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Again, a lot of healthcare costs are end of life, major surgery, cancer treatment, etc. It is not going to the doctor to get eye surgery. There is no way a free market is going to work, because the incentive will be to LIVE to GET WELL. These things will over ride costs every time.
The way forward for lower costs is already shown in Medicare and Medicaid and governments around the world.
Medicare recipients pay premiums for many years before they are even eligible to receive Medicare benefits. Countries with national healthcare fund it via highly regressive tax systems, as I've already posted.
Lefties incessantly demand universal healthcare, but refuse to understand the funding mechanisms that make such possible: pre-paying for benefits for many years AND highly regressive tax systems.
Your own government has identified the cost factors that are escalating the costs of health care. Here they are ranked in order by your very own General Accounting Office....
1
Technology up to 65%
2] Consumer Demand up to 36%
3] Expanding Health Benefits or Insuring more people up to 13%
4] Healthcare Price Inflation up to 19% (caused by Consumer Demand and insuring more people)
5] Administrative Costs up to 13% (caused by Technology, Consumer Demand and Regulations)
6] Aging/Elderly up to 7%
Source: United States Government General Accounting Office GAO-13-281 PPACA and the Long-Term Fiscal Outlook, January 2013 pp 31-36
As you can see, the "uninsured" and the "health insurance" companies (which do not legally exist) are not the problem.
You can't even blame the elderly for the problem.
If health care costs increase 10% in a given year, then the elderly at most only drive 7% of that.
Look in the mirror for the #1 and #2 problems....you are a country enamored with technology and the more that is created, the more you want, and that ----technology--- is the Number #1 driver of health care costs.
And it is not limited solely to medical technology.....
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And what is most rich, is that an ACA supporter actually had the gall to ask this question....
Why does one night in an American hospital room cost the same as 7.2 nights in a Finnish hospital room?
Now that you are armed with factual information, maybe you can actually do some soul-searching and give the correct answer......which is that Americans demand and expect way too much from health care.
Resuscitating....
Mircea
You are comparing apples to oranges. I am comparing our healthcare costs increases relative to other nation's healthcare costs.
The GAO was saying this is why internally cost are going up. But that doesn't answer the question why our costs are so much higher than other nations. This is where the having more uninsured, may have an impact.
So you are answering a question I wasn't asking.
So the problem America has in that other nation's do a much better job at controlling costs compared to us and their costs are much lower, and everyone is insured, that is the question that needs to be answered. That GAO report doesn't address that at all.
High deductible plans aren't irrelevant because they force people to actually see the cost of what they pay, thus introducing a market mechanism. Example: my father in law has a 5k ded. he had to have an mri recently and the hospital told him it would be around 3500. He said that he'll have to pay so he looked around for other option. He then found a diagnostic imaging company close to where we live that charged 750 for comparable service. He completed the scan there and forwarded the results to the hospital. If he had a low ded plan, he wouldn'thave cared and the provider would have just charged for the 3500 dollar mri. Being removed from payment is what removes the market mechanism in healthcare.
Buying across state lines isn't irrelevant either. Look at New York and Idaho. NY has one of the highest healthcare costs of any state because all the special interests that have their pet project included in premiums. Idaho has one of the lowest because it is basically a "true" catastrophe coverage. If I live in NY, I can't purcahse the Idaho plan. I should be able to purchase a plan from any state...that would FORCE health plans to be competitive.
We all know what tax credits are...advanceable tax credits are those that come before refund dates. For all intents and purposes, people who receive insurance from their employer are receiving tax advantages which are unfair to those who purcahse insurance on the market because they don't have access to the same benefits. A GOP solution to this is an advanceable tax credit to people to pay for healthcare costs, assuming the money is spend on insurance...usually up to a high-deducible plan. So, it is basically the tax credit that one would get from having employer provided insurance....without receiving employer provided insurance.
NP and PA's...this serves as competition in the provider market. I'm glad we agree here.
Issues like trauma surgery...being hit by a bus...heart attacks....are inelastic. You can't negotiate these things because more often than not you're incapacitated. These are the real reasons for catastrophe insurance. These are rare, but catastrophic events, therefore insurance should be used. The market mechanism wouldn't apply to these issues because they don't lend themselves to proper negotiation. However a market is very applicable for most of our medical issues. The things that we use often like check ups, routine screenings, physicals, dental work, pharmaceuticals, etc. All of these things are effecitvely services provided by a business and should be treated accordingly.
We basically use medical insurance these days as a payment manager only which serves to inflate cost. On top of that, organizations like the American Hospital Associate have effectively worked to inflate costs of medical treatment for years and years with no repurcussion.
High deductible plans are irrelevant. Employers have been offering high deductible plans since the 1990's and the vast majority of workers don't pick those plans because they suck and leave a person open to steep costs if they have someone in their family develop a chronic illness.
They are irrelevant to costs and they suck as insurance for most people with families. Sure for some younger highly paid single individuals the HSA's make sense, but for most people they don't and that is why the VAST MAJORITY of employees don't select those plans when offered to them.
The vast majority of healthcare spending is not routine check ups and screenings, physicals. So those things are irrelevant to costs.
tax credits don't help people who can't afford insurance or who can't afford to go to the doctor because usually they aren't paying much income taxes. This will not help people who don't have insurance gain insurance.
The state line thing is irrelevant as well, having crappy insurance from some state with terrible regulations for health insurers doesn't lower costs to the healthcare system. When that person gets seriously ill his/her crappy health insurance won't pay and we will end up footing the bill as usual.
No the only way to get insurance to people is single payer, or some kind of mix of public/private insurance combined with a mandatory requirement to buy insurance, along with subsidies to people to help them buy the insurance.
The rich get much richer, the middle class gets destroyed. Why are liberals so please with the widening wealth gap? The liberals love the billionaires and corporations.
Wow, have you gotten that backward. Do you seriously not pay attention to which party favors the wealthy, or are you just trolling!
Medicare recipients pay premiums for many years before they are even eligible to receive Medicare benefits. Countries with national healthcare fund it via highly regressive tax systems, as I've already posted.
Lefties incessantly demand universal healthcare, but refuse to understand the funding mechanisms that make such possible: pre-paying for benefits for many years AND highly regressive tax systems.
I can assure you that the vast majority of people in Medicare receive far more in benefits than they paid in their lifetimes. You can believe whatever you want, but it doesn't change reality about Medicare recipients.
And I don't have a problem with the fact that Medicare recipients get more out than they put in, but let's not pretend they don't.
Again, a lot of healthcare costs are end of life, major surgery, cancer treatment, etc. It is not going to the doctor to get eye surgery. There is no way a free market is going to work, because the incentive will be to LIVE to GET WELL. These things will over ride costs every time.
Major issues are inelastic...you're right, and these things should be covered by catastrophic coverages as is their intent. No one suggests telling the ambulance to go to St. Thomas's or Presbyterian hospital because they're offering a two bypass for one special. It's basic medical services that are open to competition.
The way forward for lower costs is already shown in Medicare and Medicaid and governments around the world.
Medicare is...and has been going broke. It has 7.7 trillion dollars in unfunded liability. Further...prices are increasing in single-payer states too. So how do we pay for it...raise taxes? Sure...and what happens when costs get to the threshold again? Raise taxes again? When does it stop?
Tort reform is irrelevant. Why conservatives are so interested in shielding doctors and hospitals from lawsuit makes no sense. Tort Reform has been implemented in many individual states, it has had zero impact on healthcare costs or lead to more people gaining insurance.
Four researchers—including a University of Texas law professor—concluded that there was no evidence that Texas physicians were leaving the state prior to the 2003 law, or that there was a significant increase in physicians moving to Texas because of better liability climate.
The same group of researchers also looked at the effect of tort reform on healthcare costs and found no evidence that they fell after 2003. The researchers compared healthcare costs in Texas counties where doctors faced a higher risk of lawsuits with those with a lower risk. The assumption was that physicians in high-risk counties were practicing more defensive medicine prior to 2003, and that fewer unnecessary procedures would be performed after 2003. However, they found that there were slightly more procedures performed in high-risk counties after the law was passed.
In seven categories of risk, Dallas and Tarrant were in the third-highest category while Collin and Denton were in the fourth-highest category.
A third report by non-profit advocacy group Public Citizen in October 2011 echoed the conclusions of both research studies. The report, called “A Failed Experiment,” found that Medicare spending and private insurance premiums both have risen faster than the national average since tort reform.
That group also examined the trend in direct-care physician growth between 1996 and 2010. It found that those physicians grew by more than 9 percent prior to tort reform, and about 4 percent afterward. It also said physician growth in rural Texas fell by 1 percent since reform, after having grown more than 23 percent prior to the law.
I could care less about tort reform. Frivolous lawsuits are bad, but they aren't a major driver...I agree with you here.
Buying insurance across state lines is another race to the bottom strategy that would have states weakening insurance regulations so people would end up with useless insurance.
Do you need the government to tell you what coverage to buy? No. You don't. Unless you're an idiot. In a true free market...bad or imcomplete coverage won't survive just as any other bad products won't survive. People will purchase the best insurance for the lowest cost. The market will find the true bottom on the cost of catastrophe insurance...just as it has with all other products that are available.
The manner in which it brings down costs is fairly straight forward, in some respects, by getting more people covered, fewer people will go to the emergency room for care, people will see the doctor for routine check ups, thus catching more disease in earlier stages, also the way in which insurance works is pooling people. In other words if an insurance company sells insurance to a single individual the risk is very high for the insurance company to lose money so they have to charge that single individual more because of that risk, but if it sells a group plan to 10,000 people there is less risk for the insurance company to lose money and so they can charge each of those 10,000 less because the costs are being spread out.
Bring down costs of insurance or treatment? Afterall, the cost of treatment is the problem...not the cost of insurance. Treatment costs can be lowered by competition, just as the cost of every other service. Massage costs used to be excessively high in the US...now an hour massage is 39.99 at most clinics. If all states mandated massages be covered by insurance, the cost would be excessive because competition wouldn't exist. Basic treatment is what we use most often, and it is NOT subject to the same inelasticity as trauma surgery and major medical issues. These issues would be covered by a catastophe policy...just as they were intended. These expenses are rare and potentially financially ruinous, which is the VERY REASON catastrophe coverage exists...to mitigate this risk.
So by creating state exchanges, insurance companies have lower risk of losing money on any individual policy so they can offer those individuals in the state exchanges lower insurance costs with better coverage.
States exchanges won't do much because the youngest and healthiest people can stay on their parents policies until they're 26. These are the people that would theoretically pay the most in while using the least services. Younger single women have a lower median income than younger single men...therefore a lot of them will qualify for subsidies and they will utilize the "free" preventative care. So they really don't pay much in, yet they use services. The exchanges will make money and build their reserves from 26-40 year old successful men...i.e., men that make enough money not to qualify for a subsidy and use basically no services. The caviot...a lot of these men will probably just pay the penalty because it will be less than premiums, and if they get sick...they'll just buy insurance then because the law allows for that. There is a great article written for Real Clear Markets by Peter Schiff about this that I think you may enjoy.
High deductible plans are irrelevant. Employers have been offering high deductible plans since the 1990's and the vast majority of workers don't pick those plans because they suck and leave a person open to steep costs if they have someone in their family develop a chronic illness.
They are irrelevant to costs and they suck as insurance for most people with families. Sure for some younger highly paid single individuals the HSA's make sense, but for most people they don't and that is why the VAST MAJORITY of employees don't select those plans when offered to them.
The vast majority of healthcare spending is not routine check ups and screenings, physicals. So those things are irrelevant to costs.
tax credits don't help people who can't afford insurance or who can't afford to go to the doctor because usually they aren't paying much income taxes. This will not help people who don't have insurance gain insurance.
The state line thing is irrelevant as well, having crappy insurance from some state with terrible regulations for health insurers doesn't lower costs to the healthcare system. When that person gets seriously ill his/her crappy health insurance won't pay and we will end up footing the bill as usual.
No the only way to get insurance to people is single payer, or some kind of mix of public/private insurance combined with a mandatory requirement to buy insurance, along with subsidies to people to help them buy the insurance.
We picked the latter system.
both your answer and the OP you were responding to, were extremely well thought out, I agree with single payer personally, but then I don't feel as informed as the two of you and because I am now on Medicare and supplemental, I don't have reason to worry. Hopefully soon my children and grandchildren can stop worrying as well. The insurance industry, big pharma and the health care bigwigs, and all their Wall Street cohorts have had a lock on the system way too long!
I can assure you that the vast majority of people in Medicare receive far more in benefits than they paid in their lifetimes. You can believe whatever you want, but it doesn't change reality about Medicare recipients.
None of the computations I've seen have analyzed the exponential growth of what the premium payments would have achieved if invested for those decades instead of just squandered by the government.
Using an investment calculator, I plugged in an unchanging $40,000 annual income with the 1.45% employee Medicare tax amount of $580 per year. After 40 years (age 25-65), if the same static amount were invested over time, the total Medicare tax paid would have been only $23,200 while the accumulated value of an investment after 40 years (average annual return of 7%) would be $123,894.
The invested value would be more than 5 times the amount paid. By even the most generous estimates, the average value of Medicare benefits received is only 3 times that of Medicare tax paid.
So, let's not pretend that Medicare taxpayers aren't losing money on the deal.
Where has the dollar been devalued? I've been hearing this "the dollar is being devalued" for six years and I am still waiting for it to happen.
This is the money supply growth since 2000:
This is the dollar index since 2000:
I don't see any dollar decline during the period when the Fed increased the money stock. From 2000-2008, now that was a decline.
The only thing that has temporarily kept the dollar from plummeting is that the European currencies have been SO weak with their socialist policies causing near bankrupcies in so many countries. If you think that the amount of monetary stimulus that your top graph shows is not going to be inflationary and weaken the dollar then you need to go back and brush up on economics 101.
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