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Obamacare Part One: Where Has National Health Care Ever Worked?
I question the motives of a politician who says things like government-run national health care will bring good medical care to everyone, that it’s a cost savings measure, it’s a budget balancing program, and that it will not require an increase in taxes on the middle class.
On July 7, 2009, President Obama said:
I am pleased by the progress we're making on health care reform and still believe, as I've said before, that one of the best ways to bring down costs, provide more choices, and assure quality is a public option that will force the insurance companies to compete and keep them honest," the president said in the statement. "I look forward to a final product that achieves these very important goals.
President Obama knows these statements are lies.
Why is it that no one in the government can come up with an idea for delivering health care to people other than through a government-run plan? Just on the face of it you would have to question their premise. If they can’t run the post office, Medicare, or anything else efficiently, what makes anyone think they can run the 16% of the economy that is health care?
Yet they continue to press for some form of government-run national health care. To be fair, they have quite a bit of support from their voters who are frustrated with the current “free market” system. Many people think government run health care is actually going to be free.
What everyone wants is a system that gives them good health care, insurance coverage at a fair price, choice as to doctors, access to the best technology, and the knowledge that they won’t go broke because of medical bills. Sounds fair.
What is the best way to deliver that to consumers? Or, to put it the way President Obama would, “what works?”
To come up with the best system possible, why don’t we first take a critical look at the systems around the world that are run or sponsored by governments. Do some research and find out what works and what doesn’t.
Of course the reason the Administration doesn’t want to do that is because all these public health care systems have problems containing costs, have some form of care rationing, and are raising taxes to cover budget shortfalls.
It is clear from a survey of current systems around the world that the programs that offer the best chance of achieving our goals are the ones that have the least amount of government control. The systems that have the most top-down government control are the ones that least meet these goals.
Heavy handed government-run single-payers programs in countries like Great Britain, Canada, and Norway have the least amount of consumer satisfaction, the highest costs, health care rationing, and delays in getting care.
Countries such as France, Netherlands, and Switzerland with national health care systems that are more market oriented, with managed competition, allow consumer choice, cost savings incentives, and market pricing are far more successful.
Every country that has a form of national health care is facing rising costs. More and more they are turning to more market based incentives to better manage costs, increase efficiency, and allow more consumer satisfaction.
By the way, every country to some extent has the same problems Americans complain about: gatekeeper issues, cumbersome prior approvals, lack of access to experimental treatment, and delays in getting treatment.
In light of all the evidence to the contrary why does President Obama continue to press for a public option plan whereby the government would compete with private insurers? It’s because he wants to drive out private companies and replace them with a single-payer system similar to the Medicare system. Since it is estimated that Medicare wastes about one-third of program spending, why go there?
Right now there are three bills pending in Congress They each have mandates for employers and individuals to purchase policies, purchase subsidies for the middle class, increased insurance regulation, and a government-run health care plan, like Medicare, that will compete with private insurance. They are similar to the highly regarded Massachusetts plan.
If anything should convince us not to go down this road, it is the Massachusetts program. After only three years of operation, insurance premiums are shooting up, subsidies to help citizens to purchase policies are skyrocketing ($1.9 billion in 2008), and choice is being limited. Sin taxes have been raised but not enough to keep up with cost increases. It is estimated that spending on health care, public and private, has increased 66% faster than without this plan. Governor Patrick is now talking about rationing care (“manage costs better”). Yet the proponents of the plan promised taxpayers that these things would never happen.
There is also a moral aspect to Obamacare that they don’t like to talk about.
What if I came to you and said that I have a great idea on how we can have everything we want without paying for it. How, you would ask, could we do that? I would answer that we’ll just have the kids and grandkids pay for it. Who cares, we’ll be dead.
In other words, instead of spending our money, we’ll load ourselves up with benefits and spend our kids’ and grandkids’ money to pay for it. You might say, that’s not fair, they haven’t even earned it yet. We can’t spend money that hasn’t been earned yet. We can’t commit them to something they don’t even know that’s coming.
Yes we can! It’s called intergenerational theft.
I think it is fair to assume, based on published reports of past predictions on the cost of federal social welfare programs that the cost of Obamacare will be much greater than the Administration projects. Even if you support the program you have to admit this truth.
We all know that the projected $1.7 trillion cost of the new plan will really be much more. Who will ultimately pay for it? [Play the thinking-over-your-answer music from Jeopardy] Yes, you’re right! Your children and grandchildren.
Here’s what the Cato Institute says:
Medicare and Medicaid are the reason that the size of the federal budget will double from 20 percent to 40 percent of GDP within 80 years. Medicare's unfunded liabilities are in the neighborhood of $80 trillion. The CBO estimates that all income-tax rates would have nearly to double by mid-century (top rate: 66 percent), and increase by nearly 150 percent by 2082 (top rate: 88 percent), just to pay for existing federal programs. If Congress creates a new government health program instead of reforming the ones we've got, tax increases will be inevitable and painful: The CBO estimates that by 2050, economic output could be 20 percent lower than if government remained at its current share of GDP.
There is no question that we have a system that needs reform. But keep in mind, contrary to what Michael Moore’s propaganda says (SiCKO), we have the best quality care in the world. Thousands of people from around the world come here to get medical rather than at home (just ask Italian Prime Minister Silvio Berlusconi).
There are many free market proposals to “fix” the system which would result in better health care delivered to most of the population without the waste, lack of choice, rationing, runaway costs, and massive tax increases always associated with publicly run systems.
Let’s go with what works.
For more information on this issue, go to Cato on Health Care Reform. It’s an excellent site
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I think the real issue we are suffering is that health costs have a parabolic relationship with age. Currently the young profitable customers for health insurance are sucked up via corporate plans but once they get old (at which point they become unprofitable) they are moved off the corporate plan (retirement) and placed on the government plan.
Considering most of the health care you will recieve will be adminstered while you are on medicare (government program last time I checked), what is the real risk here? If government option is so horrible why aren't people fighting like crazy to end medicare? If we have the best health care today but it is mostly administered during the later years and covered by a government program how can you say a government program will destroy quality. It feels like a mutually assured destruction logic problem.
Lastly, I think there is a real problem for those not fortunate enough to have a cushy corporate plan. We enjoy low cost benefits negotiated through volume, and we all pay the same rate. The skinny healthy guy in the corner cube pays the same rate as the fat smoker across the aisle. Most find this a reasonable practice but I think it is quickly changing. It seems however that individuals should be able to purchase health insurance for the same price as someone with group coverage.
"If government option is so horrible why aren't people fighting like crazy to end medicare?"
Well, no one in Washington is, at least. No one on either side of the aisle is going to pull the trigger to end this bloated, wasteful program, because old people vote in greater numbers than the working stiffs who have to pay for their pension and medical care.
There are plenty of people working to end Medicare outside of the Washington establishment. This program is largely to blame for rising medical costs. Ask your doctor how few pennies he gets back on the dollar for his Medicare patients (assuming he or she even takes them in, many don't because the reimbursement rates are cost-prohibitive). Ever wonder why they charge $30 for an aspirin during a hospital stay? Cost-shifting, my friend.
The problem is that a public option will work exactly like Medicare. It cannot possibly collect enough in taxes to pay market value for services, so it will underpay for services and force insurers, hospitals, and doctors to cost-shift to the private sector, driving insurance costs up and rendering it cost-prohibitive for the middle class. Less competition, higher prices, more cost burden. This will inevitably lead to forced rationing, reduced services, and longer wait times. DMV-style health care.
Well, the Republican Party has opposed Medicare since it began, although much more quietly once they realized how popular it was with the (likely voter) elderly. Google "Reagan Medicare socialism" and see if you can tell the difference between the arguments made against health care reform now and against Medicare in the 60s.
The skinny healthy guy paying the same "premium" as the fat old smoker is not reasonable, and it is certainly not insurance.
Oblige the fat guy to pay the full cost of his filthy vices....
The only healthcare system that has been consistantly proven to work cheaply with a high rate of satisfaction is a single payer system. The bill in congress today doesn't do that but it will be instrumental in killing off the insurance companies once and for all. This is a step in the right direction.
This article was short on facts and heavy on opinion. Some points were outright lies. I'm not going to take it on point by point but I will say this: You haven't lived life until you've been denied health insurance for a pre existing condition. I wouldn't wish this on my worst enemy.
Cheers
Uninsured and 'living' with colon cancer for 6 months.
"The only healthcare system that has been consistantly proven to work cheaply with a high rate of satisfaction is a single payer system."
A statement short on facts and heavy on opinion. I sympathize with your situation but ask yourself why insurance companies deny coverage to people with preexisting conditions? What causes conditions like yours to be so expensive to treat that insurance companies won't even offer you a policy?
I would suspect part of the answer would be "government regulation". Unleash the free market, incentivize medical savings and watch your treatment option costs plummet, perhaps even to the point where insurance is no longer necessary and costs may be paid for out-of-pocket.
Single-payer is not the answer. Health care is a commodity and therefore subject to the laws of supply and demand. Someone has to build and staff medical schools at a cost. Materials have to be produced and turned into equipment and medications. People have to be paid to do this. Single-payer systems do little other than cause massive price dislocations, driving out competition and reducing choice. Current systems have only been sustained by a vampiric system of cost-shifting to the private sector.
Now the cost-shifting is coming back to bite everyone on the ass. The consumer is tapped out, shifting those burdens right back onto socialized systems that couldn't efficiently handle their current loads, much less the rash of new people now dependent on those systems. The bakers are starting to get in line for their free bread, and that is the point where it all comes crashing down.
My condolences, but how can you get "insurance" on a pre-existing condition? Sounds like what you need is "charity", not "insurance".
He doesn't need 'charity' - he needs a country that focuses its resources on its citizens - not on bombing foreigners for money!
Listen to what you're saying...a country that FOCUSES resources on its citizens. And who exactly is doing the focusing? The Federal government? Do you really want to trust an entity that stole billions if not trillions from the Social Security "trust fund" and redirected it to the general fund, and thus leaving a huge pile of IOUs in its place, to run a public option on healthcare?
So you disagree with funds used in the prosecution of two wars. Fine. Both sides of the aisle approved the application of those funds. Are you really going to trust those people to effectively redirect funds to insuring the uninsured, without reducing competition or rationing services?
As Milton Friedman once said, where are you going to find these angels who will organize society for us?
There is a reason the Federal government was supposed to be hamstrung in certain areas. Centralized government simply cannot be trusted to run things effectively or efficiently, therefore it is best to give them little to do. It doesn't matter who runs it. Washington eats up idealists and chews them up into power-hungry vote-buyers. When their run is over they get nice cushy jobs in the lobbyist industry, peddling influence on the new crop of Congressional thieves.
I don't want the Federal government focusing anything on me. They are simply not to be trusted.
Where do they keep coming up with these moron guest posters?
How about someone posting on a subject that they've actually done some research on?
This bozo is talking about "Obamacare" and "Nationalized Health Care". WTF? First of all, the White House is not shepherding this program, the Congress is, so even referring to it as Obamacare is ridiculous. Second of all, there is no proposal on the table to nationalize health care. In fact, there's no proposal to do anything with health care. The current debate is solely about health INSURANCE. Wake the hell up.
Furthermore, there is no proposal to make even the insurance part of the industry nationalized. One part of the proposal may involve having a public option, which as the name suggests, will be an OPTION. All independent analyses have concluded that only a small fraction of the population would even be in this public program, with the majority remaining in crappy private insurance plans.
And what the hell is the deal with the comment about the government not being able to run Medicare efficiently? Does the poster actually have Medicare? Because I do, and I also have had private insurance, and Medicare beats every private plan I've had every day of the week and twice on Sundays. Medicare also runs at a fraction of the overhead that private insurance does. So, what baseline is the poster using when he claims that the government can't run Medicare efficiently?
Finally, to answer the title question, look at any other OECD nation for an example of a more publicly-managed health care system that works better than ours. The closest comparison to our situation is probably Switzerland, who used to have a system like ours, and reformed it recently. Their system is now a point of national pride, and even conservatives in Switzerland don't propose reverting to their more highly privatized system.
Do any of you libertarians ever leave your own country, or your own caves, for that matter?
Agree completely.
Disagree completely.
Medicare is bankrupt. Enjoy it while you can. That IS the problem, moron. How to set up a system that lasts.
That's because America is bankrupt!
If the government was serious about health reform, they would start by removing anti-trust status. Remove the monopolistic/price fixing that has been in place to allow the vile insurance companies to screw us. Then impose rules and regulations that would shut them down for denying coverage and claims.
Just look at the money the insurance companies give to the lawmakers???? Protecting them from us taxpayers...
To borrow from a recent post over at the Mises.org blog, one of the big problems is that the word insurance has been corrupted and twisted in common usage.
What most people mean when they talk about having health insurance is "How can I find a third party who will provide me with unlimited consumption of health care at no or minimal cost to me?"
You need to have a serious chat with the people who are lining up for seconds on prostate exams....
Rusty nails it. I harp on this at work ... and I indirectly work in insurance … like my coworkers … who don’t get it …
Insurance in the classical sense has always been about distributing risk across a group of players. I don’t think this is a foreign concept to the regulars of ZH. But with healthcare, the word “insurance” is stretched, because it’s not about distributing risk; its about distributing *cost*.
Semantics? Yes, but it matters.
For example, what are the odds I will be in a car accident on the way to work? Well, how many miles do I drive each day? How old am I? What is my gender? How many wrecks have I had in the past N years? Actuaries take all this information, and more, and have numbers to answer it. These are the questions you usually get asked, in addition to your work zip code and your home zip code, when getting auto insurance. They are asked for a reason; they help determine the odds of an accident so you can be quoted accordingly. If auto insurance companies can manage to do this competitively they make money.
The problem with health car is that the “odds of an accident” aren’t odds if they are the norm. What are the “odds” of health problems for someone who is 55, overweight, doesn’t exercise, and smokes.
Auto is about the random cost where health is about the norm cost; it is apples and oranges.
So one might conclude that the model for health only works when there are more healthy people than “sick” people. Bingo!
As I (anonymously) pointed out in another thread a while back, one only has to look at the demographics of the US to play connect the dots. Specifically, at what historical point would one have to refer to in order to find a corresponding percent of the workforce being removed from productive (taxed) employment over a span of a few years. I read this in a small biz magazine years ago (2005?). The answer they claimed was the bubonic plague (time span five years I believe – they cited 2009 to 20014).
The US is reaching the tipping point in health care where it is going to crush business in costs if its not reigned in. Without a government plan to dump costs on, our current health care system is about to roll over; the old/sick/non-paying are going to eclipse the young/healthy/paying. This will force up rates on the net payers to the point they will simply opt out.
CrazyCooter
PS: the right side widget is blocking the text box ... in IE and FF. Banners too big?
What were you people who voted in these Democrats thinking? What did you think would happen? Democrats talk about nothing but increasing the size of government. Why don't we at zero start a movement to ensure that the Dems never try for government health care again. Americans don't want government-run healthcare. What could be more obvious? Oh, sorry, I forgot....you voted for Nancy Pelosi and Harry Reid. Dozos.
Would you point out the people who voted for BOTH Pelosi and Reid?
Try to get a bit less Glenn "Sex-Offender-in-Waiting" in your diet....
Some Zero readers are 'dems'. George Bush could find $5 trillion (off-balance-sheet as they like to call it!) for military adventures in Iraq and Afghanistan but a couple of trillion worries you for universal healthcare coverage! You don't mind handing bankers $23 trillion but are truly alarmed if healthcare funding edges up! All those costs are of course to be carried by future generations.
Citizens in both the UK and Canada are very protective of their health systems (naturally improvements can always be made in large organizations) and really don't see why 'profits' have to be made on every damned thing.
Dubya increased the size of government more than any of his democrat predecessors.
Don't get me wrong, I'm not for a public option, or big government, but lets be truthful...Bush was a disaster for small government folk like me and you.
No argument here. Bush was worse than the worst Dem.
A perfect example of what is in place now was shown on on 60 minutes last night.
http://www.cbsnews.com/video/watch/?id=5419844n
Government will not regulate anything...
CAUTION, THIS VIDEO WILL RAISE YOUR BLOOD PRESSURE AND MAKE YOU SCREAM
"CAUTION, THIS VIDEO WILL RAISE YOUR BLOOD PRESSURE AND MAKE YOU SCREAM"
I caught the original broadcast, and the above quote is precisely correct. My neighbors called to see if I was OK. Everyone should check this video out before providing any support whatsoever to a public option, and then consider the fraud potential if Medicare was universal.
Incidently, the Medicare internal audit pawn they interviewed should be put naked in stocks in Little Miami for one day for every million dollars they cannot account for.
This should highly piss off anyone who still has a pulse.
The funny thing is that people think a corporate run system would be any different.
Well, granted there would be one key difference - the 'fraud' would either be legalized and just called industry profits - or the cost of the fraud would be pushed to the patients (ala identity theft).
Here in Canada for many years we had this really miserable kind of fraud, people would skim bank cards and drain peoples bank accounts. Really horrible life wrecking stuff. The Banks basically said 'meh, not our problem.' They generally did not return the lost funds, implement methods to make the scam harder, or really do *anything*. After a lot of public outrage they finally started to implement chip+pin cards. In about 5 years time they will make it so chip cards are mandatory which should trim most of the fraud. But they complained and complained at their cost to implement this system, and ended up pushing a good deal of it to the merchants.
Can't win folks!
The really hilarious thing about the 60 minutes story is that it is really pretty easy to fix. Take the 60 billion dollars that are wasted, spend 1 billion to issue a chip+pin card to every medicare member, spend another 10billion to equip every medicare billing shop with a chip+pin reader, and presto chango 90% of your fraud gone, use the remaining 49 billion as bonuses :P
although i agree with your comments they completely miss the point....you are arguing the case on its merits - i.e. which policy choices lead to the outcomes you delineated.....
nationalized health care has absolutely nothing to do about health care....it has everything to do with power, control, and subservience....
nationalized health care is all about getting access to personal information to be used in mind control, body control, and eugencis...
obama is an ardent eugenicist, believer in population control, and a nazi....that is what nationalized health care is all about.....arguing it on any other terms will destroy your brain.....
The only people who will benefit from the public option are the middlemen. Service will fall (both availability and quality) and costs will spiral out of control. But the service providers - and I'm talking about the monied interests that back these provider agencies - will make a killing. They've been gaming Medicare and Medicaid for decades and they'll do it again. Thank God I and my family are relatively healthy.
On a time horizon long enough, you and your family are guaranteed to get old, get sick and die. Heck, in fact, we all do.
Take a look at Taiwan, a tiny island nation with universal health system at a fraction cost (less than 5%) compared to that of US of A, with quality service and absolutely no wait for any medical service, from brain surgery to flu shot.
The issue that Taiwan could implement universal health care system was that no health insurance industry had existed before the universal system was implemented.
On a long enough timeline the survival rate for everyone drops to zero.
Where have I heard that before?
Yes, let's take a look at Taiwan... lower doctor to patient ratio, doctors dealing with way too frequent patient visits because people "feel" it's "free" so they limit the visit to 2-5 minutes, then the government is borrowing money from banks because they can't cover the premium, politicians can't raise premium because they are afraid of voters... 23 million population vs 307 million population. Imagine the cost and how the government is planning to pay for it in the long run, because it's not working well for Taiwan with 23 million population right now.
Don't get me wrong, Taiwan actually followed Medicare model (but covered everyone and not just the elderly like US) and in the beginning it was working well. But let's face it, putting the healthcare into politicians hands will end up becoming... well politics and $$$. Politicians just want to shift the $$$ going into health insurance's pocket to THEIR pocket.
Well done.
THE PUBLIC OPTION is government control and a form of slavery - straight up. It is the ultimate control of the people. FUBO
The public option is slavery? As in optional slavery? Isn't that an oxymoron?
No it isn't. The "public option" is not "optional". The only thing that's optional is whether you use it or not, but you are FORCED to PAY for it either way. Just like "public schools" are not "optional" everyone's taxes pay for them... the only "option" is paying but not going.
Optional? HAHAHAHA. You really are gullible aren't you?
Shiznit, there is no option. Regulation will be imposed on all parts of the system. Centralized control. An unelected bureaucrat(s) will determine what may or may not be included in private and public insurance plans, and the price allowed to be charged. Chances are they will require us to buy care or face some penalty (tax). Whatever you call it, it is a loss of freedom. But some people would rather sell their choice for the perception of security, but really it is just a Ponzi scheme -- intergenerational theft.
OK I am the guy that made the reference to the Cheney blow up doll in my comment. I would like to apologize for that comment. But as far as cost per person for aou health care please reference:
http://www.kff.org/insurance/snapshot/chcm010307oth.cfm
And how many of us are covered:
Wouldn't you think that the richest country on this planet could do better?
I do hope you remember that I am well able to self insure (it just galls the hell out of me) but 99% of those uninsured do not have that option.