Yes, the system is corrupt and bloated. But, when the government tries to "reform" anything, they just bloat it and add corruption. In fact, much of the corruption and bloated system can already be traced back to the government. The answer is not more government in health care, but less.
Another Bogus Report Card for U.S. Medical Care
- Thread starter Calabrio
- Start date
Yes, the system is corrupt and bloated. But, when the government tries to "reform" anything, they just bloat it and add corruption. In fact, much of the corruption and bloated system can already be traced back to the government. The answer is not more government in health care, but less.
I honestly dont know what the answer is. Its a very complicated issue, but having 47 million americans uninsured isnt acceptable to me.
Further, those 47 million, when they do need medical care, pay through the nose because insurance companies are able to negotiate lower rates, the uninsured are not.
ALl I know, is that what we have now isnt working well, and isnt going to get better, only worse. So something needs to be done.
fossten
Dedicated LVC Member
47 million is a myth. That number is false. Stop spewing falsehoods. You're just swallowing Michael Moore's bullcrap as gospel.
The fact is that 10 million of those people aren't Americans, they are illegals. Approximately 17 million people can afford health insurance and opt not to carry it. Furthermore, I posit that many of the remaining 20 million are single people under the age of 30 who don't even really NEED health insurance. I know when I was a 20-something I almost NEVER went to the doctor. Hell, I still don't. Either way, 20 million is only about 7% of the population, which is very small, not much larger than the unemployment rate (gee, what a coinkydink). Wise up, Joey.
EVERYBODY WATCH 20/20 TONIGHT!
We have the best health care system in the world. It isn't perfect, but that doesn't mean its bad. It is interesting that this has never been an issue in america before the 1990's. Now it is a neccessity that everyone have health care! How did we ever survive until now? No one can justify it as a "right", they just claim it is (Tommy I am talkin at you here). Well the fact of the matter is that it isn't a right. Besides, when the numbers are crunched, this country couldn't afford healthcare like Canada for its citizens.
Joey, you are missing the other side of things. First, everyone in America already has healthcare to a degree because hospitals are required by law to provide life saving and stablizations services reguardless of if someone can pay. Second the biggest group of people paying less then the going cost for certian procedures isn't people with insurance, it is those on government programs like Medicare and Medicaid. Those programs set the price they will pay for a given procedure and it is most always less then what the going rate is. The doctors have to make up the cost by charging other patients that aren't on medicare and medicare; basically, those with insurance. So don't try that "people with insurance pay lower rates" argument. It is inaccurate and misleading.
-that's the most incredible thing about this debate, as MM broke it down based on the 47 million myth- what they want to do is ruin the health care system for 93% of the population in order to accommodate the uncovered 7%
How about US news?
One of the consequences of higher health insurance costs, Altman noted, has been the rise in the number of uninsured, which reached 47 million in 2006, a 5 percent increase over the previous year.
Health Insurance Costs Rise Again
Thats my source - Ive never even been to Michal Moore's website.
Here are a few more. How about the CDC? Good enough for you? Or are they working for Michael Moore too?
In 2006, there were 43.6 million Americans of all ages who did not have health insurance (at the time of the interview), or 14.8 percent of the population.
http://www.cdc.gov/od/oc/media/pressrel/2007/b070625.htm
I know better then to quote Michael Moore around here.
shagdrum, I agree we have the best doctors and the best medical care in the US, however, that care doesnt extend to 100% of the population. I dont buy into the "its good enough" argument. I am sure you wouldnt buy that argument either if your family was one of those without insurance.
One of the consequences of higher health insurance costs, Altman noted, has been the rise in the number of uninsured, which reached 47 million in 2006, a 5 percent increase over the previous year.
Health Insurance Costs Rise Again
Thats my source - Ive never even been to Michal Moore's website.
Here are a few more. How about the CDC? Good enough for you? Or are they working for Michael Moore too?
In 2006, there were 43.6 million Americans of all ages who did not have health insurance (at the time of the interview), or 14.8 percent of the population.
http://www.cdc.gov/od/oc/media/pressrel/2007/b070625.htm
I know better then to quote Michael Moore around here.
shagdrum, I agree we have the best doctors and the best medical care in the US, however, that care doesnt extend to 100% of the population. I dont buy into the "its good enough" argument. I am sure you wouldnt buy that argument either if your family was one of those without insurance.
Its a fact. Insured pay less then uninsured for the same procedure. People on government programs didnt enter into my statement. If 2 people go to the hospital for a broken leg and receive the same treatment, one insured one not, the bill for the uninsured will be dramatically higher.
While those who are poor may have their bill forgiven by the hospital, that wont apply to the family who is scraping to get by without insurance and lose thier house because someone has a heart attack or other serious illness.
You realize, the more you argue, the smaller you are effectively claiming the group with health insurance problems is. The poor don't matter because they can have their bills forgiven. Now its about people who are "scraping by"...
The only way your claim can be seen as accurate is by looking at out of pocket cost. Of course the insured pay less then, because they just pay the premium while the uninsured pay the entire bill out of pocket. But that is obviously misleading. If they are "scraping to get by without insurance" then they are eligible for medicaid (weather they are smart enough to realize and apply for it is another story). Those people (as well as medicare patients) pay less for medical procedures then anyone. For the most part, if someone is not covered health wise it is do to their choices in life. They are not society's resposibility! No one has proven otherwise.
Even if there is a gap in medical coverage in some way, you must realize two things:
1: It isn't the governments job to make people equal, or to make life fair
2: Any gap between the classes would be magnified a great deal under more government control
fossten
Dedicated LVC Member
How about US news?
One of the consequences of higher health insurance costs, Altman noted, has been the rise in the number of uninsured, which reached 47 million in 2006, a 5 percent increase over the previous year.
Health Insurance Costs Rise Again
Thats my source - Ive never even been to Michal Moore's website.
Here are a few more. How about the CDC? Good enough for you? Or are they working for Michael Moore too?
In 2006, there were 43.6 million Americans of all ages who did not have health insurance (at the time of the interview), or 14.8 percent of the population.
http://www.cdc.gov/od/oc/media/pressrel/2007/b070625.htm
I know better then to quote Michael Moore around here.
shagdrum, I agree we have the best doctors and the best medical care in the US, however, that care doesnt extend to 100% of the population. I dont buy into the "its good enough" argument. I am sure you wouldnt buy that argument either if your family was one of those without insurance.
Sorry, those figures are incorrect. Mine are based on the United States Census. But as I've said to you before, I could hit you over the head with facts and you'd believe whatever you want. Jesus Himself could appear in front of you and you'd say He was just shilling for Bush.
Well, call the CDC and tell them. I didnt make it up, im sure they didnt either. I didnt bring bush into this whatsoever. This isnt about Bush. I dont care if there is 1 million without healthcare, its too many. I believe we can do better. What in the HELL is wrong with believing we can do better as a nation? Is it that you DONT want everyone covered for some reason? I said earlier, I dont know what the answer is, but I believe we can do better. Are you reallying saying that as a nation its totally ok to have some people unable to afford health care?
fossten
Dedicated LVC Member
You really are a glass is completely empty kind of guy, aren't you? Can't look at it like, we have over 90% of the people in this country who have health insurance, eh?
I wonder, why weren't you crowing about this stuff when Clinton was president? After all, there were "millions of people" without healthcare coverage back then, too. Of course, his wife tried a government takeover of our healthcare system back then, and the smart people of this country didn't go for it. You wanna vote for her and see her try it again?
fossten
Dedicated LVC Member
The Congressional Budget Office states that 45% of the uninsured in this country are uninsured for four months or less. That's usually an employment flux issue, not an availability or inability to afford issue. So the 47 million uninsured claim is misleading at best, phony at worst.
Nope - Im a "we can fill it a bit more" kinda guy.
And how would you know what I was or wasnt spouting when Clinton was President?
Finally, I havent decided who to vote for. I dont vote in the primaries since im not registered with any party. I wont decide until much closer to the general. Right now, I am not looking forward to the next election because I dont really like any of my likely choices for president.
Marcus
Dedicated LVC Member
Why is it that whenever someone wants to demonstrate the horrors of government-run healthcare, they always cite Canada, and then imply that if Canada's system is so bad, then ALL government-run healthcare systems must be bad? As if all government-run systems are equal? That's not the case. Germany has nationalized healthcare, and the wait times and quality of care are as good, if not better than the U.S. Speaking of which, the whole argument about wait times may be a myth. There are many procedures that Americans have to wait for, but it's because of delays by the insurance companies.
Here's an interesting article:
http://www.businessweek.com/magazine/content/07_28/b4042072.htm
The Doctor Will See You—In Three Months
The health-care reform debate is in full roar with the arrival of Michael Moore's documentary Sicko, which compares the U.S. system unfavorably with single-payer systems around the world. Critics of the film are quick to trot out a common defense of the American way: For all its problems, they say, U.S. patients at least don't have to endure the endless waits for medical care endemic to government-run systems. The lobbying group America's Health Insurance Plans spells it out in a rebuttal to Sicko: "The American people do not support a government takeover of the entire health-care system because they know that means long waits for rationed care."
In reality, both data and anecdotes show that the American people are already waiting as long or longer than patients living with universal health-care systems. Take Susan M., a 54-year-old human resources executive in New York City. She faithfully makes an appointment for a mammogram every April, knowing the wait will be at least six weeks. She went in for her routine screening at the end of May, then had another because the first wasn't clear. That second X-ray showed an abnormality, and the doctor wanted to perform a needle biopsy, an outpatient procedure. His first available date: mid-August. "I completely freaked out," Susan says. "I couldn't imagine spending the summer with this hanging over my head." After many calls to five different facilities, she found a clinic that agreed to read her existing mammograms on June 25 and promised to schedule a follow-up MRI and biopsy if needed within 10 days. A full month had passed since the first suspicious X-rays. Ultimately, she was told the abnormality was nothing to worry about, but she should have another mammogram in six months. Taking no chances, she made an appointment on the spot. "The system is clearly broken," she laments.
It's not just broken for breast exams. If you find a suspicious-looking mole and want to see a dermatologist, you can expect an average wait of 38 days in the U.S., and up to 73 days if you live in Boston, according to researchers at the University of California at San Francisco who studied the matter. Got a knee injury? A 2004 survey by medical recruitment firm Merritt, Hawkins & Associates found the average time needed to see an orthopedic surgeon ranges from 8 days in Atlanta to 43 days in Los Angeles. Nationwide, the average is 17 days. "Waiting is definitely a problem in the U.S., especially for basic care," says Karen Davis, president of the nonprofit Commonwealth Fund, which studies health-care policy.
All this time spent "queuing," as other nations call it, stems from too much demand and too little supply. Only one-third of U.S. doctors are general practitioners, compared with half in most European countries. On top of that, only 40% of U.S. doctors have arrangements for after-hours care, vs. 75% in the rest of the industrialized world. Consequently, some 26% of U.S. adults in one survey went to an emergency room in the past two years because they couldn't get in to see their regular doctor, a significantly higher rate than in other countries.[Something that contributes greatly to your costs and mine]
There is no systemized collection of data on wait times in the U.S. That makes it difficult to draw comparisons with countries that have national health systems, where wait times are not only tracked but made public. However, a 2005 survey by the Commonwealth Fund of sick adults in six nations found that only 47% of U.S. patients could get a same- or next-day appointment for a medical problem, worse than every other country except Canada.
The Commonwealth survey did find that U.S. patients had the second-shortest wait times if they wished to see a specialist or have nonemergency surgery, such as a hip replacement or cataract operation (Germany, which has national health care, came in first on both measures). But Gerard F. Anderson, a health policy expert at Johns Hopkins University, says doctors in countries where there are lengthy queues for elective surgeries put at-risk patients on the list long before their need is critical. "Their wait might be uncomfortable, but it makes very little clinical difference," he says.
The Commonwealth study did find one area where the U.S. was first by a wide margin: 51% of sick Americans surveyed did not visit a doctor, get a needed test, or fill a prescription within the past two years because of cost. No other country came close.
Few solutions have been proposed for lengthy waits in the U.S., in part, say policy experts, because the problem is rarely acknowledged. But the market is beginning to address the issue with the rise of walk-in medical clinics. Hundreds have sprung up in CVS, Wal-Mart (WMT ), Pathmark, (PTMK ) and other stores—so many that the American Medical Assn. just adopted a resolution urging state and federal agencies to investigate such clinics as a conflict of interest if housed in stores with pharmacies. These retail clinics promise rapid care for minor medical problems, usually getting patients in and out in 30 minutes. The slogan for CVS's Minute Clinics says it all: "You're sick. We're quick."
Here's an interesting article:
http://www.businessweek.com/magazine/content/07_28/b4042072.htm
The Doctor Will See You—In Three Months
The health-care reform debate is in full roar with the arrival of Michael Moore's documentary Sicko, which compares the U.S. system unfavorably with single-payer systems around the world. Critics of the film are quick to trot out a common defense of the American way: For all its problems, they say, U.S. patients at least don't have to endure the endless waits for medical care endemic to government-run systems. The lobbying group America's Health Insurance Plans spells it out in a rebuttal to Sicko: "The American people do not support a government takeover of the entire health-care system because they know that means long waits for rationed care."
In reality, both data and anecdotes show that the American people are already waiting as long or longer than patients living with universal health-care systems. Take Susan M., a 54-year-old human resources executive in New York City. She faithfully makes an appointment for a mammogram every April, knowing the wait will be at least six weeks. She went in for her routine screening at the end of May, then had another because the first wasn't clear. That second X-ray showed an abnormality, and the doctor wanted to perform a needle biopsy, an outpatient procedure. His first available date: mid-August. "I completely freaked out," Susan says. "I couldn't imagine spending the summer with this hanging over my head." After many calls to five different facilities, she found a clinic that agreed to read her existing mammograms on June 25 and promised to schedule a follow-up MRI and biopsy if needed within 10 days. A full month had passed since the first suspicious X-rays. Ultimately, she was told the abnormality was nothing to worry about, but she should have another mammogram in six months. Taking no chances, she made an appointment on the spot. "The system is clearly broken," she laments.
It's not just broken for breast exams. If you find a suspicious-looking mole and want to see a dermatologist, you can expect an average wait of 38 days in the U.S., and up to 73 days if you live in Boston, according to researchers at the University of California at San Francisco who studied the matter. Got a knee injury? A 2004 survey by medical recruitment firm Merritt, Hawkins & Associates found the average time needed to see an orthopedic surgeon ranges from 8 days in Atlanta to 43 days in Los Angeles. Nationwide, the average is 17 days. "Waiting is definitely a problem in the U.S., especially for basic care," says Karen Davis, president of the nonprofit Commonwealth Fund, which studies health-care policy.
All this time spent "queuing," as other nations call it, stems from too much demand and too little supply. Only one-third of U.S. doctors are general practitioners, compared with half in most European countries. On top of that, only 40% of U.S. doctors have arrangements for after-hours care, vs. 75% in the rest of the industrialized world. Consequently, some 26% of U.S. adults in one survey went to an emergency room in the past two years because they couldn't get in to see their regular doctor, a significantly higher rate than in other countries.[Something that contributes greatly to your costs and mine]
There is no systemized collection of data on wait times in the U.S. That makes it difficult to draw comparisons with countries that have national health systems, where wait times are not only tracked but made public. However, a 2005 survey by the Commonwealth Fund of sick adults in six nations found that only 47% of U.S. patients could get a same- or next-day appointment for a medical problem, worse than every other country except Canada.
The Commonwealth survey did find that U.S. patients had the second-shortest wait times if they wished to see a specialist or have nonemergency surgery, such as a hip replacement or cataract operation (Germany, which has national health care, came in first on both measures). But Gerard F. Anderson, a health policy expert at Johns Hopkins University, says doctors in countries where there are lengthy queues for elective surgeries put at-risk patients on the list long before their need is critical. "Their wait might be uncomfortable, but it makes very little clinical difference," he says.
The Commonwealth study did find one area where the U.S. was first by a wide margin: 51% of sick Americans surveyed did not visit a doctor, get a needed test, or fill a prescription within the past two years because of cost. No other country came close.
Few solutions have been proposed for lengthy waits in the U.S., in part, say policy experts, because the problem is rarely acknowledged. But the market is beginning to address the issue with the rise of walk-in medical clinics. Hundreds have sprung up in CVS, Wal-Mart (WMT ), Pathmark, (PTMK ) and other stores—so many that the American Medical Assn. just adopted a resolution urging state and federal agencies to investigate such clinics as a conflict of interest if housed in stores with pharmacies. These retail clinics promise rapid care for minor medical problems, usually getting patients in and out in 30 minutes. The slogan for CVS's Minute Clinics says it all: "You're sick. We're quick."
Why is it that whenever someone wants to extoll the virtues of some socialist system, they always cite examples from countries that in no way resemble ours.
Tiny little cultures with ethnic homogenized cultures can do things that we can't do in here. Let me restate that, they were able to do things longer than we could have. Ultimately all of these socialist systems are going to collapse, another aspect no one talks about.
As life spans increase and birthrates decline, how do you expect to pay for this cradle to grave government coddling?
Tiny little cultures with ethnic homogenized cultures can do things that we can't do in here. Let me restate that, they were able to do things longer than we could have. Ultimately all of these socialist systems are going to collapse, another aspect no one talks about.
As life spans increase and birthrates decline, how do you expect to pay for this cradle to grave government coddling?
fossten
Dedicated LVC Member
Because, Einstein, every time somebody (lefty like you) wants to bash the United States' healthcare system in order to promote a "Utopian" government-run healthcare system, they use Canada as an example. Canada is your torch, so the sword cuts both ways. Get used to it.
Do you so quickly forget that Michael Moore just put out a movie that FALSELY runs down the American healthcare system? Where the hell do you get off getting defensive about this? Talk about being able to dish it out and not take it.
Your article gets its info from a bias source, which would be enough for you to discredit if you didn't agree with their position.
There are so many blatant holes in that article, I don't know where to start. They purposely leave things vauge in places to suggest what they want. In fact most every place you highlight, highlights a flaw in the article.
You can't truely be foolish enough to believe this article and question the waiting periods. Yes, you may be able to find incedental exeptions to the rule, especially if you are comparing apples and oranges (as in this article). But the fact remains that by and large the waiting times are MUCH larger in ANY universal healthcare system then in ours.
here is an interesting film on the subject:
http://www.onthefencefilms.com/video/brainsurgery.html
Basically, it comes down to incentive. Universal healthcare has none for the doctor, while ours still does. Under universal healthcare, a doctor is payed a set amount per day regardless of how many patients they see (the government may require a certian number, say 10-15). In our system, the doctor is payed by the patient. If he can see more patients in a day, thats more money. It really is that simple.
There is another side to that. There isnt any incentive to compete among most doctors. Do you chose a doctor based on any real criteria? Do you look at cost or quality of service? I think what most people do when choosing a new doctor is check to see who is signed up with their insurance company and is local to them.
We are not good consumers when it comes to medical care, and there isnt really a system to evaluate a doctor like we would a plumber or other professional. Even if there was, there is no incentive or reward to bother worrying about the costs of one doctor over another.
We are not good consumers when it comes to medical care, and there isnt really a system to evaluate a doctor like we would a plumber or other professional. Even if there was, there is no incentive or reward to bother worrying about the costs of one doctor over another.
Good point. The system isn't purely dictated by competition. There is already too much government involvement for that. Still, you choose your insurance company. You can always leave them for another, if you want.
We are talking about waiting periods for healthcare in socialist systems vs. the American system. In America, doctors have incentive to see more patients due to the profit motive. That incentive is removed in socialist systems.
I would be all for a pure capitalist system when it comes to health care, and insurance. By that I mean, take the government out of healthcare, and tort reform. That would bring the cost of healthcare down dramatically, and stop the squeeze on the insurance companies. Also, reform, or do away with the FDA.
Wouldn't agree that there isn't incentive to compete amongst doctors. They advertise all over the place. In addition, just because you may not have absolute choice, due to insurance limited opitons, you still can choose from a number of doctors. Like I said, you can switch insurance companies if you need more choices. You can't under socialist healthcare. Your doctor is already decided.
Well, switching insurance companies isnt a real option for most people since the insurance is provided by your employer. Plus, even if your employer gives you a choice of companies, you can only change one a year usually and then during specific times.
One example. I have a fiend with MS. She actually works IN a hospital. Her insurance no longer carries her Doctor, so unless she wants to pay the out of network costs, she cant see him. She doesnt like the 'replacement' doctor and has a hard time getting an appointment to see him. Her last flare up, she had to wait 2 weeks to get in.
I have another friend who recently wanted to see a podiatrist. She couldnt get an appointment in less then 10 days.
Your average Doctor doesnt advertise. I dont see too many "Come in for a physical exam today" ads. What you usually see advertised is elective medical such as plastic surgery kinda stuff.
You keep saying things like "take the government out of healthcare" - what does government do that causes problems like these? I am honestly asking because I dont really see alot of government involvement short of licensing kinda things. From what I see, insurance companies have alot more control.
Ultimately, I dont think individual people are really treated as customers. Insurance companies are, but people largely are not. And why should we? It costs us the same co-pay regardless of the doctor used. Doctors seemingly think nothing about making us wait to get an appointment or even for the appointment we already have.
I spent alot of time with Doctors when my Mother and Gradmother were sick and I can tell you, it was rate that we saw the doctor at 1:00 when that was the appointment time. Usually it was alot later before we actually got in.
One example. I have a fiend with MS. She actually works IN a hospital. Her insurance no longer carries her Doctor, so unless she wants to pay the out of network costs, she cant see him. She doesnt like the 'replacement' doctor and has a hard time getting an appointment to see him. Her last flare up, she had to wait 2 weeks to get in.
I have another friend who recently wanted to see a podiatrist. She couldnt get an appointment in less then 10 days.
Your average Doctor doesnt advertise. I dont see too many "Come in for a physical exam today" ads. What you usually see advertised is elective medical such as plastic surgery kinda stuff.
You keep saying things like "take the government out of healthcare" - what does government do that causes problems like these? I am honestly asking because I dont really see alot of government involvement short of licensing kinda things. From what I see, insurance companies have alot more control.
Ultimately, I dont think individual people are really treated as customers. Insurance companies are, but people largely are not. And why should we? It costs us the same co-pay regardless of the doctor used. Doctors seemingly think nothing about making us wait to get an appointment or even for the appointment we already have.
I spent alot of time with Doctors when my Mother and Gradmother were sick and I can tell you, it was rate that we saw the doctor at 1:00 when that was the appointment time. Usually it was alot later before we actually got in.
Don't have too much time to go into it right now (gotta go to a bachlor party; Titties and beer!!!), but the influence of medicare/medicaid on the medical field (and the precedent it sets for insurance companies), the FDA and its excessive procedures (almost 1 year to approve a flu vactination) and torts in addition to excessive government regulation are a good starting list. If I'm not too hung over tommorrow, I will put up some more specific things.
You also still admit that, you still have a choice when it comes to insurances, and therefore doctors. That choice may come at a price, but you still have the choice. That choice wouldn't be there (except for the ultra wealthy) in a socialist system.
You also still admit that, you still have a choice when it comes to insurances, and therefore doctors. That choice may come at a price, but you still have the choice. That choice wouldn't be there (except for the ultra wealthy) in a socialist system.
http://www.economist.com/finance/displaystory.cfm?story_id=9407716
An unhealthy burden
Jun 28th 2007
From The Economist print edition
America's health-care market is not as unfettered as it seems
TO MANY outside the United States, America's health-care system might seem an example of capitalism at its rawest. Europeans and Canadians enjoy universal health care and cheap drugs thanks to government-run systems, the argument goes, but the market-based approach taken by the world's richest nation leaves many millions uninsured and leads the rest to pay the highest drugs prices in the world. Such doubts are sure to be reinforced by this week's release of Michael Moore's “Sicko”, a much-trumpeted new film on health care that bashes the free-market Yankee model even as it praises the dirigiste alternative north of the border.
So is America's health system really red in tooth and claw? Hardly, according to a growing body of academic evidence. As a result of interference at the federal and state levels, health care is one of America's most heavily regulated industries. Indeed, its muddled approach to health-care regulation may act as a massive drag on the American economy—what one expert has called “a $169 billion hidden tax”.
Costing an arm and a leg
That figure comes from a path-breaking study* of a few years ago by Christopher Conover of Duke University. It looked at the many ways in which the American legal and regulatory systems affect the provision of health services and lumped them into five categories: medical torts; the Food and Drug Administration (FDA); insurance regulation; and the certification of both health professionals and health facilities. His team concluded that the overall benefit to society of $170 billion per year delivered by this system of oversight was far outweighed by the $339 billion in annual costs that it imposed (see chart). Even ignoring the cost of big federal tax breaks for employer-sponsored health insurance (which Mr Conover left out), his study estimated that the net cost of America's health regulations resulted in perhaps 4,000 extra deaths each year and was responsible for more than 7m Americans' lacking health insurance.
Building on this point, a forthcoming paper† by Michael Cannon of the Cato Institute, a libertarian think-tank in Washington, DC, investigates the biggest federal component of this regulatory burden: the FDA's oversight of pharmaceuticals. It notes that some 20 cents out of every dollar spent by consumers goes on purchases under the purview of the FDA, which it calls “one of the most pervasive federal agencies in the country.”
Citing the best evidence to date on the costs and benefits of FDA regulation, Mr Cannon argues that the agency “is too slow and demands too much testing”, ultimately harming consumers. He points out that drugs regulators can make two broad types of errors. First, they might approve a drug too quickly, only to find out after its launch that it is dangerous or even deadly. Second, they could delay the launch of a highly innovative drug by demanding onerous or unnecessary trials and thereby deny many needy patients a new therapy.
Proper regulation requires balancing these two risks, but the pitch may be queered by bureaucratic self-interest. If the regulator allows even one drug to slip through the approval process that later proves harmful to some people some of the time, a hue and cry is sure to follow. Look no further than the recent public backlash against the FDA after several deaths were linked to Vioxx, a blockbuster pain remedy made by Merck.
And yet the second (and probably bigger) risk of leaving people untreated because of restrictions on drugs rarely gets the regulators into trouble. As Mr Cannon puts it, “no FDA official has ever been fired or faced a congressional inquiry for delaying the approval of a promising new drug, however unjustified the delay.” What is more, he speculates, big drug firms may quietly acquiesce to this burdensome red tape because it acts as a barrier to entry against newcomers without the cash or lobbying power to navigate the FDA.
The FDA's caution may result in the biggest federal “tax” on health care identified by the Conover study but an even bigger component is to be found in America's distorted system of malpractice insurance, which is regulated at the state level. That is the conclusion of John Graham of the Pacific Research Institute (PRI), a think-tank in San Francisco. In a paper†† published this month, Mr Graham has taken Mr Conover's federal analysis and applied it to all 50 states. The idea is to rank which states allow Americans the greatest amount of “health ownership”.
Mr Graham's analysis concludes that because regulation of health insurance and overzealous pursuit of medical torts are both typically handled at the state level, states are to blame for most of that $169 billion annual burden imposed by excessive health-care regulation (as the chart also shows). The heavy-handedness, he notes, includes groups of surgeons being denied permission to open specialist clinics because rival one-size-fits-all hospitals invoke state regulations protecting their patch. Meanwhile, enterprising “nurse-practitioners” are blocked from offering simple treatments at inexpensive clinics by state rules requiring costly supervision by doctors.
New York—a liberal bastion and home to Hillary Clinton, who in the 1990s unsuccessfully advocated a sweeping reform of America's health provision—comes out rock bottom on the PRI ranking of health freedom. That will undoubtedly please conservatives who still deride her earlier proposals for a government-run health system, which they dub “HillaryCare”. But the unstated and awkward inference of these studies will not. If America's health-care regulations are as costly as they claim, the system is merely masquerading as a free-market model and may be no better than others.
* A Review and Synthesis of the Cost and Benefits of Health Services Regulations", Christopher Conover, Duke University, July 2003.
† "Do Economists Reach a Conclusion on the Food and Drug Administration?", Michael Cannon, Cato Institute, forthcoming.
†† "US Index of Health Ownership", John Graham, Pacific Research Institute, June 2007.
An unhealthy burden
Jun 28th 2007
From The Economist print edition
America's health-care market is not as unfettered as it seems
TO MANY outside the United States, America's health-care system might seem an example of capitalism at its rawest. Europeans and Canadians enjoy universal health care and cheap drugs thanks to government-run systems, the argument goes, but the market-based approach taken by the world's richest nation leaves many millions uninsured and leads the rest to pay the highest drugs prices in the world. Such doubts are sure to be reinforced by this week's release of Michael Moore's “Sicko”, a much-trumpeted new film on health care that bashes the free-market Yankee model even as it praises the dirigiste alternative north of the border.
So is America's health system really red in tooth and claw? Hardly, according to a growing body of academic evidence. As a result of interference at the federal and state levels, health care is one of America's most heavily regulated industries. Indeed, its muddled approach to health-care regulation may act as a massive drag on the American economy—what one expert has called “a $169 billion hidden tax”.
Costing an arm and a leg
That figure comes from a path-breaking study* of a few years ago by Christopher Conover of Duke University. It looked at the many ways in which the American legal and regulatory systems affect the provision of health services and lumped them into five categories: medical torts; the Food and Drug Administration (FDA); insurance regulation; and the certification of both health professionals and health facilities. His team concluded that the overall benefit to society of $170 billion per year delivered by this system of oversight was far outweighed by the $339 billion in annual costs that it imposed (see chart). Even ignoring the cost of big federal tax breaks for employer-sponsored health insurance (which Mr Conover left out), his study estimated that the net cost of America's health regulations resulted in perhaps 4,000 extra deaths each year and was responsible for more than 7m Americans' lacking health insurance.
Building on this point, a forthcoming paper† by Michael Cannon of the Cato Institute, a libertarian think-tank in Washington, DC, investigates the biggest federal component of this regulatory burden: the FDA's oversight of pharmaceuticals. It notes that some 20 cents out of every dollar spent by consumers goes on purchases under the purview of the FDA, which it calls “one of the most pervasive federal agencies in the country.”
Citing the best evidence to date on the costs and benefits of FDA regulation, Mr Cannon argues that the agency “is too slow and demands too much testing”, ultimately harming consumers. He points out that drugs regulators can make two broad types of errors. First, they might approve a drug too quickly, only to find out after its launch that it is dangerous or even deadly. Second, they could delay the launch of a highly innovative drug by demanding onerous or unnecessary trials and thereby deny many needy patients a new therapy.
Proper regulation requires balancing these two risks, but the pitch may be queered by bureaucratic self-interest. If the regulator allows even one drug to slip through the approval process that later proves harmful to some people some of the time, a hue and cry is sure to follow. Look no further than the recent public backlash against the FDA after several deaths were linked to Vioxx, a blockbuster pain remedy made by Merck.
And yet the second (and probably bigger) risk of leaving people untreated because of restrictions on drugs rarely gets the regulators into trouble. As Mr Cannon puts it, “no FDA official has ever been fired or faced a congressional inquiry for delaying the approval of a promising new drug, however unjustified the delay.” What is more, he speculates, big drug firms may quietly acquiesce to this burdensome red tape because it acts as a barrier to entry against newcomers without the cash or lobbying power to navigate the FDA.
The FDA's caution may result in the biggest federal “tax” on health care identified by the Conover study but an even bigger component is to be found in America's distorted system of malpractice insurance, which is regulated at the state level. That is the conclusion of John Graham of the Pacific Research Institute (PRI), a think-tank in San Francisco. In a paper†† published this month, Mr Graham has taken Mr Conover's federal analysis and applied it to all 50 states. The idea is to rank which states allow Americans the greatest amount of “health ownership”.
Mr Graham's analysis concludes that because regulation of health insurance and overzealous pursuit of medical torts are both typically handled at the state level, states are to blame for most of that $169 billion annual burden imposed by excessive health-care regulation (as the chart also shows). The heavy-handedness, he notes, includes groups of surgeons being denied permission to open specialist clinics because rival one-size-fits-all hospitals invoke state regulations protecting their patch. Meanwhile, enterprising “nurse-practitioners” are blocked from offering simple treatments at inexpensive clinics by state rules requiring costly supervision by doctors.
New York—a liberal bastion and home to Hillary Clinton, who in the 1990s unsuccessfully advocated a sweeping reform of America's health provision—comes out rock bottom on the PRI ranking of health freedom. That will undoubtedly please conservatives who still deride her earlier proposals for a government-run health system, which they dub “HillaryCare”. But the unstated and awkward inference of these studies will not. If America's health-care regulations are as costly as they claim, the system is merely masquerading as a free-market model and may be no better than others.
* A Review and Synthesis of the Cost and Benefits of Health Services Regulations", Christopher Conover, Duke University, July 2003.
† "Do Economists Reach a Conclusion on the Food and Drug Administration?", Michael Cannon, Cato Institute, forthcoming.
†† "US Index of Health Ownership", John Graham, Pacific Research Institute, June 2007.
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I watched Stossel's 20/20 special, and I'm convinced that one of the biggest reasons for high healthcare prices, at least with the little things, is the very existence of health insurance. Think about it - with insurance, there's no incentive to shop for bargains b/c someone else is paying the bill. There is no incentive for providers to keep costs down because somebody else is paying the bill. Insurance actually quells the free market.
So people like Hillary want insurance coverage across the country, which will cause prices to go even higher.
So people like Hillary want insurance coverage across the country, which will cause prices to go even higher.
I didnt see the 20/20 special. But yes, this is part of my point all along. Our health care system doesnt make sense to me because of this. Its not really a competitive market and our consumers are not good consumers either because the real customer of health care is insurance companies.
I dont think just giving insurance to everyone is the answer either. I really dont know how to solve the problems. What I do know, is that what we have now isnt the best we can do.