Signs of a Slowdown in Health Care Spending
http://thedianerehmshow.org/shows/2012-05-03/signs-slowdown-health-care-spending
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There are signs that health care spending growth has slowed down in the last few years. Diane and her panel of experts look at what higher deductibles, a move away from fee-for-service plans and other changes could mean for future health care costs.
Guests
Annie Lowrey
economic policy reporter, the New York Times.
Peter Orszag
vice chairman of global banking at Citigroup Inc.; former director of the Office of Management and Budget in the Obama administration; former director, Congressional Budget Office, and author of "Saving Social Security"
Karen Davis
president,The Commonwealth Fund, former deputy assistant secretary for health policy in the Department of Health and Human Services from 1977–1980
Joseph Antos
Wilson H. Taylor Scholar in Health Care and Retirement Policy at the American Enterprise Institute, a commissioner of the Maryland Health Services Cost Review Commission and a health adviser to the Congressional Budget Office
Comments
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Foxy, I agree that I would like to see a portable, universal healthcare plan, but I must take exception to your #1 point, that we do not choose the illnesses and injuries we suffer. Our national obesity crisis has a huge effect on the illnesses and injuries we suffer -- heart disease, diabetes and cancer being only three. When we look at what we must do to correct the problems in our healthcare system, we must include individual accountability along with competence and effectiveness of healthcare professionals, competence and effectiveness of medical facilities and competence and effectiveness of slow-acting, error-filled insurance companies.
One of the panelists referred to a future lowering of the federal deficit as a result of the Affordable Care Act (ACA) of 2010. I realize that there have been multiple groups doing projections, some of which raise the deficit by billions and some of which lower it. Pick your favorite one to believe, but please pick one that makes some common sense, because the deficit will go UP. Read on for some associated information ...
We had a very complicated health care not for all system with three types of bureaucracy (http://mforall.org/p/791)
The ACA kept ALL of the complexity, added MORE and kept it a health care not for all system. (http://mforall.org/p/1051#topofcomplexity)
The Chief Auditor and staff of the Center for Medicare and Medicaid staff reported within a month of the signing of the law that within the first 10 years of implementation there will be $300 billion MORE spending than if NOTHING had been done to change U.S. health care policy. (http://mforall.org/p/1001)
Based on a section-by-section analysis of the ACA, which we did accomplish and we do have the report available, there are a little over 600 reasons why our taxes will likely go up. That incredible reality fits well with an observation by many that the Affordable Care Act does not address the question of cost control to any significant, meaningful degree.
Last but not least: ask the people of the state of New York what happens when regulations are put on health insurance companies. Try paying for health care there.
Here is the range of health insurance plan premiums for a family in one of the poorest counties of the state of New York (May 2012 prices):
$2,860.94 to $3,975.63 PER MONTH.
[$34,300 to $47,700 per year].
See further details at the link ...
(http://mforall.org/p/930)
Deficit reduction?
No, no, no: do NOT look for any deficit reduction until we implement national single-payer health care, improved Medicare for All.
Bob the Health and Health Care Advocate
In 2005, I was extremely ill. It turned out to be a liver issue. The doctors insisted on giving drugs which worsened my condition. I had a daughter living in Scotland. My two girls got together and with the aide of a Naturopothis restored me to health.
Fast forward to 2009, I was ready to retire from teaching. I was allowed to continue purchase insurance through my district until 65, but they wanted $587. a month. I opted to drop it. I had high blood pressure at the time, but the doctor told me if I lost 30 pounds I would not have HBP. So I lost the weight, and I have lived 3 years without insurance. I went to the Wellness Clinic at Walgreens' once for an antibiotic for a severe sinus infection. I turned 65 in March and now have Medicare, but I have no intention to use the system unnecessarily.
As a nation we developed a habit of running to the dr. for everything because we have insurance. I believe most people could live with less dr. visits not everyone of course. There are always exceptions, but we need to be proactice with our own health.
Gayle Alexander, I am sticking by my point #1. We do not choose what we suffer.
That is not to say there is absolutely no role for living a healthy lifestyle, prevention, etc. But you cannot prove in a single individual that their way of life caused their disease. There is no way to prove that an individual would have had a different outcome if he or she had done something different. You can only look at statistically significant samples of at least hundreds of people to prove any of that.
You certainly can't say that cancer, in the vast majority of cases, is caused by anything we could have avoided. And there are just a myriad of other diseases and injuries that we absolutely could not have avoided. It is not always true that even diabetes or heart disease could have been avoided somehow. People with healthy lifestyles get those diseases all the time. How do you explain children diagnosed with diabetes at an early age, for example? I believe that saying the individual caused his or her disease is another case of blaming the victim.
The best prevention is being able to go to the doctor at the first signs of something, not waiting because you are made to pay and can't afford it. The best way to encourage individual responsibility is to provide the incentives and the resources to accomplish that. That can't be left up to the insurance companies because they have no incentive to encourage prevention, because most people change insurance companies so often (not of their own choosing).
When we have a universal system, people can choose the doctors they like and then stay with them. As the patient and doctor get to know each other over the years, it is more possible to go beyond treating acute symptoms and talk about prevention, lifestyle, planning for old age, and on and on. Economies of scale can be implemented. We need to get the slow-acting, error-filled insurance companies, as you put it, out from between you and your doctor.
ljdurham, I have heard people say the same thing as you: "we developed a habit of running to the dr. for everything because we have insurance". This is not the problem; in fact, the opposite of that problem is proving to be true. As I said in my earlier post, people are NOT going to the doctor when they SHOULD, so they wind up sicker, which costs the whole system a lot more than necessary. This is a massive problem now, since ObamaCare has been implemented, as a number of posters have explained from their own experience with high-deductible plans.
As Orszag says- this isn't about patients/people not having money because the slow-down in spending is particularly strong in Medicare. This must be a change in physician behavior. They order most expensive items.
Why does everyone think that fee-for-service is the big culprit when other countries, Canada, Germany etc, also pay fee-for-service and have far lower per-capita costs? It is the prices that have to be dealt with, as well as overhead. The current slow-down in growth may come from physician awareness and that is good, but to hit bigger reductions, we need to change price and overhead.
Look at the other countries and learn
As Orszag says- this isn't about patients/people not having money because the slow-down in spending is particularly strong in Medicare. This must be a change in physician behavior. They order most expensive items.
Why does everyone think that fee-for-service is the big culprit when other countries, Canada, Germany etc, also pay fee-for-service and have far lower per-capita costs? It is the prices that have to be dealt with, as well as overhead. The current slow-down in growth may come from physician awareness and that is good, but to hit bigger reductions, we need to change price and overhead.
Look at the other countries and learn
Some thoughts:
1) The person who complained about her doctor doing too many tests for her diabetes.......Type 2 diabetes is self-induced, based on very poor diet and exercise. This caller has had it for 35 years. I found it strange that you and your panel comisserated with her. If the caller improved her diet and exercised she could cure her diabetes and save a lot of money by not having to go to the doctor at all.
2) Diabetes is a complicated disease requiring constant monitoring. One can go blind from diabetes, one can lose an extremity get lots of other diseases. The caller and your panel maligned the doctor for being a good doctor. It is not healthy for your listeners to think this correct.
3) Your AEI panelists insulted a caller (called him cynical) for stating the truth. Public company serve themselves , their shareholders by increasing equity value and dividends and their cusromers. That's not cynical, that's the truth. And it works the same for public health care companies as for all others. You should do a program on this topic.
4) The real truth of health in America is that doctors and hospitals are not overpaid, they are underpaid. The overpaid people in America are sports figures, entertainers, investment bankers, CEO's and....yes APPLE. I wonder how many iphones your diabetic caller has. The real truth about health care in America is that NOBODY cares about their health!!! They care about baseball games more than their health.. Americans don't deserve their excellent health care system. The more doctors ar maligned, the more the best people won't go into it. And finally the system will equal out: people who don't care about their health, will get to go to doctors who don't care about it either.