We could have had a single payer. We could have had a public option. Instead, the brain trust gives us this:
Gee, that's swell, Gatsby. And what are we supposed to do with that number? Call our boss and tell him we want cheaper, crummier health insurance?
Apparently, having this important information is going to make us smarter consumers of medical services. Oh, yeah, when we get sick or injured, the first thing we're going to do is get on the phone and start shopping doctors for a bargain. In the immortal worlds of Bugs Bunny, "What a maroon."
I think the cost is used to determine how much additional tax you have to pay if you have a "luxury" medical plan. My employer is dropping some insurance options next year due to the tax implications.
If Wyden could've spoke at the moment he was born, instead of expressing humility or thanks to his mom & dad and the doctors & nurses, he'd have declared: "Look what I did!"
Congress gets luxury premium care, additional tax for them?
What do they care about the rest of the people?
They haven't a clue and/or do
and "C'est la vie."
I wonder what the Gray Panthers think now of their "golden boy" they elevated!
I think this is a great idea and well overdue. When people see that in lieu of a raise (again) this year, their firm/company is picking up another double digit increase in healthcare premiums, perhaps they will start demanding a better return on their dollar. The more transparency the better.
"perhaps they will start demanding a better return on their dollar."
Really? Who will we be making that demand on? Our employers? Blue Cross? Kaiser? Our doctor? Employer-provided health insurance is pretty much a take-it-or-leave-it proposition for most people I know.
The first step is to make people aware of exactly how much their health insurance - and by extension health care -- is costing them. If people see the true cost of their premiums -- they might start asking why it costs so much. Frivolous law suits? Paying the medical care of the uninsured ? Administrative bureaucracy? Defensive medicine? Fraud? Huge profits for doctors? People running to the doc every time Junior sneezes? All of these are given as reasons - and no solutions are ever sought. Why? Because who really cares if their health insurance premiums go up? Their employer pays that. We will NEVER get the cost of healthcare under control until the people receiving the product, actually pay for it-- and are aware of how much it is costing them.
We will NEVER get the cost of healthcare under control until the people receiving the product, actually pay for it
So, eliminate employer-provided health care? That is not politically realistic.
And as I wrote in the post, when you're sick or injured, there's no inclination to haggle over price. All of this gyration about consumers affecting health care prices is an economist's pipedream.
And as I wrote in the post, when you're sick or injured, there's no inclination to haggle over price. All of this gyration about consumers affecting health care prices is an economist's pipedream.
Wow, you have great faith in humanity.
Perhaps people might "haggle over price" (nice characterization, there) before they're in the ambulance. It has been known to happen.
If the USA doesn't want to adopt a French-like system, then make everybody pay cash for medical coverage and only require emergency medical.
Your auto insurance doesn't cover tune-ups or implanting Double-D hood ornaments. It only covers the unexpected. And that is why that market is extremely competitive.
There is no competition in health care with the current system. We really need to stop using the term health "insurance".
"We will NEVER get the cost of healthcare under control until the people receiving the product, actually pay for it-- and are aware of how much it is costing them."
Them, everyone else, and the country. What percentage are we up to now of the GDP that goes to the medical industry? Just short of 18, headed for 20? And about 2-1/2 times more than comparable countries -- thousands of dollars more, per person, per year.
I get your point: that if people what they at some essential level, even if it seems removed, knew what they were paying, they might think, wow, I'd rather do something fun or more productive with that money. Or, how come I'm paying more -- but not getting more -- than just about everybody everywhere else?
You left medical tests and procedures off your list -- a major cost driver. A number of hospitals and medical organizations are trying to corral and stem these, quite actively.
But PomMom's big point is that when so few people pay these things directly they do not really see the bite of it. To all of us. And the country. And we are not getting our money's worth.
Jack wrote: "And as I wrote in the post, when you're sick or injured, there's no inclination to haggle over price. All of this gyration about consumers affecting health care prices is an economist's pipedream."
I'm not sure that's right my friend, at least not always.
Example number 1: there is a surgery that the doctor says will be great at improving your life (say a shoulder surgery, which I got 3 months ago). They are a painful recovery. If, on top of that, you have to pay a bunch of dough out of pocket, I think you'll be more likely to get a second opinion, or shop for someone cheaper, or even sometimes to just say, "screw it" to getting the surgery.
Example number 2: you're very old and very sick and they tell you you can get some painful surgery to possibly prolong your life a few months. The alternative is going home and dying in peace. If you add the notion that the painful solution also will cost you a bunch of money, you (or your likely heirs at least) may think twice.
I've finally become aware of the fact that I won't live forever. I also am not crazy about voluntarily taking on pain. Doctors have every incentive (their oath plus economic) to suggest you do everything medically possible. I'm not sure I want to do everything medically possible even when it's "free", but certainly not when it will blow through the few bucks I have left at this point.
If you look at medical procedures that insurance usually will not cover (lazik, plastic surgery, botox) the price has been controlled by the market. Since (thankfully) we do not let people go without emergency medical care if they cannot pay, the market is always going to be skewed when it comes to medicine - but more market, less government control should be the goal. IMHO.
"more market, less government control should be the goal."
That's a howler. If you look at the high cost and poor results of our system compared to other civilized countries, the fundamental difference is our excessive reliance on "markets" in the form of private insurance. The bits and pieces of our health care system that are the least dysfunctional are the government ones: Medicare, Medicaid and the V.A. Even in Medicare, the "Advantage" plans we got with new drug coverage under Bush, being privately run, are the most expensive and wasteful.
Health care is not a business. Rationing, denying health care and minimizing the insurance companies "loss ratio" is a business.
"Congress gets luxury premium care, additional tax for them?"
Please elaborate.
They are covered by FEHB like all the Federal employees who choose a FEHB plan (and pay their share.) In addition they (but not their families) are eligible to receive limited medical services from the Office of the Attending Physician of the U.S. Capitol, after payment of an annual fee. But services don’t include surgery, dental care or eyeglasses, and any prescriptions must be filled at the member’s expense.
FEHB offers a range of commercial health insurance plans. Luxurious coverage is missing, in my opinion.
What ever happened to the family doctor?
Now it seems so corporate and pushing people into corporate money making tests and drugs. One has to actually resist these efforts.
This last year I noticed on a new preventive service letter:
Annual screening for depression.
One could get depressed just thinking about it all. This that and what next?
Mandatory probing and mandatory depression screening for drugs!!
I don't know about others, but I don't like being subjected to fear about
every little possible wrong.
Great subject for a Woody Allen movie!
Many laughs in his film "To Rome with Love" where Woody Allen (Jerry) appears in the film, with Judy Davis (Phyllis) who plays his psychiatrist wife.
I'm sure government could do health care more efficiently than the private sector. Look at all the other things government does more efficiently/cost effectively.
Excerpt about Rep. Steve Kagen from Wisconsin: The Democrat from Wisconsin has refused to accept federal healthcare benefits, making him the only member of Congress to do without. He will continue, he said in an interview, until everyone in America can enjoy the same coverage as federal lawmakers.
Kagen recently had knee surgery, writing checks for more than $4,500 after bargaining for a reduced-rate MRI and a 50% discount on the operation. (He is still dickering over the hospital bill.)
"If every member of Congress put their heads on their pillow every night like I do . . . knowing this could be the night I lose my house, we'd fix healthcare in a week," said Kagen, who spent decades as a doctor in the Green Bay area before winning election in 2006.
Kagen said his wife and three of his four children have health coverage. But not his oldest daughter, 28, who can't afford insurance.
The first step is to make people aware of exactly how much their health insurance - and by extension health care -- is costing them.
Maybe we should look at the social environment we live in that is increasing our health costs:
1. Reliance on large population centers, where disease can grow and multiply much quicker
2. Larger school classrooms
3. Increased stress due to time constraints, less family time, more work, longer and more tedious commutes - stress reduces a body's immunity and increases liklihood of contracting sickness
4. Workplace demands (increased pressure to be at work and less opportunity to take a sick day, increased stress and now more sick employees coming into work, getting others sick)
5. Workplaces that have more people located close together (office environments, call centers)
6. Increased physical activities of a "thrill-seeking" nature - people getting lost in the woods, bicycling - all that has an increased risk of physical injury (why should I have to pay higher healthcare costs when I choose not to play tackle football, but lots of high school kids suffer severe injuries each year from choosing to injure themselves? Same with hikers/skiiers who choose to get lost on Mount Hood and I now have to pay for expensive Oregon Air National Guard and Life Flight helicopters to rescue them and take them to trauma centers hundreds of miles away)
Maybe...just maybe, if we looked at our society and decided to make smaller changes - mandating sick leave on a national or state basis (even if unpaid) and protecting workers who are legitimately sick, mandating "minimum space" requirements so people don't have to be close to sick people...
Not a bad list; but you left out the heavy subsidies of corn -- basically the prime ingredient of a poison -- as a fundamental part of our food supply.
I'm sure government could do health care more efficiently
I'm sure your comments are intended as sarcasm. But it doesn't work, since the government is demonstrably more efficient at delivering health care, health care, old age insurance and national security, to name just a few things, than the private sector. That's fact, not just opinion.
Wyden, unfortunately, is not very bright and it shows. I mean this guy found the BAR exam a chore more than once and didn't have a clue where Bosnia was on a globe.
"Employer-provided health insurance is pretty much a take-it-or-leave-it proposition for most people I know."
Public employees generally (in Portland) are offered 2-3 choices for health plan coverage every year (in terms of providers), with additional options such as amount of co-pay, etc.
Charamba, Douro 2008
Horse Heaven Hills, Cabernet 2010
Lorelle, Horse Heaven Hills Pinot Grigio 2011
Avignonesi, Montepulciano 2004
Lorelle, Willamette Valley Pinot Noir 2011
Villa Antinori, Toscana 2007
Mercedes Eguren, Cabernet Sauvignon 2009
Lorelle, Columbia Valley Cabernet 2011
Purple Moon, Merlot 2011
Purple Moon, Chardonnnay 2011
Abacela, Vintner's Blend No. 12
Opula Red Blend 2010
Liberte, Pinot Noir 2010
Chateau Ste. Michelle, Indian Wells Red Blend 2010
Woodbridge, Chardonnay 2011
King Estate, Pinot Noir 2011
Famille Perrin, Cotes du Rhone Villages 2010
Columbia Crest, Les Chevaux Red 2010
14 Hands, Hot to Trot White Blend
Familia Bianchi, Malbec 2009
Terrapin Cellars, Pinot Gris 2011
Columbia Crest, Walter Clore Private Reserve 2009
Campo Viejo, Rioja, Termpranillo 2010
Ravenswood, Cabernet Sauvignon 2009
Quinta das Amoras, Vinho Tinto 2010
Waterbrook, Reserve Merlot 2009
Lorelle, Horse Heaven Hills, Pinot Grigio 2011
Tarantas, Rose
Chateau Lajarre, Bordeaux 2009
La Vielle Ferme, Rose 2011
Benvolio, Pinot Grigio 2011
Nobilo Icon, Pinot Noir 2009
Lello, Douro Tinto 2009
Quinson Fils, Cotes de Provence Rose 2011
Anindor, Pinot Gris 2010
Buenas Ondas, Syrah Rose 2010
Les Fiefs d'Anglars, Malbec 2009
14 Hands, Pinot Gris 2011
Conundrum 2012
Condes de Albarei, Albariño 2011
Columbia Crest, Walter Clore Private Reserve 2007
Penelope Sanchez, Garnacha Syrah 2010
Canoe Ridge, Merlot 2007
Atalaya do Mar, Godello 2010
Vega Montan, Mencia
Benvolio, Pinot Grigio
Nobilo Icon, Pinot Noir, Marlborough 2009
Portuga, Rose 2011
Revelation, Chardonnay, Pays d'Oc 2010
Beaulieu, Cabernet, Rutherford 2005
Monte Alto, Tinto Reserva 2005
Chateau Ste. Michelle, Cabernet, Indian Wells 2009
Espiral, Vinho Rose
Vin-Koru, Pinot Gris 2011
14 Hands, Hot to Trot Red 2009
Rodney Strong, Cabernet, Sonoma 2009
Abacela, Vintner's Blend #11
Portuga, White 2010
La Bourgeoisie, Red 2009
Januik, Red 2009
Three Rivers, River's Red 2008
Kirkland, Alexander Valley Merlot 2008
Muga, Rioja Rose 2010
Quinta das Amoras, Vinho Tinto 2009
Mauro Molino, Barbera d'Alba 2009
Garda Chiaretto Rose
Columbia Crest, Two Vines Vineyard 10 White
Chateau Ste. Michelle, Pinot Gris, Columbia Valley 2009
L'Hortus, Rose de Saignee 2010
Maculan, Pino & Toi 2008
McKinley Springs, Bombing Range Red 2008
Trader Joe's Pinot Gris 2009
Montes Alpha, Cabernet 2007
Gran Sasso, Sangiovese, Terre di Chieti 2009
Garda, Classico Chiaretto Rose
Beaulieu, Cabernet, Rutherford 1999
Picos del Montgo, Tempranillo 2008
Chateau de Montmirail, Vacqueyras 2008
La Granja 360, Syrah 2009
Montgras, Carmenere Reserva 2009
Lange, Pinot Gris 2009
Columbia Crest, Horse Heaven Hills Cabernet 2008
Kirkland, Pinot Grigio 2010
Trader Joe's Coastal Syrah 2009
Columbia Crest, Horse Heaven Hills Merlot 2008
Trader Joe's Coastal Chardonnay 2009
Vieux Papes Red
Domaine de l'Aujardiere, Chardonnay 2009
Santa Rita, Cabernet, Medalla Real 2007
Penfold's, Koonunga Hill Shiraz Cabernet 2008
Guild, Red, Lot #02 2008
Dievole, Dievolino Sangiovese 2008
Laforet, Burgogne Chardonnay 2009
Columbia Winery, Merlot 2007
Bonterra, Cabernet 2008
Elk Cove, Pinot Gris 2009
Maquis Lien 2006
Scott Paul, Pinot Noir, Le Paulee 2007
The Occasional Book
Hope Larson - A Wrinkle in Time, the Graphic Novel
Rudyard Kipling - Kim
Peter Ames Carlin - Bruce
Fran Cannon Slayton - When the Whistle Blows
Neil Young - Waging Heavy Peace
Mark Bego - Aretha Franklin, the Queen of Soul (2012 ed.)
Jenny Lawson - Let's Pretend This Never Happened
J.D. Salinger - Franny and Zooey
Charles Dickens - A Christmas Carol
Timothy Egan - The Big Burn
Deborah Eisenberg - Transactions in a Foreign Currency
Kurt Vonnegut Jr. - Slaughterhouse Five
Kathryn Lance - Pandora's Genes
Cheryl Strayed - Wild
Fyodor Dostoyevsky - The Brothers Karamazov
Jack London - The House of Pride, and Other Tales of Hawaii
Jack Walker - The Extraordinary Rendition of Vincent Dellamaria
Colum McCann - Let the Great World Spin
Niccolò Machiavelli - The Prince
Harper Lee - To Kill a Mockingbird
Emma McLaughlin & Nicola Kraus - The Nanny Diaries
Brian Selznick - The Invention of Hugo Cabret
Sharon Creech - Walk Two Moons
Keith Richards - Life
F. Sionil Jose - Dusk
Natalie Babbitt - Tuck Everlasting
Justin Halpern - S#*t My Dad Says
Mark Herrmann - The Curmudgeon's Guide to Practicing Law
Barry Glassner - The Gospel of Food
Phil Stanford - The Peyton-Allan Files
Jesse Katz - The Opposite Field
Evelyn Waugh - Brideshead Revisited
J.K. Rowling - Harry Potter and the Sorcerer's Stone
David Sedaris - Holidays on Ice
Donald Miller - A Million Miles in a Thousand Years
Mitch Albom - Have a Little Faith
C.S. Lewis - The Magician's Nephew
F. Scott Fitzgerald - The Great Gatsby
William Shakespeare - A Midsummer Night's Dream
Ivan Doig - Bucking the Sun
Penda Diakité - I Lost My Tooth in Africa
Grace Lin - The Year of the Rat
Oscar Hijuelos - Mr. Ives' Christmas
Madeline L'Engle - A Wrinkle in Time
Steven Hart - The Last Three Miles
David Sedaris - Me Talk Pretty One Day
Karen Armstrong - The Spiral Staircase
Charles Larson - The Portland Murders
Adrian Wojnarowski - The Miracle of St. Anthony
William H. Colby - Long Goodbye
Steven D. Stark - Meet the Beatles
Phil Stanford - Portland Confidential
Rick Moody - Garden State
Jonathan Schwartz - All in Good Time
David Sedaris - Dress Your Family in Corduroy and Denim
Anthony Holden - Big Deal
Robert J. Spitzer - The Spirit of Leadership
James McManus - Positively Fifth Street
Jeff Noon - Vurt
Road Work
Miles run year to date: 32
At this date last year: 66
Total run in 2012: 129
In 2011: 113
In 2010: 125
In 2009: 67
In 2008: 28
In 2007: 113
In 2006: 100
In 2005: 149
In 2004: 204
In 2003: 269
Comments (38)
The only stones that Wyden has are in his head.
Posted by Mojo | January 30, 2013 11:11 AM
I think the cost is used to determine how much additional tax you have to pay if you have a "luxury" medical plan. My employer is dropping some insurance options next year due to the tax implications.
Posted by oldsweng | January 30, 2013 11:13 AM
Why would I want cheaper crummier health insurance when I now have more expensive crummier health insurance?
Posted by sally | January 30, 2013 11:15 AM
If Wyden could've spoke at the moment he was born, instead of expressing humility or thanks to his mom & dad and the doctors & nurses, he'd have declared: "Look what I did!"
Posted by Mojo | January 30, 2013 11:16 AM
Portland Polite again!. . . or what?
6B.
6C.
Posted by clinamen | January 30, 2013 11:18 AM
I think the cost is used to determine how much additional tax you have to pay if you have a "luxury" medical plan.
But as our astute senator points out in his tweet, everybody is being shown their number, even though only a precious few will owe any tax.
Of course, his next move will be to make everybody pay tax on that benefit. Don't think that isn't coming.
Posted by Jack Bog | January 30, 2013 11:28 AM
Congress gets luxury premium care, additional tax for them?
What do they care about the rest of the people?
They haven't a clue and/or do
and "C'est la vie."
I wonder what the Gray Panthers think now of their "golden boy" they elevated!
Posted by clinamen | January 30, 2013 11:46 AM
Woulda, coulda. Got lucky, I guess.
Single-payer means "all tax-payers". Less the government overhead expenses.
Posted by Sam T. | January 30, 2013 11:49 AM
"...as our astute senator points out..."?
I thought Wyden represented New York.
Posted by ltjd | January 30, 2013 11:50 AM
If the next step is government issues 1099's reporting cost of Medicaid, Medicare and Obamacare cross subsidies, I'm all for it.
Posted by Newleaf | January 30, 2013 12:20 PM
I think this is a great idea and well overdue. When people see that in lieu of a raise (again) this year, their firm/company is picking up another double digit increase in healthcare premiums, perhaps they will start demanding a better return on their dollar. The more transparency the better.
Posted by Pom Mom of LO | January 30, 2013 12:52 PM
I wonder if Wyden's W2 shows how much the taxpayer pays for his health insurance.
Posted by Pom Mom of LO | January 30, 2013 12:53 PM
"perhaps they will start demanding a better return on their dollar."
Really? Who will we be making that demand on? Our employers? Blue Cross? Kaiser? Our doctor? Employer-provided health insurance is pretty much a take-it-or-leave-it proposition for most people I know.
Posted by Jack Bog | January 30, 2013 12:57 PM
The first step is to make people aware of exactly how much their health insurance - and by extension health care -- is costing them. If people see the true cost of their premiums -- they might start asking why it costs so much. Frivolous law suits? Paying the medical care of the uninsured ? Administrative bureaucracy? Defensive medicine? Fraud? Huge profits for doctors? People running to the doc every time Junior sneezes? All of these are given as reasons - and no solutions are ever sought. Why? Because who really cares if their health insurance premiums go up? Their employer pays that. We will NEVER get the cost of healthcare under control until the people receiving the product, actually pay for it-- and are aware of how much it is costing them.
Posted by Pom Mom of LO | January 30, 2013 1:47 PM
We will NEVER get the cost of healthcare under control until the people receiving the product, actually pay for it
So, eliminate employer-provided health care? That is not politically realistic.
And as I wrote in the post, when you're sick or injured, there's no inclination to haggle over price. All of this gyration about consumers affecting health care prices is an economist's pipedream.
Posted by Jack Bog | January 30, 2013 2:02 PM
What PMoLO said...
Posted by cc | January 30, 2013 2:04 PM
Single Payer Action -- "Everybody In. Nobody Out."
http://singlepayeraction.org/
Health care threatens to crush U.S. growth
January 25, 2013
http://www.washingtonpost.com/opinions/bryan-r-lawrence-health-care-threatens-to-crush-us-growth/2013/01/24/82370354-6654-11e2-9e1b-07db1d2ccd5b_story.html
US GAO Financial Audit: U.S. Government’s Fiscal Years 2012 and 2011 Consolidated Financial Statements
http://www.gao.gov/assets/660/651357.pdf
Posted by Mojo | January 30, 2013 2:20 PM
And as I wrote in the post, when you're sick or injured, there's no inclination to haggle over price. All of this gyration about consumers affecting health care prices is an economist's pipedream.
Wow, you have great faith in humanity.
Perhaps people might "haggle over price" (nice characterization, there) before they're in the ambulance. It has been known to happen.
Knowing what it costs is a start.
Posted by cc | January 30, 2013 2:23 PM
If the USA doesn't want to adopt a French-like system, then make everybody pay cash for medical coverage and only require emergency medical.
Your auto insurance doesn't cover tune-ups or implanting Double-D hood ornaments. It only covers the unexpected. And that is why that market is extremely competitive.
There is no competition in health care with the current system. We really need to stop using the term health "insurance".
Posted by Tim | January 30, 2013 2:27 PM
"We will NEVER get the cost of healthcare under control until the people receiving the product, actually pay for it-- and are aware of how much it is costing them."
Them, everyone else, and the country. What percentage are we up to now of the GDP that goes to the medical industry? Just short of 18, headed for 20? And about 2-1/2 times more than comparable countries -- thousands of dollars more, per person, per year.
I get your point: that if people what they at some essential level, even if it seems removed, knew what they were paying, they might think, wow, I'd rather do something fun or more productive with that money. Or, how come I'm paying more -- but not getting more -- than just about everybody everywhere else?
You left medical tests and procedures off your list -- a major cost driver. A number of hospitals and medical organizations are trying to corral and stem these, quite actively.
But PomMom's big point is that when so few people pay these things directly they do not really see the bite of it. To all of us. And the country. And we are not getting our money's worth.
Posted by sally | January 30, 2013 2:36 PM
We really need to stop using the term health "insurance".
True, that. And it's not medical insurance either. Not insurance at all.
I've said it before, this was where Obama started. He made everyone in his administration read it. He gave it all up.
http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande?currentPage=all
Posted by sally | January 30, 2013 2:40 PM
Funny, she also left insurance company profits off her list.
Posted by Ex-bartender | January 30, 2013 2:47 PM
That's where Wyden's bread is buttered.
Posted by Jack Bog | January 30, 2013 2:53 PM
Considering I haven't been to a doctor in 8 years, I'd say my employer is being ripped off.
Posted by Anthony | January 30, 2013 3:44 PM
Jack wrote: "And as I wrote in the post, when you're sick or injured, there's no inclination to haggle over price. All of this gyration about consumers affecting health care prices is an economist's pipedream."
I'm not sure that's right my friend, at least not always.
Example number 1: there is a surgery that the doctor says will be great at improving your life (say a shoulder surgery, which I got 3 months ago). They are a painful recovery. If, on top of that, you have to pay a bunch of dough out of pocket, I think you'll be more likely to get a second opinion, or shop for someone cheaper, or even sometimes to just say, "screw it" to getting the surgery.
Example number 2: you're very old and very sick and they tell you you can get some painful surgery to possibly prolong your life a few months. The alternative is going home and dying in peace. If you add the notion that the painful solution also will cost you a bunch of money, you (or your likely heirs at least) may think twice.
I've finally become aware of the fact that I won't live forever. I also am not crazy about voluntarily taking on pain. Doctors have every incentive (their oath plus economic) to suggest you do everything medically possible. I'm not sure I want to do everything medically possible even when it's "free", but certainly not when it will blow through the few bucks I have left at this point.
Posted by The Original Bob W | January 30, 2013 4:08 PM
shop for someone cheaper
Do you actually do that? Methinks you get what you pay for. The term "getting Kaiserized" comes to mind.
Posted by Jack Bog | January 30, 2013 6:10 PM
If you look at medical procedures that insurance usually will not cover (lazik, plastic surgery, botox) the price has been controlled by the market. Since (thankfully) we do not let people go without emergency medical care if they cannot pay, the market is always going to be skewed when it comes to medicine - but more market, less government control should be the goal. IMHO.
Posted by Pom Mom of LO | January 30, 2013 6:10 PM
"more market, less government control should be the goal."
That's a howler. If you look at the high cost and poor results of our system compared to other civilized countries, the fundamental difference is our excessive reliance on "markets" in the form of private insurance. The bits and pieces of our health care system that are the least dysfunctional are the government ones: Medicare, Medicaid and the V.A. Even in Medicare, the "Advantage" plans we got with new drug coverage under Bush, being privately run, are the most expensive and wasteful.
Health care is not a business. Rationing, denying health care and minimizing the insurance companies "loss ratio" is a business.
Posted by Allan L. | January 30, 2013 7:29 PM
"Congress gets luxury premium care, additional tax for them?"
Please elaborate.
They are covered by FEHB like all the Federal employees who choose a FEHB plan (and pay their share.) In addition they (but not their families) are eligible to receive limited medical services from the Office of the Attending Physician of the U.S. Capitol, after payment of an annual fee. But services don’t include surgery, dental care or eyeglasses, and any prescriptions must be filled at the member’s expense.
FEHB offers a range of commercial health insurance plans. Luxurious coverage is missing, in my opinion.
Posted by annoyed | January 30, 2013 7:48 PM
What ever happened to the family doctor?
Now it seems so corporate and pushing people into corporate money making tests and drugs. One has to actually resist these efforts.
This last year I noticed on a new preventive service letter:
Annual screening for depression.
One could get depressed just thinking about it all. This that and what next?
Mandatory probing and mandatory depression screening for drugs!!
I don't know about others, but I don't like being subjected to fear about
every little possible wrong.
Great subject for a Woody Allen movie!
Many laughs in his film "To Rome with Love" where Woody Allen (Jerry) appears in the film, with Judy Davis (Phyllis) who plays his psychiatrist wife.
Posted by clinamen | January 30, 2013 8:32 PM
I'm sure government could do health care more efficiently than the private sector. Look at all the other things government does more efficiently/cost effectively.
Posted by Eric L | January 30, 2013 9:00 PM
I don't know all the details, but this article explains some.
http://archive.truthout.org/080209E
Congress' Own Health Care Benefits: Membership Has Its Privileges
Excerpt about Rep. Steve Kagen from Wisconsin:
The Democrat from Wisconsin has refused to accept federal healthcare benefits, making him the only member of Congress to do without. He will continue, he said in an interview, until everyone in America can enjoy the same coverage as federal lawmakers.
Kagen recently had knee surgery, writing checks for more than $4,500 after bargaining for a reduced-rate MRI and a 50% discount on the operation. (He is still dickering over the hospital bill.)
"If every member of Congress put their heads on their pillow every night like I do . . . knowing this could be the night I lose my house, we'd fix healthcare in a week," said Kagen, who spent decades as a doctor in the Green Bay area before winning election in 2006.
Kagen said his wife and three of his four children have health coverage. But not his oldest daughter, 28, who can't afford insurance.
She's a nurse in Miami.
Posted by clinamen | January 30, 2013 9:14 PM
"That's where Wyden's bread is buttered."
And Obama's. My recollection is the medical insurance industry was the major contributor to that gargantuan inauguration.
Posted by sally | January 31, 2013 7:44 AM
The first step is to make people aware of exactly how much their health insurance - and by extension health care -- is costing them.
Maybe we should look at the social environment we live in that is increasing our health costs:
1. Reliance on large population centers, where disease can grow and multiply much quicker
2. Larger school classrooms
3. Increased stress due to time constraints, less family time, more work, longer and more tedious commutes - stress reduces a body's immunity and increases liklihood of contracting sickness
4. Workplace demands (increased pressure to be at work and less opportunity to take a sick day, increased stress and now more sick employees coming into work, getting others sick)
5. Workplaces that have more people located close together (office environments, call centers)
6. Increased physical activities of a "thrill-seeking" nature - people getting lost in the woods, bicycling - all that has an increased risk of physical injury (why should I have to pay higher healthcare costs when I choose not to play tackle football, but lots of high school kids suffer severe injuries each year from choosing to injure themselves? Same with hikers/skiiers who choose to get lost on Mount Hood and I now have to pay for expensive Oregon Air National Guard and Life Flight helicopters to rescue them and take them to trauma centers hundreds of miles away)
Maybe...just maybe, if we looked at our society and decided to make smaller changes - mandating sick leave on a national or state basis (even if unpaid) and protecting workers who are legitimately sick, mandating "minimum space" requirements so people don't have to be close to sick people...
Posted by Erik H. | January 31, 2013 10:45 AM
the social environment
Not a bad list; but you left out the heavy subsidies of corn -- basically the prime ingredient of a poison -- as a fundamental part of our food supply.
Posted by Allan L. | January 31, 2013 9:32 PM
I'm sure government could do health care more efficiently
I'm sure your comments are intended as sarcasm. But it doesn't work, since the government is demonstrably more efficient at delivering health care, health care, old age insurance and national security, to name just a few things, than the private sector. That's fact, not just opinion.
Posted by Allan L. | January 31, 2013 9:35 PM
Wyden, unfortunately, is not very bright and it shows. I mean this guy found the BAR exam a chore more than once and didn't have a clue where Bosnia was on a globe.
Posted by ron wade | February 1, 2013 12:09 PM
"Employer-provided health insurance is pretty much a take-it-or-leave-it proposition for most people I know."
Public employees generally (in Portland) are offered 2-3 choices for health plan coverage every year (in terms of providers), with additional options such as amount of co-pay, etc.
Posted by richard | February 1, 2013 5:28 PM