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Politics : A US National Health Care System? -- Ignore unavailable to you. Want to Upgrade?


To: Mary Cluney who wrote (2908)11/15/2007 11:00:41 AM
From: Road Walker  Respond to of 42652
 
Map to better health care: centralize, organize By Maggie Fox, Health and Science Editor
Thu Nov 15, 12:34 AM ET


Experts laid out a health care road map for U.S. presidential candidates on Thursday, recommending more organized care, with an emphasis on overall health as opposed to expensive interventions.

They said it will be essential to ensure that everyone in the United States has health insurance and said the most pragmatic way to achieve this would be a combination of federal, state, employer and private coverage.

And the country needs to train more primary care physicians and move away from expensive, specialized medicine, the panel appointed by the non-profit Commonwealth Fund recommended.

"We do not get good value for our health care dollars," Karen Davis, president of the Commonwealth Fund, told reporters in a telephone briefing. "The United States falls short when compared to other countries."

The Fund, which commissions research on health care and advocates for universal coverage, issued a scorecard in October 2006 that gave the United States a rating of 66 out of a possible 100 on 37 health indicators such as premature death and infant mortality.

Earlier this week the Organization for Economic Cooperation and Development noted that Americans spend far more than any other country on health care at $6,401 per person per year in 2005, compared to the OECD average of $2,759.

The 2008 elections represent a unique opportunity to turn around rising spending and set up a system that will provide better care for everyone, Davis said.

"There is no question that health care is at the top of the nation's agenda in the presidential election and will be a key issue for the next president," she said.

Most of the 2008 presidential candidates have offered some kind of health care proposal, with Democrats mostly calling for expansions of government insurance augmented by the private sector and Republicans advocating a market-based approach.

UNFETTERED PAYMENTS

The Fund appointed a committee of health policy experts from government, private industry, health care delivery organizations, academia, and professional associations to come up with a plan.

One of the main recommendations was to move away from "unfettered fee for service" payments that encourage doctors to perform expensive procedures such as diagnostic screening tests or surgical operations.

Instead, doctors should be rewarded for keeping patients healthy, said Dr. James Mongan, chief executive officer of Partners HealthCare System, Inc. in Boston and chair of the panel.

Insurance companies can help do this but first everyone needs insurance, Mongan said. "The first strategy is affordable coverage for all Americans," he said. Currently, 47 million Americans have no health insurance.

Some of this might be mandated, the report said, and insurers may have to be barred from refusing coverage to some people.

Another must-have: electronic health records. That will be the basis for another recommendation, which is more cohesive care, with doctors talking to one another and patients taking more of an active role in managing their own health.

Not all decisions can be left to a free market, the panel said. "Many of the highest-cost patients arrive at a hospital on a stretcher, with little or no ability to make care decisions. Every American -- not just those with the luxuries of time and ability to navigate their way -- deserves excellent care," the report reads.

(Reporting by Maggie Fox; Editing by Stuart Grudgings)



To: Mary Cluney who wrote (2908)11/15/2007 9:53:43 PM
From: Ilaine  Read Replies (1) | Respond to of 42652
 
You're correct about the information logjam needing to be unjammed.

The impetus towards improved technology in the medical system doesn't come from government run hospitals, of which we already have quite a few.

The big money comes from private industry, wanting to be more efficient and make a bigger profit. They're willing to spend money to make money.

I've used technology in my own service industry (law) since 1983, when we still used Unix. Lawyers and doctors have the money to pay for newer, better technology.

My husband, who's a government bureaucrat (USPTO) can only relate horror stories, years and years of horror stories, until technology became so good and so cheap it was a no-brainer even for the government.

I wish I could introduce you to the brother in law who's an administrator at a government hospital, too. Sure, he'd love to have more money to hire more nurses and buy more equipment, but he'd never tell you that he's able to give improved service for less money than the private sector. It's just not so. The people willing to work for lower pay are not the best people.

Eliminate competition and all you've done is lower the common denominator.



To: Mary Cluney who wrote (2908)11/16/2007 7:24:22 AM
From: Road Walker  Respond to of 42652
 
As Peter Orszag, the director of the Congressional Budget Office, put it in a recent article co-authored with senior analyst Philip Ellis: “The long-term fiscal condition of the United States has been largely misdiagnosed. Despite all the attention paid to demographic challenges, such as the coming retirement of the baby-boom generation, our country’s financial health will in fact be determined primarily by the growth rate of per capita health care costs.”
__________________________________________________

Played for a Sucker
PAUL KRUGMAN
Lately, Barack Obama has been saying that major action is needed to avert what he keeps calling a “crisis” in Social Security — most recently in an interview with The National Journal. Progressives who fought hard and successfully against the Bush administration’s attempt to panic America into privatizing the New Deal’s crown jewel are outraged, and rightly so.

But Mr. Obama’s Social Security mistake was, in fact, exactly what you’d expect from a candidate who promises to transcend partisanship in an age when that’s neither possible nor desirable.

To understand the nature of Mr. Obama’s mistake, you need to know something about the special role of Social Security in American political discourse.

Inside the Beltway, doomsaying about Social Security — declaring that the program as we know it can’t survive the onslaught of retiring baby boomers — is regarded as a sort of badge of seriousness, a way of showing how statesmanlike and tough-minded you are.

Consider, for example, this exchange about Social Security between Chris Matthews of MSNBC and Tim Russert of NBC, on a recent edition of Mr. Matthews’s program “Hardball.”

Mr. Russert: “Everyone knows Social Security, as it’s constructed, is not going to be in the same place it’s going to be for the next generation, Democrats, Republicans, liberals, conservatives.”

Mr. Matthews: “It’s a bad Ponzi scheme, at this point.”

Mr. Russert: “Yes.”

But the “everyone” who knows that Social Security is doomed doesn’t include anyone who actually understands the numbers. In fact, the whole Beltway obsession with the fiscal burden of an aging population is misguided.

As Peter Orszag, the director of the Congressional Budget Office, put it in a recent article co-authored with senior analyst Philip Ellis: “The long-term fiscal condition of the United States has been largely misdiagnosed. Despite all the attention paid to demographic challenges, such as the coming retirement of the baby-boom generation, our country’s financial health will in fact be determined primarily by the growth rate of per capita health care costs.”

How has conventional wisdom gotten this so wrong? Well, in large part it’s the result of decades of scare-mongering about Social Security’s future from conservative ideologues, whose ultimate goal is to undermine the program.

Thus, in 2005, the Bush administration tried to push through a combination of privatization and benefit cuts that would, over time, have reduced Social Security to nothing but a giant 401(k). The administration claimed that this was necessary to save the program, which officials insisted was “heading toward an iceberg.”

But the administration’s real motives were, in fact, ideological. The anti-tax activist Stephen Moore gave the game away when he described Social Security as “the soft underbelly of the welfare state,” and hailed the Bush plan as a way to put a “spear” through that soft underbelly.

Fortunately, the scare tactics failed. Democrats in Congress stood their ground; progressive analysts debunked, one after another, the phony arguments of the privatizers; and the public made it clear that it wants to preserve a basic safety net for retired Americans.

That should have been that. But what Jonathan Chait of The New Republic calls “entitlement hysteria” never seems to die. In October, The Washington Post published an editorial castigating Hillary Clinton for, um, not being panicky about Social Security — and as we’ve seen, nonsense like the claim that Social Security is a Ponzi scheme seems to be back in vogue.

Which brings us back to Mr. Obama. Why would he, in effect, play along with this new round of scare-mongering and devalue one of the great progressive victories of the Bush years?

I don’t believe Mr. Obama is a closet privatizer. He is, however, someone who keeps insisting that he can transcend the partisanship of our times — and in this case, that turned him into a sucker.

Mr. Obama wanted a way to distinguish himself from Hillary Clinton — and for Mr. Obama, who has said that the reason “we can’t tackle the big problems that demand solutions” is that “politics has become so bitter and partisan,” joining in the attack on Senator Clinton’s Social Security position must have seemed like a golden opportunity to sound forceful yet bipartisan.

But Social Security isn’t a big problem that demands a solution; it’s a small problem, way down the list of major issues facing America, that has nonetheless become an obsession of Beltway insiders. And on Social Security, as on many other issues, what Washington means by bipartisanship is mainly that everyone should come together to give conservatives what they want.

We all wish that American politics weren’t so bitter and partisan. But if you try to find common ground where none exists — which is the case for many issues today — you end up being played for a fool. And that’s what has just happened to Mr. Obama.