Enormous Cost of US Health Care

[KeithE]

I’m going to be highlighting some of Ricky Andersson’s solutons to our big national problems. Stare at this Key Figure for a while.



The U.S. health care system is a fee-for-services, for-profit insurance-based health care system; the rest of the OECD countries with the exception of Mexico has universal health care system of various sorts.

They try to put several factors on this chart but the important one to realize is the high cost of the US system. Notice the US red line. Now the righthand y-axis is life expectancy and the US is below average at that (probably as much to do with eating and exercising habits than the health care system, imo). But we also rate below average in:
- infant mortality
- recovery from life threatening illnesses
- mortality of men 15-60
- mortality of women 15-60

and high in:
- bankruptcies due to health care bills
- uninsured people

Read this article from the prestigious New England Journal of Medicine for more gory details and why current approaches (ObamaCare) will not hack it. Of course continuation of present system should be considered a non-starter (for all but few of the chief beneficiaries).

Rocky’s solution recommends a single-payer, universally available* health care insurance, with private doctors of the patient’s choice and private hospitals. Patterned after Taiwan or Canada. Alternative is Medicare could serve as an interim. We simply cannot let the costs of heath care continue to line the pockets of the insurance companies, pharmaceuticals, and large hospital conglomerates who in turn lobby for advantageous inserts into often unrelated bills, take an ever increasing amount for administrative costs (17% vs Medicare’s 3%) and advertising (now at 30%), urge doctors to overtreat so that they can be overpaid, and line the coffers of sympathetic (really pathetic) candidates who spur great lines about the UnAmericanness of “socialized medicine” and the so-called "loss of liberty" it involves.

You know we lose a lot of liberty by the large amounts of dollars taken by the health care industry and we lose a lot of job mobility by the pre-existing conditions prohibitons we often must go through to change jobs or retire. And let us not forget we are the only OECD country that have over a few percent uninsured (and we have 16.7% uninsured).

* You know a country can have universally “available" health care coverage w/o a mandate. I’m not sure what Ricky says here - I’ve seen it mentioned both ways. I’d be pragmatic and let the Supreme Court decide on the Constitutionality of mandated coverage but will call for at least universally available health care coverage. Unlike car insurance which is and should be mandated, a choice of being non-insured hurts mainly the chooser. Cost can be made up by some combination of more efficiency (like all the other countries), a reduction in overtreatment, defense cuts (but not Missile Defense , just those offensive wars), and higher taxes on the rich (I’d be more than willing to pay more).

[Gene Scarborough]

It is difficult for me to see the chart without a magnifying glass. Any way to make it a little larger and bolder?

My wife works at Nash General Hospital Physical Therapy. Let me share some of the things going on there as an example of why healthcare costs are a problem in America.

Ever since she started there 10 years ago there has been constant pressure to do more work per person from nurses to techs. The pay is not that great and raises have been minimal. It is difficult for me to buy their "high quality patient care" mantra when the work demands prevent many of their key employees from spending quality time with patients.

This hospital is constantly building new buildings and modifying everything from carpets to computers to make them "look nice." Meanwhile, much very usable carpet and computers are tossed out the door to "get the latest." This major renovation approach is causing much "do and re-do" wasted change. The Administrator gets a big raise and public praise for putting on a big show of "improvements."

The most recent development in our area is a regional hospital concept whereby a number of community hospitals are being drawn together under the umbrella of a new name: Viadant. They say the name was chosen because it implies "life." They are spending more money in commercials and signs to promote their system and get patients to come to them.

We have the East Carolina University Medical Center which has offered "down home" services which used to be found only in the Raleigh-Durham area at Duke or Chapel HIll. Also Winston-Salem has Baptist Hospital associated with the Wake Forrest University Bowman-Grey School of Medicine. All of these major teaching hospitals is an asset, but an expensive one needing patients to pay their high cost through their insurance policies.

Sometimes I think we are obsessed with fancy procedures being made more simple with new technologies avoiding invasive surgery. The process of putting in a stint to widen an artery has taken the place of open heart procedures---BUT the cost of such does not reflect the simplification. It is like our chocolate bars full of air now = you get less basic ingredient and more air bubbles to keep the size looking the same = more profit to the manufacturer.

Add to this the preying Lawyers waiting to sue doctors and pharma and companies producing devices to help. No telling how much in legal expenses an artificial heart valve company pays!

The cost of US healthcare is astronomical compared to many other countries world-wide. For example, I have a relative who recently had a stint procedure in Accra, Ghana, the capital of the West African nation. It was $1,500! I suspect the exact same prodedure with an equally qualified surgeon here would be at least $15-150K. Quite a difference and the above approaches in hospitals is more the cause of high costs.

Our facilities are fancy and our costs of everything from personnel to carpet does not always guarantee better healthcare. When the mundane workers who make the difference are paid a pitance and a Dr. sticking his head in the door for a "consult" gets him $200 added to the patient's bill.

Something is wrong and we can do better.

[KeithE]

It is difficult for me to see the chart without a magnifying glass. Any way to make it a little larger and bolder?

If you have a Mac, you can magnify by holding down the Apple key and hitting the +/= key

Here is another look at the comparative OECD country costs per capita.


The US average is more than double the average of the OECD countries, and more than 50% higher than the second most costly country Norway.

The cost of US healthcare is astronomical compared to many other countries world-wide. For example, I have a relative who recently had a stint procedure in Accra, Ghana, the capital of the West African nation. It was $1,500! I suspect the exact same prodedure with an equally qualified surgeon here would be at least $15-150K. Quite a difference and the above approaches in hospitals is more the cause of high costs.

Our facilities are fancy and our costs of everything from personnel to carpet does not always guarantee better healthcare. When the mundane workers who make the difference are paid a pitance and a Dr. sticking his head in the door for a "consult" gets him $200 added to the patient's bill.

The cost of my stint was $55,000 but that was probably higher than normal due to he fact that my stay was longer than most because they had to thicken up my blood (have taken Coumadin since 1970) before the procedure and thin it up again afterwards. Stay in hospital I believe was 6 days.

I know a case where someone took his wife into the hospital ER and they put her in a “holding room”, saying a doctor will come see you soon. They waited from 8:30am to 3:00pm before anyone showed up. A doctor came, asked questions for about 1 minute and ordered what turned out to be a wrong dosage of a pill which she took. Also that doctor said she would be back shortly but never did come. The hospital finally sent them home at 5:30pm. She was never admitted or given a wrist band. The bill was $1875 to the hospital and $500 to the doctor. The patient did not have insurance. A letter has be written to the hospital to plead their case but no response has benn given them for now over two months. Not sure if they are going the legal route yet nor if they have been contacted by a collection agent or if they have paid yet for that matter.

This hospital is constantly building new buildings and modifying everything from carpets to computers to make them "look nice." Meanwhile, much very usable carpet and computers are tossed out the door to "get the latest." This major renovation approach is causing much "do and re-do" wasted change. The Administrator gets a big raise and public praise for putting on a big show of "improvements."

It is interesting to note what industries are building new buildings beyond what is actually needed to perform their function. Those are usually the industries that are making so much money that they have to hide their profit in some manner. In my town it is hospitals, banks, hotels, big DoD contractors (Lockheed-Martin, Northrop-Grumman, and Raytheon; Boeing not so much) and the Space and Rocket Center (which is actually donated money). These are all showy type buildings. What about in ya’ll's town.

Same goes (hiding their profit) for those companies with high CEO/Execs/BoDs salaries+stipends+excessive perks+stock options+bonuses. You get the picture (at least you should).

[Dave Roberts]

I have talked with hospital department heads, who are no longer with our local for-profit hospital, who described their situation as having to go to a weekly meeting in which each department had to describe what it was doing to make their process more profitable. While that certainly fits in the free-enterprise scheme, it means that departments were pressured to show a profit each month and criticized if they could not. This means continuing to order tests and procedures so that the bottom line stays up.

[Gene Scarborough]

The PT Department where my wife works is the same.

Part of her annual is a look at her time cards making sure there is no overtime even if her services are needed.

There is now a concern that 2 of the PT's in her department competed against the hospital to get a contract at the local State Prison facility. Her old boss saw it as a conflict of interest, but the higher-ups did nothing.

Where there is collusion among the staff, they are making enough with that most profitable department not to stir the waters. The PT's are the cash cow without the cost of expensive medical equipment and diagnostic tools like an MRI scanner which cost them several million and is being used for procedures not necessary many times.

It's all about the money, honey----and protection from lawsuits!!!!

[Sandy]

So, do you think that the propaganda that is put forth, about our high standards of medical care, and how terrible socialized medicine is in 'Canada and England is bought and paid for by profiteers in the insurance business?

George W. Bush sold this country out to the highest bidder. The end result is a one percent class of corporate wealthy that control the rest of the country. Unless something is done, they will have complete control of everything, and the government will be unable (or unwilling) to protect its citizens from what already amounts to an immoral level of legalized robbery. If Romney gets in there, the process will be accelerated.

It's becoming clear that the enemies of Obamacare are being bankrolled by the health insurance industry. They are paying a fortune for the publicity, the rumor mills, and all the crap that is disseminated by Limbaugh, Hannity and Beck, and all these other idiots like Drudge.

[KeithE]

So, do you think that the propaganda that is put forth, about our high standards of medical care, and how terrible socialized medicine is in 'Canada and England is bought and paid for by profiteers in the insurance business?

Not really. The insurance business is happy with ObamaCare - ~30,000 more mandated buyers. Pharmaceutics are thrilled by the agreement that bulk purchases of drugs from Canada or wherever has been negotiated away for their support of ObamaCare. Now neither is too unhappy with the status quo either. They just do not want single payer system - understandable in that the health insurance business would be out of business and drug costs down by more than 50%. But industries have to re-invent themselves periodically with changing times.

George W. Bush sold this country out to the highest bidder. The end result is a one percent class of corporate wealthy that control the rest of the country. Unless something is done, they will have complete control of everything, and the government will be unable (or unwilling) to protect its citizens from what already amounts to an immoral level of legalized robbery. If Romney gets in there, the process will be accelerated.

Agreed most whole-heartily!

It's becoming clear that the enemies of Obamacare are being bankrolled by the health insurance industry. They are paying a fortune for the publicity, the rumor mills, and all the crap that is disseminated by Limbaugh, Hannity and Beck, and all these other idiots like Drudge.

Truth is the health care and pharmaceuticals and hospital conglomerates industries has contributed very heavily Obama and to the Democrat Max Bacchus (who led the Health Care Act Reform).

Congress and the Obama administration worked out an unconscionable compromise health care bill that

perpetuates the perverse stranglehold for-profit insurance companies have on our system;
maintains the United States’s status as having the most expensive, inefficient health care system in the world; and
will still leave 23 million people without any basic health care coverage.
How did that happen? Basically, through bribery and the worst of Washington, D.C. politics-as-usual.

During three months – April, May, and June, 2009 – the lobby blitz by insurance companies and pharmaceutical companies makes it clear how the U.S. public was shafted – and the insurance and pharmaceutical companies, once again, made a killing. During those three months, the Blue Cross and Blue Shield Association spent $2.8 million on lobbyists; GlaxoSmithKline, $2.3 million; Novartis, $1.8 million; Metlife Group, $1.7 million; Allstate, $1.5 million; Johnson & Johnson, $1.6 million; America’s Health Insurance Plans, $2 million; and Bayer Corp., $2 million. The American Medical Association spent $8.2 million on lobbying from January through June.

The second quarter of 2009 was expected to set a record, exceeding the first quarter, when health-care firms and their lobbyists spent at the rate of $1.4 million per day to prevent the health care system desired by a majority of Americans.[12]

That’s just for lobbying. The most blatant bribery comes in the form of campaign contributions. Senator Max Baucus, a Democrat from Montana, played a powerful role in the health care “reform” negotiations and was Chair of the Senate Finance Committee. He was one of the insurance industry’s hired guns, working against the public’s desire for a competing public insurance option. Here’s how the situation was described by The Guardian:

A primary target of criticism is Senator Max Baucus, the single largest recipient of health industry political donations and chairman of the finance committee that drafted the legislation criticised by [Dr. Steffie] Woolhander professor of medicine at Harvard University and co-founder of Physicians for a National Health Program].

The committee twice voted against including public insurance in the legislation, with Baucus opposing it both times.

Baucus took $1.5m from the health sector for his political fund in the past year. Other members of the committee have received hundreds of thousands of dollars. . . .

Baucus holds dinners for health industry executives at which they pay thousdands of dollars each to be at the table, and an annual fly-fishing and golfing weekend in his home state of Montana that lobbyists pay handsomely to attend.[13]

One lobbyist was candid about how members of Congress are bought off:

“It would be very naïve to say they’re not influenced [by campaign contributions]. The contributors certainly hope they’re influencing and the recipients probably ultimately are influenced,” he [John Jonas, of lobbying firm Patton Boggs] said. “I think it’s a morally suspect practice, and then you have to look at its application to see if it’s morally bankrupt. . . .I think what’s bad about the system is it’s got more and more lax over time.

“When I started in this practice you did not talk issues at a fundraiser. It was impolite. And then with this need for money, the system has got coarser over time so that they go around the room asking what issues you’re interested in, much more of a linkage of dollars to a discussion of the issues now.”[14]

Then there’s the revolving door, from industry, to Congress, and back to make the big bucks in industry:

At Baucus’s side, drafting much of the wording of the reform, was Liz Fowler, a senate committee counsel whose last position was vice-president of the country’s largest health insurer, Wellpoint, which stands to be a principal beneficiary of the new law.

But the health care industry is also buying off Republicans because they really fear a single payer system (understandably for its survival). But survival of an industry cannot trump the needs of the people.

The ideological idiots you point out are attempting to do ObamaCare in with cries of "loss of freedom to choose doctors, “death panels”, “rationing of care” and the so-called gigantic deficit it would cause. Most of that noise from the RW pundits is utter lies and comes from the Republican propaganda machine which already has control over FoxNews and Clear Channel radio sans any extra money. Do not believe them, and I know you don’t Sandy, at least. CBO is now estimating a $150B drop in deficit over 10 years with ObamaCare compared to current practices. But that can hardly be very precise until the states start rolling out their programs in 2014 as planned under ObamaCare - could be more, could be less. Now the RW most often just reports on total costs of ObamaCare ($1.76T/year) and does not compared that to the current practice that is already more than $2T/year and growing at 6.7% a year - what a deceptive lie!
From Wiki:

In 2007, the U.S. spent $2.26 trillion on health care, or $7,439 per person, up from $2.1 trillion, or $7,026 per capita, the previous year.[32] Spending in 2006 represented 16% of GDP, an increase of 6.7% over 2004 spending. Growth in spending is projected to average 6.7% annually over the period 2007 through 2017.

But I’m not here to support ObamaCare. Under Rocky’s plan and other OEDC health care systems (e.g. Taiwan, France, Norway, Canada), you are "free to choose" doctors and hospitals (although I understand UK is not that way). There will be a goal of "right-sizing” health care but that is different than “rationing” - much needed to control our fee-for-services system which is motivated to treat more to get more and CYA from suits. Tort reform and control of overtreatment by a single payer best practices protocols will bring down costs and therefore insurance costs faster than anything - a lot more than ObamaCare under the best of likely states programs. I have no estimates but see that we can cut costs by at least 40% (Norway’s level) and that in all likelihood exceeds ObamaCare estimate savings. That is itself gives more “freedom” to people and universally available coverage gives “freedom" to move jobs and retire as well. So if you value “freedom”, as good Baptists do, you will want Rocky’s health care plan.

And note no matter what the SCOTUS says about the constitutionality of mandated coverage, coverage can be made universally available to all but not mandatory. So if you hear the SCOTUS has shot down single-payer systems, that would also be utter lies from the RW press.

An excellent source of information is at Physicians for a National Health Program (PNHP). Here’s just one key point from PNHP:

The U.S. spends twice as much as other industrialized nations on health care, $8,160 per capita. Yet our system performs poorly in comparison and still leaves 50 million without health coverage and millions more inadequately covered.

This is because private insurance bureaucracy and paperwork consume one-third (31 percent) of every health care dollar. Streamlining payment through a single nonprofit payer would save more than $400 billion per year, enough to provide comprehensive, high-quality coverage for all Americans.

Other places I’ve seen that administrative costs as being 17% instead of 31%. But with advertising and exorbitant CEO pay, it could easily be that high.

[Gene Scarborough]

I am confident that, if legislators would get together, we can solve the problems of the uninsured.

If doctors and hospitals and pharma work for their clients instead of using them for large profits, it will succeed.

Part of the problem is rediculous lawsuits so the legal profession has to get on board as well.

[Neil Heath]

One recent afternoon as I was listening to NPR news at 5 PM, I heard a conversation with one of the state attorneys-general who filed the lawsuit now in before the Supreme Court. He said that if the law had created a single payer system instead of what they did create, that it would be constitutional and the lawsuit would not have been filed.

[ET]

CBO is now estimating a $150B drop in deficit over 10 years with ObamaCare compared to current practices. But that can hardly be very precise until the states start rolling out their programs in 2014 as planned under ObamaCare - could be more, could be less. Now the RW most often just reports on total costs of ObamaCare ($1.76T/year) and does not compared that to the current practice that is already more than $2T/year and growing at 6.7% a year - what a deceptive lie!

It's easy to "save" money when you insure 2,000,000 fewer people. I notice the article you quoted leaves out that little bit of critical information that was in the CBS news version:

Assuming the Supreme Court does not overturn the law, the Congressional Budget Office would reduce the number of uninsured by 30 million in 2016, or 2 million fewer people than estimated last year.

Not to be deceptive or anything, I'm sure.

As for deception and lies, what does it say when you sell a product costing $900 billion and use creative accounting to make your case, and then the real world numbers come in and they are almost double?

I can't remember if I posted this article related to another CBO post, but since it fits in the discussion, here it is: CBO: ObamaCare-Like Programs Don’t Save Money or Reduce Costs

Health care reform programs that are similar to those promoted by the ObamaCare law do not save the government money or reduce health care costs, according to a report by the Congressional Budget Office (CBO).

For a different take on American health care: Why do Americans spend more on healthcare? Because they can

Americans have the highest health spending on the planet. Why? Because they can afford to do so. What few people realize is that the United States has increased its standard of living vis-à-vis its biggest competitors despite rising health expenditures.
***
It may seem trivial to observe that Americans spend more on healthcare because they can afford it. But it gets to the heart of an important question: Why are we so preoccupied with rising health costs in the first place? From the standpoint of the average American’s welfare—measured in terms of their standard of living—what really matters is how much they have to spend on everything else once healthcare has been purchased.
***
In the United States, real (inflation-adjusted) healthcare spending per capita has been rising faster than real GDP per capita for as long as we can measure it (back to 1929). Consequently, healthcare absorbs a growing share of GDP. But the same has been true for all our major competitors for as long as we can measure it (back to 1960).
***
From 1980-2007, U.S. health spending per capita grew by 4.3 percent a year. In Germany, this increase was only 2.5 percent a year. One might suppose that this large difference in health spending growth rates would have allowed Germany to catch up with the United States in terms of its non-health GDP per capita. That is, if Americans were spending more on healthcare, they must be spending less on everything else. But that’s not what happened. Between 1980 and 2007, the difference between U.S. and German health spending per capita grew by more than $3,000 (i.e., Americans spent $528 apiece more than Germans in 1980, but by 2007, this difference had grown to $3,078). Had non-health GDP per capita grown by identical amounts in each country, this would have reduced the U.S. non-health standard of living by more than $3,000 vis-a-vis Germany. But the rise in U.S. GDP per capita instead was so large that it not only covered the $3,000 in added health spending, but increased the U.S. margin of advantage over Germany in non-health spending by nearly $4,000!

[KeithE]

CBO is now estimating a $150B drop in deficit over 10 years with ObamaCare compared to current practices. But that can hardly be very precise until the states start rolling out their programs in 2014 as planned under ObamaCare - could be more, could be less. Now the RW most often just reports on total costs of ObamaCare ($1.76T/year) and does not compared that to the current practice that is already more than $2T/year and growing at 6.7% a year - what a deceptive lie!

It's easy to "save" money when you insure 2,000,000 fewer people. I notice the article you quoted leaves out that little bit of critical information that was in the CBS news version:

Assuming the Supreme Court does not overturn the law, the Congressional Budget Office would reduce the number of uninsured by 30 million in 2016, or 2 million fewer people than estimated last year.

Not to be deceptive or anything, I'm sure.

ET,

Read the above again, my friend. Carefully this time. ObamaCare (for all its warts) would "reduce the number of uninsured by 30 million in 2016” by the CBO’s latest estimate. Apparently it was 32 Million uninsured by their previous estimate leading to the phrase ET highlighted in red. All that assuming of course the SCOTUS let’s the mandate stand (which I do not think they will do judging from reports). The claim from CBO at least is that ObamaCare will lead to medical costs of $1.76T/year while it was $2.26T/year in 2007, $2.5T/year in 2009. That despite insuring 30 million more people not 2 million less.

Now I do not really trust the preciseness of CBO estimates given the many unknowns what the states will do about ObamaCare in 2014 (if the Law lasts), but there is no reason to believe costs will go up under ObamaCare.

Personally I hope ObamaCare is dropped and replaced with a single-payer system. That will work for all Americans for a lot less money like all other OECD countries (even the highest other country than the US is 35% less than the US). We are being ripped off by the medical industry at this time and it is only getting worse.



I’ll deal with the rest of your post later (maybe). Just had to correct your error in comprehension.

[KeithE]

I can't remember if I posted this article related to another CBO post, but since it fits in the discussion, here it is: CBO: ObamaCare-Like Programs Don’t Save Money or Reduce Costs

Health care reform programs that are similar to those promoted by the ObamaCare law do not save the government money or reduce health care costs, according to a report by the Congressional Budget Office (CBO).

Your linked article (from which your took the quote above from) has a very strange reading of the CBO study it reports on. Here is the highoights of the CBO report in toto w/o some conservative website spin on it.

In the past two decades, Medicare has conducted two broad categories of demonstrations aimed at enhancing the quality of health care and improving the efficiency of health care delivery in its fee-for-service program:

-Disease management and care coordination demonstrations have sought to improve the quality of care of beneficiaries with chronic illnesses and those whose health care is expected to be particularly costly.
-Value-based payment demonstrations have given health care providers financial incentives to improve the quality and efficiency of care rather than payments based strictly on the volume and intensity of services delivered.

CBO reviewed the outcomes of 10 major demonstrations that have been evaluated by independent researchers. The evaluations show that most programs have not reduced Medicare spending. Programs in which care managers had substantial direct interaction with physicians and significant in-person interaction with patients were more likely to reduce Medicare spending than other programs, but on average even those programs did not achieve enough savings to offset their fees. Results from demonstrations of value-based payment systems were mixed. In one of the four demonstrations examined, Medicare made bundled payments that covered all hospital and physician services for heart bypass surgeries; Medicare’s spending for those services was reduced by about 10 percent under the demonstration. Other demonstrations of value-based payment appear to have produced little or no savings for Medicare.

Demonstrations aimed at reducing spending and increasing quality of care face significant challenges in overcoming the incentives inherent in Medicare’s fee-for-service payment system, which rewards providers for delivering more care but does not pay them for coordinating with other providers, and in the nation’s decentralized health care delivery system, which does not facilitate communication or coordination among providers. The results of those Medicare demonstrations suggest that substantial changes to payment and delivery systems will probably be necessary for programs involving disease management and care coordination or value-based payment to significantly reduce spending and either maintain or improve the quality of care provided to patients.

The results were mixed but on the whole the 10 demo progras did not make up for the added fees. But note, the article do not say any of these demo programs were like ObamaCare (that was added by your conservative spin machine). In fact the spending from these demonstration programs did not work within the Medicare fee-for-service payment system. Big surprise. In fact these demo programs were more like our current fee-for-service as the CBO says in the 2nd red sentence. The Fee-for-Service approach says by all means let’s do more service (whether it is called for or not), so that we can have more fees.

A single-payer system reduces the ~14.8% administrative costs to something like Medicare’s ~4.7% admin costs, does away with advertising, and lowers outlandish CEO pay ($10M's) and VP salaries ($0.5-2M) to SES levels ($200-300K). Add to that the establishment of reasonable protocols (like all the OEDC countries do) and we have what the USA really needs!

For a different take on American health care: Why do Americans spend more on healthcare? Because they can

Americans have the highest health spending on the planet. Why? Because they can afford to do so. What few people realize is that the United States has increased its standard of living vis-à-vis its biggest competitors despite rising health expenditures.
***
It may seem trivial to observe that Americans spend more on healthcare because they can afford it. But it gets to the heart of an important question: Why are we so preoccupied with rising health costs in the first place? From the standpoint of the average American’s welfare—measured in terms of their standard of living—what really matters is how much they have to spend on everything else once healthcare has been purchased.
***
In the United States, real (inflation-adjusted) healthcare spending per capita has been rising faster than real GDP per capita for as long as we can measure it (back to 1929). Consequently, healthcare absorbs a growing share of GDP. But the same has been true for all our major competitors for as long as we can measure it (back to 1960).
***
From 1980-2007, U.S. health spending per capita grew by 4.3 percent a year. In Germany, this increase was only 2.5 percent a year. One might suppose that this large difference in health spending growth rates would have allowed Germany to catch up with the United States in terms of its non-health GDP per capita. That is, if Americans were spending more on healthcare, they must be spending less on everything else. But that’s not what happened. Between 1980 and 2007, the difference between U.S. and German health spending per capita grew by more than $3,000 (i.e., Americans spent $528 apiece more than Germans in 1980, but by 2007, this difference had grown to $3,078). Had non-health GDP per capita grown by identical amounts in each country, this would have reduced the U.S. non-health standard of living by more than $3,000 vis-a-vis Germany. But the rise in U.S. GDP per capita instead was so large that it not only covered the $3,000 in added health spending, but increased the U.S. margin of advantage over Germany in non-health spending by nearly $4,000!

There is some truth in what you say here ET. Americans need to not run to the doctor as often they do. And if they do, the doctors/nurse practioneers need to screen patients. I’ll add to your article, that our US diets and lack of exercise adds some to our costs as well, but it doesn’t double it.

[Gene Scarborough]

I can tell you this about my wife's observations at her PT Department where they are treating the obese masses of WIC abusers and porch sitters.

They are now having people wanting hip and joint replacements because of their 300# and up size. Medicare is refusing to pay for such. Now, that is a money-saving measure toward people who brought on their disease with too much eating and sitting and not working daily as we do!

[ET]

I’ll deal with the rest of your post later (maybe). Just had to correct your error in comprehension.

No error in comprehension. The original plan was going to reduce the number of uninsured by 32 mil. Now the guesstimates reduce the uninsured by 30 mil. So they've disposed of insuring 2 million people. Nice cost "savings".

Gene, interesting story you mention. Similar sentiments in a commentary from across the pond: Why should fat people take precedence over the elderly in the NHS?

Even the most sentimental champions of the NHS recognise its dark side. Given that its Chief Executive Sir David Nicholson has demanded a £20 billion efficiency saving if the NHS is to survive, and that demographic changes mean millions more elderly people will rely on its services (and space), the NHS can only do one thing: ration.

[KeithE]

I’ll deal with the rest of your post later (maybe). Just had to correct your error in comprehension.

No error in comprehension. The original plan was going to reduce the number of uninsured by 32 mil. Now the guesstimates reduce the uninsured by 30 mil. So they've disposed of insuring 2 million people. Nice cost "savings".

Not to beat a dead horse but here is the context:

CBO is now estimating a $150B drop in deficit over 10 years with ObamaCare compared to current practices. But that can hardly be very precise until the states start rolling out their programs in 2014 as planned under ObamaCare - could be more, could be less. Now the RW most often just reports on total costs of ObamaCare ($1.76T/year) and does not compared that to the current practice that is already more than $2T/year and growing at 6.7% a year - what a deceptive lie!

It's easy to "save" money when you insure 2,000,000 fewer people. I notice the article you quoted leaves out that little bit of critical information that was in the CBS news version:

Assuming the Supreme Court does not overturn the law, the Congressional Budget Office would reduce the number of uninsured by 30 million in 2016, or 2 million fewer people than estimated last year.

Not to be deceptive or anything, I'm sure.

The cost comparison was between the CBO estimate of total yearly health care costs under ObamaCare ($1.76T) and what it costs now which I conservatively said was over $2T (really is at lest $2.5T which is what it was in 2009). To which you said "It's easy to "save" money when you insure 2,000,000 fewer people.”. Truth is the ObamaCare costs is insuring 30,000,000 more people and does so for a lot less $$ (at least according to the CBO estimate).

If you argument is with the CBO estimate I’ll admit is is a very rough estimate and I have my doubts as well (since the states will construct the “health exchanges” and how they will do so is largely unknown at this time). But your argument is flawed since you thought the “savings” (1.76T vs >2T) was due to 2M less people being insured. Not so. It was really 30M more being insured.

Things can get confusing, but think carefully about the words you said in context - it had to come from a misunderstanding.

[KeithE]

Gene, interesting story you mention. Similar sentiments in a commentary from across the pond: Why should fat people take precedence over the elderly in the NHS?

Even the most sentimental champions of the NHS recognise its dark side. Given that its Chief Executive Sir David Nicholson has demanded a £20 billion efficiency saving if the NHS is to survive, and that demographic changes mean millions more elderly people will rely on its services (and space), the NHS can only do one thing: ration.

What some call rationing health care, I call right-sizing health care.

ET, I suspect you and I should both be right-sizing our diets.

[Gene Scarborough]

Gluttony is a sin which separates us from the ability to walk without breathing hard and straining our bodies into a potential stroke or heart attack----and I speak to myself as well with my 200# overweight condition.

Maybe universal healthcare should include "chester drawers" syndrome = my chest done fell into my drawers!

[Gene Scarborough]

Down-to-earth article from a person suffering from a lifetime illness:

http://truth-out.org/

She was 25 years old, and her right arm had gone sideways on her over the last nine months with a collection of symptoms - numbness, tingling, and tremors of such severity that her good hand was all but useless for anything besides waving at friends - that we had run out of explanations for. Nerve damage? Carpal tunnel? We didn't know. She had gotten an MRI two days earlier, and the doctor had called that day asking us to come down and talk about it. The conversation began with, "You have multiple sclerosis," and that has been our undeniable reality ever since.

If all US citizens had this kind of protection, so many could be humanely treated by good medicine!

[Gene Scarborough]

Richard Land now pontificates on the National Healthcare issue:

http://blogs.ajc.com/political-insider-jim-galloway/2012/04/10/southern-baptist-leader-jesus-wouldnt-like-health-care-panels/

On C-SPAN this morning, Richard Land, president of that arm of the Southern Baptist Convention that concerns itself with national issue, was asked by a caller to justify his opposition to President Barack Obama’s health care overhaul.

Said Land:

”I don’t think Jesus would support the rationing panels that are in place for Obamacare. I’m getting letters every day – every day – from people who are already being rationed care since the new head of Medicare came in. They’re being told if they have terminal conditions, they can’t get treatment for other diseases.

“Even Mr. Obama said that perhaps it wasn’t the best allocation of resources to give his grandmother, who was dying of cancer, a hip replacement. So I guess she can hobble around in terrible pain with a bad hip while she was dying of cancer. I don’t think that’s very Christian, ma’am.”

I think we have a moral obligation to make healthcare available to all throughout their life. The "awful Obamacare" (which no one can describe really) is no different than what we have now! No one with Hepatitis needing a liver will get one because such efforts would simply infect a good transplanted kidney. Why would someone with liver cancer--for which there is no cure--even elect to endure pain and suffering from chemotherapy and radiation? Their finances would be bankrupted if they personally paid. The insurance rates within any company would sky rocket if all covered were given whatever they wanted over what would work for healing.

We are foolish to think any of us can live forever. We are greater fools to endure misery in wasted treatments when ultimately we will all die.