CaptainJJack

First Read of House Health Care Reform Act (H.R. 3200)

I generally agree that market prices do an effective job rationing goods and services.

However, in order to set an accurate price, you have to have a sense of what you are buying, and there is no effective way to measure quality of care.

As Michael Porter, in Redefining Health Care, puts it, you know the free market is working right when prices DECREASE over time and quality increases over time. In most markets, this is true.

But, not in health care. We see all the time where some parts of the country spend much less and have better results.

We see where PPOs and HMOs are doing well because they only contract with hospitals that have very reduced emergency care and very availablity for uninsured -- and no teaching hospitals.

Further they hire MDs and lawyers to figure out ways to get out of paying for coverage -- in effect one version of rationing procedures -- just like the government except that it is far more arbitrary.

Worse, MRIs and CAT scans are now profit centers in many clinics, and heart centers are common in many more hospitals because the procedures are so profitable.

We have a very broken system


On Jul 17 09:48 AM MSimon wrote:

> "2) Eliminate pre-existing clauses. This is just a way insurance
> plans game the system and deny coverage to those who are sick and
> need help.
> 3) There has got to be a way to control prices. While I would be
> cautious with regulating prices, there may be no other way. I would
> start with making pricing and pricing practices very public. There
> is extensive gouging especially from hospitals on outpatient services.
> Somebody's ox will be gored here...so be it.
> 4) Get doctors back to doctoring and not searching for ways to get
> richer. "
>
> Items 2 and 3 are contradictory.
>
> To get item 4 you are going to have to lower the cost and time for
> medical school. Otherwise you wind up with not enough doctors.<br/>
>
> Supply and demand meet at a PRICE. Set the price too low and demand
> outstrips supply.
>
> Why does the USA spend so much on health care? We are richer than
> the rest of the world and want that added 6 months of life and will
> pay a lot for it.
>
> Why do we pay for air conditioning when previous generations didn't
> need it? We can afford it. Why have average house sizes grown? We
> can afford it. etc. etc. etc.

First Read of House Health Care Reform Act (H.R. 3200)

Here is a flash: health care will be rationed.

Here is another flash: Health care IS being rationed RIGHT NOW.

That is what motivated Michael Porter, who probably knows more about competition and free markets than anyone on the planet, to write an entire book on the problem.

We WILL have rationing. The only question is how it will be done.


On Jul 16 10:23 AM Duude wrote:

> "The public plan would have to be self sustaining following receipt
> of seed money from the federal government. The premiums charged would
> need to be high enough for an honest actuarial accounting of a going
> concern."
> This is a pipe dream. I don't care what they write into the bill
> now, it will be edited out later when premiums escalate, or the government
> will eliminate certain expenses in running the government option
> from premiums paid by government option participants with the remaining
> expenses paid by all taxpayers. The goal isn't to compete, its to
> move all low income and middle income households into government
> subsidized healthcare. That's when things get real interesting. Can
> the democratic party continue blocking tort reform as premiums escalate?
> Will they start down the path of rationing care? Will they deny life
> saving care to elderly Americans? Considering how rampant fraud is
> in medicare and how completely inept government has been in stopping
> it, can we expect they will ever get a handle on it as they expand
> the government's role? Obese Americans contribute greatly to America's
> healthcare bill. Will we ever see the government drop ludicrous policies
> that call obese Americans handicapped and not responsible? Stay tuned
> as healthcare expenses either reach 30-40% of GDP a decade from now
> or government starts rationing care.