Health costs scare us toward socialism

PittsburghLive.com / Pittsburgh Tribune Review ^ | October 23, 2003 | Jack Markowitz

[inPhase]

It troubles the conscience, in fact, that 43.6 million Americans are uninsured by the latest government estimate. That huge number, more than 15 percent of us, conjures up nightmares. Are millions going to emergency wards and doctors' offices and being turned away? In scattered cases, this undoubtedly happens.

[inPhase]

See also: http://www.washingtonpost.com/wp-dyn/articles/A29672-2003Oct28.html "Discount retail giant Wal-Mart is poised to bring is supermarkets to Southern California, sparking labor strikes and lockouts as unionized workers fear competition from non-unionized Wal-Mart stores. Columnist Steven Pearlstein was online to talk Wal-Mart as a symbol of the hyper-globalization of the economy. A transcript follows. "

This is a hit piece on Walmart, some questions and answers follow, many views exposed, or shall we say weaknesses.

[pgyanke]

Most of the increases in health care costs can be attributed to government regulation! Does anybody see a grand plan yet?

[waverna]

Eggzactly! As Walter Williams often points out, we don't have a health care crisis, we have a socialism crisis. The government creeps into the healthcare industry, then complains that people who smoke or eat a lot of fatty foods are a huge cost to taxpayers. Therefore they need to regulate these activities to lower the cost to the taxpayers. Its a vicious cycle that cedes more power to the govt.

[inPhase]

Need to let the free market handle health care.

Heard Drudge the other night while driving a few hundred miles,

he was talking about the Vons, Safeway Albertsons strike in California, esp LA. They are striking for 100 % health care benefits.

He said, hey, are you going to pay my car insurance?

[LiteKeeper]

INTREP - SOCIALISM

[Mamzelle]

HERE IS THE REASON IT COSTS SO MUCH...

Bear with me just a moment--I need to use an example to illustrate.

It's fifteen years ago, and you have the plain-vanilla condition known as gall bladder disease. You go to the hospital, they make a diagnosis using mostly experience and a few tests that don't help them much. It's mostly just an educated guess.

They remove your gall bladder, using a scalpel and anesthesia, and a large incision is made. This makes for a significant hospital stay and a significant recovery time and significant risks of complications.

OK--now it's 2003, and you have the plain vanilla condition known as gall bladder disease. The hospital runs an ultrasound--cool thing, but you need the $$$equipment, the $$$technician, and it must be $$$maintained and $$$improved. The surgeon has neat new tools--this little $$$machine with a light and camera that worms it's way through your innards. This machine must be $$$maintained, $$$stored, $$$operated by trained$$$technicians. He makes four tiny incisions instead of one big one. You get better quicker, with better outcome.

Getting the picture? That surgeon is no longer allowed to use that cheaper scalpel, that wouldn't be "standard of care."

This is why it costs so much--it is the infrastructure, the constantly improving medical infrastructure.

But when that same surgeon goes on a medical mission to Nicaragua, he uses his scalpel because it is cheaper and easier and there is no access to fancy gadgetry.

[X-Servative]

There is a problem with the current system. I am self-employed with a family PPO. Because of my son's seizure condition, my medical bill (premium plus out of pocket) will be $20,000 for the past two years. Makes me want to go back to work for smoemone else.

[waverna]

Interesting, but I wonder if we'd have the neat gadgetry if the demand didn't warrant the cost.

[pgyanke]

No. I don't have the research in front of me but my mother was a physician all of her life. The equipment and infrastructure costs are dwarfed by the direct costs of government regulation and the indirect costs of malpractice prevention and litigation brought on by the aforementioned regulation. My mother, and many others, have been regulated right out of their practices.

For a simple example, she was no longer allowed to clean, sterilize and reuse her own equipment as taught in medical school. She had to open a new, shrink-wrapped tray of instruments for each patient. That alone adds up. Don't even get me started on the government medical "programs"...

[Mamzelle]

That this is an improvement is undeniable.

But, consider this--

The hospital has no choice but to improve. It is not allowed NOT to improve or it would be committing malpractice by not being "standard of care."

IOW--this is a blank check for constant improvements. The pharma industry and the equipment industry are well aware that the personnel have no choice but to go for the best.

I could illustrate with other examples--

What if docs and hospitals were allowed to make judgements about what is cost effective? At present, they are only allowed to figure out what is the best and to bring it to the public.

Is there a place for the old operation?

[waverna]

In other words, for example, when grocery stores all began upgrading from old-style registers to scanners for checkout, electronic inventory systems, customer discount card systems, etc... there wasn't a concurrent spike in grocery prices. Why? Because this non-socialized industry felt that the demand warranted the cost. If our healthcare delivery system was as unregulated as our grocery delivery system we'd be in much better shape. That is why American healthcare is superior to other, more socialized countries' systems up until now, but I fear that as the government encroaches on the industry this advantage will be lost.

[Mamzelle]

re: indirect costs of malpractice prevention and litigation brought on by the aforementioned regulation. My mother, and many others, have been regulated right out of their practices.)))

But, my point was that the personnel have no other choice but to go for the "best"--the best as perceived by the public and by the lawyers. It is, in effect, an indirect cost of litigiousness.

The alternative is to provide the personnel with some sort of safe harbor--to allow them to make judgements about costs and quality.

[waverna]

Without the costly regulations, they could afford the best.

[Mamzelle]

You are still allowed to shop at ill-equipped grocery stores, like the mom-pop convenience I use regularly.

You are not allowed to be operated on with 1985 technology--

[Mamzelle]

Without the regulations, we'd have a multi-tiered system of quality in medical care. Some could afford the scalpel, some could afford the gadgets.

This would be very politically hot--people tend to feel as entitled to cadillac medical care as they are to the air that they breathe.

Don't get me wrong--this might work--but with our present resentment-culture it will not be allowed.

[waverna]

I think we agree that the government has too heavy a hand in the healthcare industry. This "crisis", solveable by MORE socialism, was created by the burden of government regulation in the first place. Its the same thing that is causing the inflation rate for college tuition to be 15% when ordinary inflation rates are 2.5%. The government subsidizes the cost to the point that demand is not based on price and people that maybe shouldn't be in college will go just because they can and someone else is picking up at least part of the tab. Since seats are limited the increased demand causes prices to soar.

[Mamzelle]

re: government regulation in the first place. Its the same thing that is causing the inflation rate for college tuition to be 15% )))

Frankly, I regard this increase as evidence of outright fraud.

At least with higher costs of medicine, you are getting better than what you got before. With tuition, you're getting worse. Is the education better? No. Worse.

But the recovery time for the new gall bladder surgery has been cut by 100%, morbidity lowered, pain much less.

[boris]

"If you think health care is expensive now, wait until it is 'free'"

--Boris

[waverna]

You got that right.
I like the idea of different cost levels of care but its true that no one would accept that.
When a third party is paying or subsidizing anything, demand increases which drives up the price. When that third party is the government, and has the rule of law behind it, look out!
Also, when these figures are thrown around about the number of uninsured there are, it doesn't account for people who voluntarily do not have coverage, like me when I was in my twenties. And, it may be that, like "the poor", it isn't a static set of individuals uninsured but rather people moving in and out of that uninsured class.

[Ron in Acreage]

The liberals will do whatever it takes to destroy our current system. They refuse to address tort reform, regulations, price controls, competition among providers etc. They continue to lower govt. reimbursement rates to doctors and hospitals, thereby forcing them to raise rates on the private sector insurance plans and individuals. When the govt. only pays 40 cents on the dollar under Medicare and Medicaid, who do you think pays the other 60%? WE DO in the private sector! We also pay the govts. 40% out of our paychecks! WE PAY IT ALL ALREADY The only way to go is to get the govt. out completely! When people reach age 62 or 65 do they get govt. car insurance? Govt. home owners insurance? Govt. life insurance? Absolutely NOT. They pay the same premiums as the rest of us, thereby making it affordable for everyone. When you eliminate an entire generation of people from paying their share, it only increases the cost to everyone else.