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ObamaCare Clusterfuck: RomneyCare has not controlled costs

Maine AllCare's Dr. Phillip Caper, Bangor Daily News:

Since Americans view health care as a business, we’ve allowed our health care system to become populated by thousands of profit seeking companies (some nominally nonprofit), each trying to maximize profits and competing for a larger share of an ever-growing pie. Many of these private businesses are heavily subsidized by tax-supported health care programs and tax breaks. So far, we have been unwilling to put any effective restraints around the growth of this huge pot of gold.

This is not a failure of capitalism or corporations, They are simply doing what they are supposed to do — create wealth for their owners. It’s a massive failure of public policy. It’s the fault of all of us, including our political leaders, for failing to put any meaningful constraints around our health care system to keep it affordable for everybody.

The result has been the creation of a gargantuan medical-industrial complex that has become the pac-man of public and private budgets. It is riddled with inefficiency and waste including unjustifiably high prices and excessive use of lucrative services and products, many of them without demonstrated value or downright harmful,.

The Affordable Care Act begins to make some timid efforts at addressing this problem. Nobody I know thinks they will be sufficient. After seven years of “RomneyCare” (after which the Affordable Care Act was patterned), Massachusetts now has almost everybody insured, but it has the highest health care costs of any state in the country. Some public figures there are beginning to suggest moving toward a statewide single-payer system.

As I’ve written before, the market forces the ACA is trying to harness have not, will not and cannot solve this problem. As most other wealthy countries have done, we need to channel the many existing health care revenue streams together into a single funnel with a publicly managed flow-control valve, and then muster the political will to use it. That is what our neighbors in Vermont are now in the process of trying to do.

Nice metaphor.

And clearly, Massachusetts has done better than ObamaCare will, since even ObamaCare advocates say it will only cover half the uninsured.

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Comments

Alexa's picture
Submitted by Alexa on

to hear rhetoric about "overuse of services"--especially since many Americans typically "under use" medical services.

Got more to say when we stop.

But "best practices" is a concept that appears (IMO) to be developed partly to facilitate the "rationing" of medical procedures, from what I've read.

Notice--only after they create a market system that "forces" all Americans into it, are the PtB worrying about these inefficiencies.

Don't think for a minute that once Democrats finish with their health care "reform"--winnowing down the allowed procedures, test, treatments, etc., for the great unwashed masses in all of our "public health care systems"--that they won't continue demanding and receiving " all of these so-called "unnecessary" treatments.

Just like the ACA was a giveaway to the insurance industry, and intended to help governments and insurance beneficiaries int he private insurance market, BUT marketed as though "the poor and/or low income Americans" were the concern, IMHO, this move to obsess about "best practices" is a red herring.

The real intention is "rationing" of health care. And Best Practices is just a necessary step (and cover) in that direction.

For example, look at recent Democratic led legislation to limit the availability of some pain killing medicines needed by the sickest and most chronically ill (not to mention, terminally ill) patients. I've posted on this at some blogs, but not sure if I did here.

Anyway, the recent laws to "reclassify" many of these drugs will make it much more difficult, as usual, for poor and low income Americans to have access to them.

This was led by Joe Manchin (of DLC/Third Way/No Labels fame) and none other than "liberal" (cough!) Senator Jay Rockefeller. I hope to post a blurb on my "ACA--Deck Chairs" QH, if I find that I haven't done that already.

[Please excuse typos, syntax., etc.]

Submitted by lambert on

... which might strike some of us as nuts... But probably reads well with the moderate audience for the Bangor Daily News.

The author writes: "excessive use of lucrative services" not just "overuse." And I think it's clear that health care for profit has a built in bias to do that, whether the services are medically necessary or not. (IIRC, there's a bias toward operating on prostate cancer in men, no matter their age; which is nutso if its slow spreading, because it's a cancer you die with and not from.) I'm sure examples can be multiplied.

Now, that's to say that the efforts made to "curb cost" will not be done in bad faith by current actors; they surely will be. But in a better world....

NOTE I'm against any cuts to Medicare for exactly this reasoning; the cuts will not be made in good faith.