[ETWolverine]

Charles Hugh Smith at [email protected] says it best when he writes;

The “Impossible” Healthcare Solution: Go Back to Cash

The expansion of health insurance and government entitlements created “free money” and thus the explosion of healthcare costs. The solution is simple and “impossible”: we all pay cash.

Here’s why healthcare (a.k.a. sick-care) costs cannot be reduced; the entire system is based on vast pools of “free money.” The corporate-America or union/government employee who goes to the doctor pays a few dollars for a visit and drugs; the “real cost” is of no concern. Ditto the “real costs” charged to Medicare and Medicaid.

The link between the “consumer” of healthcare and the provider has been broken for decades. There is no “free market” in healthcare — there isn’t any market at all. We live in a Kafka-esque nightmare system in which “some are more equal than others” and hundreds of thousands of dollars are lavished on worthless tests, procedures and medications for two reasons:

1. Because there’s “free money” to pay the bills

2. So-called “defensive medicine” in which worthless tests are administered to stave off random (sometimes valid, sometimes nuisance) malpractice lawsuits.

There is a solution so simple and so radical that it is “impossible” (and of course you’re reading it here): shut down insurance and all government entitlements, and return to the “golden era” of the 1950s when everyone paid cash for healthcare. Here are the costs of childbirth as of 1952 at one of the finest hospitals on the West Coast, The Santa Monica Hospital:

And here are the obstetrical rates:

Having a baby cost $30, which is today’s dollars is $244. A private deluxe room cost $23 or $187 in today’s dollars. According to the Bureau of Labor Statistic’s inflation calculator, $1 in 1952 is $8.14 in 2009 dollars.

What does it cost to have a baby now? $10,000? Or is it $25,000? Who even knows?

I know all the reasons why “costs had to skyrocket”: we’re getting so much better care now, right? Actually, as measured by death rates and any other metric you want to select, there is simply no way to justify a 40-fold increase (or is it 100-fold?) in medical care costs. The returns on all the “miracles of modern medicine” are in fact exceedingly marginal — but nobody wants to talk about that.

In 1952, if something awful happened and a patient died, here was the response: “We’re very sorry.” Families weren’t outraged; they expected people to die and interventions were not expected to be miraculous every single time. Doctor Kildaire and all his imitators on TV had not brainwashed the public into reckoning that if someone died, a mistake had been made. They also hadn’t been brainwashed by the mental disorder known as “the American Legal System” into thinking that in every possible circumstance in life, there is liability, and the only question is where to pin it for the big bucks jackpot.

Stories about people suing doctors and hospitals for 5 times the value of a house ($1 million in today’s money would have been $120,000 in 1952, when you could buy a nice house for $20,000) simply did not exist in the 1950s. The cultural mindset that someone somewhere must be at fault and it’s a “right” to go after them did not exist. Since insurance was limited, there was no “free money jackpot” to go after, either.

A lot of good points here.

There is one thing I would dispute, however. He says that "The returns on all the “miracles of modern medicine” are in fact exceedingly marginal — but nobody wants to talk about that. "

I'll talk about it. It's factually incorrect. Literally millions of lives have been saved due to breakthroughs in cancer treatments, heart treatments, etc. People who had NO CHANCE at survival 50 years ago are surviving after outpatient treatments today. The invention of the heart stent alone has prevented thousands of heart attack-related deaths. Chemotherapies and radiotherapies that didn't exist 50 years ago are de-rigure today and save thousands of lives. The existence of transplantation technologies that didn't exist 50 years ago save thousands of people every year today. The existence of blood-presssure meds and cholestoral lowering meds save thousands of lives every year.

Each one of these techniques, therapies or meds, cost about a billion dollars to develop. And for each one that is successfully developed, there are hundreds of meds, therapies, and techniques that fail... but still cost money to investigate and study. I've posted the costs of developing a single medicine here before. I'm not just pulling that billion dollar number out of a hat.

The higher cost of medicine today than in the 1950s is justified on that basis alone. And the differences between the quality of care today and the quality of care in the 1950s are HUGE.

So I dispute that point.

The rest of what he said has some validity... in fact more than some, in most cases.

Elliot

[amdeist]

A lot of good points here.

There is one thing I would dispute, however. He says that "The returns on all the “miracles of modern medicine” are in fact exceedingly marginal — but nobody wants to talk about that. "

I'll talk about it. It's factually incorrect. Literally millions of lives have been saved due to breakthroughs in cancer treatments, heart treatments, etc. People who had NO CHANCE at survival 50 years ago are surviving after outpatient treatments today. The invention of the heart stent alone has prevented thousands of heart attack-related deaths. Chemotherapies and radiotherapies that didn't exist 50 years ago are de-rigure today and save thousands of lives. The existence of transplantation technologies that didn't exist 50 years ago save thousands of people every year today. The existence of blood-presssure meds and cholestoral lowering meds save thousands of lives every year.

Each one of these techniques, therapies or meds, cost about a billion dollars to develop. And for each one that is successfully developed, there are hundreds of meds, therapies, and techniques that fail... but still cost money to investigate and study. I've posted the costs of developing a single medicine here before. I'm not just pulling that billion dollar number out of a hat.

The higher cost of medicine today than in the 1950s is justified on that basis alone. And the differences between the quality of care today and the quality of care in the 1950s are HUGE.

So I dispute that point.

The rest of what he said has some validity... in fact more than some, in most cases.

Elliot

I think what he means by the returns being marginal are the increasing costs of keeping people alive. Yes, without doubt, modern medicine has extended life, but at what cost? We have an increasing elderly population, of which I am one, that daily add to the burden on society for healthcare, social security, medicare, retirement funds, etc. We simply have too many people on earth today, and another major war is inevitable. Look how many people in our society have health, social, emotional or psychological problems. I certainly wouldn't advocate eliminating anyone, but to keep finding new ways to extend life without quality of life borders on what I would call insane!

[inthebox]

Charles Hugh Smith at [email protected] says it best when he writes;

The “Impossible” Healthcare Solution: Go Back to Cash

The expansion of health insurance and government entitlements created “free money” and thus the explosion of healthcare costs. The solution is simple and “impossible”: we all pay cash.

Here’s why healthcare (a.k.a. sick-care) costs cannot be reduced; the entire system is based on vast pools of “free money.” The corporate-America or union/government employee who goes to the doctor pays a few dollars for a visit and drugs; the “real cost” is of no concern. Ditto the “real costs” charged to Medicare and Medicaid.

The link between the “consumer” of healthcare and the provider has been broken for decades. There is no “free market” in healthcare — there isn’t any market at all. We live in a Kafka-esque nightmare system in which “some are more equal than others” and hundreds of thousands of dollars are lavished on worthless tests, procedures and medications for two reasons:

1. Because there’s “free money” to pay the bills

2. So-called “defensive medicine” in which worthless tests are administered to stave off random (sometimes valid, sometimes nuisance) malpractice lawsuits.

There is a solution so simple and so radical that it is “impossible” (and of course you’re reading it here): shut down insurance and all government entitlements, and return to the “golden era” of the 1950s when everyone paid cash for healthcare. Here are the costs of childbirth as of 1952 at one of the finest hospitals on the West Coast, The Santa Monica Hospital:

And here are the obstetrical rates:

Having a baby cost $30, which is today’s dollars is $244. A private deluxe room cost $23 or $187 in today’s dollars. According to the Bureau of Labor Statistic’s inflation calculator, $1 in 1952 is $8.14 in 2009 dollars.

What does it cost to have a baby now? $10,000? Or is it $25,000? Who even knows?

I know all the reasons why “costs had to skyrocket”: we’re getting so much better care now, right? Actually, as measured by death rates and any other metric you want to select, there is simply no way to justify a 40-fold increase (or is it 100-fold?) in medical care costs. The returns on all the “miracles of modern medicine” are in fact exceedingly marginal — but nobody wants to talk about that.

In 1952, if something awful happened and a patient died, here was the response: “We’re very sorry.” Families weren’t outraged; they expected people to die and interventions were not expected to be miraculous every single time. Doctor Kildaire and all his imitators on TV had not brainwashed the public into reckoning that if someone died, a mistake had been made. They also hadn’t been brainwashed by the mental disorder known as “the American Legal System” into thinking that in every possible circumstance in life, there is liability, and the only question is where to pin it for the big bucks jackpot.

Stories about people suing doctors and hospitals for 5 times the value of a house ($1 million in today’s money would have been $120,000 in 1952, when you could buy a nice house for $20,000) simply did not exist in the 1950s. The cultural mindset that someone somewhere must be at fault and it’s a “right” to go after them did not exist. Since insurance was limited, there was no “free money jackpot” to go after, either.

I agree with the cash part - as an out patient. The prices of laser eye surgery and botox have come down [ relatively speaking ] compared to when they first came out.

Let that side of it be truly free market. However I doubt physicians, and health insurance companies will not want to compete based purely on suppply, demand, service , value.

I'm not sure about the acute care / hospital side of healthcare. Technology costs. Can people afford it? A motor vehicle accident causing multiple trauma and multiple organ system involvement can easily cost thousands of dollars a day. It is easy to see why. You have hospital costs , labor [ physicians, nurses, phlebotomists, transporters etc.. ] material costs [ medications, the ivs, the repsirator, the bed, the Mri, cat scans ] etc.

This is where the US healthcare system IS BETTER than others... I think thisarea of healthcare will still be via third party [ whether gov and or insurance co ] . Just watch " trauma: life in the ER " and any of the reality medical shows and ask yourself how much does it costs or how does it get paid?




G&P

[tomder55]

amdeist ,yes to contain costs eliminating a bunch of infirmed would do the trick . The Dems seem to have the culture of death covered in both ends of this deal. Advise seniors to opt for early death ,and increase funding for abortion services.

Once those ends are optimized and costs are still out of control can eugenics be far behind ?

SS and Medicare are supposedly funded by us when we are young and working contributors to society .They in liberal theory are self funded .
The fact that our lives contribute to a burden to these programs is a gross distortion of the problem . The real problem is that they are government run programs that have been pilfered by our elected representatives for years .The real problem is that like most government programs they are poorly managed.

[N0help4u]

Quinn and Rose just read the outline of the healthcare plan. Pages 29 to 200+

29 talks about it being mandated
If you choose your own plan they will go through it with a fine tooth comb and try to insist you switch.

Further on
It talks about free health care for the illegal aliens

How medicare/medicaid will simply just become a part of the national health care.

The national ID for the national health care (toward the mark)

How there will be a board to determine if you qualify for life saving care and surgery.

That there will be NO appealing if they turn you down for care.

[excon]

That there will be NO appealing if they turn you down for care.

Good morning, N0:

Do you remember when George W. Bush said that the Gitmo detainees DIDN'T have habeas corpus rights? He said that he has the power to prevent them from ever having their cases heard in court... Well, of course, they DO have the right to challenge their imprisonment, and their cases ARE in court...

So, when some rightwinger tells you that you can't appeal a government decision, he's either lying, can't read or has an agenda.

Your Constitution says quite clearly in the First Amendment that you have the right to "..petition the government for a redress of grievances...".

excon

[N0help4u]

This is the left saying IN THEIR health care package that there will be no appealing if they say YOU can not get heart surgery.

Do you think they are going to let the constition or anything stand in their way when they are going for CHANGE that will reframe what our rights are??

Its in THEIR healthcare package plan they are so ready to pass asap

[NeedKarma]

This is the left saying IN THEIR health care package that there will be no appealing if they say YOU can not get heart surgery.

Why would one not get heart surgery? What would be the grounds for refusing that? Where in the bill does it say that?

[ETWolverine]

Why would one not get heart surgery? What would be the grounds for refusing that? Where in the bill does it say that?

Because the government has decided that this 80-year-old man doesn't have a very long life expectancy anyway, and the Health Benefits Advisory Committee (established on page 30 of the bill for the purpose of determining what benefits will be granted and which will not be) has decided that the cost of providing that operation isn't justified. THAT would be the grounds for denying it. And that is where it is written... pages 30-40 of the Bill.

But of course, you have to have read the bill to know that. And since the President has been trying to get the bill passed without anyone reading it, there's no way you would have known that little fact.

Elliot

[N0help4u]

Yeah if you have health issues they will say that your quality of life doesn't warrant the expense. ETW has it right it is in pages 30-40 of the bill.

[excon]

This is the left saying IN THEIR health care package that there will be no appealing if they say YOU can not get heart surgery.

Hello again, N0:

I remind you again, that the most powerful man in the world, POTUS, SAID that the detainees won't get hearings... But, they did...

So, I don't care WHO writes down the words "you can't appeal", or who says them to you in the hopes that you'll be frightened by them, they're full of ka ka.

excon

[N0help4u]

So you are saying Obamas change will be disregarded after it is passed?


We shall see
Let me know in your later years how it goes with your health if you need surgery or life sustaining care and get it.

[excon]

So you are saying Obamas change will be disregarded after it is passed?

Hello again, N0:

What I'm saying is that I highly DOUBT there are such words written into the bill. I think they're just made up by the right to scare people.

Certainly, NO lawmaker is going to propose a law that takes away peoples rights under the Constitution... It's just not going to happen.

I'd be happy to be WRONG, though. Just show me the words in the bill, and I'll back down.

excon

[ETWolverine]

Hello again, N0:

I remind you again, that the most powerful man in the world, POTUS, SAID that the detainees won't get hearings.... But, they did....

So, I don't care WHO writes down the words "you can't appeal", or who says them to you in the hopes that you'll be frightened by them, they're full of ka ka.

excon

Who would you appeal to? The same guys who made the decision in the first place?

And you think you'll get a fair hearing on said appeal?

Such trust you have in our government!!

Such a drone you've become.

"Government is good... they have your best interests at heart. They'll let you appeal. They only want what's best for you."

Ever try to appeal with the IRS? How far did you get?

That's what we're talking about here... health care run by a cross between the IRS and the DMV. Incompetence AND cold-heartedness rolled into one.

[excon]

Who would you appeal to? The same guys who made the decision in the first place?

Hello again, El:

It's pretty hard to discuss these issues if you don't even have a basic understanding of HOW our country works, and you don't.

excon

[N0help4u]

LOOK up page 29 line 4-16

I would be interested in knowing the exact wording myself.

If you can find different than 'what you think the righties are making it to say' I would be interested in knowing.

[amdeist]

amdeist ,yes to contain costs eliminating a bunch of infirmed would do the trick . The Dems seem to have the culture of death covered in both ends of this deal. Advise seniors to opt for early death ,and increase funding for abortion services.

Once those ends are optimized and costs are still out of control can eugenics be far behind ?

SS and Medicare are supposedly funded by us when we are young and working contributors to society .They in liberal theory are self funded .
The fact that our lives contribute to a burden to these programs is a gross distortion of the problem . The real problem is that they are government run programs that have been pilfered by our elected representatives for years .The real problem is that like most government programs they are poorly managed.

After watching the bloodbath that just happened with the non-government financial industry, the automobile industry, and the insurance industry that is yet to come, to say the government run programs are the problem is somewhat misinformed. It is unfortunate that the government got involved with helping any of these companies. Were they to be allowed to fail, millions who would find themselves unemployed without any unemployment payments would wake up and smell the coffee. All that the stimulus has done is pushed forward the demise of capitalism for a short while.

[ETWolverine]

After watching the bloodbath that just happened with the non-government financial industry, the automobile industry, and the insurance industry that is yet to come, to say the government run programs are the problem is somewhat misinformed.

Actually, it is very well informed. What is misinformed is to say that these financial companies failed of their owen accord. They were pushed by the government.

The mortgage debacle was a direct result of the Community Reinvestment Act and various Fannie Mae and Freddie Mac programs DESIGNED to create a market for sub-prime mortgages. The CRA laws FORCED banks to make 60% of their loans to people who couldn't afford them. I, as a lender, was FORCED to make loans that I knew were bad because if I didn't my bank would be shut down by the Federal Government. The existence of these bad loans was not the fault of the banks. It was the DIRECT RESULT of a government program that interfered with the normal workings of the credit market.

Fannie Mae and Freddie Mac were both DESIGNED to create a guarantee for lenders so that these lenders could make loans to people who would not otherwise be able to afford these loans. That was the reason for their creation. Eventually Fannie and Freddie stopped guaranteeing those loans, and instead began both MAKING them and BUYING them, thus creating a marketplace for these bad loans. If not for the existence of Fannie and Freddie, NONE of the bad mortgage loans would have been made, because there would never have been a market for them. Again, these two government programs, designed specifically for the purpose of interfering with the normal workings of the credit market, were the direct cause of the sub-prime mortgage crisis. If they hadn't existed, those mortgages would never have been made in the first place.

Say what you will about the derivatives markets being the cause of the problem... without the existence of the sub-prime mortgages there never would have been a mortgage derivatives market. And the sub-prime mortgages were the direct result of the existence of CRA, Fannie and Freddie.

So informed people KNOW that the failures we have experienced in the sub-prime mortgage market were the result of GOVERNMENT PROGRAMS that caused the problems, not failures of the financial institutions that made the loans in the first place or traded in derivatives.

Same thing for the auto industry. Government interference in auto manufacture, along with their support for unions over management are what made GM and Chrystler's business models unsustainable. Government regulations, monitoring and café standards drove the costs of manufacture through the roof. Union requirements caused the price of labor to be double or triple what non-union shops were charging. Between these two factors, GM and Chrystler were driven out of the market in terms of pricing. You could by essentially the same vehicle from Toyota or Nissan for 1/3 to 1/2 off the price of a GM or Chrystler vehicle, because the foreign car makers didn't have the same overhead in terms of regulatory costs, café standards, and labor costs. Again, this is a case where government interference caused the problem in the first place. And INFORMED people know that.

It is unfortunate that the government got involved with helping any of these companies. Were they to be allowed to fail, millions who would find themselves unemployed without any unemployment payments would wake up and smell the coffee.

Agreed. They would have realized that belonging to a union and putting your trust in government programs designed for social engineering and weal redistribution are NOT the solutions to making a better life for themselves.

All that the stimulus has done is pushed forward the demise of capitalism for a short while.

Exactly the opposite. Helping those companies only pushed back the inevitable demise of GOVERNMENT Interference in capitalism. A demise that has taken place every time it has been tried throughout history.

Elliot

[excon]

So informed people KNOW that the failures we have experienced in the sub-prime mortgage market were the result of GOVERNMENT PROGRAMS

Hello a:

Actually informed people know the failures were due to greed, a LACK of government oversight and a LACK of regulation...

It's not ME who is saying that... It's the American people, who FIRED the folks who think that way. Because, THAT thinking WAS in play for the last 8 years, and it brought us DISASTER!

excon

[ETWolverine]

Hello a:

Actually informed people know the failures were due to greed, a LACK of government oversight and a LACK of regulation...

No, that's what uninformed amateurs looking for someone at whom to point a finger and looking for simplistic solutions to complex problems "know". REAL economists and analysts know exactly what I stated. All of which is demonstrable through historical fact.

It's not ME who is saying that... It's the American people, who FIRED the folks who think that way. Because, THAT thinking WAS in play for the last 8 years, and it brought us DISASTER!

Excon

Yep... uninformed Americans made that decision. And now they are learning better. They are becoming more informed.

That's why this health care bill is floundering and Obama is trying to rally his forces to get it moving again.

Elliot