National health care is aready in the cards. And it will be lousy.
The chart below is based on projections by Boston University's Laurence Kotlikoff, presented in his new paper, "Staticide: America's Suicidal Status Quo."
Kotlikoff is comparing the present value of all future government health benefits to the present value of all future gross domestic product. (Present value is what you would pay today in exchange for money at a future date.) Lots of caveats apply here: Projections like this are extremely sensitive to the guesses you make about future trends, as well as to the discount rate you use to come up with the present value figures. For these projections, Kotlikoff assumed health care benefit spending would grow at the rate it has since 1970 for the next four decades, and then grow on pace with per capita GDP thereafter.
So these numbers are really just a warning of what would happen if we stick to our present course. But what a warning. The other countries on this chart all have something approaching universal health care. But all Kotlikoff is measuring for the U.S. is projected spending on Medicaid and Medicare. "The U.S. is, under stated assumptions, on a course to spend close to one fifth of all future output (measured in the present) on two health care programs that, to repeat, cover only a minority of the population," writes Kotlikoff. That's right: We'll get all the cost and big government associated with universal care, only without the universal part.
Maybe we could do better. Don't you think?
A research paper I wrote in 2003 found that the overhead for U.S. health insurance companies was 16% to 26%, the low end being non-profits. Overhead in single-payer systems like Canada are 3-6%. Certainly, Canada has it's problems (which I'm sure plenty of people here will be quick to throw at me), but nothing is perfect and nothing ever will be. We can only aim for "better" and "more efficient". Having said that, with a reasonably higher co-pay on visits to temper demand, we could likely quell the over-use problem.
I am also a fan of universal health care because I believe health-care provision has become an enormous competitive disadvantage for American companies - particularly small businesses. That burden should be lifted off companies to allow better global competition and greater opportunity for entrepreneurialism.
I know we can do better. The US is rated very poor in overall health care by the World Health Organization, somewhere around 76th place (I believe) out of 200 countries. There is such a thing as prevention! However, insurance companies won't/don't compensate for preventative measures........ For instance, a person who belongs to a gym and can show he/she has worked out consistently 3 times per week over the last 6 months deserves some sort of break in their insurance premiums versus someone who hasn't stepped foot in one EVER. Additionally, there are really GREAT nutitional supplements on the market today, that are NON-toxic, but can't be purchased with insurance dollars - where insurance dollars CAN be spent on TOXIC (have to be leathal in order to be called a drug) narcotics. Something here, doesn't add up. Did you know the 3 leading cause of death in the USA is OUR MEDICAL SYSTEM! Many die from PROPERLY PRESCRIBED DRUGS, or get infections that NO drug can heal while a person is ailing in the hospital - you ask CAN WE DO BETTER - WE BETTER DO BETTER - YOUR HEALTH AND MINE DEPENDS ON IT! Shouldn't we all be entitled to the same standard of care as our president.........why is he any more valuable in "life" than say, YOUR mother??????? I know RADICAL CHANGES have to take place or we will bankrupt our own country. The first place to start is to OUTLAW drug commercials from TV just like we did back in the 60/70's when we banned advertising cigarettes........... From there, mandate that pharmacuetical companies look for NATURAL ways to heal, instead of TOXIC. There is a time and place for everything - we need to start at home with supplementing our diets as the AMA recommended back in 2000 and NOT be enticed to run to the doctor for the latest greatest drug everytime you or your child sneezes.........we have addicted ourselves to "the system" we call Health Care - when it there isn't really any care going on. All doctor's need to have mandated CEU in some form of Natural Prevention. American's need to wake up......Medicare/Medicade can't and won't last forever IF we don't take charge ourselves.
My wife worked for Kaiser Permanente (HMO) in the 80's when employees and their families received essentially free health care. To say the program was abused is an understatement. Most employees went to the doctor at the first sign of a sniffle and many had medicine chests with enough free prescription and non-prescription drugs to rival a pharmacy. Once the Kaiser Permanente program changed to add modest co-pays for these services, over-use and abuse of the system ceased practically overnight.
Shifting even a relatively small amount of the financial burden for medical care to the recipient would significantly reduce system abuse and save both the government and private businesses millions, if not billions of dollars.
Wow. Comments are now permissable!!!
Socialized medicine has been a disaster in every venue ever tried--just like socialism.
If you can't afford medical care in the US because of the scumbag HMO's and drug dealers, go to Mexico. You can walk in, get quality treatment by a USC medical school grad who, in my experience, beats the hell out of the typical 15 year-old intern you get in an emergency room in the US. And for pennies one the dollar.
So Hillary, blow your socialist health care ripoff out your fat A$$.
The issue that no one wants to address is how society should ration health care. When you consider that, on average, 50% of all monies spent on a single person's healthcare is spent in the last 6 months of their lives, society MUST start having a reasoned discussion regarding this factor.
Also, there must be some concept of responsibility. When an individual repeatedly presents for treatment of the same problem because they do not take any responsibility for their own care, society needs to decide if that individual deserves everyone else's monies and resources spent on their healthcare.
Consider the penchant for multimillion dollar lawsuits (come on, after your medical expenses are paid, do you really need millions more?)
Doctors pay very high premiums for malpractice insurance and I imagine hospitals do the same. My father was paying $14,000 a year as an opthalmologist back in the 1980's. I can only imagine what it is now.
Also, the cost of going to medical school is outrageous. It's not uncommon for a young doctor to have over $100,000 in debt. How many years does it take them to get rid of that debt?
This society has created its own problems with choices made. Yes, I feel we can make different choices and do better, perhaps by combining the best models from socialized medicine with capitalism, perhaps by putting stringent limits on malpractice award e.g. only enough to cover lost work wages or living expenses above medical expenses rather than $10 million for "emotional suffering." If I got paid for all the emotional pain I've been through so far in my life, I'd be a trillionaire!
By the way, animal lawsuits are starting to send veterinary care down the same path. Be a good citizen - don't add to the mess by suing for more than you're owed.
There is a difference between socialized medicine - such as the U.K. has - and a single-payer system with private health care provision. I'm far from a socialist, but a single-payer system has proven to be more effective and a more efficient use of resources.
Remember, "Free Market" capitalism is just another market structure like anything else. It's not "free"; "Free Market" is a marketing slogan. Every market structure has included and excluded factors, and different legal mechanisms. But this is all metaeconomics.
However you look at it, single-payer systems have proven themselves even inside the Free Market(tm) economic system as more efficient. Beyond ensuring all can receive health care, it would alleviate the burden on U.S. companies trying to compete globally against foreign companies that need not provide health care coverage. U.S. workers would become more employable versus foreign outsourced labor as companies no longer need to absorb those quickly growing costs of hiring U.S. employees. Small businesses have long suffered at attracting top talent because they are at a substantial disadvantage in their ability to offer benefits. Taking this burden off corporations would help the small business the most. Thus, not only is a single-payer system significantly more efficient, it also will aid U.S. companies in being more competitive, reduce the need to outsource labor to places like China and India, and will encourage entrepreneurialism by making small business more viable.
Insurance companies of all types and the pharmacuetical companies have had a free run of things for far too long. We need to do something now because I'm sure other countries are looking at us with a big question mark. When the majority of U.S. citizens can no longer insure themselves, we will be at risk and the insurance companies will disappear. Seems they keep forgetting our premiums are their paychecks.
We also need to remember no matter how you cut it, we will have to pay for health care. It isn't "free". At the very least it comes out of your taxes. I think we pay lower taxes than the countries that provide universal health care.
We also need to focus on preventive care. This is good for economics and good for us. Don't we all want to feel better? Ever wonder why we have so much sickness that transends all age groups?
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