Comments like this concern me. Now, I don't know the numbers so this is just hypothetical, but it is relevant to the health care debate.
Just because a program benefited someone or some group, does not mean that that program is a good idea. We live in a democracy, and we need to ask if the program was good for the nation (and maybe CETA was). We need to look at how much was put in, how much we got out, and also consider if alternatives would have provided a better bang for the buck.
As a parallel, I'm sure a sugar producer would say that sugar subsidies are a "wonderful program", but are they good for the nation?
I've posted enough on this topic, I should probably take a little break... so rather than comment point-by-point on some of the recent posts (and I support many of the comments) I'll just say again that I wish we had some documents like that one about the energy sustainability without the hot air. We can go back and forth on individual issues, but it is pretty meaningless w/o a real big picture view. What % of our current costs go to supporting illegal immigrants, what % of our costs goes to internal medical technology funding that helps subsidize other country's health care, what % of our costs could be reduced by more preventative care to poor people (and what % would utilize it?), etc, etc, etc?
W.O more hard numbers, I feel like so much of this goes in circles. And the emotional aspect of something that can totally turn around our lives makes it that much harder to get to the numbers.
The more I think about that, the more I think that Congress is NOT the place to deal with the details. Set up a voucher system, get some group like that MedPac to define terms and basic coverage options, and let the system work outside of Congress. Something like that.
-ERD50
I figured it would be too far off topic to give lots of facts and figures about CETA.
You are not going to get all the hard numbers on health care because the GAO can't figure out some of the savings. For example, it has said that it can not look into savings from best practices and eliminating redundancies.
A lot of the answers regarding
costs (in contrast to savings) can be found. I have read several books and many studies. This place is not the place where you can talk about all of them. But it may be surprising all that we do know.
As I have said many times, we can get our arms around some of the
savings by comparing different parts of the country and why some areas and some providers cost a lot less with as good or better outcomes. We also know that there will be savings to offset cost that we all bear through higher insurance premiums which go to pay for uncompensated costs that providers end up eating.
One big problem still remains the high admin costs we have as compared to other countries, resulting from the fact that we have too many reimbursement plans and every state with their own plan regulations. Even if we keep insurance companies I would like to see this attacked through some kind of standardization. Thirty one percent admin costs is a big area to save money.
One thing that is intriguing me more and more is changing reimbursement for medicare and medicaid to move the emphasis off of procedures and more on prevention and best practices. This could end up being a model for insurance companies to follow in the future, which could save costs (by eliminating unecessary procedures and focusing on prevention) and improve outcomes. I think that specialists will have to take a hit, which is going to be tough, and I think that primary care providers should be paid more and be more of a gatekeeper, especially for the elderly.
My sister is in California, in HMO land. She has a number of health problems due to life threatening asthma. She recently had pneumonia. She can stay in touch with her doc through email. It is very efficient for the both of them to communicate that way to make sure that day by day she is doing fine and can stay out of the hospital. They can only do that because of the way her doctor is compensated. I have asthma as well. The only way my doctor gets paid is through visits. She will not get reimbursed for phone calls and email is not an option. When I get sick due I have to make more visits to the doc which ends up more costly.
My doctor has gone to electronic records. It has been a bit frustrating for her as it slows her down as she imputs data, but it is growing on her. I recently had my physical. Her computer program would prompt her to be sure that she asked certain questions and checked certain boxes. It reduces her risk of error. Plus, she could press a button to print out prescriptions, which are now legible, and sign them on the spot.
A few years ago I had an accident where a huge container of sand fell on my hands. My hands were badly bruised and swollen. I went to the doctor. She said that compression injuries such as that rarely had broken bones. I said I was a piano player and wanted to make sure so she did an x-ray anyway. All was fine. That probably was unnecessary care in retrospect. Maybe I should not have been able to get the x-ray. Unless I was Van Cliburn.
But it is tough on doctors, who likely do not want to spend a good part of the day arguing with patients.
I tell these stories as just a small examples of how we can make delivery of heath care more efficient. Government can do that through the medicare and medicaid system now.
