The Bulletin had a rather odd editorial (well, that’s not exactly news) on Friday morning. The subject was taxes, but what really interested me was the lead-in to that subject, which talked about medical care.
The reason medical care costs so much, the editorialist opined, is that consumers get it too cheaply: “Were Americans forced to pay more up front for the services they use, they might not rush to the doctor’s office for every little ache and pain. Neither would they prod reluctant physicians so forcefully to order up MRIs and other expensive tests.”
I’ve heard that argument before, and every time I always wonder: “Where ARE all these people who are ‘rushing to the doctor’s office for every little ache and pain’? Most people I know dread going to the doctor and put it off as long as possible – sometimes too long. And I don’t know anybody who gets his kicks from having MRIs, CT scans and colonoscopies either.” (I’ve had all three, and trust me, they’re not much fun.)
But the argument fits neatly with the conservative doctrine that when something goes wrong, it’s always the little guy who’s to blame.
Thus the bankruptcy of General Motors wasn’t the fault of the executives who made bad decisions about what kind of vehicles to build – no, it was the fault of those greedy workers who wanted to be paid too much.
The subprime mortgage fiasco wasn’t the fault of the lenders who wrote unsound mortgages or the financial manipulators who packaged and sold securities based on those unsound mortgages – it was the fault of the low- and middle-income people who took out the mortgages.
And the high cost of health care isn’t the fault of health care providers, such as doctors who order unnecessary lab tests and MRIs because they have a financial interest in the labs and imaging centers that do them – it’s the fault of the patients.
In the conservative alternative universe the buck is never passed up, only down.
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Once again, as it seems to do in roughly two years out of three, the Oregon Department of Transportation has extended the studded tire removal deadline into mid-April because storms continue to dump snow on the mountain passes.
This almost-annual business of drivers rushing to get their studs removed and then rushing to get them back on again is ridiculous. Oregon should either (a) ban studs or (b) permanently extend the stud season to mid-April. Although people in Salem and Portland might not comprehend it, in two-thirds of this state it’s still winter.
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Bill Bradbury, aspirant for the Democratic nomination for governor, has come out with his first TV campaign spot. It shows Bradbury, who has multiple sclerosis, rolling along on a Segway. “I’ve found in life that when you’re faced with a challenge, you just have to find a solution,” he says.
It’s a cute ad, but I’m not sure it conveys the proper aura of gubernatorial gravitas. To me, people riding Segways always look kind of silly.
This article appears in Apr 8-14, 2010.
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I don’t agree with either point made here about the rising cost of health care. The main reason for the high costs of health care is the legal exposure of the provider.
Too many people in the country are ready to sue a doctor over anything. Some are legitimate, most are based soley on greed. Because the cost of litagation is high, many doctors will settle petty claims rather than fight them out in court. This raises their insurance and the cost is passed on to the rest of us.
Until Tort Reform is addressed, nothing will change. This reform must address two primary issues; Loser Pays and Caps on Punitive Damages.
In cases of real malpractise, (amputating the wrong appendage, etc.), the doctor should lose their license and face jail time. In cases where unforseen complications arise, lawsuits should be limited to actual costs incurred if at all.
I, myself, had a medical proceedure go wrong which put me in the hospital for 4 days. The doctor paid for the hospitalization and the corrective surgery to repair it. Was the doctor incompetent? No. Should he be sued into oblivion? No. Should I be enriched by this? No. Are future patients in danger of having surgury performed by this doctor? No.
Could I win a lawsuit against him? Yes. Should I sue him? No. What could society gain by me sueing this doctor? NOTHING!
So, the thought process ends on whether this suit would be for my greedy selfishness or for the TRUE and REALISTIC betterment of society? I chose self-sacrifice. I realize you will have to look that up in wikipedia, Mr. Miller. Once again, the Givers and the Takers!
Now it is your turn to take a small peice of this and attempt to destroy the entire content. As usual, you will fail.
All the evidence indicates that the rising cost of malpractice insurance is NOT due to a rise in the number of malpractice claims or in the size of malpractice awards. The insurance companies are gouging the doctors just as they’re gouging the patients. Read this Boston Globe story if you’re interested: http://www.boston.com/business/globe/articles/2005/06/01/rising_doctors_premiums_not_due_to_lawsuit_awards/
Of course “tort reform” has long been the wet dream of insurance companies and their lackeys in Congress (of both parties) but it would do little or nothing to bring down health care costs.
BTW if a doctor is guilty of negligence the victim is not performing a service to society by not suing him; he is just enabling an incompetent doctor to go on practicing. “Iatrogenic disease” — illness caused by medical treatment — has become the third leading cause of death in the US.
And no, I have never sued a member of the medical profession for malpractice — although I thought long and hard about it once.
Bruce,
Over 70% of malpractice cases that go to a Jury end in a decision for the doctor, nurses and hospitals, not the plantiff. Why is this? Because most of these cases are not Malpractice. They are driven to court by Plantiff lawyers hoping to make millions by exploiting their clients outcome for thier own personal gain. Plantiff lawyers can make multiple millions of dollars (ask your hero John Edwards). I say pay the Plantiff lawyers Medicaid rates to represent their clients ($50 per hour) and they should still work hard because they believe in justice. But they should not do it to make millions and millions taking cases that are not malpractice to jury. This will save our country billions as it will take pressure off the docs who practice defensive medicine
Hi-
I was curious. What is a person who uses a device to assist with their mobility supposed to look like? Thanks, Don.
We had a winter here this year?
Four and a half inches of total snowfall in Bend this past ‘winter’. That’s not enough snow to warrant snow Tires, let alone Studded snow tires. And who is going to pay for the damage done running ten thousand studded tires around on dry pavement all ‘winter’? Certainly not the ignorant pussy driving around on studded snow tires.
Tax tire studs. Tax fat people. Tax churches… that’ll solve the problem.
Kitz!
Well, Miller, you are right about one thing. GM management have been idiots for years! They allowed unions to negotiate ridiculous salary and benefit contracts that made them wholly uncompetitive with the rest of the auto industry. These contracts were also so protective of the worker that those that should have been fired haven’t been and consequently GM quality sucks! It has for years and it shall well into the future! Look at how well GM vehicles hold their value , its pathetic! They suck from top to bottom, and the company should not have been saved at taxpayer expense! Now we all get to, in a sense be shareholders of a really shitty company!!
Ironically after writing my comments, I just read an article that on Forbes worst car list based on consumer reports GM has 4 of the top 7 worst cars!! Woohoo, aren’t you glad we saved them?
34,000,000= those without health insurance
200,000,000= money supposedly spent by the insurance industry
to stop the Health Bill
40,800,000,000= at 34 million by $100 per month by 12 months is the amount, at a low estimate, the insurance companies could make yearly, there's probably more involved.
Under the new health care law, insurance becomes mandatory- those who can't afford it, will be provided insurance at taxpayer's expense- there are no provisions that change the way the health care industry provides health care- the US is rated 25th in the world for the quality of health care even before this law- Americans will now be forced, by law, to pay money for medical care that is even surpassed by many third world nations. “Don't p** on my leg and call it rain”.
Please take the time to contact your representatives to encourage your state to join the other states that are fighting this as unconstitutional.
Thomas: The snow in Bend don’t amount to squat in many years, like this one, but getting over the passes can be a problem without chains or some kind of winter tires.
I’m not a stud believer myself — use studless “sticky” tires.
BTW how fat do you think somebody should be before the Fat Tax kicks in?
HBM, how ironic you mention a Boston Globe article. You should have read the Wall Street Journal commentary in Friday’s edition.
In Massachusetts, small businesses and individuals can no longer purchase the state mandated health coverage required by law. It seems the NON-PROFIT insurance companies will be paying out over $100 million in claims than they take in from premiums. Their reserves are completley gone as well. The governor turned down virtually all rate increase requests of these NON-PROFITS. We’re talking about Blue Cross/Blue Shield here.
The governor has also ordered insurance companies to sell at last years’ prices, thus driving them totally out of the market. Tell me HBM, how this won’t be what the rest of the country will face under Obama Care. If the little guy voted for Obama and the Obama zombies in Congress, he gets exactly what he deserves.
Elections do have consequences and unfortunately those who believed they would be helped by this administration (and by this state adminstration) are sadly mistaken.
Hi-
Once again. Re: your remark about Bill Bradbury’s TV spot. I am curious. What should an individual who uses a device to assist with their mobility look like? Thanks, Don.
The subprime mortgage fiasco wasn't the fault of the lenders who wrote unsound mortgages or the financial manipulators who packaged and sold securities based on those unsound mortgages – it was the fault of the low- and middle-income people who took out the mortgages.
I personally believe that the fault starts at the beginning. The person that took these applications, was, for the most part, compliant in the falsification of the application and surely had a part in telling the applicant, “don’t worry, it will all work out.” If you truly think these people at the beginning of the process had nothing to do with the domino effect of this whole mess,you are not aware of the payment process these peoples employers ascribe to. COMMISIOM folks. What ever it takes to get that commision check and they make damn good money. They belong in jail right along with every level in the financing industry that is involved in the home financing business, right up to the CEO. Damn the stockholders, put these bastards in jail, they are all compliant and desrve to put some time in “The Big House”
I find it odd that no body is mentioning the frontl line employees, just the big shots. They all deserve time, they are crook. They say car salesmaen are bad, they don’t make a patch on a mortgage brokers ass when it comes to being corrupt.
Bruce, buddy, I love checking out your reference material because it always comes back to bite you. This report covers the period of 1991 through 2003. You are the first to criticize anyone who brings up the past yet you want to use it here as gospel.
I through down the gauntlet and, as predicted, you failed. And that was just in your first paragraph. The second is just liberal BS that is totally incorrect.
Your third paragraph only parrots what I said with the addition of information that is not news to anyone – you hang around sick people, there’s a good chance you’ll get sick too.
As for the 4th paragraph, why did you not share your reasons for not sueing?
“there are no provisions that change the way the health care industry provides health care- the US is rated 25th in the world for the quality of health care even before this law”
Yes, but imagine the screams from the right if Obama and the Democrats had actually tried to “change the way the health care industry provides health care”! The Republicans and tea partiers are calling people socialists and communists for supporting even the very, very modest reform that got passed.
Donald: All I was saying is that to me, ANYBODY looks kind of silly on a Segway. I didn’t mean to give offense to the disabled community, and if I did I’m sorry.
Once again H Bruce Miller creates a straw man argument, assigns it to his opposition, and then proceeds to use non sequitur after non sequitur to shoot down the mischaracterization he has created.
Here is an example of his favorite ploy. There seems to be some correlation between A and B so A=B. There also seems to be some correlation between B and C so B=C. There are also seems to be some correlation between C and D so that means that F=W, and A=Z.
Read the following article
http://www.cato.org/pubs/pas/pa211.html
Note figures 1, 4, and 8. The reason why health care costs are rising is because a higher and higher % of what used to be out-of-pocket costs are now paid by a third party. There is a disconnect between what health care costs and how much you consume. This is the argument that is being made, it is not the nonsensical straw man that H Bruce Miller is attempting to characterize it as.
Ironically, your Cato Institute (right-wing think tank) guy makes the same faulty post-hoc-ergo-propter-hoc argument that you accuse me of making. I have read the article you linked to and I see no data to support his assertion that health care costs are so high in this country BECAUSE people have too much health coverage and therefore overuse the system. In fact he concedes himself that “measuring excessive use of a product is a difficult and usually imprecise task. The best that can be hoped for is a crude estimate, and even that will require some rather broad generalizations, such as lumping many disparate medical resources into a single whole.”
Some of his data seem to undercut his own argument. For example, he has a chart showing that the proportion of the US population with private health insurance has declined since 1975 — yet the costs of health care continued to rise at an even faster pace than before.
Finally, if too many Americans being insured (either by private insurers or through Medicare and Medicaid) is the reason for soaring health care costs here, why do other nations in which virtually everybody has health insurance (private or government) spend dramatically LESS than we do on health care, measured as a percentage of GDP? According to the logic of the Cato guy they should be using MUCH MORE health care, and health care costs should be much HIGHER as a result.
I agree that the cost of health care is a big problem in this country, but I am not persuaded that’s because large numbers of people are seeking unnecessary care, and I doubt you will have much luck getting many Americans to believe it.
You continue to make the ASSumption that this bill is healthcare reform. The only thing it does that you like is limit private insurance companies and give health care to everyone in America(legal or not).
How does this bill make our healthcare better? How does it move us up from 25th place? The only way this bill will do that is by gutting senior care. If we don’t have to treat the elderly for all of their maladies and focus on the young, I guess the statistics will go up. This program absolutely takes care away from seniors and if you disagree, you are either ignorant or a liar. I still don’t understand how someone who claims to be compassionate can support such a bill. Perhaps we will have to wait until it hits you personally.
Tim: I’m not enraptured by the bill; it doesn’t go nearly far enough. But it’s a first step, and at least it will provide coverage for a lot of Americans who don’t have it now.
As for the seniors, I’m within less than two years of being eligible for Medicare myself and my wife is within three years of it, so we definitely have a personal stake in it. I don’t see how this legislation is “gutting” care for seniors; on the other hand it eventually will close the “donut hole” for prescription drugs, and that’s a positive step. The AARP (of which I am a member) has strongly supported it; I can’t see them doing that if it’s going to “gut” care for seniors.
Tort reform would trim about 5% off healthcare costs.
Illegal immigrants will not have access the Obama healthcare plan. (They will seek care the old fashioned way; go to the emergency room where it costs twice as much).
The real reason for escalating health care costs is US. We demand medical science keep us healthy while we continue to chomp down those double cheeseburgers and sit our fat be-hinds on the couch expecting the frequest trips to the fridge to count as our daily excercise. Figure it out folks, over half of all Americans are overweight or obese. Nobody wants to talk about this being the real problem, but this really is the 800 pound gorilla hiding in the closet.
Maybe it’s time to tax food based on it’s fat, colestrol, sugar and salt contents and use those funds to pay for healthcare for all, and it also could be used to subsidize healthier food choices for lower income people. We make smokers and drinkers pay, why not do the same for those who make bad food choices. We’re not taking away their choices, just imposing a “user fee”.
It would be more cost effective to address the root cause of the problem rather then paying more $$ in the end. Our current healthcare system will be bankrupt by the end of the decade, and the Obama Healthcare law won’t fix the problem either unless we change our lard loving ways.
Alphabet Soup Guy: Good point, but you stretch it too far. Obesity is not the cause of ALL health problems.
“Really, I can have this $350K shitshack for only $500 a month? And refi when the note comes due in 2 years and buy a $50K pickup with fancy rims and big tires with what’s leftover?” People were given what they wanted. It was only a matter of time before someone had to hit the reset button.
HBM, I am always amazed at how you can completely misrepresent an argument opposing yours.
At no point did I say that people have too much health care coverage. I said that there is a high degree of correlation between rising health care costs, and the declining amount of health care that is paid out of pocket. When there is an incentive for people to manage their health care spending, they spend less. The statistical R squared for this correlation is very high.
At no point was there a claim that increasing rate of private health care leads to increasing costs, yet you characterize your opponents argument as such. Pure rubbish!
A comparison between us and other nations, within the context you framed it, is completely irrelevant. When you have a single payer system, health care decisions become a budget issue, not a health care issue. So they manage their health care spend through rationing, as it is now a budget issue. Neither I the Republican party, or the Libertarians are arguing that the health care system we have had was the best and only approach, even though that is once again how you like to mischaracterize the situation.
Finally I love how you use your favorite brain dead approach to framing an argument. Your statement “Cato Institute (right-wing think tank)” is so typical of your vapidness. I will say though I do appreciate your characterization in this case. The CATO Institute is actually a libertarian think tank, so I guess that means you place freedom on the right side of the continuum and Authoritarian/Totalitarian/Socialism/National Socialism/Fascism on the left side. Finally we agree on something.
“At no point did I say that people have too much health care coverage. I said that there is a high degree of correlation between rising health care costs, and the declining amount of health care that is paid out of pocket.”
The clear implication of your second sentence is that if people had less coverage (insurance), health care costs would fall. IOW, health care costs are high because people have too much coverage. You may not have said that in so many words, but it’s the gist of your argument.
But let’s try to get a clear statement on the record instead of trying to parse each other’s statements. In your opinion, what is the best way to solve the problem of high health costs?
“Neither I the Republican party, or the Libertarians are arguing that the health care system we have had was the best and only approach”
I have heard many conservatives make the preposterous claim that the US health care system is “the best in the world.”
“When there is an incentive for people to manage their health care spending, they spend less. The statistical R squared for this correlation is very high.”
This reminds me of a point I meant to make earlier. It is indisputable that when people have no insurance or very high deductibles and co-pays they will spend less on health care. But this begs the question: Are they actually eliminating unnecessary care, or are they foregoing needed care because they can’t pay for it?
Since only hypochondriacs and people with Munchausen Syndrome seek health care when they don’t need it, I strongly suspect the second explanation is the true one.
“Over 70% of malpractice cases that go to a Jury end in a decision for the doctor, nurses and hospitals, not the plantiff. Why is this? Because most of these cases are not Malpractice. They are driven to court by Plantiff lawyers hoping to make millions”
Can you not see the contradiction in your own argument? If over 70% of their cases are thrown out of court, how are the lawyers making millions?
We already have an adequate safeguard against frivolous and meritless lawsuits. It’s called “the legal system.”
When a case is thrown out of court, the defendant still has legal fees to pay since it is rare that the plantif is ordered to pay that. The doctor’s insurance pays for his defense. That will raise premiums. If “Loser Pays” goes into effect, people will think twice about filing a frivolous claim.
Lawyers work this cases on a base guarantee and/or a percentage of the award (reasonable attorney fees my @$$), laws are needed to reign in the abuse of our court system. This current safeguard system you speak of is wholley inadequate because this losing suits are still being filed on a “flip-of-the-coin” basis. The system needs fixing!