Medicaid for All Would ‘Bankrupt the Nation,’ Warns Bernie Sanders—In 1987 – Hit & Run : Reason.com

“Notably absent from Sanders’ proposed single-payer system was a detailed plan to pay for it. The senator said he would lay out the tax hikes necessary to fund his new system in separate legislation.

That may be because enthusiasm for single payer tends to die down pretty quickly once people get a sense of what sort of tax increases would be necessary to fund it. An Urban Institute analysis of a previous version of Sanders’ plan estimated that it would cost $32 trillion over a decade.

It promises huge overall savings along with coverage that would be far more expansive, and far more expensive, than Medicaid for all, with no clear way to pay for it, and no specific strategy for driving costs or spending down.

In 30 years of political advocacy, Sanders has not solved any of the fundamental problems with single payer. He has merely opted to pretend they do not exist.”

[Note: On annualized basis, that would more than double the amount we currently spend annually on healthcare.  And past projections related to the costs of gov’t programs always vastly underestimate the actual costs, as evidenced below. – The Sovereign Patient]

“The House Ways and Means Committee estimated that Medicare would cost only about $12 billion by 1990 (a figure that included an allowance for inflation). This was a supposedly “conservative” estimate. But in 1990 Medicare actually cost $107 billion.” http://reason.com/archives/1993/01/01/the-medicare-monster

Source: Medicaid for All Would ‘Bankrupt the Nation,’ Warns Bernie Sanders—In 1987 – Hit & Run : Reason.com

CMT CANADA: ‘I think one of the biggest misnomers about Canadian healthcare is that it is “free”. It definitely is NOT free.’ ~ | Concierge Medicine Today

The Canadian Health Act of 1984 is the law that frameworks healthcare in that country.  As individuals enroll in the program they are issued a health card which enables them to receive health care services which the government deems “essential”.  As I outlined in yesterday’s post, there are a multitude of services which are not covered and thus the individual must pay for themselves (either out-of-pocket or through insurance).  It is unlawful for private insurance to duplicate public healthcare system benefits.  Private insurance is only allowed to address coverage gaps, similar to supplemental insurance in the United States (yes, the AFLAC duck).

I think one of the biggest misnomers about Canadian healthcare is that it is “free”.  It definitely is NOT free.  Canadians pay heavily for healthcare through the tax system.  In 2013, the average Canadian family paid $11,320 in taxes just for the public healthcare insurance.  Furthermore, the cost of public healthcare (before inflation) has increased 53% just in the past 10 years and is now running a deficit of $540 billion.

via CMT CANADA: ‘I think one of the biggest misnomers about Canadian healthcare is that it is “free”. It definitely is NOT free.’ ~ | Concierge Medicine Today.

How Government Killed the Medical Profession | Cato Institute

Command and Control


Coding was one of the earliest manifestations of the cancer consuming the medical profession, but the disease is much more broad-based and systemic. The root of the problem is that patients are not payers. Through myriad tax and regulatory policies adopted on the federal and state level, the system rarely sees a direct interaction between a consumer and a provider of a health care good or service. Instead, a third party—either a private insurance company or a government payer, such as Medicare or Medicaid—covers almost all the costs. According to the National Center for Policy Analysis, on average, the consumer pays only 12 percent of the total health care bill directly out of pocket. There is no incentive, through a market system with transparent prices, for either the provider or the consumer to be cost-effective.

healthcareAs the third party payment system led health care costs to escalate, the people footing the bill have attempted to rein in costs with yet more command-and-control solutions. In the 1990s, private insurance carriers did this through a form of health plan called a health maintenance organization, or HMO. Strict oversight, rationing, and practice protocols were imposed on both physicians and patients. Both groups protested loudly. Eventually, most of these top-down regulations were set aside, and many HMOs were watered down into little more than expensive prepaid health plans.

via How Government Killed the Medical Profession | Cato Institute.

Supply Side Contraceptives – John C. Goodman – Page full

Should we really be insuring items that cost less than $400 per year? Third-party Health Plans in general, and ObamaCare specifically, continually come down on the wrong side of this issue.

Free contraceptives are only one example of how the Obama administration gets it priorities wrong when it comes to health insurance. For example, the Affordable Care At requires employers and insurers to provide a long list of preventive services, such as mammograms, blood pressure screening, cholesterol screening, etc.. And as in the case of contraceptives, the administration Officials have been claiming that the money spent on these procedures will result in overall savings.

Yet here again the evidence says otherwise. Most preventive procedures cause health care spending to go up not down. And while we are spending scarce premium dollars on low-dollar items of sometimes dubious value we are continuing to leave people exposed for large catastrophic costs.

One of the worst examples of getting the priorities wrong is the way ObamaCare changed Medicare. Every senior is now entitled to a free wellness exam of almost no medical value. At the same time, every senior continues to be at risk for tens of thousands of dollars of costs from a prolonged hospitalization.

How do we explain such irrationality? I call it the “politics of medicine.” As reported in a previous Town Hall editorial and in my book, Priceless:

In a typical U.S. insurance pool about 5 percent of enrollees will spend 50 percent of the money. About 10 percent will spend 70 percent. The numbers differ a bit from group to group, but you get the idea: a small number of people spend most of our health care dollars in any given year.

Now suppose you are a Minister of Health. Can you afford to spend half of all health care dollars on 5 percent of the voters? Even if they survive to the next election, they are probably too sick to get to the polls and vote for you anyway! Can you afford to spend virtually nothing on the vast majority of voters just because they happen to be healthy?

The answer is clearly “no.” The inevitable political pressure is to skimp on care for the sick in order to spend on benefits for the healthy. Put differently, the politics of medicine pushes decision makers to underprovide to the sick in order to overprovide to the healthy.

That is why it is easier to see a primary care physician in Britain than it is in the United States, but harder to see a specialist and much harder to access expensive technology. In the 1970s, the British invented the CAT scanner and for a while supplied half the world’s usage probably with government subsidies. But the NHS bought very few CAT scanners for use by British patients. The British also invented renal dialysis along with the United States, but even today Britain has one of the lowest dialysis rates in all of Europe.

via Supply Side Contraceptives – John C. Goodman – Page full.

Health Costs in Canada Increased 2.85 Times Faster Than Inflation in the Last Decade | Health Policy Blog | NCPA.org

Health care in Canada is not “free.” Canadians often misunderstand the true cost of our public health care system. This occurs partly because Canadians do not incur direct expenses for their use of health care, and partly because Canadians cannot readily determine the value of their contribution to public health care insurance because there is no “dedicated” health insurance tax.

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In 2014, the estimated average payment for public health care insurance ranges from $3,592 to $11,786 for six common Canadian family types, depending on the type of family. For the average Canadian family, between 2004 and 2014, the cost of public health care insurance increased about 1.5 times faster than average income, 1.3 times as fast as the cost of shelter, 1.6 times as fast as clothing, and more than three times as fast as food. The 10 percent of Canadian families with the lowest incomes will pay an average of about $523 for public health care insurance in 2014. The 10 percent of Canadian families who earn an average income of $57,818 will pay an average of $5,522 for public health care insurance and the families among the top 10 percent of income earners in Canada will pay $37,239.

via Health Costs in Canada Increased 2.85 Times Faster Than Inflation in the Last Decade | Health Policy Blog | NCPA.org.

Medicine’s Top Earners Are Not the M.D.s – NYTimes.com

THOUGH the recent release of Medicare’s physician payments cast a spotlight on the millions of dollars paid to some specialists, there is a startling secret behind America’s health care hierarchy: Physicians, the most highly trained members in the industry’s work force, are on average right in the middle of the compensation pack.

That is because the biggest bucks are currently earned not through the delivery of care, but from overseeing the business of medicine.

The base pay of insurance executives, hospital executives and even hospital administrators often far outstrips doctors’ salaries, according to an analysis performed for The New York Times by Compdata Surveys: $584,000 on average for an insurance chief executive officer, $386,000 for a hospital C.E.O. and $237,000 for a hospital administrator, compared with $306,000 for a surgeon and $185,000 for a general doctor.

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And studies suggest that administrative costs make up 20 to 30 percent of the United States health care bill, far higher than in any other country. American insurers, meanwhile, spent $606 per person on administrative costs, more than twice as much as in any other developed country and more than three times as much as many, according to a study by the Commonwealth Fund.

As a result of the system’s complexity, there are many jobs descriptions for positions that often don’t exist elsewhere: medical coders, claims adjusters, medical device brokers, drug purchasers — not to mention the “navigators” created by the Affordable Care Act.

Among doctors, there is growing frustration over the army of businesspeople around them and the impact of administrative costs, which are reflected in inflated charges for medical services.

via Medicine’s Top Earners Are Not the M.D.s – NYTimes.com.

Why Contraceptives Are Important | John Goodman’s Health Policy Blog | NCPA.org

But here is something else that should be of interest to all of us: why would Congress pass a law mandating free contraceptives but leave people exposed for thousands of dollars of out-of-pocket costs if they need bypass surgery? I have been trying to explain this phenomenon to people for 30 years — ever since I discovered similar anomalies in the British National Health Service.

I call it the “politics of medicine,” and it illustrates why government should always play a very limited role in health care and why individual choice and competition should be given maximum reign.

via Why Contraceptives Are Important | John Goodman’s Health Policy Blog | NCPA.org.