28 August 2009

26 August 2009

Personal liberty

 ... larger government not only means less personal freedom but more corruption, influence peddling, and "rent seeking" as interest groups and industries inevitably must seek to sway government representatives and bureaucrats who would hold enormous power over their economic destiny.
 Let's avoid all that. (from here)

17 August 2009

Best health care in America at the VA?

I was reading Paul Krugman's piece in the NYTimes about various approaches to universal coverage. He mentioned that "our own Veterans Health Administration, which is run somewhat like the British health service, also manages to combine quality care with low costs."
I had thought that there were a lot of problems with VA care, but apparently that's not the case these days. This piece talks about an article singing the praises - deservedly so, it seems - of the care provided by the VHA. 
I think Krugman downplays valid concerns about following the English or Canadian models - particularly since he got burned recently polling Canadians about their thoughts on their health service.
Still, the fact that the VA manages to provide superlative care definitely gives me food for thought. 

more whole foods fun

The agitator sees irony in the proposed whole foods boycott.

16 August 2009

Why does health care cost so much in the US?

That's the question I typed into Google. About halfway down the results page I found this article from the NYTimes Bizness section.

Compared to other countries, health care is more expensive here. We knew that. Health care expenditures per capita seem to be closely related to GDP per capita - so countries with more money spend more on health care - makes sense. 

But that doesn't account for the discrepancy in the US. We pay more here for 
" factors other than G.D.P. per capita. Prominent among these other factors are:
1. higher prices for the same health care goods and services than are paid in other countries for the same goods and services;
2. significantly higher administrative overhead costs than are incurred in other countries with simpler health-insurance systems;
3. more widespread use of high-cost, high-tech equipment and procedures than are used in other countries;
4. higher treatment costs triggered by our uniquely American tort laws, which in the context of medicine can lead to "defensive medicine" — that is, the application of tests and procedures mainly as a defense against possible malpractice litigation, rather than as a clinical imperative."
Any real reform needs to address all those factors.  

Health care reform

The president's op-ed sounds reasonable. He usually sounds reasonable until he gets off message or off prompter - which is understandable, he doesn't actually have much experience after all. It's charming, really, the glimpses into his real attitudes and ideas.
I liked that he wrote so much about reforming Medicare. That's a great idea and since that's already a government program they should get started on that right away. For the rest I think we should wait and see how that part goes.
And for a look at what's ACTUALLY in one of the bills under consideration - so, to be clear, what the actual law would be as opposed to what the op-ed says - here are answers to a few questions like - 
df
WILL THE PLAN RATION MEDICAL CARE?
um ... yeah
WILL THE PLAN PUNISH AMERICANS WHO TRY TO OPT OUT?
un hunh - well, it imposes a tax penalty, so it would only actually punish the 60% or so who actually pay taxes ...
WILL THE PLAN DESTROY PRIVATE HEALTH INSURANCE?
yes - it doesn't outlaw it, but it creates a situation that is so disfavorable to private plans that they will be quickly marginalized if not completely eliminated.
DOES THE PLAN ALLOW THE GOVERNMENT TO SET FEES FOR SERVICES?
of course - as with medicare. 

There's more, please follow the link and read it all for yourself.