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

To: Lane3 who wrote (18627)	8/5/2010 11:51:11 AM
From: Murrey Walker	Read Replies (1) \| Respond to of 42652

8 reasons why healthcare costs are rising And how many of those reasons did those who pushed Obamacare, use as rational? I'm not quite sure what Lundberg meant with 8.

To: Lane3 who wrote (18627)	8/6/2010 7:22:29 AM
From: skinowski	2 Recommendations Read Replies (2) \| Respond to of 42652

I am not as "anti-Pharma" as many on SI. It seems to be almost anti-social and in poor taste to say anything positive about Pharmas - against the general consensus. Yes, they spend money on marketing - who doesn't? I'm told that lawyers pay literally hundreds of dollars to Google every time when someone clicks on some of their ads... related to big cases. If Pharmas stop marketing their "new expensive" drugs, those drugs will never have a chance of becoming old and cheap. About defensive medicine - I agree, there is a degree of collusion between many doctors, and the messy system. They make money being defensive. What came first is a question of the chicken and egg. The obvious cure is a malpractice reform - which is exactly what Mr. Obama has so quickly decided against.

To: Lane3 who wrote (18627)	8/31/2010 1:24:52 PM
From: TimF	Read Replies (1) \| Respond to of 42652

6. Insurance companies that primarily care about making money for their owners and senior executives. I don't see this as an important factor. Primarily because the profits of health care insurance companies, combined with the total compensation for the senior executives of those companies, make up such a small part of the cost of total health care and health care related activities. Secondarily because he's essentially saying "its expensive because their greedy", and I don't think they are more than other sectors with cost growing at a lower speed, and also greed to me is on the scale of an important market for a whole nation, pretty much a given. Its like blaming an airplane crash on gravity. People usually care about profit, and this is usually a good thing not a bad one. The same would apply to the drug companies that push their more expensive drugs, and the "American marketing" point. To the extent that far more expensive drugs are used that are far more effective, that isn't something entirely under the control of drug companies. Physicians have to proscribe and patients have to buy these drugs, and insurance companies have to decide if, and how much, they will pay for them. Its not "greedy drug companies grabbing all the money", its something more complex about the market that lets them do this. I think he makes some points though. Particularly the cost insulation mentioned in item one with patients who consider medical care a "freebie" (or cheaper than its real cost) because they don't pay it (This is probably the biggest factor out of the one's he mentioned, but one of the hardest to deal with), the absences of transparency, and the defensive medicine. The defensive medicine is probably the largest liability related cost, perhaps by far, but you also have the direct cost of awards and settlements, the legal costs, the insurance costs, and the cost of time and effort to deal with actual or potential lawsuits. You also have a reduction in supply in some areas of medicine which would tend to push prices up in certain areas for certain specialties (for example you have very few ob-gyns in some areas) I would add Baumol's cost disease, which has been discussed here before. Areas with lesser productivity gains, get more expensive relative to other areas. The workers who productivity does not greatly increase, have their compensation increase with the increase in the more productive areas, because otherwise the workers in this area would move on to the more productive area to get the higher wages in that area. Doctors and other medical workers pay has probably increased more than just the amount in other industries because in addition to the cost disease issue, they have been required to have more education and training than in the past, rising the cost to become a doctor (or to a lesser extent some other form of health care worker), and limiting the supply. There also may be other limits to supply in terms of medical school slots and such, and in terms of any shortages taking some time to fill up, becuase it takes years to become a doctor, and it would also take some time and money to change specialties (which often wouldn't be worth it)