Competition Solves Health Care?

[one...two...tree 2,762]

By David Sirota, Salon

(edited)

Anyone who remembers the 1993-94 healthcare fights knows that Republicans have long asserted that private insurance is more efficacious and more adored by patients than government-run programs like Medicare. To solve the healthcare crisis, those on the right say we must foster more price-cutting, efficiency-producing competition. "The American people know that innovation, choice, and competition work," wrote Sen. Tom Coburn, R-Okla., in an archetypal Op-Ed titled "Competition Solves Health Care."

Give conservatives credit here: At minimum, this argument had a logic to it, however flawed. Sure, it is belied by data: The Urban Institute reports that private insurers spend up to 30 percent of their revenue on administrative costs (read: salaries, paperwork, etc.) while government programs spend just 5 percent, and polls show Medicare recipients are far more satisfied with their healthcare than those in the private system. But, in nonetheless claiming that the private sector will always outperform the government, Republicans at least presented an ideologically coherent (if fantastically inaccurate) hypothesis.

That all changed, though, when Democrats this week began pushing to let citizens buy into a government-sponsored health plan similar to the one federal lawmakers enjoy.

The allegedly competition-loving GOP immediately stated its strong opposition on the grounds that the initiative would begin "forcing free market plans to compete with government-run programs," as congressional Republicans lamented. While Rep. Roy Blunt, R-Mo., insisted that the GOP remains "committed to common-sense solutions that promote competition," he said his party is "concerned that if the government" is permitted to compete, "it will eventually push out the private healthcare plans."

Hold on a second.

Don't Republicans insist that "competition solves healthcare?" Yes, ad nauseam.

Haven't they been telling us that government programs are obviously worse than private health insurance? Yes, again.

Then, don't they welcome a private-versus-public competition, believing that the former will easily trump the latter? Well ... uh ... no.

As I said, this is truly perplexing.

In one breath, GOP Jekylls say government medical plans will be inefficient, inferior to private insurance, and thus hated by Americans. In another breath, Republican Hydes effectively admit that government programs would be so efficient, superior to private insurance, and loved by Americans that they will attract more consumers and dominate a healthcare competition.

Of the two assertions, of course, the latter is closer to the truth -- and the GOP knows it.

Republican lawmakers received the new Commonwealth Fund report showing that a public system would save consumers $2 trillion through reduced premiums and lower administrative costs. They see surveys showing that the country overwhelmingly wants the government to create a public health program -- and they know if given a choice, many Americans will opt into that program rather than swim with the private insurance sharks.

Republicans can't simply acknowledge these truisms, however, because doing so would undermine the insurance industry that's filling their campaign coffers. So instead, we get pro-competition, government-is-ineffective "conservatives" working to thwart competition and implicitly admitting they believe the government will be too effective.

Yes, when it comes to competition, Republicans were for it before they were against it. And this time, that confounding flip-flop doesn't merely threaten a bumbling presidential candidate, it imperils a healthcare revolution.

http://www.salon.com/opinion/feature/2009/03/14/sirota/

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... Republicans can't simply acknowledge these truisms, however, because doing so would undermine the insurance industry that's filling their campaign coffers.

As if insurance industry execs don't donate in large numbers to the Democrats Is Obama even proposing single-payer HC? No, he is not. Guess why?

[DeadPoolX 9]

More partisan nonsense, as usual.

In reference to health care, I don't see why it has to be private or government -- why not both? Let the government handle basic health care needs and for anything major, private health care would be required. For instance... if someone went for a checkup at the doctor, that would be covered by the government. However, if someone needed an MRI or surgery, private health care would be necessary.

I realize some people might say it's "unfair" if larger procedures remain privately funded, but if everyone got basic health care needs, perhaps our overall need to have surgery, use MRIs and whatever else would decrease. They'd never disappear, but if people took better care of themselves, maybe they wouldn't need that triple-bypass later in life.

[fozzie 41]

More partisan nonsense, as usual.

In reference to health care, I don't see why it has to be private or government -- why not both? Let the government handle basic health care needs and for anything major, private health care would be required. For instance... if someone went for a checkup at the doctor, that would be covered by the government. However, if someone needed an MRI or surgery, private health care would be necessary.

I realize some people might say it's "unfair" if larger procedures remain privately funded, but if everyone got basic health care needs, perhaps our overall need to have surgery, use MRIs and whatever else would decrease. They'd never disappear, but if people took better care of themselves, maybe they wouldn't need that triple-bypass later in life.

What are you views on the Canadian healthcare system?

Coming from England I know that neither system is perfect. It is free in England (free? Oh I paid higher taxes for it). However the thing with a NHS system is that you do not have the choice to search for the best doctors available. You do not see a specialist unless you are referred by a General Practitioner (GP). Private healthcare is available in England for those who can afford it and are not satisfied with the NHS.

Here in the US private healthcare drives technological advancements that better the diagnostic and treatment capabilities of the system. I have the choice of some of the best doctors and specialists that are available at a reasonable cost. The red tape and complexities confuse the patients and the healthcare providers themselves. Making sure you are covered or finding out the treatment you need is not even covered is wrong. I like the idea of choice but not the way insurance companies are out for profit not to make peoples lives better.

[NickD 203]

How can you have competition, when dealing with a bunch of guys and gals that all belong to an extremely powerful AMA? That AMA has the power to decide whether you are going to remain a doctor or not. So if you start to undercut your peers, they can find anything wrong with your practice, always something, no matter how minor, and say, goodbye.

[britty 1]

More partisan nonsense, as usual.

In reference to health care, I don't see why it has to be private or government -- why not both? Let the government handle basic health care needs and for anything major, private health care would be required. For instance... if someone went for a checkup at the doctor, that would be covered by the government. However, if someone needed an MRI or surgery, private health care would be necessary.

I realize some people might say it's "unfair" if larger procedures remain privately funded, but if everyone got basic health care needs, perhaps our overall need to have surgery, use MRIs and whatever else would decrease. They'd never disappear, but if people took better care of themselves, maybe they wouldn't need that triple-bypass later in life.

What are you views on the Canadian healthcare system?

Coming from England I know that neither system is perfect. It is free in England (free? Oh I paid higher taxes for it). However the thing with a NHS system is that you do not have the choice to search for the best doctors available. You do not see a specialist unless you are referred by a General Practitioner (GP). Private healthcare is available in England for those who can afford it and are not satisfied with the NHS.

Here in the US private healthcare drives technological advancements that better the diagnostic and treatment capabilities of the system. I have the choice of some of the best doctors and specialists that are available at a reasonable cost. The red tape and complexities confuse the patients and the healthcare providers themselves. Making sure you are covered or finding out the treatment you need is not even covered is wrong. I like the idea of choice but not the way insurance companies are out for profit not to make peoples lives better.

I paid excruciating taxes in the UK to fund a system that was restricted beyond belief, where misdiagnosis and lack of basic attention to patients was rife, where good GPs, doctors, surgeons and specialists would run to the US to practice in a country where their services warranted a nice fat paycheck

(as it should be) and where they could really help patients, where waiting lists for surgery exceeded four years in certain cases I am aware of, and where access to certain medications are simply denied due to rationing. Currently, my elderly aunt, who found a lump in her breast about 7 moinths ago, is still waiting for an appointment for a mammogram. My father was told by a NHS "specialist" that unfortunately his eyesight couldn't be improved and he would likely go blind. When I sent my father to a specialist of MY choosing in the UK, it was determined he had deep set cataracts on both eyes and underwent surgery two days later to have them liquidised, removed, and now has better vision than I do. The reason his care was excellent and he was treated by a wonderful doctor amounts to the fact that I parted with $20k.

The US has some of the best medical experts in the world, along with cutting edge medical technologies. There are people all over the UK trying to raise money to send themselves or others to the US to receive the life saving operation, treatment, or medication that they CANNOT get in the UK. If someone was dying and there was something out there that could save them, why wouldn't the UK provide it? Pay peanuts, get monkeys.

[fozzie 41]

More partisan nonsense, as usual.

In reference to health care, I don't see why it has to be private or government -- why not both? Let the government handle basic health care needs and for anything major, private health care would be required. For instance... if someone went for a checkup at the doctor, that would be covered by the government. However, if someone needed an MRI or surgery, private health care would be necessary.

I realize some people might say it's "unfair" if larger procedures remain privately funded, but if everyone got basic health care needs, perhaps our overall need to have surgery, use MRIs and whatever else would decrease. They'd never disappear, but if people took better care of themselves, maybe they wouldn't need that triple-bypass later in life.

What are you views on the Canadian healthcare system?

Coming from England I know that neither system is perfect. It is free in England (free? Oh I paid higher taxes for it). However the thing with a NHS system is that you do not have the choice to search for the best doctors available. You do not see a specialist unless you are referred by a General Practitioner (GP). Private healthcare is available in England for those who can afford it and are not satisfied with the NHS.

Here in the US private healthcare drives technological advancements that better the diagnostic and treatment capabilities of the system. I have the choice of some of the best doctors and specialists that are available at a reasonable cost. The red tape and complexities confuse the patients and the healthcare providers themselves. Making sure you are covered or finding out the treatment you need is not even covered is wrong. I like the idea of choice but not the way insurance companies are out for profit not to make peoples lives better.

I paid excruciating taxes in the UK to fund a system that was restricted beyond belief, where misdiagnosis and lack of basic attention to patients was rife, where good GPs, doctors, surgeons and specialists would run to the US to practice in a country where their services warranted a nice fat paycheck

(as it should be) and where they could really help patients, where waiting lists for surgery exceeded four years in certain cases I am aware of, and where access to certain medications are simply denied due to rationing. Currently, my elderly aunt, who found a lump in her breast about 7 moinths ago, is still waiting for an appointment for a mammogram. My father was told by a NHS "specialist" that unfortunately his eyesight couldn't be improved and he would likely go blind. When I sent my father to a specialist of MY choosing in the UK, it was determined he had deep set cataracts on both eyes and underwent surgery two days later to have them liquidised, removed, and now has better vision than I do. The reason his care was excellent and he was treated by a wonderful doctor amounts to the fact that I parted with $20k.

The US has some of the best medical experts in the world, along with cutting edge medical technologies. There are people all over the UK trying to raise money to send themselves or others to the US to receive the life saving operation, treatment, or medication that they CANNOT get in the UK. If someone was dying and there was something out there that could save them, why wouldn't the UK provide it? Pay peanuts, get monkeys.

You seem to have experienced healthcare at its best and worst. I have been fortunate enough to have never needed any major treatment (may family and friends have not either) and therefore only ever heard about the bad things.

I think there needs to be better treatment for all here in the US though. Medicare and Medicaid need to be more far reaching. Not everyone can afford health insurance. Many retail stores only let their employees work 30 hours a week so they do not have to offer health insurance. The insurance options they have are crazy. The personal health insurances are priced way too high. This is where competition is stifled. What choice do I have in choosing a health plan? None, my company offers one, if I do not want that then I have to pay double to get anything at all. The bigger the company you work for the cheaper your insurance seems to be also. There are many flaws in the current system.

As for the "excruciating taxes", well once you take health insurance into account the deductions are about the same as in the UK.

[NickD 203]

With over six people in the medical field in my family, three doctors, I can see only two man made problems with our health industry that started in the last twenty-five years.

If I go back 25 years, having a kid was barely a weeks paycheck, today its several months of hard work for most people as just one small example.

First problem is very greedy health insurance companies trying every trick in the book to make more profits while be completive with other insurance companies. My kids are spending more of their time dealing with insurance companies than with their patients. This is a major crime.

The second is so-called medical malpractice that causes a great deal of hesitation in making basic medical decisions. If someone comes in with a minor cold, do you just send them home or do you conduct a number of tests to dig a lot deeper. If you do the latter, you have to justify these tests to the insurance companies, and if you don't, could be in a court of law getting sued crazy so as a doctor, you are put between a rock and a hard place. All this BS started about 25 years ago.

Another thing that was started by insurance companies was a precondition. While you may have paid premiums for many years, a kid that has a chronic condition that just developed, say at age 13 is covered for that year, but the next year, not even insurable because now that kid has a precondition. Is kicked off of your insurance policy and can cost you hundreds of thousands of dollars, mostly due to malpractice that is eaten up in no time. A family that was once well to do is now dead broke and deep in debt, but at least now eligible for Medicaid that once required constant proof of that condition.

Just got in a bill yesterday showing coverage on my health insurance, was only 90 bucks, but was for hardly a 30 second visit with my doctor for a follow thought, Just took a quick look at my right eye and said it was okay, 25 years ago when minimum wage was around three bucks an hour, that visit would have cost me ten bucks, today, about nine times as much where the minimum wage has only doubled. Healthcare cost is way beyond proportion. 25 years ago with prenatal care, delivery, and hospital costs, was about 600 bucks, today, even with a much shorter hospital stay, over 9,000 bucks. Everything is way out of proportion, that is what has to be looked into, this way out of proportion bit.