the red because of it being based as dollar as a constant figure. So now to undo this mess of tax failure, a forum to tax against a all ready troubled system of Health Care is in the works. Well ” I told you so !”
Force pay and a new tax, wow, this is our tax dollars hard at work. But there is a better way and it will remove this extra $2 trillion dollars and in 10 years there will be a sur- plus of cash in Our Government System. {let me show you how our Government Officials work.} Please help the people understand why this force pay within failed insurance groups and there is no supporting information about Health Care Insurance Companies that do not have suits against them and even after 50 years they value the dollar over life. A good company fixes mistakes and a great company learns from the mistakes. I have not found one….as of yet, so why force pay into the failures and cover ups.
So as these Officials get your vote and send you off to you room so that all can be fixed by their Artificial Intelligence, because they have been stuck in that Matrix and now all they can do is see us as variables in a equation as dollar numbers, they do try to see, but without that Mathematical A.I. They are so lost. This is the same with Health Care Insurance Companies, as A.I. shows the way for D.N.A testing and other inventive forms of how to calculate the dollar as a human input.
We intend to put on page 100 at our site a Prime Directive for Health Care and it will be released in 7 days. Why 7 days ? it is because of a added 2 trillion dollars to the debt of our system and a Health Care Tax Forum against it and still no inside look of a balance.
But I do offer my congratulations again to the Administration and theses Law Makers In And for The People Of The United States Of America.
Henry Massingale
FASC Concepts in and for Pay It Forward
http://www.fascmovement.mysite.com.
I think nobody can be brief as like your post!Thanks for the insight! There is a lot of helpful information within those links.
Free Diabetes Dentist Guide
I agree wholeheartedly that the current health care system is broken. However, I have never seen a government run program that really reduces the underlying costs of anything–let alone quality health care. To pass a mandate to arbitrarily reduce reimbursement to health care providers does nothing to reduce the cost of health care. It will result in those unpaid costs being pushed back to hospitals and/or patients who will not be able to pay. The logical result of that, as in all business that must have money to operate a quality organization, will be reduced quality of health care, fewer physicians, and many patients (even with their health care “coverage”) who will not be able to find quality treatment. I think this last point will be directed primarily to senior citizens on Medicare. To eliminate fraud in the Medicare reimbursement system, there are plans to create yet another government agency (or outsourced to third parties) to uncover that fraud. What is the expense to the American taxpayer for yet one more level of bureaucracy?
I will support health care reform when every congressional representative personally agrees to become a part of it. If the American taxpayer is going to have an unwanted system imposed upon us, it should apply equally to everyone–including every member of Congress. No more of this system where they (congress)impose rules on every American citizen except themselves. It is easy to impose regulations on the citizens when you are exempt from those same rules–and force us to pay for it! It is an outrage to even think that our government will “force” us to pay for coverage–and we will be considered outlaws if we do not subscribe to this doctrine and pay for insurance whether we want it or not. I beleive this goes against our basic freedom as granted by our Constitution.
To see the true Health Care Tax forum you must stop thinking in 3-D,This multi tax forum is against a $100 Trillion Dollar system.. …
To force pay into another system of failures within Health Care Insurance Groups.
This economy will not balance with this concept of a tax forum against the Health Care System. The issue of how to force pay into this system of Health Care may have worked but I am still troubled over the progressive tax forum within this Bill. It covers so many items and Countries that it only forces the system to adjust itself. In some areas, increases against the people and the troubled economy, and in other areas, less effects will be felt.
But this is my big problem, Government Officials seek help and they are to proud to ask us, “the true working force of Government.” It is understandable they have failed the People and within the United States Of America all we ask is to see us as who we are and not try to bring us into this world of the intellectual. I guess our Prime Directive is that of Star Trek, so it must be understood that for millions of people we are just as happy as can be making $13.00 per hour and we have no interest in this world of politics, and how to be a Enstine. Government Officials must understand that there is a level of people within different parts of this Country, that seek to be only that they find to make them happy.
As for this economy well, it is said that the U.S.A. Arms Division has created enough arsenal to destroy every last creature in the world 2 times over,built with tax dollars. This would be funny if not for the irony of it. And now as time has passed Government Officials keep failing. Before 9/11 all the way to today.
As it is in a world of a system, when employees continue to fail, one or two things happen, one; you get fired, two; if you see into a person a good, then it is political correct to implement a penalty or roll back in pay. But this implement of penalty is more favored in the course of action in the Federal Employment World. So how to fix the economy and unite it with the Health Care issue. It would be in the Countries best interest to implement a 10% per cent penalty against every State, County and Government Official within this Matrix of failures. Hey what is that old saying, what is good for the Goose is good for the Gander. I am serous about this, it is past due to show that our Government Officials they have failed, their system failure reaches into this world of warnings that they brush aside as if the information is not worthy noting. From Pearl Harbor to 9/11/2001 to 3/07/2010 of our tax system and Health Care Reform. This 10% per cent penalty should go into the Health Care Forum.
The big problem that Government Officials have is that they have no street credit. President Obama still has some but if he does not take his family and step away from these dueling Parties, that fight over this Health Care Dollar, and stand with Us he will lose all credit from the streets to the county.
President Obama, I would say to you, you have one last chance to regain the hopes and dreams of the American People. To reach out in a concept that states, if there is 250 million people in trouble because of these failures, I would give all my money to them and then I would say to all that I gave money to, “I have no money left, would you all please give me $1.00 back and then I would have $250. million dollars to start all over again.”
As for this $100,trillion dollar in site………….
Results 1 – 10 of about 685,000 for net worth of medicine development industry
Just to show how deep this Health Care Tax split petition reaches. The term split petition is used because of the Tax factor plan that is not seen because of the intent not to show a capital Taxing of close to a $100 trillion dollar package, a yearly system income, not profit…..
Some have stated that I clam to have spiritual in site or something of the sort. I assure you this is not true, so when I state that I asked God to help, it is my way of saying hey Bobby show me how to work on theses Chevy engines. But I do thank you for the consideration. Consider me a cross of Jethro Bodine from the Beverly Hill Billies with my 10th. Grade education and Vin Diesel from the move Pitch Black.
So drop on by and see page 100 at our site and follow the blue pill link
Health Care within a moral value, is to ,
{ GIVE LIFE TO HOPE WHERE THERE IS NONE }
Henry Massingale
FASC Concepts in and for Pay It Forward
http://www.fascmovement.mysite.com on google. yahoo, and Aol.com
please take the time and visit all my new friends on the net and if you wish to post with FASC Concepts you will be most welcomed. So join us and share your ideas as one in one voice.
If the Healthcare Bill passes, I plan to wear a black arm band to mourn what Americans have lost.
I agree wholeheartedly that the current health care system is broken. However, I have never seen a government run program that really reduces the underlying costs of anything–let alone quality health care.
Thank you for the article
There are a lot of people who have money and they do not want to spend their money for health care. My opinion is, that some medicine should be free… like urgent help. But also people should spend money for more deep research to keep the medicine on the high level. Everyone should understand, that there are a lot of expenses in health care.
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[...] MKH provides the link to the Mayo Clinic’s statement here. [...]
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Next step is the explanation of the needs for the region of public health of all, whom you want to include in the plan of medical insurance. This stage can be sufficiently complex. You and others in a good health as a whole? Someone is some already exi…