My main concern with this debate as concerns misinformation is the contention that the US health care system is one of the best in the world.
There are basically two arguments here, both of which have merit.
First. The United States does have the best health care
quality. This should be undisputed. Our treatments have the highest success rates in the world, and people who are treated for heart attacks, cancer, etc...in the United States live longer than those treated elsewhere.
Second. On the flipside, the United States does not have the best
coverage, meaning not everyone can take advantage of the premium health services that can be found in the US.
So in other words, if you have health coverage, you receive the best care in the world, if you don't have health coverage you're SOL.
yet in return for this gets a system that by almost all measuring sticks (life expectancy, infant mortality rate, citizen satisfaction, coverage of medical insurance, etc.) is poor by the standards of the developped world.
Another problem is that many of those measuring sticks are tangentially related to health care at best. Take life expectancy. More than just health care factors into life expectancy, including number of accidental deaths per year, number of homicides per year, the lifestyle choices of the average citizen (e.g., morbid obesity rate in the US), among others. Additionally, to call the standards "poor", is a bit of a misnomer. The difference between the privatized insurance system of the US (ranked 30th at 78.07 years) and the NHS of Great Britain (Ranked 26th at 78.7) is barely more than half a year.
Out of curiosity, ID, since you reject so strongly the contention that preventive measures would save money, what measures would you propose to reduce US health care costs? It's clear that such measures should be possible.
I'll preface this by stating that my ideas would step on everyone's toes and be politically impossible to implement, absent a miracle.
I'd start by removing the tax code provisions that create the employer provided health care incentive. While it may have seemed like a good idea at the time, our current situation shows it wasn't. Right now, prices are high in part because there is very little need for competition. Consumers have been detached from the services they are buying, while their employers are making the choices for them. To quote the economist Milton Friedman, "people are least careful about their money when they are using someone else's money on someone else." That is, employers aren't going to be all that frugal about selecting the plans for their employees. Oh, and just to nip this in the bud, just because you are getting health care from your employer doesn't mean that its not your money the employer is spending, because you received a reduced salary in return for that health care coverage (and the employer is happy with this because he gets a bigger tax deduction for paying health care instead of paying standard salary).
This employer based insurance also has the disadvantage of creating over-regulation, which also drives up costs. For plans to qualify, they must have certain coverages and cover certain people, even if some employees would rather not have certain types of coverage (all this additional coverage adds to costs, even if the employees don't want the added benefits).
Basically, I'd return health insurance to a true free-market state, like every other insurance type, and prices are guaranteed to go down. Of course, insurance companies wouldn't like this because they'd have to cut prices to remain competitive (and this is why Republicans will stick with do-nothing plans).
Second, as Super mentioned earlier, you need to discourage overuse of hospital emergency rooms. Allowing access to low cost health clinics for low income families could help. Similarly, raising health awareness might help, though as I said earlier, people are notoriously difficult to change so you'll quickly run into diminishing returns if you try to put to much money into such programs.
There are also miscellaneous steps that could be taken, such as reigning in the costs to the hospitals and doctors have to pay (such as malpractice insurance).
If we disagree with your math, don't whine that we didn't understand it; we probably did. If we throw alternative calculations back at you, don't accuse us of deliberate obfuscation; it's just math.
Except it adds nothing to the discussion at hand, so why bother bringing it up in the first place? Again, the purpose of the math was to ILLUSTRATE how the general principle works. Attacking the math itself is ass backwards and sloppy.
There really isn't much evidence presented at all in that report.
So...you have more to offer? The specific research studies are fully cited in the assessment. Thus, you have the information to look the raw data up yourself if you so desire. The purpose of the assessment is to summarize the findings of research, not to rehash all of the research projects in their entirety.
The author Nathan Deal is a Republican Congressman.
Dot. Dot. Dot.
The letter is addressed to Nathan Deal, the author is Douglas Elmendorf.
All that being said, look at his conclusion: "However, government funding for some specific types of preventive care might lower total spending. In its estimates, CBO seeks to capture the likely future effects on the budget on a case-by-case basis." Funny, that was exactly my conclusion and suggested policy as well.
One, there's a keyword there: "might." Might does not mean definitively. Especially when the specifics of such a program are, at this point, totally non-existent.
Two, the CBO makes no policy recommendation at all; it states the effects of a policy. A case-by-case preventive care policy MIGHT save money, but we don't know with certainty because no such policy was put before the CBO for analysis.
Three, you missed this part:
"In sum, expanded governmental support for preventive medical care would probably improve people’s health but would not generally reduce total spending
on health care."
and how it relates to my original assertion that politicians who claim that preventive care is a magic bullet are lying.
1. We can still make estimates, the same way a first-year physics student can still get some OK pendulum calculations.
2. The principle of "check if it costs less, done", is still the basic strategy for determining if a preventative measure will save money.
So...you still don't have any plan of implementation other than extremely broad generalizations. How are you going to implement the "check if it costs less, done" paradigm? What methods of valuation are you going to apply? Again, to say its as simple as "done" is naive.
