The Most Startling Sentence I Read Today

Here’s my bottom line: after we get through spending our $1 trillion under ObamaCare, there is no convincing reason to believe that the bottom half of the income distribution will have more care, better care, or better access to care than they have today.

That’s John Goodman on health care reform. Read the whole thing.

4 responses to “The Most Startling Sentence I Read Today

  1. What did you find startling about it?

  2. It’s “startling” because Obama claimed in his big healthcare address that costs would go down while quality and quantity would go up.

    I was reading the other day that the USPO started out as a “public option” but then eventually shut down private competitors. This so-called non-profit gov’t agency posted $8 and $7 billion in losses in the last two years and will likely run out of cash to pay employees by the end of this year.

  3. The USPO is not something that everyone <em<has to partake in. Whereas the private sector has stepped in to offer communication that replaces old-fashioned letters at no cost to the consumer and UPS, DHL, FedEx, et al are offering cheaper package delivery, the private sector in health care has only served to make prices skyrocket and care levels go down. And health care is something we all need at some point.

    I think a better comparison is the US military. 40 years ago, when the military did nearly everything “in house” the cost of a standing army and infrastructure were a fraction of what it is now, with nearly everything (including the shooting and dying) sub-contracted out.

    I still have yet to see a study that shows a reduction in quality of care (or consumer satisfaction with care) in countries that have implemented a single-payer system. Goodman’s bias towards health savings accounts is frightening; I don’t want Wall St. any closer to my health than they already are. A savings account with an interest rate subject to market whims does about as much good if I have a serious illness as my checking account does now. Which is to say, not much. I’d wager most Americans who aren’t Bill Gates and Paris Hilton are in the same boat.

    The only answer is single payer. Hopefully, the shortcomings of the ACA (quit calling it “Obamacare”, it’s very immature) will lead us to that path.

  4. “…the private sector in health care has only served to make prices skyrocket and care levels go down. And health care is something we all need at some point.”

    Is the private sector in health care making prices skyrocket? Isn’t health insurance heavily subsidized thereby increasing demand? Don’t medical schools limit enrollments thereby reducing the potential supply of new doctors? The U.S. health care system is hardly a free market system run amok.

    “I still have yet to see a study that shows a reduction in quality of care (or consumer satisfaction with care) in countries that have implemented a single-payer system.”

    I am not a health economist and therefore cannot speak to the vast literature on quality and single payer service. However, consider the effects of Medicare balanced billing restrictions found by Brunt and Jensen:

    The maximum amount physicians can charge Medicare patients for Part B services depends on Medicare reimbursement rates and on federal and state restrictions regarding balance billing. This study evaluates whether Part B payment rates, state restrictions on balance billing beyond the federal limit, and physician balance billing influence how beneficiaries rate the quality of their doctor’s care. Using nationally representative data from the 2001 to 2003 Medicare Current Beneficiary Survey, this paper finds strong evidence that Medicare reimbursement rates, and state balance billing restrictions influence a wide range of perceived care quality measures. Lower Medicare reimbursement and restrictions on physicians’ ability to balance bill significantly reduce the perceived quality of care under Part B.

    This is direct evidence that attempts to hold down costs through price/reimbursement restrictions reduce the quality of care.

    And, of course, there is anecdotal evidence such as this:

    http://www.walesonline.co.uk/news/wales-news/2011/04/06/patients-left-to-die-as-they-are-denied-cancer-drugs-in-wales-91466-28467706/

    The only way to reduce health care costs is by reducing the quantity of care or by reducing prices. We can either do this through reforms that provide individuals an incentive to reduce their consumption of health services or by restricting access/reducing the quality of care. There is no free lunch.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s