Unless we replace the awful, inefficient and profit driven private health insurance industry with a government single payer system there is no real health care reform. by Joel S. Hirschhorn
(libertarian)
Thursday, June 25, 2009
In the national debate about health care reform absolutely nothing makes less sense than the positive views of much of the public about private health insurers. There is no good reason to have positive views of private health insurers, the companies that have relentlessly increased the costs for very limited health insurance. Copays, deductibles and premiums have raped those lucky enough to have health insurance while also making it very difficult much of the time to get coverage for all kinds of health problems. The US health care system is unbelievably inefficient, providing far less effective health care for what is incredibly high costs, compared to all other industrialized countries. The main reason is the private health insurance industry.
If you need solid information to believe this view, then consider these facts.
On the cost side, what is the problem? As Senator Bernie Sanders has said: The current private health insurance system is the most costly, wasteful, complicated, and bureaucratic in the world. Its main function is not to provide quality health care for all people but to make huge profits for companies. Private health insurance companies spend an incredible 30 percent of each health care dollar on administration and billing. Thirty cents of every dollar is not going to doctors, nurses, medicine, medical personnel; it is going to bureaucracy and administration plus exorbitant CEO compensation packages, advertising, lobbying, and campaign contributions. More efficient public programs such as Medicare, Medicaid, and the VA are administered for far less money, less than 10 percent.
As Sanders noted: From 2003 to 2007, the combined profits of the nation's major health insurance companies increased by 170 percent. William McGuire, the former head of United Health, several years ago, accumulated stock options worth an estimated $1.6 billion; CIGNA CEO Edward Hanway made more than $120 million in the last 5 years. CEO compensation for the top seven health insurance companies now averages $14.2 million. Over the last three decades, the number of insurance administrative personnel has grown by 25 times the number of physicians.
The double whammy is that we get so little for so much spending. Sanders also noted: The US spends far more per capita on health care than any other nation, and health care costs continue to soar unsustainably, now at $2.4 trillion and 18 percent of our GDP. Our per capita spending is 40 percent more than the second most costly national system. The insanity is that we get poor value for what we spend. According to the World Health Organization, the US ranks 37th in terms of health system performance; we are far behind many other countries in terms of such important indices as infant mortality, life expectancy, and preventable deaths. Even the latest federal National Health Quality Report concluded: "health care quality in America is suboptimal…the health care system is not achieving the more substantial strides needed to close the gap or ‘quality chasm’ that persists."
If Congress and the Obama administration believed in true, necessary health reform, then they should favor a government run single payer system. But they do not because they are corrupted by the money from the private health insurance industry. If the public was not delusional and brainwashed, then they would be screaming for a single payer system, but the latest Washington Post-ABC News poll posed this question to respondents: What if having the government create a new health insurance plan made many private health insurers go out of business because they could not compete? In that case would you support or oppose creating a government-run health insurance plan? Remarkably, 33 percent were opposed and 25 percent were opposed if private health insurers could not compete. Only 37 percent support the government run option regardless of any impact on the private insurers.
Considering the predominantly negative experiences most Americans have had with their private health insurance companies, these results are depressing. The only rational explanation is that Americans have been successfully brainwashed by years of propaganda and disinformation from the health insurance industry. As I and other Medicare users can attest to, a government run plan has provided me total freedom in choosing any physician and hospital I want to use. There is no sound reason to believe that a larger version of Medicare offered to all Americans would in any way reduce the quality of health care received.
The simple fact is that a huge amount of money can be saved by shifting from private to government health insurance, $4 trillion over ten years, more than enough to pay for universal health care coverage for absolutely all Americans.
What we are now witnessing in Congress and the White House is a total, ugly capitulation to the money and power of the private health insurance industry. If the private health insurance industry maintains its stranglehold on the national system, then taxpayers will pay even more money for the worst national health care system in the world, if Congress makes that costly insurance available to more Americans by using government money.
There were some other recent poll results. The New York Times/CBS News poll found that most Americans would be willing to pay higher taxes so everyone could have health insurance and that they said the government could do a better job of holding down health-care costs than the private sector. In fact, 85 percent of respondents said the health care system needed to be fundamentally changed or completely rebuilt, nearly 60 percent said they would be willing to pay higher taxes to make sure that all were insured, and 72 percent supported a government-administered insurance plan — something like Medicare for those under 65 — that would compete for customers with private insurers, versus 20 percent that said they were opposed.
Part of the disinformation campaign is that people are being manipulated to think that a government insurance plan equates to government run health care itself, which is shear nonsense. Medicare users access exactly the same private health care system as those with private health insurance. Of course, private health insurers charge so much money that they pay physicians and hospitals more money than Medicare, which is primarily a tactic to keep much of those parts of the health care system supportive of maintaining the private insurance system.
Dr. David Himmelstein is a founder and spokesperson for Physicians for a National Health Program. He believes President Obama is caving to the insurance industry: "The President once acknowledged that single payer reform was the best option, but now he’s caving in to corporate healthcare interests and completely shutting out advocates of single payer reform."
Did you like this article? If you did, Thumb It! 3
thumbs so far
The views expressed
in this article are those of Joel S. Hirschhorn only and
do not represent the views of Nolan Chart, LLC or its affiliates.
Joel S. Hirschhorn is solely responsible for the contents
of this article and is not an employee or otherwise affiliated
with Nolan Chart, LLC in his/her role as a columnist.
Posted By: Steven A. Rosile
Date: 2009-06-25 15:46:07
How on earth, sir, did you get in the libertarian quadrant? No true libertarian promotes socialism or statism in any of its forms. In single payer systems the tendency is always toward rationed services, increased costs and deterioriating quality. As P.J. O'Roark has said, "If you think health care is expensive now just wait until its free" and see how much more it will cost you.
Surely, you are not sincere. I know radicals will be up in arms over this one.
While the differences libertarians have may rival those of other political philosophies, one thing we all seem to agree on is when feasible, the best service should be rendered to the market. I know the range between minarchism and pure anarcho-capitalism to be based on market control of certain services, but I've never seen any such exception made for healthcare.
Forgive me, but you must have followed Gravel's exodus from the Democrats.
Secondly, I think many of your figures are way off. Of the NY Times/CBS Poll you reference, roughly 60% surveyed voted for Obama. Naturally, they lean towards liberal causes anyway.
While I respect Sanders as one of the few honest senators, he's a socialist and his job is to spin numbers and facts just as much as anyone else. Bringing up VA, Medicare, and Medicaid are not aids to your cause. VHA has failed recent veterans, with backlogs of applications and surgery delays. Also, Medicare and Medicaid will mushroom to $60 trillion in unfunded liabilities in the next 10 years. Fraud has also ballooned in recent years, to where $2 billion has been wasted since 2006 alone. It's almost a joke to mention.
But nevermind that. Let's completely wipe that out of the picture. Any further government intervention in healthcare will be the nail in the coffin, but just for kicks, let's say the U.S. does adopt a single-payer healthcare system. For the last 50 years and on, the silver lining has always been that medical innovation in the U.S. ranked consistently at the top. Most of this may be attributed to private investments, which equates to 75% of the world's R&D expenditures, against Europe's paltry 13%. This U.S. share in biopharmaceuticals R&D alone is roughly $300 billion. With private firms out of the picture, where will you fill this enormous void of research funding? With more pork barrel projects or other lump sum appropriations?
If $1 trillion is the most conservative estimate of Democrats for healthcare reform over the next decade, what amount do you think will compensate for the drop in research? Or let me phrase it this way: how much does lack of incentive cost?
Government does not create incentives, demand, or even supply. These are all things that determine scarcity of a good or service. Once we subsidize sick care and have a whole new liability on our hands, how do you think the government will keep costs low to keep up with demand? They'll either print more money or raise taxes further.
He who would stick his $ecker in a fire is more intelligent
than the brainless sheeple who would turn over their health
to the insane/amoral psychopaths of DC.
Want to envision true hell ?
Imagine yourself sick in a federal health clinic.
As an advocate for a new third party, with a different political attitude, I try to steer clear of social issues and stick to basic government reform, which is sorely needed. However - - healthcare is a major concern for nearly every American. Our healthcare system is broken and so is our system of government. Done in by corporatists, special interest and the like. The money influence. The medical/pharma industry has been at work since WWII to keep the right people in the right positions to garner tax breaks, perks, etc for their corporations. C. Rangel is right, no debate needed, get on with it as the congress has been lobbied hard and paid well for their votes. No debate needed. The outcome can be easily forecast. There will be no real healthcare reform. Change, maybe. Change the name on some medical programs, change a few prices, etc.
If we have a broken government and a broken healthcare system there really is not much to debate. Before debating this or any other issue we would have to have completed government reform. Such as; abolish corporate personhood and abolish money is free speech, reform campaign finance to remove the influence of money, invoke a flat tax policy where the government can’t make winners and losers based on tax law. Then, you could begin to debate such social issues as healthcare with some acuity to purpose.
Post reform I think you could go either way with healthcare. In a more true capitalist economy competition would operate just fine to support a free market system for healthcare. I’m against socialism in government in all things but perhaps healthcare. Because healthcare is so important to life I could tolerate a government run system. Here too, if certain reforms were completed a government sponsored healthcare program would operate just fine.
However, we have to face the reality of the current situation. Makes little to no sense to me to waste time debating healthcare or anything else. IMO the only solution to our growing problems is government reform through a 3rd party effort such as Republic Sentry.
"I’m against socialism in government in all things but perhaps healthcare. Because healthcare is so important to life..."
--- well so is food not everybody is elligible for food stamps.
I’m against socialism in government in all things but perhaps healthcare. Because healthcare is so important to life.
This reads as a blatant fallacy, not just for the logic mines it provokes. Health is important to life. Any sensible person, who maintains a balanced lifestyle, is practicing their own "healthcare".
The reason costs are so high in this country is because we have illegal aliens clogging hospitals, people abusing their policy providers with frequent miniscule check-ups, and a machine that endorses high-cost care. Not to mention the turnarounds you'll get from the HMOs whenever they try to reduce their own expenditures.
But people are people. And like always, even all the above might have been acceptable factors minus the fact that our collective diet is poorer than many third-world countries.
People need to realize that healthcare is a negative right, not a positive one. That is, it is not a responsibility of others to watch what YOU eat or pay for YOUR kidney transfer.
Adeian, that's sort of what I meant when I was repeating roy's commet about social medicine to be "free" because is "essential" to life. FOOD is MORE essential. We HAVE to consume it every day, and we have to pay for it. With a family of 5 I have spent way much more money on food than healthcare. Where is my government supplied free food? The healthcare costs are high because of a lot of factors: over-regulation, government-sponsored restriction of supply through licensing and limitations on medical schools, lack of price transparency before the service, etc...
Posted By: Joel S. Hirschhorn
Date: 2009-06-27 10:16:44
Never have I seen such wrong information in comments; must be that political philosophy blinds many people to seeking and accepting correct information. No single payer, government run system would be "free." People would pay to get the health care insurance, but they would pay far less and get much more as compared to private insurance. As to Medicare, which I have had for some years, I get the very best that our health care system offers, comparable to the most expensive private insurance, with freedom to use whatever doctors and hospitals I choose; of course, I pay for it plus I have supplemental insurance from a private company because Medicate does have limits. Illegal immigrants in any statistical sense cannot possibly explain the high US spending on health care: period, end of story. As to food, well in any society including the US there are private and public safety nets to prevent human beings from dying from starvation. Why can't libertarians accept all the data that show that the US simply is not getting really good health care results despite spending far more money than other countries? Corruption is the answer. Why would you defend a totally inefficient system that literally kills people? Why should citizens want so high a fraction of the GDP going to health care? Being ripped off by a large piece of the private sector should not be acceptable to anyone, regardless of their political philosophy.
Here is some "data" for you:
1) There is NO Constitutional authorization for ANY govt meddling in health care.
Therefore, such is a direct violation of the 10th Amendment.
2) You have no "right" to force ME to pay for YOUR health care !
Joel:
You may like your medicare, but I have to pay for it. I am 34, so there is a lot of years of medicare payments that I still have to do in order to receive the benefit myslef (if I ever get it). So, yes, it is good for you to get your medicare at MY expense through government theft. They took it from you too when you were younger, but you are either not getting all of it back, or you are robbing from me. Eithe way is wrong.
When you cherry pick statements from your dissidents, be prepared to come off like an arrogant fool. Actually, listening to them at all would help your case greatly.
We all know high costs are obviously not attributable to one reason alone. But if you were true to your words about "accepting correct information", then you would recognize government's already disastrous effects in regulating the medical industry. On the off chance you really cannot see how government has already created a de facto socialization of healthcare through its constant regulation since the 1960's (at the very least), then I encourage you to actually do the research.
What confuses me most of all is how you can rant about "total, ugly capitulation to the money and power of the private health insurance industry" in Congress and you want the same crooked regime to forge a new system for you. Somehow, they're going to get this one right!
I got news for you. Insurers are not the true enemy here. If you want to tackle healthcare reform, you must make that distinction carefully. HMOs are just one part of the formula. What about the pharmaceutical and technical companies that endorsed high-cost medicine, or the regulations that drove smaller insurance carriers out of business? Not to mention the colossal failure of your own subsidized coverage and its ripple effect on the private sector. For years, D.C. has used Medicaid and Medicare to their advantage to restrict alternative forms of healthcare and low-cost solutions. This phenomenon is the "crowding out" principle. Look it up sometime.
Libertarians, of which apparently you've agreed to be identified as one by your posting here, fundamentally believe in the competition of ideas. So when you call us out on blindly supporting political dogma, don't be too surprised to be labelled a hypocrite or an idiot.
I think the liberal Marxists have infiltrated the libertarian party. You are a good example. You are NOT a libertarian. You are a progressive liberal.
There is absolutely no way that the free market can be responsible for the health care mess. It's the government's fault, totally and completely. And they've screwed everything up in so many areas that nothing short of a radical shift is going to change it. They've screwed it up over decades and decades of meddling and incompetent, bumbling idiocy.
Second. The government has no interest is providing "health care." What they want is the means to control life or death over the populace, the means to subvert parental rights and the means to control every aspect of the individuals life. What we can look forward to is population control, forced abortion and euthanasia for old people and "unproductives." And if you think I'm kidding... well, look at Marxist countries the world over. There are no retarded people or blind people or deformed people in North Korea. Guess why! They KILL them at birth.
Put health care in the hands of the goverment? Don't make me laugh. There has never been a problem that the goverment couldn't make worse.
I think the real question is do we need health insurance at all. The worms have already been let out of the can, but it is my belief that insurance, (All insurance) as well as all types of credit are destroying this country.
#1 If I as an individual I have credit at my disposal I can “Afford” items and services that I could not otherwise get without savings. Thus putting myself in debt to the credit companies or insurers.
#2 With credit / insurance available companies are able to charge far more for a service than the average American can pay out of pocket. This allows for an ever increasing inflation of the prices.
With no insurance / credit, companies would be forced by the law of supply and demand to lower the cost of those services and items to an affordable level where the average person could purchase them or they risk pricing themselves out of business.
I realize this would put some people below the point of affording a service or item, but when did it become my responsibility to make sure everyone owns a car or can get that heart transplant.
However as I said, the worms are already out of the can. I could never envision Americans willingly giving up their precious credit cards and insurances. Heaven forbid people might have to actually save for what they want or need. Then where would we be?
Does the Nolan Chart site screen these essays before putting them up? How on earth did this article get posted as being libertarian? Mr. Hirschhorn, let me show you what a real libertarian thought of medicare years ago and you will see that the only one here delusional is ......ok no personal attacks. lol
Medicare provides a good example [of how government doesn’t work]. It was created in 1965 to make it easier for the elderly to get health care. But by reducing the patient’s out-of-pocket costs, it increased the demand for doctors and hospitals. And it reduced the supply of those services by requiring doctors and other medical personnel to use their time and attention handling paperwork and complying with regulations. So the price of medical care rose sharply as the demand soared and the supply diminished. As a result, the elderly now pay from their own pockets over twice as much for health care (after adjusting for inflation) than they did before Medicare began. And most older people now find it harder to get adequate medical service. Naturally, the government points to the higher costs and shortages as proof that the elderly would be lost without Medicare--and that government should be even more deeply involved.
Source: Why Government Doesn’t Work, by Harry Browne, p. 15 Jul 2, 1995
Want to comment on
this article? Leave your comment
here. Your email address is required to track your
comment. However, we will neither publish your email
address nor distribute it to other organizations or
persons. The only reason we might use it would be if
we needed to contact you regarding your comment. All
comments are subject to our
terms of use policy.
