Best healthcare? No, but we have costliest

Coincidentally with the arrival of The Citizen in my driveway, there appeared an article in the New York Times about a very recent study by a well-respected independent group claiming the U.S. healthcare system contains $750 billions of waste per year.

Dr. Lawson claimed my most recent letter contained many “misleading statements and few facts,” which he quickly followed up with his own misleading statements and outright fabrications. Undoubtedly the doctor ... feels he has an economic interest in the status quo. That status quo is a healthcare industry which delivers excellent care in some cases and middling care in others when measured against the major industrialized countries of the world.

For my facts I read various articles, again easily obtainable online. The one I found most pertinent was an article entitled “Explaining High Health Care Spending in the United States: An International Comparison of Supply, Utilization, Prices and Quality” by Mr. David A Squires, writing for The Commonwealth Fund (www.commonwealthfund.org/).

Mr. Squires used data published by the Organization for Economic Cooperation and Development (OECD) and other sources to compare healthcare spending, supply, utilization, prices, and quality in 13 industrialized countries: Australia, Canada, Denmark, France, Germany, Japan, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States.

This is not some dry article with an overabundance of numbers and absence of purpose but a hard look at what we’re getting for our healthcare dollars, both public and private.

Mr. Squires’ conclusions, though, are inescapable. We pay a lot more than anyone else in the world. The service delivered is sometimes at or near the top (5-year survival rates for the cancers studied; breast, cervical and colorectal, top only in breast cancer survival rate) and often not near the top (practicing physicians per 1,000 population, physician consultations per capita, average length of stay for acute care, asthma mortality among ages 5-39, diabetes lower extremity amputations, acute myocardial infarction death rate, ischemic and hemorrhagic stroke death rate).

However, we always lead in costs by a huge margin. Dr. Lawson’s assertion that the cost numbers are misleading is flat out wrong. The numbers used in the study involve the total cost of healthcare in each country subdivided into public funds, insurance funds, and out of pocket funds. This is a total number and already takes into account the source.

The United States spent $7,960 per capita; Japan spent $2,878 per capita; Germany $4,218 per capita.

While holding their spending to slightly short of one-third of our costs, the Japanese system delivered more doctor’s visits per individual and better overall health statistics. If you want a hip replacement, go to Germany, where they perform 296 hip replacements per 100,000 people to our system which performs 166 hip replacements per 100,000.

Our drugs are more expensive. Our hospital stays are vastly more expensive and we seem to have a great deal of wasted expense which is pure profit for insurance companies and providers.

Dr. Lawson is correct stating that I should not have used the term “uninsured” when that number is far less than 50 million. Interestingly in his report, Mr. Squires writes:

“For many U.S. households, healthcare has become increasingly unaffordable. In 2010, four of 10 adults went without care because of costs and the number of either uninsured or ‘underinsured’ (i.e., people with health coverage that does not adequately protect them from high medical expenses) increased to more than 80 million. A 2007 survey in five states found that difficulty paying medical bills contributed to 62 percent of all bankruptcies, up 50 percent from 2001. For the average worker with employer-based health insurance, growth in premiums and cost-sharing has largely erased wage gains over the past decade.”

So the number of people who have insurance problems in this country is really 80 million, not 50. For those people Dr. Lawson suggests use of the emergency room.

Now this is a great use of our healthcare dollars: the most expensive and short-lived care you can get. And since the underinsured can’t pay much and the uninsured can’t pay anything, guess who gets stuck with the bill?

As for Medicaid it is certainly better than the alternative nothing. Notice also it is the thing Paul Ryan wants to denude of funding. And incidentally, if your parents need nursing home care, Medicaid will pay as long as their estate is depleted and they’ve signed over all but $66 per month and that is after a five-year look-back to ensure they haven’t transferred any funds or assets to you. Keep worrying about the billionaire’s passing on their national expenditure size estates to their worthless spawn.

Other fantasies in Dr. Lawson’s letter: There are no “entitlements” in the Constitution. He should read it sometime. The health panel’s recommendations on testing for certain cancers are based on survival rates both with, and without testing. It does not mean someone couldn’t pay for their own testing. In the end their statistical survival rate is not affected.

How about the $20 billion coming out of the Massachusetts healthcare system? Turns out that is the shortfall incurred by the largest 50 municipalities in Massachusetts for healthcare for retired employees. That shortfall was incurred over a long period including Mitt Romney’s term as governor and it is NOT coming out of the healthcare system. It is an obligation of the municipalities.

One Republican voted for the Affordable Care Act but that doesn’t mean no Republican had an input. George Mason, Elbridge Gerry, and Governor Randolph of Virginia refused to sign the Constitution, but they had a huge input forming that document.

And it was kind of Mr. Gilmer to give us some foam at the mouth Rush Limbaugh invective. Quite frankly if he has 100 million like-thinkers, he won’t need his civil war (unless he likes tanks driving through his living room).

And I’m not a socialist (like the guy in the parable I have too much stuff) and I’m not leaving, seeing as how I have to collect my military pension, military healthcare, and then rail about government spending.

Conclusion: We’re being sold a bill of goods. Most of us have good healthcare but it isn’t top notch by international standards.

We pay way too much and we have a lot of people who have an economic interest in seeing that we pay a lot more.

You can start off by getting the facts (not Lawson facts but real ones) and make your own decision, but don’t swallow this crap from the Republican leadership and others who are in bed with the healthcare pirates.

Timothy J. Parker

Peachtree City, Ga.

Peter Pfeifer
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Mr. Sussman from Pfeifer

You can call yourself a “moderate” (undefined by you), and you can deny that you are a socialist. But, the solution you support (Obamacare) is a socialist solution. You state; “no one is discussing socialism (except you) ...” But, in your first post here, you say, “Americans need to get informed...about socialized medicine...”. In Mr. Parker's letter, the one you responded to, he says; “I am not a socialist...”. So, I didn't insert the term into this, you two did.
I think the reason socialists claim not to be one is because they don't want readers to link their position to their philosophy because the term “socialist” has negative connotations (which it should!).
You also say that “we've never met but you 'suspect'...” that I am “a career politician or politico”. I believe that the redundancy is intended to be a prejudicial description of me and your use of the word “suspect” confirms it. But, I'm really pretty much just an average citizen who's had a little more than the average involvement in the local community. Some call that “experience”.
Can we look at a couple of the other things you say?
The Banks. The “controls” you refer to were formulated by (both) politicians who don't know anything about banking and those who do know and have an advantage to gain by manipulating those regulations. Your example of Weill is an apt one. That's one of the problems when government tries to run what they should not. Those who are interested and have something to gain are those who “help” write legislation that is voted on by people (politicians) who often don't understand the things they attempt to regulate but they do understand contributions and patronage.
Then, the “Rules” are selectively enforced or ignored. “Regulators” can't seem to find any problems before they occur and it becomes so obvious they can't ignore them any longer. Think about Bernie Madoff or Countrywide or MF Global. Were any of these brought to light by “Regulators”? How many “Regulators” pay any price at all for their errors?
You say this yourself, in your “Washington is a disaster” paragraph. It is a disaster but your solution to healthcare issues is to put the same people, with the same incentives, in charge of it along with all the other things they don't do well. But, socialists don't seem able to learn this lesson.
My example of North Korea was simply a stark and undeniable example, if extreme, of the results of both systems.

Larry Sussberg
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Mr. Pfeifer

If you feel better putting a label on me as a "socialist" fthat's ok. The truth be known I am a registered blue dog Democrat but vote as an independent.

Luckily for both of us, neither of our extreme views will ever reach the White House although Obama has gotten close but yet he is not really a "true" socialist; the same way Mitt Romney is not a "true" conservative. We will come out somewhere in the middle, just a shade bue or red each and every time.

Like I said, lets agree to disagree.

If you are interested in seeing my health care ideas in practice, research the Swiss health care system.

Also if you wish to continue the debate, feel free to find me on Facebook or let's meet for coffee. I have enjoyed this healthy exchange.

Thanks
Larry Sussberg
sussberg@aol.com

Peter Pfeifer
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Larry, Larry, Larry (and Parker)

Larry, Larry, Larry. More “progressive/socialist/liberal/Democrat” ways to take care of us.

It's not “the insurance companies”, the “medical industry”, the “drug makers” or anyone else PSLDs typically blame.

It's the COST. And, the cost is too high because “someone else” pays. The “someone else” can be insurance companies or it can be the government or any other bureaucracy that comes between you and your doctor.

Your comments about pricing are correct but you miss the point you make. Prices are higher to “deal”. Deal with the government and deal with the insurance company.

You won't fix it by substituting one bureaucracy for another; replacing the insurance company with the federal government. But you can, and will, make it worse because federal bureaucrats dictate to you and your doctor because they are the LAW and they have guns.

Americans do need to get informed and stop listening to the BS. The BS can come from everyone; government, hospitals, insurance companies, doctors and socialists.

It won't get fixed until people are responsible for themselves; their own insurance and their own health care. That works every time it's tried.

Larry Sussberg
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Mr. Pfeifer

"People need to take responsiblity for themselves their own insurance and their own health care."

IF what you are suggesting is leave the government completely out, total free market with no Federal or State regulations....Isn't that what we did with our airlines in the 1980s and our banks in the 1990s?

How's that working out? Banks too big to fail, and only a handful of airlines (charging $100 per bag to fly).

I believe that allowing free market rule including corporate consolidations into potential monopolies may lead to some efficiencies and lower prices in the mid term but long term is the question? We have seen throughout US business history that increased competition in some industries lead to consolidations resulting in higher fees and other problems.

Somewhere in the process, the consumer needs protection, either in consumer regulations or anti-trust regulations.

Are we ready to gamble that idea on our children's or grandchildren's health care?

I'm in favor of free enterprise and market competition with less government but in some cases we know it just doesn't work on the long term and for the betterment of the consumer.

The Sherman Act - Benjamin Harrison and Ohio Senator John Sherman were both Republicans.

Peter Pfeifer
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Mr. Sussberg - Is that meant to be a joke?

It's proven impossible “to leave the government completely out”. But, the more we can, the better off we, and the Healthcare System will be.

The “banks” have been highly regulated. That's how we got the most recent real estate crash. When the airlines were deregulated to the extent that they were, fares came down.

And, “increased competition … lead to higher fees”? What does that mean? What does the fact that the sponsors of the Sherman Act were Republicans have to do with the cost of healthcare?

And, you cannot be “in favor of free enterprise and market competition with less government.” when then you add “in some cases we know it just doesn't work”. You want “the experts” to run things for us dummies for our own good. As I said in my first post about this, freedom works and socialism doesn't.

Do we always get a “perfect result” from freedom? Don't be silly. But, we always will get a better result from freedom that we will from socialism. Please look at the night time photos, from space, of North and South Korea for an illustration. Just type into your search field; North Korea by night. You'll get a number of alternatives to look at the photos. It's a good illustration of the different results of each approach.

Larry Sussberg
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Mr Pfeifer

As an independent business owner for over 15 years with an additional 15 years prior experience in the international and American corporate world. I fully understand free market and competition. The reality is its not always free. I have seen what Chinese competition can do which is not free market, and prior to China, Japan played the same games with transfer pricing to support their electonics industry supported by the government in conjunction with Japan's banks. It was commonly refered to as a karetsu and they engaged in the practice of dumpng through low pricing.

No one is discussing socialism and your example of the North Korean dictatorship is not an example of socialism. And FYI I am not a Socialist!

As for the banks being highly regulated, you are skipping over the recent history allowing banks to become financial service companies (removal of some regulations) which was the Glass-Steagall Act. This ill conceived legislation was a result of the DC banking lobby and Sandy Weill's pressure to expand the Citibank empire. That was the real beginning of the change in our banking system. Career politicans with no practical business experience being lulled into financial reforms. "Reforms" that were not consumer or Main Street friendly and led us to where we are today which is using our tax dollars to bail them out.

As for airlines, fares did come down as competition increased but now, after industry consolidation that is not the case. Ever wonder about the baggage fees and how everone charges the same and increase at the same time? Congress is too busy trying to embarrass the current administration based upon which party controls the White House than consider price fixing. Arbitray application and enforcement of the laws we currently have.

Being a small business owner scrambling to get banks to lend or fair & reasonable health insurance coverage for employees, I would be more than happy to sit down at any time to discuss the issues faced. The system is broken for small business in America!

Also, if you prefer we can sit to review and debate the history and merits of Federal commercial law starting with the Sherman Act. We can use my West Business Law books if you wish.

We have never met but I suspect you are a career politician or politico. Your comments appear to be slimplified campaign snipets and statements I'd expect to hear from a political candidate.

I only hope that Mr. Romney, if elected, takes his advice from professionals including business owners and operators and that if legislation is necessary to protect Main Street and the consumer he will employ "the experts" not lobbyists or special interest to protect "intelligent people" from lack of competition and resulting abuse either from US or international corporations in unfair trade practices.

Washington is a disaster. They randomly enforce the legislation they want at the time it suits them or re-write legislation based upon pressures from lobbyists/special interest groups. No one is listening to real American consumers and small business. Washington is full of career politicians that are more concerned with power playing and gamesmanship than the American people. Too many career politicians. Some joke that lawyers are the problem, its career politicans that are the danger!

Personally,, I believe that legislation is needed now to protect and promote the free market of health insurance to avoid "too big to fail". Choices are being limited by state insurance commissioners and roll ups are occuring. Americans and American small business need more competitive options in buying insurance and we need protection to avoid limited options.

Meanwhile, we now live in a global marketplace courtesy of inexperienced politicians who sat back and watched our manufacturing base be outsourced to low wage countries with governments that participate in "dumping" policies into the US market. Wake up to the fact that many countries are not playing by the same rules.

It my turn to use a silly example like you did with North Korea...here goes...

"Maybe some day China will buy Blue Cross/Blue Shield with Washington's approval under the pretense that it's all about free market and competition."

Let's agree to disagree!

PTC Observer
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Wait a minute Mr. Pfeifer,

are you saying that people should be responsible for themselves?

Why, why that's just blasphemy against the god of social equality Mr. Pfeifer. We can't have that kind of thinking here. Pretty soon if that catches on the whole government house of cards could collapse!!

Larry Sussberg
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Costliest Health Care

Of course it is...for a number of reasons

1-high prices for drugs from the drug makers. Z Pack antiboditics can be purchased in Greece over the counter for $8.00 made by Merck. Buy the same exact brand name in the US, without insurance coverage its over $150.

2-hospital prices are high too, for 2 reasons, they mark it high so when the insurance companies negoitate with them, they give 50%. For those who may have sold department stores in the past, its overbilling which reflects in the constant 50% off sales that you see. Also they are high because many hospitals have to write off 25% or more depending upon location of their emergency room charges to cover people without insurance who use the emergency rooms as health clinics.

Heath care prices are high so they can discount to the health care insurers who stand between us and the best health care system in the world.

Americans need to get informed and stop listening to the BS that keeps coming out about socialized medicine, death panels, government take over, Obamacare, etc.

Every president since Teddy Roosevelt - Democrat and Republican has tried to tackle this problem!