Controlling healthcare costs key to tackling the debt and providing affordable coverage for all
Dr. Gary Maynard
Without addressing healthcare costs, the cost of healthcare and our national debt will continue to spiral out of control and current programs [Medicare] will be cut. Controlling healthcare costs would allow insurance coverage for the uninsured and more affordable healthcare coverage without expanding the National Debt.
The healthcare literature suggests many proposals to decrease healthcare costs including the four methods outlined below. As a physician and a healthcare executive, I believe these four proposed methods could have an immediate, lasting impact on healthcare costs and could be implemented without significant cost to the taxpayers. Experts in healthcare estimate that implementing these four methods could reduce healthcare costs by 50 percent. Recent estimates of U.S. healthcare costs are $4.5 billion to $5 billion, and rising.
Subhead: National electronic medical record system
A seamless electronic medical record [EMR] system, available to all healthcare providers, could reduce repetitious and unnecessary diagnostic medical tests by half. The EMR would provide immediate and accurate healthcare information about a patient anywhere the healthcare system is accessed. This patient-specific, up-to-date medical information will ensure higher quality, safer medical practice at less expense as tests will not need to be repeated and diagnoses will already be established. An added benefit for the healthcare provider is lower risk of liability.
Patient confidentiality is the major concern about personal data in a large multi-access computer system. Just as Social Security numbers are protected and individualized for everyone, why not create a system to protect each patient’s confidentiality? One thought is to give each patient his own password to be shared only with the healthcare provider of his/her choice and another individual in case of emergencies.
Initial costs of an electronic medical record would include setting up a central data repository and developing and implementing computer software to facilitate access by healthcare providers. The costs to initiate this proposal would be sizable, but the overall savings in healthcare cost would more than off set the cost of implementation.
Subhead: National medical disease database:
A centralized national database staffed by a panel of experts to maintain the latest, most current information on the treatment of all diseases, which could be accessed by all healthcare providers, is the next recommendation.
Medical information about diseases and their treatments is changing very rapidly. Sometimes the medical literature has conflicting recommendations for treatment of diseases. Busy physicians struggle to keep up with the latest information. Often the recommendations for the best treatment for a patient’s disease differ depending on the healthcare providers. This problem reveals a need to standardize treatment options for safer and improved patient care.
Imagine a central database, managed by the National Institute of Health [NIH], as an example, with a panel of healthcare experts that continually receive, analyze and update new medical information. The panel would create the current best treatment for all diseases. These treatment recommendations would become the “Standard of Care” database, which could then be accessed by all healthcare providers. The end result would be huge advances in quality of care as well as a marked reduction in medical liability.
The costs to set up this system would be less than the EMR recommendation. Again, the resultant healthcare cost savings would soon absorb the initial and maintenance costs.
Subhead: Standardize and cap medical liability:
A physician’s greatest fear is being sued for medical liability and the uncertainty associated with the legal system. Although healthcare providers feel patients deserve some compensation for a poor outcome, they find the process onerous.
Compounding the fear of the legal system is the wide variation from state to state of liability laws and regulations. Some states have limits on portions of the liability and others do not. It is this fear of being sued that drives duplication and unnecessary tests and procedures.
Standardization of tort reform and predictable insurability for physicians would thus lead to a huge reduction in healthcare costs.
Data on the cost of liability from state to state is available. A national panel of experts could analyze the impact of current implemented legislation and the most effective state legislation could be enacted nationally. The initiation cost of this recommendation would be minimal compared to the first two recommendations.
This recommendation would create enormous political and lobbying battles. At some point America would have to decide if lowering healthcare cost or increasing lawyers’ income is our national priority.
Subhead: Regulate and minimize promotion of medications, medical products and medical facilities:
Pharmaceutical companies spend millions of dollars on promotion of drugs, often creating artificial demand for medications. Researchers and financial reports indicate that 30 to 50 percent of their budgets are promotion of medications. This includes advertising on TV, radio, magazines, etc., as well as the promotion of medication to physician offices and hospitals.
“Free” trips, food and entertainment are common ploys by drug companies and medical product companies to get healthcare providers to use and recommend their products. Patients often demand medications based on the advertising, even if they do not need the medication.
This promotion of medication and medical products is expensive and unnecessary. Imagine a 30 to 50 percent reduction in the cost of medications that would occur if this promotion were to stop.
Again, I would anticipate significant lobbying efforts on behalf of these advertising facilities at any attempt of regulation.
Therefore, as we increase the coverage to include the uninsured, let’s hear discussion of controlling healthcare costs from our legislators and leaders.
Dr. Gary D. Maynard is a retired anesthesiologist and physician executive with a master’s degree in medical administration. He has served as the medical director at hospitals and insurance companies. He resides in Chelsea.
Comments
maallen
Mon, Feb 14, 2011 : 7:30 p.m.
Don't you just love how certain individuals think Canada's Supreme Court ruling to allow private health care to exist is from one or two instances? That somehow the Canada's Supreme Court bought into this myth? I have family living in the Ontario province and unfortunately they had to bring my nephew here to have an MRI done because there was a year wait. The poor kid was in so much pain and double visioned. The Doctor's response: "Unfortunately, it's not a life and death situation, YET. We can't put him in front of others until we feel it's critical." So the family came here and got in within 2 days! Also, just 2 years ago my sister-in-law in Canada gave birth, but she had to go to a hospital 3 hours away from her home because the 2 hospitals nearby didn't have the necessary equipment because they lacked funding from the gov. While advocates of the single payer system often point to England and Canada as models, they are in the process of getting away from that system due to a bloated bureaucracy that is inefficiently run and costs the taxpayers way too much. However you have to like this quote taken from the link that bugjuice provided: " T h e C a n a d i a n m e t h o d o f c o n t r o l l i n g h o s p i t a l c o s t s h a s l imi t e d t h e u s e o f e x p e n s i v e , h i g h - t e c h n o l o g y d i a g n o s t i c a n d s u r g i c a l p r o c e d u r e s . A s a r e s u l t , w a i t i n g lists o r q u e u e s h a v e d e v e l o p e d f o r s o m e s p e c i a l t y c a r e s e r v i c e s , s u c h a s c a r d i a c b y p a s s s u r g e r y , l e n s imp l a n t s , a n d m a g n e t i c r e s o n a n c e ima g i n g . E m e r g e n c y c a s e s , h o w e v e r , a r e t r e a t e d imme d i a t e l y , b y p a s s i n g t h e w a i t i n g lists."
maallen
Mon, Feb 14, 2011 : 8:16 p.m.
Sorry about that....apparently the new website isn't good at copy and paste: However you have to like this quote taken from the link that bugjuice provided: "The Canadian method of controlling hospital costs has limited the use of expensive, high-technology diagnostic and surgical procedures. As a result, waiting lists or queues have developed for some specialty care services, such as cardiac bypass surgery, lens implants, and magnetic resonance imaging (MRI). Emergency cases however, are treated immediately, bypassing waiting lists." And that quote came directly from our own government back in 1991 in the link provided by bugjuice. And that is only 20 years after the Canadian government fully implemented single payer universal healthcare in 1971. In just 20 years Canada started rationing care by not allowing better technology for diagnostics and surgeries. 40 years after inception of the single payer universal health care, now Canada is slowly going back to private health care. And some want us to believe that long waits, rationing of health care is just a myth.
bugjuice
Mon, Feb 14, 2011 : 4:33 p.m.
Don't we love it that people who have little or no experience in any health care system other than here in the USA continually bring up one or two instances of some kind of "rationing" or long wait time or some such myths from another country? And then try to extrapolate this info to mean that the same thing will happen here? Do any anti health care for everyone advocates have any other mythical references to Canadian Health Care system and their two MRI machines? I have family living in Nova Scotia and think their health care is great. One had knee and hip replacement surgery without any lengthy wait or problems. Both surgeries were scheduled and she had to wait 30 days for the knee and the hip was done in three weeks.
braggslaw
Mon, Feb 14, 2011 : 5:37 p.m.
Was that before or after the change from a single payer system to private insurance? The two MRI machine was sarcasm based onreal need. Good for your family in Novia Scotia. Thankfully the voters in the USA have spoken and a single payer system is dead. If people want to emigrate to Canada, knock yourself out.
braggslaw
Mon, Feb 14, 2011 : 2:54 p.m.
It was two a decade ago... but you get the point on the MRI issue. (and all other advanced procedures) ****************************** Management of MRI Wait Lists in Canada Abstract Excessive wait times for magnetic resonance imaging (MRI) studies are a major problem in the Canadian healthcare system. ......Efforts to reduce wait times for MRI have focused on increasing the number of diagnostic imaging devices, as Canada lags far behind other countries in this regard. For instance, Japan and the United States have 35.3 and 19.5 MRI units per million population, respectively, whereas Canada has only 4.6. (Stein 2005). The number of MRI scanners in Canada is lower than the median of 6.1 scanners per million for all countries within the Organisation for Economic Co-operation and Development (Stein 2005).
maallen
Mon, Feb 14, 2011 : 2:36 p.m.
It used to be illegal in Canada to have a private practice but because of Canada's single payer system, long waits & cost overruns have occurred. Private practices can now be set up. The provinces of Alberta, British Columbia, and Quebec are now combining both public and private care to help reduce wait times and control public spending. Canada's Supreme Court said this in June of 2005 "The Courts majority found that waiting lists for health care services have resulted in deaths, have increased the length of time that patients have to be in pain and have impaired patients ability to enjoy any real quality of life." The Court voted to invalidate the prohibition on private insurance. In 2006 Quebec announced it would improve access within the public system for cardiology, radiation oncology, hip and knee replacements, and cataract surgery within 6 month after being diagnosed. If the surgery can't be performed at a government facility within 6 months, then Quebec will pay for the surgery at a private institution within or outside of Canada. England is making cuts in their healthcare because costs have gotten out of control. They are now decentralizing the system and putting the power back into the hands of the patients and doctors instead of some government employee. Currently in England, the system is designed so as the how and the where patients are treated, and by whom is determined by decisions from 150 government entities known as primary care trusts. England's government has now put forth a plan to abolish this and allow the decisions and choices go to the patients. They are also abolishing their many current government set targets, like limits on how long patients have to wait for treatments and surgeries. Wow what a system Single payer system is! People point to these two countries as a model for universal single payer health care and both of these countries are moving away from it because it is not working.
golfbum
Mon, Feb 14, 2011 : 11:41 a.m.
Let the consumer control health care cost. Each person's conscience should determine support for those without the means to pay for health care thru donations to charities of choice. Get bureaucracy out of our pockets. Support the unfortunate and not the government!
bugjuice
Mon, Feb 14, 2011 : 2:05 p.m.
The massive private health care bureaucracy (insurance, hospitals, doctors, PHARMA, etc) is far larger than any so called government health care bureaucracy. Do you like paying for private health care bureaucracy profits instead of those profits and CEO salaries being used to provide actual health care? How much do you personally donate, give, tithe etc to charities or individuals expressly for their health care. Most folks in those circumstances are straining to have enough to eat, put a roof over their heads and find a job much less have enough money or find a charitable organization to help with their health care costs. Most charities are not set up to handle indigent people's health care costs.
David Briegel
Mon, Feb 14, 2011 : 1:50 a.m.
Tony, Thank You for posting whroark. The idea that "tort reform" will dramatically improve healthcare is a widely held Right Wing Myth! It is simply not true. Like so many of the "myths" they attempt to confuse the sheep with. And what it really means is that all the victims who are literally butchered under the current system would receive NO relief. NONE! For Profit Silliness!! And the biggest myth is that America has the best health care system in the world. Only if you are deluded into believing that 34th is "the very best"! Bragg, Please try waiting to NEVER, EVER receive the health care you need to survive. That is the real "health care OUTCOME" espoused by the for profit sector! The health care deniers at the "for profit" Corporatocracy that rules our nation!
braggslaw
Mon, Feb 14, 2011 : 2:33 a.m.
Disagree While the two percent Is accurate it fails to quantify the numerous procedures doctors execute to avoid a potential lawsuit These procedures would not have been executed but for the potential threat of a lawsuit
Tony Dearing
Mon, Feb 14, 2011 : 12:15 a.m.
One of our users, whroark, has experienced trouble posting a comment on this piece and has asked me to post it on his behalf. Here is his comment: The article "Methods could reduce health-care costs by 50 percent" states that "U.S. health-care costs are $4.5 billion to $5.0 billion and rising." This statement is highly incorrect. From kaiseredu.org, " Expenditures in the United States on health care surpassed $2.3 trillion in 2008". Reducing healthcare expenditures in the U.S. by 50% is essentially impossible. The suggestion that significant savings can be realized through medical liability reform (tort reform) is seriously flawed. From the New England Journal of Medicine, 2006; 354, 2024-2033. article titled "Claims, Errors, and Compensation Payments in Medical Malpractice Litigation". A study by the Harvard School of Public Health, Brigham's and Women's Hospital, and the Harvard Risk Management Foundation. The authors' conclusions are that "portraits of a malpractice system that is stricken with frivolous litigation are overblown", and "three quarters of the litigation outcomes were concordant with the merit of the claim". From Washingtonpost.com, October 10, 2009, "Congressional budget analysts [CBO] said Friday that lawmakers could save as much as $54 billion over the next decade by imposing an array of new limits on medical malpractice lawsuits". That's $54 billion over ten years, about $5.4 billion per year or, $5.4 billion/$2.3 trillion, or about 0.23%. This does not include estimated savings from decreased defensive medicine costs, whose magnitude is controversial. I agree that a national electronic medical record system and a national medical disease database will provide savings and decreased medical errors, but saving 50% of current healthcare costs by the suggested measures is unbelievably optimistic.
Mike
Sun, Feb 13, 2011 : 10:40 p.m.
I have a fifth initiative that would save untold billions in health care costs: disband the AMA and allow foreign Medical doctors to be recognized in the US. This would impose the same salary reductions on the medical profession that the rest of American society has experienced. Medical doctors seem to think they are immune to the pressures of globalization and this should not be so. The entire compensation scheme of the health care field is an inverted pyramid scheme built atop the falsely inflated salaries of physicians (many now safely esconsed in retirement). Anesthesiologists (such as the author) are notoriously overcompensated as are most procedure based practitioners. In this global economy we should price procedures by what is charged globally and not by what some AMA-rigged panel posits is appropriate compensation. It is time to gore the author's profession along with the insurance and legal lobbies.
1bit
Sun, Feb 13, 2011 : 11:25 p.m.
See my comment above. In most urban and suburban areas, there is already an oversupply of doctors. This does not reduce costs or increase quality. It actually makes things even more expensive. There are a lot of private special interests and organizations that I would like disbanded as well. Good luck with that.
Townie
Sun, Feb 13, 2011 : 10:24 p.m.
The doctor is overstating the medical liability costs (often doctors do): a 2004 report by the Congressional Budget Office said medical malpractice makes up only 2 percent of U.S. health spending. Even "significant reductions" would do little to curb health-care expenses, it concluded. We would do better to send a study group to Finland to ask why it is that Finnish healthcare costs per person are $ $2,104 annually and ours are $5,711. And, oh, it's not because our system gets better outcomes. It doesn't - life expectancy, infant mortality figures for the US put us pretty far down the list of countries. Even Canada has better outcomes and spends only $2,998 annually. It's our terrible system that needs to be reformed where 'more' means more to doctor and hospital bottom lines but costs us so much more than other countries. And our poor health habits. It's worth looking at Finland there as well: they have bent the curve on preventing teenage obesity while our curve goes skyward. But we're so great that we never need to look elsewhere since we have all the answers here.
1bit
Sun, Feb 13, 2011 : 6:38 p.m.
alpha alpha: Increasing the number of providers in the area not only does not reduce costs, it reduces the health of the local population (through unnecessary testing, etc.). In other words, increasing providers in an area from 10 to 100 does not necessarily reduce the cost of providing the service(s). Moreover, increased access to healthcare actually raises costs through increased utilization (especially when not talking about preventative medicine). As for access, there is an oversupply of physicians in most urban and suburban areas.
tim
Sun, Feb 13, 2011 : 6:28 p.m.
The only check on cost was the public option part of the Obama Plan. Republicans and blue dog Democrats shot it down and then turn around and blame Obama for not controlling costs. The only real way to control large costs is to stop writing large checks to the hospitals. This method works for the rest of the economy why won't it work for health care. Due your research we pay almost double per capita on health care than other industrialized countries but they cover everybody and they are ranked higher by the World health Organization.
braggslaw
Sun, Feb 13, 2011 : 4:11 p.m.
A single payer system will lead to an inefficient rationed health care system. Something I will never vote for. I want choice and market driven efficiencies. 85% of the people in the USA are happy with their health care. I won't create rationed health care for the super-minority
timjbd
Mon, Feb 14, 2011 : 3:55 p.m.
"I am happy with my health care and so are 270,000,000 people." This is a ridiculous statement. You assume that EVERY SINGLE PERSON who has health insurance is satisfied with it. That is ludicrous and I can prove it wrong right now- I have health insurance and I'm not satisfied with it. There. It is a system set up to extract profit from captive customers. It will increasingly be more bout extracting profit than keeping people healthy as time goes on and they figure out better ways to do less for more money.
Craig Lounsbury
Mon, Feb 14, 2011 : 4:49 a.m.
"You have a right to your opinion, I have a right to mine." "Get in line to use the 2 MRI machines in Canada...." You have a right to your own opinion but not to make up your own "facts". Canada does have a shortage of MRI machines per-capita relative to most developed nations but the number isn't two, its more like 222 or there abouts.
braggslaw
Sun, Feb 13, 2011 : 7:23 p.m.
you have no idea what rationed is... Try waiting a year to get a heart surgery.. and then right before you are going to die fly to India and pay out of pocket Get in line to use the 2 MRI machines in Canada.... The US has the best health care in the world for the super-majority of its people. It's not perfect but it is surely better than outlawing private hospitals and forcing people into socialized medicine.
John B.
Sun, Feb 13, 2011 : 6:36 p.m.
Healthcare is already rationed in the US. If you have wonderful healthcare benefits, you are very fortunate, as most of us do not. We are the only country in the developed World that permits people to go bankrupt due to healtcare expenses. It is a fallacy to state that 270 million Americans are satisfied with their health care system. I am not, and I have Insurance. I pay a premium of almost $1000 per month for a healthy family of four with very few claims, and that Insurance covers very little other than major items (which we never have!). Our total out-of-pocket medical expenses currently run about $20,000 per year, which is a huge portion of our income. That is *far* from acceptable.
braggslaw
Sun, Feb 13, 2011 : 6:11 p.m.
There are 310 million people in the USA 15% would be aroun the 45,000,000 million number you quoted. I have seen numbers in the 30,000,000 range. I am happy with my health care and so are 270,000,000 people. I am not going to screw it up for the minority so we all get bad health care. I want choices and responsiveness something that a single payer system will destroy. You have a right to your opinion, I have a right to mine. The majority wins in a democracye.
bugjuice
Sun, Feb 13, 2011 : 5:31 p.m.
Health care is already rationed according to one's ability to afford it. Pay nothing, get nothing. Pay less, get less. Pay more, get more. The insurance companies don't care because they value shareholder profits more than customers needs. Have you ever heard of an insurance company or any company for that matter cutting profits in order to provide better service or product? It's cheaper and simpler to squeeze their current business model for every drop long before they begin to seek to innovate and seek "efficiencies". Business considers CEO salaries and shareholder profits first, then customer needs. 45 million Americans don't have health care and can't afford it. Are they included in your claimed 85% satisfaction? Of course everyone wants "efficiencies". But it's a myth and a Republican talking point used when there are no facts to support one's argument. If you truly believe in market efficiencies it won't be long before insurance companies move their businesses to India and China and send all their profits to foreign banks to avoid paying taxes.
bugjuice
Sun, Feb 13, 2011 : 4:07 p.m.
Like all businesses, private for profit health care insurers compete more for investors than customers. Health care is a "need" not a "want". In todays marketplace, when people need health care they have little choice but to play by the insurers rules including paying for the companies profits and enduring their rules governing coverage.
SonnyDog09
Mon, Feb 14, 2011 : 1:49 a.m.
"45 million Americans don't have health care and can't afford it. Are they included in your claimed 85% satisfaction?" Many of those without health insurance are young, healthy people who see no need to purchase insurance that merely pays for someone else's hip replacement, or viagra, or whatever. Those people are satisfied with not paying for the healthcare of others. Do not count everyone that does not have health insurance as "dissatisfied."
AlphaAlpha
Sun, Feb 13, 2011 : 2:58 p.m.
Here is a concept: More competition in the medical business. As it is, the AMA over-influences most legislation; they have limited free market competition. Increasing the number of health care providers, something AMA opposes, would reduce costs and improve service. Increased competition benefits consumers.
bugjuice
Sun, Feb 13, 2011 : 3:44 p.m.
In the case of health care increased competition may not reduce costs due to increased fragmentation of providers and the insured pool. Each provider will have their own unique administrative systems each adding costs thru duplicated efforts. Increasing the number of insurance companies thru competition increases total administrative costs across the industry. This will also increase the need for all insurers to seek competitively higher profits (at the expense of the amount of money spent on actual care) in order to compete for investors.
Ed Stankevich
Sun, Feb 13, 2011 : 2:43 p.m.
I always find this interesting. No mention of the cost imposed by the Government with HIPPA or the ELECTRONIC CHART beginning to be implemented now. Both of these have increased Health Care Costs by BILLIONS of dollars. So to make up for these additional costs what are they going to do? Cut back on services for Medicare you bet you will hear this in the press sometime sone!
bugjuice
Sun, Feb 13, 2011 : 3:54 p.m.
I guess you don't value your privacy concerning your personal medical records. In the hands of unscrupulous profiteers this information could be used to deny you insurance and health care. This could easily occur if we decide to allow the profit driven "free market" to make decisions about and administer people's health care .
David Briegel
Sun, Feb 13, 2011 : 2:29 p.m.
The waste in the current system is huge as there is no incentive for insurance companies to reduce operating costs. Each company has it's own paperwork and reimbursement system that the provider must utilize. Advertising, salaries, bonuses, profits and other costs are passed on to the consumer while providing NO real health benefits. And remember, the death panels really do exist in every single insurance company! If you don't think they "ration" care you are deceiving yourself. An insurance company bureaucrat whose job it is to deny your care while pocketing your premiums. They are the only person between you and your doctor! Their profit comes from denying YOU Health Care!
David Briegel
Sun, Feb 13, 2011 : 2:34 p.m.
A2.com, why does a post get edited in the above manner?
Craig Lounsbury
Sun, Feb 13, 2011 : 2:19 p.m.
Another way to cut health care in half might be to throw a dart at a map of all the modernized countries on the planet (minus ours) and adopt the plan of whatever country the dart hits. Alternatively we could put the names of all those countries on pieces of paper and place them in a hat. The Surgeon General (or the president I suppose) could then pull a name out of the hat and away we go health care cut in half.
Craig Lounsbury
Sun, Feb 13, 2011 : 2:21 p.m.
my semi-tongue in cheek post should read "health care costs" cut in half. This place really needs an edit option.
Craig Lounsbury
Sun, Feb 13, 2011 : 2:11 p.m.
"A seamless electronic medical record [EMR] system, available to all healthcare providers, could reduce repetitious and unnecessary diagnostic medical tests by half. ..... as tests will not need to be repeated and diagnoses will already be established." I find it hard to believe that half the patients in America are getting the same tests done twice by two different healthcare providers unknown to one another.
1bit
Sun, Feb 13, 2011 : 2:01 p.m.
The biggest reduction in healthcare costs would come if we took better care of ourselves. Losing weight, stopping smoking, brushing our teeth, wearing our seatbelts/helmets, eating healthier, etc. Taking responsibility for ourselves has the natural corollary of reducing medical liability as we won't be so quick to blame others for what we either did not control ourselves or was beyond control.
bugjuice
Sun, Feb 13, 2011 : 3:21 p.m.
Nobody will disagree with the assessment that better health begins with the choices made by the individual, but there is such a thing as "human nature" that tells us that humans won't always do the right thing like not smoke, drink, eat stuff that clogs arteries or buckle their seat belts.
bugjuice
Sun, Feb 13, 2011 : 1:57 p.m.
Health Care costs will continue to rise at extraordinary rates unless the insurance pool is designed to cover as many people as possible. If people opt out and do not participate, for whatever reason, the entire system falls apart. If we go the route of HSA's and expensive, exclusive for profit health insurance providers it will reduce the size of the user pool and raise the costs for everyone left in the pool. The only people who will receive health care will be those wealthy enough to afford the ever rising rates. All the rest will either die sooner, not get timely care and their disease/illness/condition will become ever more desperate and costly to treat. Anything less than single payer is rationed health care by virtue of people's ability or inability to pay. Those wealthy enough to pay will be healthier. People who can't afford HSA's or ever rising insurance rates will either die early in life or end up being non contributing members of society that end up costing everyone. This is social Darwinism based on the financial ability to pay. And this is the choice of those wealthy enough to afford insurance, not the 45 million Americans who can't afford health care. Any idiot knows that without broadening the insurance pool by requiring health insurance of some sort (like no fault auto) the pool of insured will be smaller and the costs will be higher because so few people participate. Given the choice, most healthy people, particularly young people will not choose to spend any money on health care until they become ill and then it's usually at the emergency room, the most expensive care available. Please read the results of the studies compiled that since 1991 that come to the conclusion that single payer health care systems cost far less to administer and are more effective at providing health care than any other kind of system. <a href="http://www.pnhp.org/facts/single_payer_system_cost.php?page=all" rel='nofollow'>http://www.pnhp.org/facts/single_payer_system_cost.php?page=all</a>
maallen
Sun, Feb 13, 2011 : 3:46 p.m.
It used to be illegal in Canada to have a private practice but because of Canada's single payer system, long waits & cost overruns have occurred. Private practices can now be set up. The provinces of Alberta, British Columbia, and Quebec are now combining both public and private care to help reduce wait times and control public spending. Canada's Supreme Court said this in June of 2005 "The Courts majority found that waiting lists for health care services have resulted in deaths, have increased the length of time that patients have to be in pain and have impaired patients ability to enjoy any real quality of life." The Court voted to invalidate the prohibition on private insurance. In 2006 Quebec announced it would improve access within the public system for cardiology, radiation oncology, hip and knee replacements, and cataract surgery within 6 month after being diagnosed. If the surgery can't be performed at a government facility within 6 months, then Quebec will pay for the surgery at a private institution within or outside of Canada. England is making cuts in their healthcare because costs have gotten out of control. They are now decentralizing the system and putting the power back into the hands of the patients and doctors instead of some government employee. Currently in England, the system is designed so as the how and the where patients are treated, and by whom is determined by decisions from 150 government entities known as primary care trusts. England's government has now put forth a plan to abolish this and allow the decisions and choices go to the patients. They are also abolishing their many current government set targets, like limits on how long patients have to wait for treatments and surgeries. Wow what a system Single payer system is! People point to these two countries as a model for universal single payer health care and both of these countries are moving away from it because it is not working.
Kafkaland
Sun, Feb 13, 2011 : 1:37 p.m.
Why is nothing in this piece that would reduce profits of hospitals, physicians, and insurance companies? That's where really most of the money goes, and where the savings have to come from. Medical liability, for instance, is peanuts compared to that, even though still worth reforming. And electronic records and databases are worthwhile in their own right, but we'll be lucky if we break even on the costs. Is it naivety or deliberate deception? I guess the byline "retired anesthesiologist and physician execetive [...] medical director at hospitals and insurance companies" says everything.
1bit
Sun, Feb 13, 2011 : 2:02 p.m.
I think you are exactly correct about electronic records. They may increase safety but they do not reduce costs.
SonnyDog09
Sun, Feb 13, 2011 : 1:13 p.m.
I find it hard to take anything in the article seriously after I read: " Recent estimates of U.S. healthcare costs are $4.5 billion to $5 billion, and rising." That estimate is off by an order of magnitude, given that the 2011 budget for Medicare is over $500 Billion.
braggslaw
Sun, Feb 13, 2011 : 1:08 p.m.
I think the biggest lever is making the consumer understand his health care choices and making the consumer responsible for the consequences. HSA' s were a bit new to me so I didn't know whether I would like it. Turns out I love it. I get to put untaxed money in an account, manage my expenses and choose the care I believe is economical. This type of consumer choice is important in driving the costs of health care down. When a consumer feels the pinch and makes choices based on financial consequences it forces doctors and healthcare companies to become more efficient. Compare that to third party paid health care with small deductibles where there is no penalty for seeing the doctor once week. (which is unnecessary in most cases)
dotdash
Sun, Feb 13, 2011 : 9:55 p.m.
I agree. The costs of any medical procedure are so hidden from consumers that we are not able to ask the question "is this worth the money?" -- my money, the insurance company's money, the government's money, it doesn't matter. Because cost is invisible, no one has to answer that question. If costs were patent, we could all save each other thousands.