On Sun, 19 Jul 2009 23:14:16 -0400, Eisboch wrote:


I was thinking more of terminal conditions and the costs associated with
keeping people alive for a relatively short period of time.

I understand that, and that's where decisions get very difficult. As
national policy, however, I would be looking to save costs in other
places, rather than life and death decisions. I have yet to hear a valid
reason our health costs are nearly twice that of other industrial
nations. There has to be considerable savings to be found in that 7-8%
GDP.

On Mon, 20 Jul 2009 02:30:25 -0400, gfretwell wrote:


There are lots of reasons why we have higher health costs. We generally
have less healthy lifestyles and diet. We invented "extreme sports" and
generally stupid human tricks people do, that result in a lot of
expensive injuries. We have a lot more violence in our cities that clogs
ERs every night and we have a big appetite for elective procedures.
We also have a huge lawyer tax. Ask your doctor what his insurance bill
is. Compare that to a Canadian doctor. Add in all the extra tests to
show "due diligence" that causes and you start to understand why we are
#1 in cost.

All of the above sound reasonable, although it does smack of blaming the
victim. I found this report that was made for Congress. It seems well
balanced, and contained several surprises for me.

http://assets.opencrs.com/rpts/RL34175_20070917.pdf

There are two main cost savings that jump out at me. Administrative
costs, we spent 20-25% of our health care dollars on administration. The
second would be, more professional health care workers, supply and
demand. I would also consider reducing the educational debt load that is
carried by our health care professionals. Perhaps even a free education,
for doctors.

One of the surprises was pharmaceuticals. We tend to pay more for new
drugs, but considerably less as the drugs get older. Overall, our
pharmaceutical spending, as a percentage of total health spending is
relatively low.

A second surprise, more visits to doctors, tend to keep the overall cost
of health care down. On first glance, perhaps counter-intuitive, but not
after thinking about it.

This country's obesity, as you pointed out above, is a problem.

On Mon, 20 Jul 2009 12:39:10 -0400, gfretwell wrote:


How can anyone believe a government medical agency will be cheaper than
someone with a profit motive to cut costs?

Huh? Because the motive it to increase profits, not cut costs. While
it's not a fair comparison, Medicare's administrative costs are @6%,
compared to the 20-25% of our current health care system. Perhaps, more
telling, administrative costs in a for-profit hospital are @ 34%, as
opposed to 24.5% at non-profits, but get this, the costs are 22.9% at
public hospitals, you know, government run hospitals.

http://www.pnhp.org/single_payer_resources/
forprofit_hospitals_cost_more_and_have_higher_admi nistration_expenses.php

wrote:
On Mon, 20 Jul 2009 13:07:57 -0500, thunder
wrote:

On Mon, 20 Jul 2009 12:39:10 -0400, gfretwell wrote:


How can anyone believe a government medical agency will be cheaper than
someone with a profit motive to cut costs?
Huh? Because the motive it to increase profits, not cut costs. While
it's not a fair comparison, Medicare's administrative costs are @6%,
compared to the 20-25% of our current health care system. Perhaps, more
telling, administrative costs in a for-profit hospital are @ 34%, as
opposed to 24.5% at non-profits, but get this, the costs are 22.9% at
public hospitals, you know, government run hospitals.

http://www.pnhp.org/single_payer_resources/
forprofit_hospitals_cost_more_and_have_higher_admi nistration_expenses.php


Medicare is not going to be a good example for you to hang your hat
on. A lot of the administration is actually done by the health care
provider and SSA/IRS does the accounts receivables. It is hard to get
a fair number to compare.
You also have to understand that taking 3% of every wage dollar earned
in this country they are still going broke providing health care to
16% of the population.


A tremendous amount of "administration" is done by health care providers
who have to deal with the vagaries of private health insurance companies.

We probably would not have the horrific health insurance problems that
challenge us today if the insurers were properly regulated, as they are
under the Federal Employes Health Benefit Act. Hundreds of insurers
compete to get in and stay in this program, and offer top coverage, more
than competitive rates, and a plan for almost every pocketbook.
Typically, the plans are offered by employe organizations to any federal
employe. The organization retains an underwriter and processor to handle
the actual operation of the plan, and the plans are easy to compare as
to which organization is offering what. The plans are profitable, there
is a lot less waste than in the totally private sector, and there is a
lot of innovation.

There's nothing magical or even particularly efficient about the health
care industry today.


--
A wise Latina makes better decisions than a dumb elephant.

On Mon, 20 Jul 2009 14:29:51 -0400, wrote:



Medicare is not going to be a good example for you to hang your hat
on. A lot of the administration is actually done by the health care
provider and SSA/IRS does the accounts receivables. It is hard to get
a fair number to compare.
You also have to understand that taking 3% of every wage dollar earned
in this country they are still going broke providing health care to
16% of the population.

Right, and Aetna HMO takes 50% of my wife's wage dollar.
And we seldom use it. I call it Keep-Your-House insurance.

--Vic