Why Americans Should Demand Socialized Medicine

It’s gotten so only the rich, those on Medicare and the insured can afford health care.  Must everyone else just suffer and die from poor health, because of the outrageous prices of American health care for the uninsured?

It’s not the cost of the services–it’s profiteering by the hospitals!  Meanwhile, Medicare is able to negotiate much lower, more reasonable prices for services, paying far less than the original bill, leaving the patient with a much smaller bill as well.

Simply making everyone buy insurance or be fined, is not going to solve the problem.  Going to a single-payer system, on the other hand, could be the only thing that would.

We saw some of the outrageous prices outlined in this article, in my husband’s medical bills after surgery.  Since we have insurance now, we got “discounts,” then insurance payments, helping make them still outrageous but not nearly as bad.  (They started at nearly $20,000!)  But we also have a high deductible to help us pay the insurance premiums.

What if my past issues come back and I need yet another surgery to prevent cervical cancer?  My husband needs to make regular visits to the doctor, several times a year, for one of those overinflated tests, to make sure he doesn’t get cancer–what if he does get it?  Do we just let the cancer take over because we’re not rich?

People who glibly say things like, “If you’re having problems with health/mental health/learning disorders, then obviously you should do the responsible thing and get it checked out and diagnosed,” obviously have good insurance.

Lots of us are forced to do our own diagnoses (for such things as irritable bowels, learning disorders, or PTSD) and our own treatments (diet changes, reading about it, writing about it, pushing our dislocated shoulder back in place and wearing a sling) because we just plain can’t afford doctors, even though we are suffering from lack of treatment.

And we’re treated like we’re just leeches, with terms like “entitlements” and “lazy” and “thieves” and “communists,” when we ask for more government help.  The current system benefits no one but the hospitals–and their CEOs.

See this article in TIME by Steven Brill, Bitter Pill: Why Medical Bills Are Killing Us:

Taken as a whole, these powerful institutions and the bills they churn out dominate the nation’s economy and put demands on taxpayers to a degree unequaled anywhere else on earth.

In the U.S., people spend almost 20% of the gross domestic product on health care, compared with about half that in most developed countries. Yet in every measurable way, the results our health care system produces are no better and often worse than the outcomes in those countries.

According to one of a series of exhaustive studies done by the McKinsey & Co. consulting firm, we spend more on health care than the next 10 biggest spenders combined: Japan, Germany, France, China, the U.K., Italy, Canada, Brazil, Spain and Australia. We may be shocked at the $60 billion price tag for cleaning up after Hurricane Sandy. We spent almost that much last week on health care.

We spend more every year on artificial knees and hips than what Hollywood collects at the box office. We spend two or three times that much on durable medical devices like canes and wheelchairs, in part because a heavily lobbied Congress forces Medicare to pay 25% to 75% more for this equipment than it would cost at Walmart.

The Bureau of Labor Statistics projects that 10 of the 20 occupations that will grow the fastest in the U.S. by 2020 are related to health care. America’s largest city may be commonly thought of as the world’s financial-services capital, but of New York’s 18 largest private employers, eight are hospitals and four are banks.

Employing all those people in the cause of curing the sick is, of course, not anything to be ashamed of. But the drag on our overall economy that comes with taxpayers, employers and consumers spending so much more than is spent in any other country for the same product is unsustainable. Health care is eating away at our economy and our treasury.

On pages 8 and 9, see how attempts to bring costs down were derailed by spurious criticisms of creating “death panels”:

Peter Bach, an epidemiologist at Sloan-Kettering who has also advised several health-policy organizations, reported in a 2009 New England Journal of Medicine article that Medicare’s spending on the category dominated by cancer drugs ballooned from $3 billion in 1997 to $11 billion in 2004. Bach says costs have continued to increase rapidly and must now be more than $20 billion.

With that escalating bill in mind, Bach was among the policy experts pushing for provisions in Obamacare to establish a Patient-Centered Outcomes Research Institute to expand comparative-effectiveness research efforts. Through painstaking research, doctors would try to determine the comparative effectiveness not only of drugs but also of procedures like CT scans.

However, after all the provisions spelling out elaborate research and review processes were embedded in the draft law, Congress jumped in and added eight provisions that restrict how the research can be used. The prime restriction: Findings shall “not be construed as mandates for practice guidelines, coverage recommendations, payment, or policy recommendations.”

With those 14 words, the work of Bach and his colleagues was undone. And costs remain unchecked.

“Medicare could see the research and say, Ah, this drug works better and costs the same or is even cheaper,” says Gunn, Sloan-Kettering’s chief operating officer. “But they are not allowed to do anything about it.”

Along with another doomed provision that would have allowed Medicare to pay a fee for doctors’ time spent counseling terminal patients on end-of-life care (but not on euthanasia), the Obama Administration’s push for comparative effectiveness is what brought opponents’ cries that the bill was creating “death panels.”

Washington bureaucrats would now be dictating which drugs were worth giving to which patients and even which patients deserved to live or die, the critics charged.

….If covered by Medicare, Janice S.’s $21,000 bill would have been deeply discounted and, as is standard, Medicare would have picked up 80% of the reduced cost. The bottom line is that Janice S. would probably have ended up paying $500 to $600 for her 20% share of her heart-attack scare. And she would have paid only a fraction of that — maybe $100 — if, like most Medicare beneficiaries, she had paid for supplemental insurance to cover most of that 20%.

In fact, those numbers would seem to argue for lowering the Medicare age, not raising it — and not just from Janice S.’s standpoint but also from the taxpayers’ side of the equation. That’s not a liberal argument for protecting entitlements while the deficit balloons. It’s just a matter of hardheaded arithmetic.

….The only way this would not work is if 64-year-olds started using health care services they didn’t need. They might be tempted to, because, as we saw with Alan A., Medicare’s protection is so broad and supplemental private insurance costs so little that it all but eliminates patients’ obligation to pay the 20% of outpatient-care costs that Medicare doesn’t cover.

To deal with that, a provision could be added requiring that 64-year-olds taking advantage of Medicare could not buy insurance freeing them from more than, say, 5% or 10% of their responsibility for the bills, with the percentage set according to their wealth. It would be a similar, though more stringent, provision of the kind I’ve already suggested for current Medicare beneficiaries as a way to cut the cost of people overusing benefits.

If that logic applies to 64-year-olds, then it would seem to apply even more readily to healthier 40-year-olds or 18-year-olds. This is the single-payer approach favored by liberals and used by most developed countries.

….The real issue isn’t whether we have a single payer or multiple payers. It’s whether whoever pays has a fair chance in a fair market. Congress has given Medicare that power when it comes to dealing with hospitals and doctors, and we have seen how that works to drive down the prices Medicare pays, just as we’ve seen what happens when Congress handcuffs Medicare when it comes to evaluating and buying drugs, medical devices and equipment.

Stripping away what is now the sellers’ overwhelming leverage in dealing with Medicare in those areas and with private payers in all aspects of the market would inject fairness into the market. We don’t have to scrap our system and aren’t likely to. But we can reduce the $750 billion that we overspend on health care in the U.S. in part by acknowledging what other countries have: because the health care market deals in a life-or-death product, it cannot be left to its own devices.

Put simply, the bills tell us that this is not about interfering in a free market. It’s about facing the reality that our largest consumer product by far — one-fifth of our economy — does not operate in a free market.

Brill’s ideas for fixing the problem are on page 11; he does not endorse a specific kind of system, single vs. multiple payer.  His criticisms are not just against Republicans, but against Democrats and Obamacare.  His ideas involve forcing costs down.

 

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