$239 billion will be added to the Federal Deficit. I assume this added cost is not included in the recent announcement from the White House:
"Estimate for 10-Year Deficit Raised to $9 Trillion" NYTimes
Showing posts with label healthcare. Show all posts
Showing posts with label healthcare. Show all posts
Tuesday, August 25, 2009
"Free Health Care Plan Costs Add Up"
Love this graphic...
$239 billion will be added to the Federal Deficit. I assume this added cost is not included in the recent announcement from the White House:
"Estimate for 10-Year Deficit Raised to $9 Trillion" NYTimes
$239 billion will be added to the Federal Deficit. I assume this added cost is not included in the recent announcement from the White House:
"Estimate for 10-Year Deficit Raised to $9 Trillion" NYTimes
Monday, August 24, 2009
"The Whole Foods Alternative to ObamaCare"
Older article, but this deserves a complete repost...
The Whole Foods Alternative to ObamaCare
The Wall Street Journal
By JOHN MACKEY
“The problem with socialism is that eventually you run out
of other people’s money.”
—Margaret Thatcher
With a projected $1.8 trillion deficit for 2009, several trillions more in deficits projected over the next decade, and with both Medicare and Social Security entitlement spending about to ratchet up several notches over the next 15 years as Baby Boomers become eligible for both, we are rapidly running out of other people’s money. These deficits are simply not sustainable. They are either going to result in unprecedented new taxes and inflation, or they will bankrupt us.
While we clearly need health-care reform, the last thing our country needs is a massive new health-care entitlement that will create hundreds of billions of dollars of new unfunded deficits and move us much closer to a government takeover of our health-care system. Instead, we should be trying to achieve reforms by moving in the opposite direction—toward less government control and more individual empowerment. Here are eight reforms that would greatly lower the cost of health care for everyone:
• Remove the legal obstacles that slow the creation of high-deductible health insurance plans and health savings accounts (HSAs). The combination of high-deductible health insurance and HSAs is one solution that could solve many of our health-care problems. For example, Whole Foods Market pays 100% of the premiums for all our team members who work 30 hours or more per week (about 89% of all team members) for our high-deductible health-insurance plan. We also provide up to $1,800 per year in additional health-care dollars through deposits into employees’ Personal Wellness Accounts to spend as they choose on their own health and wellness.
Money not spent in one year rolls over to the next and grows over time. Our team members therefore spend their own health-care dollars until the annual deductible is covered (about $2,500) and the insurance plan kicks in. This creates incentives to spend the first $2,500 more carefully. Our plan’s costs are much lower than typical health insurance, while providing a very high degree of worker satisfaction.
• Equalize the tax laws so that that employer-provided health insurance and individually owned health insurance have the same tax benefits. Now employer health insurance benefits are fully tax deductible, but individual health insurance is not. This is unfair... (full op-ed)
The Whole Foods Alternative to ObamaCare
The Wall Street Journal
By JOHN MACKEY
“The problem with socialism is that eventually you run out
of other people’s money.”
—Margaret Thatcher
With a projected $1.8 trillion deficit for 2009, several trillions more in deficits projected over the next decade, and with both Medicare and Social Security entitlement spending about to ratchet up several notches over the next 15 years as Baby Boomers become eligible for both, we are rapidly running out of other people’s money. These deficits are simply not sustainable. They are either going to result in unprecedented new taxes and inflation, or they will bankrupt us.
While we clearly need health-care reform, the last thing our country needs is a massive new health-care entitlement that will create hundreds of billions of dollars of new unfunded deficits and move us much closer to a government takeover of our health-care system. Instead, we should be trying to achieve reforms by moving in the opposite direction—toward less government control and more individual empowerment. Here are eight reforms that would greatly lower the cost of health care for everyone:
• Remove the legal obstacles that slow the creation of high-deductible health insurance plans and health savings accounts (HSAs). The combination of high-deductible health insurance and HSAs is one solution that could solve many of our health-care problems. For example, Whole Foods Market pays 100% of the premiums for all our team members who work 30 hours or more per week (about 89% of all team members) for our high-deductible health-insurance plan. We also provide up to $1,800 per year in additional health-care dollars through deposits into employees’ Personal Wellness Accounts to spend as they choose on their own health and wellness.
Money not spent in one year rolls over to the next and grows over time. Our team members therefore spend their own health-care dollars until the annual deductible is covered (about $2,500) and the insurance plan kicks in. This creates incentives to spend the first $2,500 more carefully. Our plan’s costs are much lower than typical health insurance, while providing a very high degree of worker satisfaction.
• Equalize the tax laws so that that employer-provided health insurance and individually owned health insurance have the same tax benefits. Now employer health insurance benefits are fully tax deductible, but individual health insurance is not. This is unfair... (full op-ed)
Tuesday, August 11, 2009
Cap the Doctors; Sky's the Limit for Lawyers
From George Gilder's newsletter...
Cap the Doctors; Sky's the Limit for Lawyers
By Philip K. Howard, July 31, 2009
"Health-care reform is bogged down because none of the bills before Congress deals with the staggering waste of the current system, estimated to be $700 billion to $1 trillion annually. The waste flows from a culture of health care in which every incentive is to do more -- that's how doctors make money and that's how they protect themselves from lawsuits.
Yet the congressional leadership has slammed the door on solutions to the one driver of waste that is relatively easy to fix: the erratic, expensive and time-consuming jury-by-jury malpractice system. Pilot projects could test whether this system should be replaced with expert health courts, but leaders who say they want to cut costs will not even consider them.
What are they scared of? The answer is inescapable -- such expert courts might succeed and undercut the special interest of an influential lobby, the trial lawyers. An expeditious and reliable new system would compensate patients more quickly and at a fraction of the overhead of the current medical justice system, which spends nearly 60 cents of every dollar on lawyers' fees and administrative costs.
Even more compelling, expert health courts would eliminate the need for "defensive medicine," thereby helping to save enough money for America to afford universal health coverage.
Defensive medicine -- the practice of ordering tests and procedures that aren't needed to protect a doctor from the remote possibility of a lawsuit -- is ubiquitous. A 2005 survey in the Journal of the American Medical Association related that 93 percent of high-risk specialists in Pennsylvania admitted to the practice, and 83 percent of Massachusetts physicians did the same in a 2008 survey. The same Massachusetts survey showed that 25 percent of all imaging tests were ordered for defensive purposes, and 28 percent and 38 percent, respectively, of those surveyed admitted reducing the number of high-risk patients they saw and limiting the number of high-risk procedures or services they performed.
Defensive medicine is notoriously hard to quantify, but some estimates place the annual cost at $100 billion to $200 billion or more. Quantification is difficult because defensiveness is now embedded in the culture of American health care; it's hard to separate the financial incentives from the distrust of justice. Yet every physician, and most patients, can give examples. In a recent letter to the Wall Street Journal, a Texas doctor described how, since being unsuccessfully sued in 1995, he has "doubled and tripled the number of tests and consultations that I order."
A few years ago, I was not allowed to have minor knee surgery at an orthopedic hospital unless I went through a comprehensive "pre-operative examination." There was no financial incentive to the hospital because this pre-operative exam was to be done elsewhere. As it turned out, I had recently endured all those tests in my annual physical. But the orthopedic hospital would not accept month-old test results, nor even an explicit waiver by me of any liability. The result was pure waste: more than $1,000 spent on wholly unnecessary tests.
Health-care professionals live the reality of defensive medicine every day. Do an online search of the phrase "defensive medicine," and you will find scores of testimonials. But congressional leadership, amid all the talk of cost-containment, has assiduously avoided even mentioning the phrase.
Containing costs, as Rep. Jim Cooper (D-Tenn.) noted on "Face the Nation" recently, requires overhauling the culture of health-care delivery. Incentives need to be realigned. That requires a legal framework that, instead of encouraging waste, encourages doctors to focus on what's really needed. One pillar in a new legal framework is a system of justice that is trusted to reliably distinguish between good care and bad care. Reliable justice would protect doctors against unreasonable claims and would expeditiously compensate injured patients. The key is reliability. Traditional "tort reform" -- merely limiting noneconomic damages -- is not sufficient to end defensive medicine, because doctors could still be liable when they did nothing wrong.
The shifts in legal structure required to contain costs are hard to "score," using the terminology of the Congressional Budget Office. Only with experience can anyone quantify the real value of realigning incentives. But surveys and studies repeatedly confirm what every doctor knows -- that they go through the day ordering tests and procedures that aren't really needed.
As the nation debates health-care overhaul, not addressing defensive medicine would be a scandal, a willful refusal by Congress to deal with one of the causes of skyrocketing health-care costs. The real crisis here is not that health care is broken; people of good will could come together and create the conditions for rebuilding the incentive structure of health-care delivery. The real crisis is that Congress is broken, and that it answers to special interests instead of the needs of all Americans."
Cap the Doctors; Sky's the Limit for Lawyers
By Philip K. Howard, July 31, 2009
"Health-care reform is bogged down because none of the bills before Congress deals with the staggering waste of the current system, estimated to be $700 billion to $1 trillion annually. The waste flows from a culture of health care in which every incentive is to do more -- that's how doctors make money and that's how they protect themselves from lawsuits.
Yet the congressional leadership has slammed the door on solutions to the one driver of waste that is relatively easy to fix: the erratic, expensive and time-consuming jury-by-jury malpractice system. Pilot projects could test whether this system should be replaced with expert health courts, but leaders who say they want to cut costs will not even consider them.
What are they scared of? The answer is inescapable -- such expert courts might succeed and undercut the special interest of an influential lobby, the trial lawyers. An expeditious and reliable new system would compensate patients more quickly and at a fraction of the overhead of the current medical justice system, which spends nearly 60 cents of every dollar on lawyers' fees and administrative costs.
Even more compelling, expert health courts would eliminate the need for "defensive medicine," thereby helping to save enough money for America to afford universal health coverage.
Defensive medicine -- the practice of ordering tests and procedures that aren't needed to protect a doctor from the remote possibility of a lawsuit -- is ubiquitous. A 2005 survey in the Journal of the American Medical Association related that 93 percent of high-risk specialists in Pennsylvania admitted to the practice, and 83 percent of Massachusetts physicians did the same in a 2008 survey. The same Massachusetts survey showed that 25 percent of all imaging tests were ordered for defensive purposes, and 28 percent and 38 percent, respectively, of those surveyed admitted reducing the number of high-risk patients they saw and limiting the number of high-risk procedures or services they performed.
Defensive medicine is notoriously hard to quantify, but some estimates place the annual cost at $100 billion to $200 billion or more. Quantification is difficult because defensiveness is now embedded in the culture of American health care; it's hard to separate the financial incentives from the distrust of justice. Yet every physician, and most patients, can give examples. In a recent letter to the Wall Street Journal, a Texas doctor described how, since being unsuccessfully sued in 1995, he has "doubled and tripled the number of tests and consultations that I order."
A few years ago, I was not allowed to have minor knee surgery at an orthopedic hospital unless I went through a comprehensive "pre-operative examination." There was no financial incentive to the hospital because this pre-operative exam was to be done elsewhere. As it turned out, I had recently endured all those tests in my annual physical. But the orthopedic hospital would not accept month-old test results, nor even an explicit waiver by me of any liability. The result was pure waste: more than $1,000 spent on wholly unnecessary tests.
Health-care professionals live the reality of defensive medicine every day. Do an online search of the phrase "defensive medicine," and you will find scores of testimonials. But congressional leadership, amid all the talk of cost-containment, has assiduously avoided even mentioning the phrase.
Containing costs, as Rep. Jim Cooper (D-Tenn.) noted on "Face the Nation" recently, requires overhauling the culture of health-care delivery. Incentives need to be realigned. That requires a legal framework that, instead of encouraging waste, encourages doctors to focus on what's really needed. One pillar in a new legal framework is a system of justice that is trusted to reliably distinguish between good care and bad care. Reliable justice would protect doctors against unreasonable claims and would expeditiously compensate injured patients. The key is reliability. Traditional "tort reform" -- merely limiting noneconomic damages -- is not sufficient to end defensive medicine, because doctors could still be liable when they did nothing wrong.
The shifts in legal structure required to contain costs are hard to "score," using the terminology of the Congressional Budget Office. Only with experience can anyone quantify the real value of realigning incentives. But surveys and studies repeatedly confirm what every doctor knows -- that they go through the day ordering tests and procedures that aren't really needed.
As the nation debates health-care overhaul, not addressing defensive medicine would be a scandal, a willful refusal by Congress to deal with one of the causes of skyrocketing health-care costs. The real crisis here is not that health care is broken; people of good will could come together and create the conditions for rebuilding the incentive structure of health-care delivery. The real crisis is that Congress is broken, and that it answers to special interests instead of the needs of all Americans."
Tuesday, July 28, 2009
"Health Care Mythology"
Excellent post by Cliff Asness that it deserves its own spot on my blog :)
Health Care Mythology
By Clifford Asness
What We Know That Ain't So
Will Rogers famously said, "It isn't what we don't know that gives us trouble, it's what we know that ain't so."[1] So it is with the health care debate in this country. Quite a few "facts" offered to the public as truth are simply wrong and often intentionally misleading. It seems clear that no truly productive solution will emerge when these false facts represent our common starting point. So, this essay takes on the modest task of simply disabusing its readers of some untrue notions about health care.
I do not take on the harder task of prescribing how we should (and if we should) reform health care, though I offer a few thoughts. Important work must be done here by those who understand, far better than I, the details of health care provision. However, no details are necessary for this essay, and no animals (though perhaps some egos) were harmed in its creation. The fallacies I present are basic and it takes only a rational economic framework to expose them... (full post)
Related news:
"CBO deals new blow to health plan" Politico
"Dean: ‘What’s the point of having a 60 vote majority’ if you can’t pass health reform?" ThinkProgress
Health Care Mythology
By Clifford Asness
What We Know That Ain't So
Will Rogers famously said, "It isn't what we don't know that gives us trouble, it's what we know that ain't so."[1] So it is with the health care debate in this country. Quite a few "facts" offered to the public as truth are simply wrong and often intentionally misleading. It seems clear that no truly productive solution will emerge when these false facts represent our common starting point. So, this essay takes on the modest task of simply disabusing its readers of some untrue notions about health care.
I do not take on the harder task of prescribing how we should (and if we should) reform health care, though I offer a few thoughts. Important work must be done here by those who understand, far better than I, the details of health care provision. However, no details are necessary for this essay, and no animals (though perhaps some egos) were harmed in its creation. The fallacies I present are basic and it takes only a rational economic framework to expose them... (full post)
Related news:
"CBO deals new blow to health plan" Politico
"Dean: ‘What’s the point of having a 60 vote majority’ if you can’t pass health reform?" ThinkProgress
Friday, July 24, 2009
Clayton Christensen's Free-market Solution to Healthcare
Over at BigThink, Clayton Christensen, Harvard Business School Professor and author of The Innovator’s Dilemma, discusses how government should be hands off in healthcare reform.
Monday, July 20, 2009
Jindal & Crowder on the Healthcare Debate
A bit exhausted from organizing and attending the "More Than Money" conference this past weekend, so I'm just catching up on the news. Here are a couple takes on the current healthcare debate:
'A trillion here, a trillion there' by Bobby Jindal
"Steven Crowder Investigates CanadaCare...Will ObamaCare Be Any Better?"
'A trillion here, a trillion there' by Bobby Jindal
"Steven Crowder Investigates CanadaCare...Will ObamaCare Be Any Better?"
Tuesday, May 6, 2008
"Canadian Invasion"
I love The Wall Street Journal's James Taranto (from his Best of the Web Today):
The United States and Canada share the longest unprotected border in the world, and Totonto's Globe and Mail has a story illustrating why that is so dangerous:
More than 100 Canadian women with high-risk pregnancies have been sent to United States hospitals over the past year--in what a doctors' group attributes to the lack of a national birthing plan.
The problem has peaked, with British Columbia and Ontario each sending a record number of women to U.S. neonatal intensive care units (NICUs). Specifically, 80 B.C. women have been sent to U.S. hospitals since April 1, 2007; in Ontario, 28 have been sent since January of 2007, according to figures from the respective health ministries.
André Lalonde, executive vice-president of the Society of Obstetricians and Gynaecologists of Canada, said the problem is due to bed closings that took place almost a decade ago, the absence of a national birthing initiative and too few staff.
"Neonatologists are very stretched right now," Dr. Lalonde said in a telephone interview from Ottawa. "We're so stretched, it's kind of dangerous."
Aw, look at the cute little Canadian babies! It's all very sweet and innocuous, right?
Don't believe it. Read between the lines, and you realize this is a sinister Canadian plot to take over America. Canada's military is no match for ours, so the crafty Canucks are using infancy instead of infantry to carry out their imperial designs.
Think about it. Canadian officials send women across the border, smuggling in "anchor babies" cleverly disguised as clumps of tissue. The women give birth inside the U.S., which means their Canadian offspring are entitled to U.S. citizenship. As these "children" grow and mature, they receive instructions from their masters in Ottawa about how to undermine American culture.
Before you know it, your kids are stuffing themselves with litres of back bacon, downing kilogram after kilogram of Crown Royal and Labatt Blue, and belting out "God Save the Queen" as they watch hockey on TV.
It's all so horrible to contemplate, but it can be stopped. All we need to do is make America as inhospitable as Canada for expectant Canadian mothers. Hillary Clinton has the right idea: The U.S. needs socialized medicine.
The United States and Canada share the longest unprotected border in the world, and Totonto's Globe and Mail has a story illustrating why that is so dangerous:
More than 100 Canadian women with high-risk pregnancies have been sent to United States hospitals over the past year--in what a doctors' group attributes to the lack of a national birthing plan.
The problem has peaked, with British Columbia and Ontario each sending a record number of women to U.S. neonatal intensive care units (NICUs). Specifically, 80 B.C. women have been sent to U.S. hospitals since April 1, 2007; in Ontario, 28 have been sent since January of 2007, according to figures from the respective health ministries.
André Lalonde, executive vice-president of the Society of Obstetricians and Gynaecologists of Canada, said the problem is due to bed closings that took place almost a decade ago, the absence of a national birthing initiative and too few staff.
"Neonatologists are very stretched right now," Dr. Lalonde said in a telephone interview from Ottawa. "We're so stretched, it's kind of dangerous."
Aw, look at the cute little Canadian babies! It's all very sweet and innocuous, right?
Don't believe it. Read between the lines, and you realize this is a sinister Canadian plot to take over America. Canada's military is no match for ours, so the crafty Canucks are using infancy instead of infantry to carry out their imperial designs.
Think about it. Canadian officials send women across the border, smuggling in "anchor babies" cleverly disguised as clumps of tissue. The women give birth inside the U.S., which means their Canadian offspring are entitled to U.S. citizenship. As these "children" grow and mature, they receive instructions from their masters in Ottawa about how to undermine American culture.
Before you know it, your kids are stuffing themselves with litres of back bacon, downing kilogram after kilogram of Crown Royal and Labatt Blue, and belting out "God Save the Queen" as they watch hockey on TV.
It's all so horrible to contemplate, but it can be stopped. All we need to do is make America as inhospitable as Canada for expectant Canadian mothers. Hillary Clinton has the right idea: The U.S. needs socialized medicine.
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