4.22.2005

Krugman on Healthcare (continued)....

Paul Krugman on the state of American Healthcare - part 2...

http://www.nytimes.com/2005/04/22/opinion/22krugman.html?th&emc=th

Excerpts:

The United States spends far more on health care than other advanced countries. Yet we don't appear to receive more medical services. And we have lower life-expectancy and higher infant-mortality rates than countries that spend less than half as much per person.

According to the World Health Organization, in the United States administrative expenses eat up about 15 percent of the money paid in premiums to private health insurance companies, but only 4 percent of the budgets of public insurance programs, which consist mainly of Medicare and Medicaid. The numbers for both public and private insurance are similar in other countries - but because we rely much more heavily than anyone else on private insurance, our total administrative costs are much higher

Isn't competition supposed to make the private sector more efficient than the public sector? Well, as the World Health Organization put it in a discussion of Western Europe, private insurers generally don't compete by delivering care at lower cost. Instead, they "compete on the basis of risk selection" - that is, by turning away people who are likely to have high medical bills and by refusing or delaying any payment they can.

Yet the cost of providing medical care to those denied private insurance doesn't go away. If individuals are poor, or if medical expenses impoverish them, they are covered by Medicaid.

So we've created a vast and hugely expensive insurance bureaucracy that accomplishes nothing. The resources spent by private insurers don't reduce overall costs; they simply shift those costs to other people and institutions. It's perverse but true that this system, which insures only 85 percent of the population, costs much more than we would pay for a system that covered everyone.

First, in the U.S. system, medical costs act as a tax on employment. For example, General Motors is losing money on every car it makes because of the burden of health care costs. As a result, it may be forced to lay off thousands of workers, or may even go out of business. Yet the insurance premiums saved by firing workers are no saving at all to society as a whole: somebody still ends up paying the bills.

Think about how crazy all of this is. At a rough guess, between two million and three million Americans are employed by insurers and health care providers not to deliver health care, but to pass the buck for that care to someone else. And the result of all their exertions is to make the nation poorer and sicker.

Why do we put up with such an expensive, counterproductive health care system? Vested interests play an important role. But we also suffer from ideological blinders: decades of indoctrination in the virtues of market competition and the evils of big government have left many Americans unable to comprehend the idea that sometimes competition is the problem, not the solution.

4.21.2005

Way to take a stand....

2 Winona High Students Put Free Speech to the Test

http://startribune.com/stories/462/5359758.html

I don't think expulsion will happen if they get 100 students to show up...

This is how to do it, take a stand, organize support, make a difference...

An Idea for the Next Underheim or Esslinger Speach...

http://www.msnbc.msn.com/id/7548667/site/newsweek/

A Must Read and A waste of a Good Life...

Marla Ruzicka's death is a blow to all of us. It is too bad that we did not know more about her when she was alive.

These are the people we need to spend more media time on.

This is where most of the world met her:

http://www.nytimes.com/2005/04/21/opinion/21herbert.html?th&emc=th

This is where we should have:

http://www.commondreams.org/headlines03/1230-08.htm

Out of the mouths of babes.....

"I repeat, personal accounts do not permanently fix the solution."—George W. Bush; Washington, D.C., March 16, 2005

4.20.2005

Here is a great look at the state chair's race....

very well thought out.


http://ascendent.dailykos.com/story/2005/4/19/13726/7117

Krugman on Healthcare....

Here's the link:

http://www.nytimes.com/2005/04/15/opinion/15krugman.html?th&emc=th

And excerpts:

Before I get to the numbers, let me deal with the usual problem one encounters when trying to draw lessons from foreign experience: somebody is sure to bring up the supposed horrors of Britain's government-run system, which historically had long waiting lists for elective surgery.

In fact, Britain's system isn't as bad as its reputation - especially for lower-paid workers, whose counterparts in the United States often have no health insurance at all. And the waiting lists have gotten shorter.

But in any case, Britain isn't the country we want to look at, because its health care system is run on the cheap, with total spending per person only 40 percent as high as ours.

The countries that have something to teach us are the nations that don't pinch pennies to the same extent - like France, Germany or Canada - but still spend far less than we do. (Yes, Canada also has waiting lists, but they're much shorter than Britain's - and Canadians overwhelmingly prefer their system to ours. France and Germany don't have a waiting list problem.)

Let me rattle off some numbers.

In 2002, the latest year for which comparable data are available, the United States spent $5,267 on health care for each man, woman and child in the population. Of this, $2,364, or 45 percent, was government spending, mainly on Medicare and Medicaid. Canada spent $2,931 per person, of which $2,048 came from the government. France spent $2,736 per person, of which $2,080 was government spending.

Amazing, isn't it? U.S. health care is so expensive that our government spends more on health care than the governments of other advanced countries, even though the private sector pays a far higher share of the bills than anywhere else.

What do we get for all that money? Not much.

Most Americans probably don't know that we have substantially lower life-expectancy and higher infant-mortality figures than other advanced countries.

Above all, a large part of America's health care spending goes into paperwork. A 2003 study in The New England Journal of Medicine estimated that administrative costs took 31 cents out of every dollar the United States spent on health care, compared with only 17 cents in Canada.

4.19.2005

Roosevelt's great ideas:

Bob Hebert discusses what I believe to be one of the greatest speaches of all time:

Roosevelt referred to his proposals in that speech as "a second Bill of Rights under which a new basis of security and prosperity can be established for all regardless of station, race or creed."

Among these rights, he said, are:

"The right to a useful and remunerative job in the industries or shops or farms or mines of the nation.

"The right to earn enough to provide adequate food and clothing and recreation.

"The right of every farmer to raise and sell his products at a return which will give him and his family a decent living.

"The right of every businessman, large and small, to trade in an atmosphere of freedom from unfair competition and domination by monopolies at home or abroad.

"The right of every family to a decent home.

"The right to adequate medical care and the opportunity to achieve and enjoy good health.

"The right to adequate protection from the economic fears of old age, sickness, accident and unemployment.

"The right to a good education."

"The test of our progress," said Roosevelt, "is not whether we add more to the abundance of those who have much; it is whether we provide enough for those who have too little."

http://www.nytimes.com/2005/04/18/opinion/18herbert.html?n=Top%2fOpinion%2fEditorials%20and%20Op%2dEd%2fOp%2dEd%2fColumnists%2fBob%20Herbert

If only people paid more attention to the real issues before Nov 2nd.....

President Bush doesn’t fare very well in the latest CBS News poll with an approval rating of just 44 percent and still limp support for his proposed Social Security overhaul.

But at least he's doing better than Congress, which earns a thumbs-up from only 35 percent of Americans – nearly as low a rating as it received last month immediately after lawmakers' unpopular intervention in the Terri Schiavo case.

Approval ratings for Congress have historically been low but they're now at one of their lowest points since the late 1990s. Disapproval of the Republican-controlled Congress even extends to 39 percent of Republicans, along with 59 percent of Democrats.

Just 37 percent think what the current Congress has accomplished so far has been good for the country; 41 percent think what Congress has done has been bad.

http://www.cbsnews.com/stories/2005/04/18/politics/main688974.shtml