CNN special: Road Map for Saving Health Care

[Chuckanut]

Below is a history of the British NHS and how it has been reformed (or disorganized as some would say) from 1974 to 2006.

As you can see from the chronology table in the article, it took a long time to get it to where it is now. But, despite the problems, I have yet to meet a Brit who would trade their system for ours, or who would want to disband the NHS and go back to what they had pre 1948.

Reform of the National Health Service - a chronology

 

[Gone4Good]

To me, the biggest shift in the middle ground, possible area for compromise, was when the public option provision of the ACA was dropped.

That was obviously a compromise on the part of one side, which itself was a compromise of their ideal single payer plan. But as they say, "It takes two to Tango." One wonders how much better a place we'd be in today if there were two willing dance partners.

 

[samclem]

That was obviously a compromise on the part of one side, which itself was a compromise of their ideal single payer plan. But as they say, "It takes two to Tango." One wonders how much better a place we'd be in today if there were two willing dance partners.

And here we go again . . . right down the road that leads to the pig.

 

[eytonxav]

I really like Fareed's perspective on issues and his GPS show is always a learning experience and I suspect the healthcare show will be great as well. As far as ACA goes, it is overly complex and convoluted with way too many exceptions and doesn't do much for cost containment. That said, if ACA is a good basis for change, "everyone" should be made to comply without exception.

 

[Midpack]

And here we go again . . . right down the road that leads to the pig.

I was just hoping to provide a program note, but discussion is hard to resist on health care, self included...

 

[ziggy29]

And here we go again . . . right down the road that leads to the pig.

It's an important topic and one that's critical for many people who are FIREd and hope to FIRE. It is *the* 800 pound gorilla standing between millions and the ability to retire (or STAY retired). It's certainly the largest obstacle in my way, by a country mile.

But unfortunately these discussions tend to inevitably veer into the same clash of ideologies and political finger-pointing that have brought the Pig out so many times in the past. I think it's safe to say that these clashes haven't really worked very well in the past, as referenced by the mess we have now...

 

[Lancelot]

I don't think we've reached the tipping point yet. Most folks with decent employer sponsored health insurance seem to be satisfied with the status quo. If/when that group becomes the minority, I'd bet on change...

 

[samclem]

It is *the* 800 pound gorilla standing between millions and the ability to retire (or STAY retired). It's certainly the largest obstacle in my way, by a country mile.

For sure. But when we start talking about which "side" has compromised and which has been intransigent on this, well, I'll choose to stay on track and not go down that road.

I think it's safe to say that these clashes haven't really worked very well in the past, as referenced by the mess we have now...

It's the system we have. Sometimes it works well (it's not hard to find middle ground between a proposed tax rate of 15% and one of 10%). But sometimes it fails utterly. A compromise that results in an individual mandate and universal coverage (driving up the demand for insurance and care) but virtually no cost controls is an example of a process failure--a result that might prove to be worse than the "pure" plan proposed by either side.
Luckily, I think the process will work, but only after the thing proves so obviously failed that the popular consensus moves and we have an election result that allows a coherent plan to be built. The same thing will happen on spending/the budget, probably precipitated by a backlash among holders of US debt. When it's popularly recognized as a crisis, we'll fix it. Until then, we're just a frog in the beaker oblivious to the rising water temperature.

 

[Midpack]

I don't think we've reached the tipping point yet. Most folks with decent employer sponsored health insurance seem to be satisfied with the status quo. If/when that group becomes the minority, I'd bet on change...

Unforunately you're probably right. But I wonder if they realized they're actually paying the full amount, and how much that is - if they'd be more interested?

 

[mickeyd]

Unfortunately just about every article or TV story that covers obamacare seems to be slanted right or left. The authors/producers of the segment/article always depends on whose ox is gored or to-be-gored. I caught part of this CNN documentary and eventually went channel surfing. If I see it on again I think I'll TIVO it and watch it is small chunks. I'm willing to try it again since so many of you folks think it have a good message.

 

[ziggy29]

A compromise that results in an individual mandate and universal coverage (driving up the demand for insurance and care) but virtually no cost controls is an example of a process failure--a result that might prove to be worse than the "pure" plan proposed by either side.

I think you'll find almost everyone on both sides (all sides?) of this debate will agree that the lack of cost controls in the ACA is a major disappointment. Ultimately that is the worst problem in our system -- address runaway costs and everything else, including universal coverage and elimination of underwriting among other things, probably become a lot easier to address. Not breaking the employer link or a tax system that encourages delivery of health insurance through employment is a big part of this problem, too.

I can only assume the hope is that a year or two under ACA will reveal the deficiencies in the law for all to see, and that we can address them appropriately. Unfortunately that also requires that Washington be open minded and not intractably welded to their respective base.

 

[Midpack]

I caught part of this CNN documentary and eventually went channel surfing. If I see it on again I think I'll TIVO it and watch it is small chunks. I'm willing to try it again since so many of you folks think it have a good message.

Unless I'm mistaken, this hasn't aired before. I don't know what the message is yet.

The first GPS special of 2012, Global Lessons: The GPS Road Map for Saving Health Care, will debut on Sunday, March 18 at 8:00pm and 11:00pm ET & PT on CNN/U.S.
In this special, I look around the world for insights into how to raise the quality and lower the cost of health care in the United States.
Saving Health Care will replay on Saturday, March 24 at 8:00pm and 11:00pm ET and PT on CNN/U.S.

 

[Free To Canoe]

Great post Midpack!
I will be sure to watch.

 

[mickeyd]

Unless I'm mistaken, this hasn't aired before. I don't know what the message is yet.

Thanks. I must have seen something else on CNN that was simular to this.

 

[Gone4Good]

I think you'll find almost everyone on both sides (all sides?) of this debate will agree that the lack of cost controls in the ACA is a major disappointment.

Everyone agrees that more cost control is better than less cost control. Fortunately ACA includes the largest set of initiatives we've ever implemented to control healthcare costs. (Kaiser summary of cost control initiatives begin on pg 8 of this pdf)

 

[SpencerM]

Everyone would like to see costs controlled, true. Most do not want the government to be in control however. That will just breed bad decisions, for the latest political reasons du jour,and out of control administrative costs...

 

[obgyn65]

+1. I am resting at home today, since I have a severe cold. Will watch the program anyway, even if it's a bit biased.

Unfortunately just about every article or TV story that covers obamacare seems to be slanted right or left.

 

[Lancelot]

Unforunately you're probably right. But I wonder if they realized they're actually paying the full amount, and how much that is - if they'd be more interested?

Possibly. I think most folks don't honestly care what what health care costs- as long as some one else is paying... <or at least the perception that some one else pays>

Off topic but I wonder what the impact of footing the bill for employee health care affects competitiveness with foreign companies...

 

[ziggy29]

Everyone agrees that more cost control is better than less cost control. Fortunately ACA includes the largest set of initiatives we've ever implemented to control healthcare costs. (Kaiser summary of cost control initiatives begin on pg 8 of this pdf)

Perhaps so -- but *any* cost control measures, even meager ones, constitutes the "largest set" of initiatives ever taken when you consider there's been close to nothing in the past.

 

[FIREd]

Thanks everyone!

Porky Pig Cartoon Ending "That's All Folks!" - YouTube