Americans Want More Health Care Investment by Government

[dazzleman]

Adding more government to the mix certainly isn't the solution.  What we need is less government in this matter, not more. 

I agree completely with this.  I shudder to think of the consequences of government control of health care.

[dazzleman]

angus, you're very right to point out the legal angle to this problem.

Our ailing and dysfunctional legal system is being used as a means of legalized extortion to milk the health care system of huge amounts of money that go into the pockets of ambulance-chasing lawyers.

A health care system with the government as the sole payer will not change this.  Taxpayers will simply assume billions of dollars of illegitimate legal liabilities directly, rather than indirectly as is currently the case.

Until the legal system is fixed, there is no point in putting through any type of real reform, because the current legal system is a dealbreaker as far as the success of any reform is concerned.

[dazzleman]

One thing that we don't talk about much is that the term 'insurance' is really a misnomer for medical coverage.

The term 'insurance' implies that there is a pretty low likelihood that it will ever be used to a major degree.  I own a home and have fire insurance, but the theory there is that a lot of people pay a small amount of money to protect them against something that is highly unlikely.

In the case of health 'insurance,' it is not insurance at all, really.  It's a plan by which we pay a steady (if ever increasing) amount of money on an ongoing basis, rather than paying when we need the service.

I suspect some combination of medical savings accounts for routine issues and catastrophic insurance for major issues might be better than the system we have now.

The catastrophic insurance would be a lot closer to the true insurance concept -- there is a low likelihood that it will be needed at any given time, though like life insurance, it will probably be needed eventually.

And with medical savings accounts, the consumer will be directly in touch with what he/she is actually paying for medical care, making the market more efficient.

There will never be the necessary legal reform until enough people wake up and realize how badly we are all being raped by these lawyers and frivolous lawsuits, and demand legal reform.  That has a better chance of happening if people see the effect directly, and can't just blame 'greedy' insurance companies.

[dazzleman]

I do blame the juries.  But the system seems to pre-ordain that bad juries will be chosen.  And that the same case heard in different jurisdictions will yield completely different results.

Your dad's story is a very sad one, and not the only one I am sure.  Still, the legal system has to find a better way, other than relying on pools of people in which anyone who shows any sign of brain wave activity is automatically eliminated, in order to separate the legitimate from the illegitimate cases.

In the meantime, more government 'investment' in health care (whatever that means) can only serve to further enrich people who are illegitimately manipulating the legal system to the detriment of the rest of us.

[dazzleman]

I do blame the juries.  But the system seems to pre-ordain that bad juries will be chosen.  And that the same case heard in different jurisdictions will yield completely different results.

Your dad's story is a very sad one, and not the only one I am sure.  Still, the legal system has to find a better way, other than relying on pools of people in which anyone who shows any sign of brain wave activity is automatically eliminated, in order to separate the legitimate from the illegitimate cases.

Agreed. There is no simple solution. My point was simply that blaming only lawyers is simplistic at best and deceptive at worst.

The reality is that anyone with a highly marketable and rare skill is going to charge an arm and a leg for their services, whether it be a doctor, a lawyer, or a professional athlete, or any other profession. Someone always has to pay the bill, and whether it's through the private sector or the public sector, it still all comes back to the consumer in the end.

It's not right to blame only lawyers.  That is true.

But it's also true that lawyers have a lot to do with what is wrong with the legal system.

Still, lawyers are like out of control children.  While they are bad and responsible for their own behavior, it is still a failure of the parents who allow that behavior to continue.  We have to find some type of mechanism to get rid of the frivolous lawsuits to the greatest extent possible, other than taking up years of time in the system to put them in front of brain-damaged juries who are incapable of comprehending the decisions they are making.

[dazzleman]

The big problem with the legal system is that even an innocent person has to spend huge sums of money to defend himself.

This acts as an incentive for unscrupulous lawyers to go after soft targets like insurance companies who have deep pockets.

Many companies will settle even when they know they're right because (a) it would cost more to mount a good defense, and (b) with the way juries are selected, there is no guarantee that a reasonable determination will be reached.

The effect of all this is subtle, and goes beyond the medical realm.  So many business decisions that are often not the best thing overall are made based upon the assumption that the legal system cannot be trusted to reach reasonable conclusions, and that involvement with it must be avoided at all costs.

I like your grand jury idea for civil cases.

[dazzleman]

The right loves to demonize lawyers, but the reality is that lawsuits/legal costs account for less than 1% of health insurance costs.

Do you have a source for that Scoonie?

[dazzleman]

The behaviour you mentioned above was not 'irresponsible', David S, it was caused by the position of the participants in the social heirarchy.  They are powerless poors, and therefore are oppressed, lack resources and options, and therefore live in the fashion described.  The 'blame', as always, lies with the powerful who made it happen that way, not the powerless who were mere victims.

Yes, the poor have absolutely no control over their own behavior. They're incapable of making personal choices. If one is poor, one can't control whether or not one only has one girlfriend or not, or whether one commits a crime.

Reality is that poor people are just as capable of making good decisions as everyone else. Maybe you need to consider the reason that many people like the ones David described are poor because they make bad decisions, not the other way around.

I agree with you completely Dibble.  But why waste your time talking common sense to that guy?

[dazzleman]

The right loves to demonize lawyers, but the reality is that lawsuits/legal costs account for less than 1% of health insurance costs.

Do you have a source for that Scoonie?

I do not, but according to a report given to me by an obstetrician recently, during the period from 1995 to 2004 the severity, or size, of medical malpractice claims remains on the rise.  They were growing at a trend rate of 7.5 percent annually.  And show no signs of slowing.  This also means that the profitability for insurance companies on medical malpractice policies was getting pretty weak.  I don't have it in front of me, but something like:  for every dollar of premium they collected near the end of that period, they were paying out 1.09 dollars in claims.  And this report was just an AMA sponsored malpractice study, and didn't even take into account the money paid by groups to lobbyists to get laws passed in the first place.  So I have a very hard time believing that it's one percent.  My guess would be that  mandated health benefits and excessive health services regulation at the state and federal levels account for maybe twenty to thirty percent, depending on how you count it.  but that's just a guess.  And it doesn't include peripherals.  You could probably count it in a way that it's more than fifty percent.  Whatever the figure is, the legal expenses contribute to the level of Americans who cannot afford to purchase private health insurance.  So it's easy to see why so many want a Nationalized system.  My only point here is that further government might not be the best way to go.  We always talkabout more government involvement, but no one talks about less.  That's a fresh idea that ought to be further examined before deciding it's a bad one.

A nationalized system, without legal reform, is not going to lower costs, and we'll choke on the taxes to pay for it.

I'll go on record as saying I flat out don't believe the 1% number, in any way, shape or form.  It can only be a gross distortion.  Many untrue 'facts' are put out there by interest groups, and this sounds like one of them.

Under the current political and legal constraints, I would expect a nationalized system to work as well as, say, inner city school systems, in many areas.  The same effect of dragging the middle class down to the level of the poor, or alternatively, forcing them to pay twice for the same service, would take over.

[dazzleman]

I would think, in assessing the effects of a universal system, one would have to study how well it has (or hasn't, as the case may be) worked in other countries that have it. The United States is one of the few first world countries to not have some system of unviersal coverage. What have the effects been in places like Canada or the UK? What are some of the key differences in those countries that might make a universal coverage system work better or worse there than it does here?

Well, we know that people in Canada who really need serious medical care and can afford to pay for it come to the US for it.  That should tell you something.

And the Canadians, for various reasons [smaller population, less diversity], have generally gotten BETTER results from government programs than we have.

[dazzleman]

I would think, in assessing the effects of a universal system, one would have to study how well it has (or hasn't, as the case may be) worked in other countries that have it. The United States is one of the few first world countries to not have some system of unviersal coverage. What have the effects been in places like Canada or the UK? What are some of the key differences in those countries that might make a universal coverage system work better or worse there than it does here?

Well, we know that people in Canada who really need serious medical care and can afford to pay for it come to the US for it.  That should tell you something.

And the Canadians, for various reasons [smaller population, less diversity], have generally gotten BETTER results from government programs than we have.

I agree that the US has the best health care in the world for those who can afford it.

Americans frequently go to Canada to buy prescription drugs due to their cheaper cost. Both systems have their pros and cons.

True.

My big fear with respect to federal control of the health care system is that they will do to it what they did to urban education when they effectively took control of that in the 1970s.

With respect to urban education, the feds effectively said, "We have to make everybody equal, and since there are certain people we can't pull up, we will pull everybody else down."

What they did was bad, and they did it in an illegitimate and undemocratic fashion.

The highly localized nature of education made it possible for those who weren't satisfied with this scenario to escape it by moving, if they had the economic means.  Or they could effectively pay for the service twice, by sending their kids to private school.

I deeply fear the same result with health care -- that the vast majority of people will end up paying more than they are currently, and will see a degredation in the quality of care they receive, in order that a smaller number of people can receive care that is modestly improved over what they get now, with heavy subsidies.

Once again, people will have to submit to something they find unsatisfactory, or they will have to pay for the service twice by opting out.