Why Rush Health Reform? Let's Fix Insurance First

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What is not being mentioned anywhere is that the cost of medical care is being vastly increased by illegals using emergency departments for ordinary medical service. Many hospitals haved closed because they are mandated to treat anyone at any time for any reason, without pay if the people state they cannot pay. No business of any kind can continue to provide products without pay.
Closing the borders and deporting illegals would ease the financial strain on many of our institutions.

C. Lawrencelle of NY 2:06PM July 23, 2009

I find it appalling that while America preaches into the world that it is the epitome of Capitalism with free market in the hands of the private sector, the more Socialistic/Communistic America is turning into! Yes, while telling to Obama, not so fast, by the top Republicans in the Federal Government.
Yes, over 60 years ago, this hoopla started with Truman and ever since, all kinds of insulting Socialistic/Communistic health care programs have contributed to the fact that now the true National Debt, when all shortages are accounted for, like SS, Medicare, etc., etc., etc., has reached the mindboggling amount of over 100 trillions dollars.
I would like for the people at the USNEWS to please take a look where America stands as to this despicable National Debt, that keeps the Founding Fathers shaking in their graves. "No pecuniary consideration is more urgent, than the regular redemption and discharge of the public debt: on none can delay be more injurious or an economy of time more valuable". By George Washington, America's first President.
Thomas Jefferson said this: "The principle of spending money to be paid by posterity, in the name of funding, is but swindling futurity on a large scale". So, our dear America is sort of the swindler of the world swindling itself deeper and deeper into somekind of pit, never to get out? America, what are you doing to yourself? Why such a flagrant disobedience to the Founding Fathers?

H. D. Schmidt of CA 7:54AM July 23, 2009

This is a far better solution than the ideas coming out of DC because its more market based. The DC approach -paying all health care costs from "dollar 1" with a government program sounds wonderful but like most progressive ideas its hugely impractical and will bankrupt this county. Furthermore Washington is always looking for somebody else to pay all the bills. Unless someone is truly destitute - we should all pay for these propsed plans equally. Everyone knows the existing system is flawed and it needs to be fixed - her solution regulates a competitive marketplace and gets everyone covered.

Flavian of NJ 10:56PM July 22, 2009

One problem with this: moost working-class people cannot afford even a $2,000 deductable. They live from paycheck to paycheck, many hold more than one job just to make ends meet. With wages nearly frozen and jobs going overseas where is the income for such plans? This is the age-old argument and one of the big problems. Those with large incomes seem to have no idea how the majority live and how little money they have, yet they get to make decisions regarding how much the average person can afford when they do not live as the average person. Catastrophic plans with high deductibles only work for the high middle class or upper classes. The rest of us have few options and often have to decide if we can get any treatment at all. Those folks are left to die or become disabled by a society that still clings to a "survival of the fittest" (or richest) mentality.
Wake up and see how the majority are living!

theoracle of CO 7:54PM July 22, 2009

Insurance is what it is, actuaries look at your risk profile and set a premium that you can either afford or not. The law of large numbers ensure that the set premiums generate profit. Can't pay? Sorry, no insurance. You cannot just mandate away this fundamental business model.
There is nothing magical about catastrophic insurance, it is just insurance with a high deductible. The issues are the same: Large numbers of health dollars going to shareholders, executive compensation, and redundant and inefficient bureaucracies, coupled with the the insurer's conflict of interest where they have to choose between profitability and subscriber health needs. This approach promotes waiting until health issues become a crisis, instead of promoting preventive care. This costs more in the long run.
A single payer system creates economy of scale and a more consistent set of policies. Americans already pay enough money to provide good health care to everyone, the problem is that we waste so much of this money on inefficiency and profiteering, and it is those who pocket all this waste that are attacking any movement toward a more efficient system.
I would prefer single payer system to a public option, but public option is better than nothing. The question posed to Obama sounded like at attempt to make perfection the enemy of the good.

bar of CA 5:33PM July 22, 2009

“Affordable care for everyone” is a misnomer. It can never be “affordable” on an individual basis, except to a select few. All health care is “affordable” only through pooled averaging in the form of insurance. That said, fixing the insurance industry is an excellent tack. This is a case where regulated capitalism has somehow conspired to give us the least cost-effective system. Healthcare is inherently expensive, but on top of that my PPO retains a large portion of every dollar I give them, partially for profit, and partially to support an army of claim workers tasked with making payment so onerous that they, in turn, require my physician to maintain her own dedicated staff to submit and argue every bill. Physicians’ high billing cost means they charge more per visit and decrease personal attention because throughput is paramount to positive cash flow.
This is waste and inefficiency encouraged by a system that rewards the highest profit to those insurers that pay the fewest claims. Government, as exemplified by Medicare/caid is unlikely to do better.
Sort out a way to fix these “middleman” costs while still maintaining costs averaging and the windfall will be enormous.

Mister Q of MD 5:32PM July 22, 2009

The driving force behind health care cost increases are the innovative (and expensive) treatments continually being developed.
The health care insurance system in the United States provides no suitable economic mechanism to cap future investments in health care research.
Investments in health care reduce investments in other areas that benefit society. We should ask the question, "as a society, how much is too much to spend on health care?" and then come up with a way to limit health care expenditures to no more than that amount. (E.g., reduce patent terms to X years after FDA approval etc.)
Yes, this will slow the advancements in health care treatments, but obviously there should be some cap on health care expenditures, e.g., 10 or 15 percent of GDP. The benefits will be seen in lower overall health care costs for all as well as increased investments in other areas of technology as the overall costs of labor (salaries + benefits) go down.

Dan of MN 5:30PM July 22, 2009

Commenter Earl Hendricks wrote: "Instead they are more worried about profits than peoples welfare...When did we stop worring [sic] and loving our neighbor..."
I'm amazed at how many letters to the editor, opinion pieces and comments share this sentiment. The entire dialog on healthcare has been consumed with such inanity.
Of course an insurance company is concerned with profits. How will they provide their services next year if they don't make a profit this year?
Of course a doctor wants to profit from his services. Why would he (or she) go to medical school and incur tens of thousands of dollars in debt to become a practicing physician, if there were no payoff?
And this is exactly why government-run healthcare will ultimately drive costs up - there's no profit motive. In fact, government bureaucracies are incentivized to grow larger, not to "keep costs down." The only incentive is to hand out more goodies to the voters to keep the program alive and the bureaucrats employed.
There's never been a government program that was managed by the profit motive, and it is profit that attracts talent, innovation, investment and competition.
And before anyone accuses me of being a shill for pharma or the insurance industry, let me state that I have no connections with either of these industries. In fact, I purchase catastrophic health coverage privately, just as the author describes, and pay for routine coverage totally out-of-pocket from doctors who can tell me what they are going to charge me beforehand.

Profiteer of NC 5:22PM July 22, 2009

author should understand that the healthcare costs have risen to this level because of greed that the hospitals and providers have, which is funded ONLY by insurance companies.
Now that there is situation that without insurance companies you cannot go to doctors, the insurance companies have gained more ground...so decide what you get, at what price...
If the govt run plan comes in to picture, govt can bargain and fix healthcare costs with hospitals and providers because of huge enrollment. This way, cost comes down and everyone can afford health insurance and not worry about it

Satish of VA 5:03PM July 22, 2009

Under the current health care system in the United States, the only mechanism to reduce the demand for newly-developed treatments, and thus limit health care costs, is a reduction in the numbered of insured consumers. While the incremental cost of a health care treatment is little or nothing to an insured consumer, private health insurance is paid for by consumers either directly, or indirectly through their employers. Increased health care costs lead to a reduction in the number of insured consumers because increased health care costs result in increased premiums for private health insurance. Reducing the number of insured consumers limits the ability of health care providers to profit from newly-developed health care treatments. For this reason, a reduction in the number of insured consumers reduces incentives for development of new health care treatments and retards the ever-increasing health care costs in the United States. Eventually, the current health care system can be expected to provide an equilibrium of health care costs as a percent of GDP; however, reaching this equilibrium will require an even greater number of uninsured consumers than currently present in the United States.
Conversely, increasing the number of insured consumers increases the ability of health care companies to profit from patented health care treatments. Under the current system for funding health care in the United States, an increase in government-funded health insurance results in increased incentives for development of new health care treatments. Over time, increasing government-funded health insurance accelerates the increase in health-care costs and health insurance premiums. Because increased health insurance premiums lead to a reduction in the number of privately-insured consumers, over the long term, increases in government-funded health insurance actually have the perverse effect of reducing the number of privately-insured consumers.

Dan of MN 5:03PM July 22, 2009