Americans Die Younger — Spend the Most on Health Care

❝ Typically, the more a developed country spends on health care, the longer its people live. The U.S., which spends the most on health care, bucks that trend. Compared to the 35 countries in the Organization for Economic Cooperation and Development, which promotes policies to improve social and economic well-being, the U.S. life expectancy of 78.8 years ranks 27th. It has the fourth highest infant mortality rate in the OECD, the sixth highest maternal mortality rate and the ninth highest likelihood of dying at a younger age from a host of ailments, including cardiovascular disease and cancer.

❝ The U.S. is the most obese country in the OECD, leads in drug-related deaths and ranks 33rd in prevalence of diabetes. Yet 88 percent of Americans say they are in good or very good health, according to OECD statistics. Only 35 percent of Japanese, who have the highest life expectancy in the OECD, regard themselves as healthy or very healthy.

❝ Unlike other countries in the OECD, the U.S. mostly relies on voluntary health insurance to fund health-care costs. Public health insurance, such as Medicare and Medicaid, accounts for 27 percent of coverage. By contrast, the 10 countries with the highest life expectancy depend on voluntary insurance for an average of less than 6 percent of their costs, and government spending for nearly half.

❝ One big reason U.S. health care costs are so high: pharmaceutical spending. The U.S. spends more per capita on prescription medicines and over-the-counter products than any other country in the OECD.

RTFA for beaucoup stats, details. I would add emphasis on the insurance profiteers who rip off Americans without the slightest peep from either Establishment party. Our governments manages SSA, Medicare and Medicaid with admin costs <3%. Corporate-run insurance says they need 14-24% to do the same job.

Why Single-Payer Health Care Saves Money

❝ Lingering uncertainty about the fate of the Affordable Care Act has spurred the California legislature to consider adoption of a statewide single-payer health care system.

Sometimes described as Medicare for all, single-payer is a system in which a public agency handles health care financing while the delivery of care remains largely in private hands.

Discussions of the California measure have stalled, however, in the wake of preliminary estimates pegging the cost of the program as greater than the entire state government budget. Similar cost concerns derailed single-payer proposals in Colorado and Vermont.

❝ Voters need to understand that this cost objection is specious. That’s because, as experience in many countries has demonstrated, the total cost of providing health coverage under the single-payer approach is actually substantially lower than under the current system in the United States. It is a bedrock economic principle that if we can find a way to do something more efficiently, it’s possible for everyone to come out ahead.

❝ By analogy, suppose that your state’s government took over road maintenance from the county governments within it, in the process reducing total maintenance costs by 30 percent. Your state taxes would obviously have to go up under this arrangement.

But if roads would be as well maintained as before, would that be a reason to oppose the move? Clearly not, since the resulting cost savings would reduce your county taxes by more than your state taxes went up. Likewise, it makes no sense to oppose single-payer on the grounds that it would require additional tax revenue. In each case, the resulting gains in efficiency would leave you with greater effective purchasing power than before.

❝ Total costs are lower under single-payer systems for several reasons. One is that administrative costs average only about 2 percent of total expenses under a single-payer program like Medicare, less than one-sixth the corresponding percentage for many private insurers. Single-payer systems also spend virtually nothing on competitive advertising, which can account for more than 15 percent of total expenses for private insurers.

The most important source of cost savings under single-payer is that large government entities are able to negotiate much more favorable terms with service providers. In 2012, for example, the average cost of coronary bypass surgery was more than $73,000 in the United States but less than $23,000 in France.

Although Republicans and Conservative Democrats have blocked civilians from the opportunity – so far – the essential benefit that produces lower cost insurance for our military and military veterans is just such negotiations.

Liars lie. That’s what they are paid to do. From Congressional politicians down to their state-level peers, media hacks, foundations chartered by conservative dollar$ – earn a significant chunk of their payola providing lies about the cost of universals insurance, class-conscious education, policing responsive to the needs of citizens instead of gun lobbies. No doubt, anyone thoughtful enough to look at lobbying practices in the United States can add to the list.

Dumb enough to get ripped-off for healthcare = dumb enough to vote for Trump


Click to enlargeWorld Bank

Yes, all those countries paying a lot less than Americans for their healthcare mostly have what American pundits now call “single-payer” health insurance coverage. Mostly, those countries call it a National Health Service and have no hangups over discussing socialized medicine. Since we live in the land that invented McCarthyism and took over the Big Lie after Hitler and Goebbels were shut down, you won’t hear those terms except as a pejorative from Republicans…the right-wing half of our TweedleDeeDumb political parties.

Insurance companies, healthcare providers, corporate pharma? They simply donate to both parties and now own two complete sets of plastic fantastic Congressional bobbleheads.

Nevada’s legislature just passed Medicaid for all

❝ Nevada, with little fanfare or notice, is inching toward a massive health insurance expansion — one that would give the state’s 2.8 million residents access to a public health insurance option.

❝ The Nevada legislature passed a bill Friday that would allow anyone to buy into Medicaid, the public program that covers low-income Americans. It would be the first state to open the government-run program to all residents, regardless of their income or health status.

The bill is currently sitting with Nevada Gov. Brian Sandoval, a Republican. His office did not respond to an inquiry about whether he would sign the bill or veto it.

❝ Democrats in Washington have previously proposed a similar “Medicare for all” scheme, which would open up the public program for the elderly to Americans under 65. The idea has always fizzled out, however, due to a lack of political support.

“Medicaid for all” offers an alluring alternative to those proposals. For one, Medicaid coverage generally costs less than “Medicare for all” because the program pays doctors lower rates. This might make it a more alluring option for price-sensitive consumers worried about their monthly premium.

Because states have a large role in running Medicaid, they can move these proposals forward with less involvement of the federal government. A public option program like this has always failed at the federal level. But a liberal state such as Maryland or Connecticut — or, in this case, even a more centrist state like Nevada — might explore the option unilaterally.

A good chance to watch the 2 wings of our craptastic political establishment flounder about nationwide – trying to avoid doing something similar. Republicans are doubly stuck in knee-deep political manure with all their years of using states’ rights as a pet excuse to avoid anything as modern as, say, the horseless buggy – or equal rights for anyone below corporate CEO pay grade. Interested to see what copouts we’ll get from self-identified centrist Democrats.

Aetna CEO wants public discussion of single-payer healthcare coverage

❝ The chief executive of one of the country’s largest health insurance companies says he is open to having a single-payer debate….“Single-payer, I think we should have that debate as a nation,” Aetna chief executive Mark Bertolini said…

❝ Bertolini spoke to a private meeting where Aetna employees could ask questions of their chief executive. A partial video of his remarks provided to Vox includes Bertolini responding to a question about single-payer health care.

“In the news media, it is reporting that the Republican health plan is paving the way to a single-payer system,” an Aetna employee asks Bertolini. “What are your thoughts on that, and how would it impact Aetna?”

This was his response:

Single-payer, I think we should have that debate as a nation. But let me remind everybody that Aetna was the first financial intermediary for Medicare. We cut the first check for Medicare in 1965 to Hartford Hospital for $517.57.

❝ The government doesn’t administer anything. the first thing they’ve ever tried to administer in social programs was the ACA, and that didn’t go so well. So the industry has always been the back room for government. If the government wants to pay all the bills, and employers want to stop offering coverage, and we can be there in a public private partnership to do the work we do today with Medicare, and with Medicaid at every state level, we run the Medicaid programs for them, then let’s have that conversation.

But if we want to turn it all over to the government to run, is the government really the right place to run all this stuff? And that’s the debate that needs to be had. They could finance it, and if there is one financer, and you could call that single-payer. …

I think it’s hilarious that he ignores federal administration of SSA and Medicare. Both of which have administration costs less than 10-25% of typical American private insurance companies.

❝ What Bertolini seems open to is a version of single-payer where the federal government would contract out certain functions private companies, such as Aetna. These insurers would, in his own words, become a “back room for government.”

Insurance companies drive physicians crazy – nearly half now prefer upgrading Obamacare to single-payer

❝ There are many reasons people put off going to the doctor. One of the big reasons is cost — a huge arc in the current debate about whether and how to repeal and replace Obamacare, which sought to increase the number of Americans with quality health insurance. Another is access, or finding a doctor who takes your insurance and has appointment openings. But whatever the reasons, the disconnect means that many people choose to become patients only in extreme circumstances and are then at the mercy of the system.

❝ “It really debases and demeans and takes away your dignity to be shuffled around when you know you have something wrong with you,” said Dr. Paredes, an obstetrician-gynecologist in Lakeland, Fla., who practiced in a variety of healthcare settings before retiring two and a half years ago. “I think healthcare is something that should be available to everyone from cradle to grave.”

That’s one of the main reasons nearly half of the 500 doctors who responded to a February LinkedIn survey said they would support a single-payer healthcare system, or Medicare-like coverage for everyone, not just the elderly, instead of the current patchwork model of insurance coverage.

Aside from the crap lies offered by Congressional Republicans…

❝ …For many physicians, the issue comes down to efficiency. In their responses, they cited the administrative hassle of working with multiple insurance companies, each with its own rules and billing procedures. And they pointed to some of the less visible costs, like patients who bounce from one healthcare provider to another as their health plans change.

A total of 48% of physicians said they would be in favor of single-payer healthcare, while 32% were opposed and 21% said they didn’t know.

❝ And even though doctors acknowledged that they might take a financial hit under a single-payer system, many respondents said it would be more than mitigated by getting out of the collection business. In other words, even if they earned less, there would be more patient care and less of the aggravation that comes with negotiating with and tracking down payment from multiple insurance companies.

RTFA for pretty middle-of-the-road analysis. For me, the truth has always been cost. Social Security and Medicare each are national insurance programs with premiums paid by the insured and, generally.their employers. There’s an artificial cap allowing high earners to stop paying the SSA tax at just over $100K income. Still, both of these systems are run with administrative costs less than 3%. And they work well. Helluva lot better than the motley arrangement Obamacare relies on.

Our adorable insurance companies declare their administrative costs run 14-25% and jack up all their rates accordingly. Couple that with a Congress that refuses civilians the same right the military has to negotiate fixed prices for prescriptive drugs – and we get screwed twice by the existing system. That’s the system Republicans and Blue Dog Democrats want to make more expensive and less safe for the insured.

Humbug!

Thanks, Barry Ritholtz


A win for working class families


Click to enlarge

Now it’s time to set the stage for single-payer Medicare for all. Improvements in the existing plan are always to be considered – if Republicans want to join Bernie’s side. If Democrats want to join Bernie’s side.

Nothing wrong with showing the flag for freedom, an end to healthcare as privilege instead of a Right. Let our Congress-critters know what’s coming.

Thanks, gocomics.org

Calls for single-payer system includes physicians

In an editorial and proposal published recently in the American Journal of Public Health, 2,231 physicians called for a single-payer national health program to replace the current private insurance model of financing healthcare.

While the Patient Protection and Affordable Care Act has increased access to healthcare services for millions of people, many physicians still have grave concerns over patients’ ability to get the care they need, said Steffie Woolhandler, MD, a co-author of the editorial and proposal…

Physicians are supporting a single-payer system, Woolhandler said, because they know that “lives are literally at stake.”

“I think doctors are seeing lots of patients who can’t get the care they need despite improvements that have come from the ACA. There are still 26 million to 30 million uninsured people, depending on the source, and there is no prospect of that going down because the ACA is almost fully implemented. Many patients will die because they can’t get the preventive or primary care they need,” she said. “Doctors see this in their practice. They also see patients all the time who are underinsured. They have insurance but still can’t afford the care they need … Many doctors feel the ACA has not solved the problems around access to care.”

Among the main points outlined in the national health program are:

Patients could choose to go to any doctor and hospital.

Most hospitals and clinics would remain privately owned and operated, receiving a budget from the NHP to cover all operating costs.

Physicians could continue to practice on a fee-for-service basis, or receive salaries from group practices, hospitals, or clinics.

The program would be paid for by combining current sources of government health spending into a single fund with modest new taxes that would be fully offset by reductions in premiums and out-of-pocket spending.

Co-pays and deductibles would be eliminated…

“Once you have a single-payer system, you have to decide how much you are willing to spend. Our group would say, at least initially, to spend what we are spending now for the first few years to avoid disruption, but over time there would be huge administrative savings,” she said.

RTFA for some discussion and debate. Most industrial, educated nations have some sort of single-payer national health service. Many provide better care than that received by most Americans. They all cost taxpayers and consumers less than our current system.

So-called administrative costs are where insurance companies hide their biggest lies. They claim to need 14-24% of costs for administration. Social Security and Medicare function well with less than 3% charged off to admin.

Ignore conservative whiners – Medicare improves your health

In a 15-year study of older Medicare patients, Yale School of Medicine researchers saw an estimated 20% drop in mortality, about 30% fewer hospitalizations, and 40% reduction in deaths after hospitalization…

Published in the July 28 JAMA theme issue on Medicare and Medicaid at 50, the study took a comprehensive look at national trends in mortality, hospitalizations, outcomes, and expenditures from all causes from 1999 to 2013. The team, from the Center for Outcomes Research and Evaluation at Yale-New Haven Hospital, analyzed data on 68,374,904 Medicare recipients 65 years of age or older from key demographic groups and geographic areas.

“We are in the midst of a remarkable era of improvements in health and health care in America,” said lead author Harlan M. Krumholz, M.D….co-director of the Clinical Scholars Program. “This decline represents millions of hospitalizations averted and hundreds of thousands of deaths delayed.”

“The news should give us reassurance about our current efforts, but not make us complacent. We should seek to continue our advances in technology, health behaviors and policies, and quality of care — and seek to continue this remarkable trend,” Krumholz added.

Krumholz and his team also found that the total number of hospitalizations for major surgery decreased over the course of the study. The average length of time spent in the hospital declined from 5 to 4 days, and the average inpatient costs per Medicare fee-for-service recipient declined from $3,290 to $2,801. The findings were consistent across geographic and demographic groups.

Now, imagine how much better this good news might be – if we kicked whiners and ideologues out of Congress and concentrated on solid science, best administrative practices and took as the single goal improving health and healthcare for all Americans.

That would really be good news.