Here are my ideas for Federal Health Care…
We spend more on health care than all these countries while life expectancy is lower than others, comprehensive care per capita is less and quality is less than some.
Here are the numbers:
| Country | Health Care Spending as % of GDP |
| United States | 13.9 |
| Switzerland | 11.1 |
| Norway | 8 |
| Germany | 10.7 |
| Canada | 9.7 |
| Luxembourg | 5.6 |
| Iceland | 9.2 |
| Netherlands | 8.9 |
| France | 9.5 |
| Australia | 9.2 |
| Denmark | 8.6 |
| Belgium | 9 |
| Sweden | 8.7 |
| Italy | 8.4 |
| Austria | 7.7 |
| Japan | 8 |
| United Kingdom | 7.6 |
| Ireland | 6.5 |
| Finland | 7 |
| New Zealand | 8.1 |
| Portugal | 9.2 |
| Spain | 7.5 |
| Greece | 9.4 |
| Czech Republic | 7.3 |
| Hungary | 6.8 |
| Korea | 5.9 |
| Slovak Republic | 5.7 |
| Poland | 6.3 |
| Mexico | 6 |
| Turkey | 4.8 |
| median | 8.1 |
Specific Reasons:
ability to pay, as measured by GDP per capita, has repeatedly been shown to be one of the most important factors
In other words, if we can be reamed, we will be (and are)
Americans pay much higher prices for the same health services than citizens in other countries pay
The relatively greater market power on the demand side of health systems in other countries can explain why so many countries allocate a lower fraction of their GDP to health care even though they appear to be more heavily endowed with hospital capacity and health professionals than the United States.
In other words, supply and demand works better for health care in other countries
the U.S. approach to financing health care is extremely complex
gives society the option of purchasing, through health care, additional quality-adjusted life years (QALYs) at increasingly higher prices
In other words, if you want higher end goods and services other countries have graded cost scales for higher and higher cost goods and services
http://content.healthaffairs.org/cgi/reprint/23/3/10.pdf
Solutions with Medicare and Medicaid
Public option
Insurance companies simply pass the increasing cost of health care to the consumer. The HMOs has some amount of cost control because of negotiated costs of standard services and bigger pools. A public option would provide a very large pool of consumers and therefore, more negotiation power. This would address many of the issues cited above.
Comprehensive health care reform will cost the federal government $940 billion over a ten-year period, but will increase revenue and cut other costs by a greater amount, leading to a reduction of $138 billion in the federal deficit over the same period, according to an analysis by the Congressional Budget Office, a Democratic source tells HuffPost. It will cut the deficit by $1.2 trillion over the second ten year period.
http://www.huffingtonpost.com/2010/03/18/cbo-score-on-health-care_n_502543.html
Other solutions for health care costs
Obesity, smoking, and other population risk factors can lead to expensive chronic conditions; the increased prevalence of such conditions—for example, diabetes and heart disease—drives growth in the utilization of health care resources and therefore in spending.
Bad personal habits drive the cost up. This costs all of us more money. We could address these issues with education, new medical technologies and programs that directly address these issues.
Experts note that the nation’s general tendency is to treat patients with available technology when there is the slightest chance of benefit to the patient, even though the costs may far outweigh the benefit to society as a whole.
Over use of treatments that have marginal benefit to the patient. We should probably have a graded cost scale for these types of treatments so the consumer can make decisions on cost and effectiveness of treatment.
Although the Food and Drug Administration (FDA), for example, evaluates new medical products based on safety and efficacy data submitted by manufacturers, it does not evaluate whether the new products are cost-effective compared with existing products used for the same treatment indications. In turn, Medicare, which generally relies on FDA approval decisions, does not evaluate whether new technologies are superior, either clinically or economically, compared with technologies already covered and paid for by the program.
Nobody evaluates whether new drugs are better than older, more cost effective drugs. Standards for drugs and procedures are needed based on effectiveness and cost.
In an ideal market, informed consumers prod competitors to offer the best value. Without good comparative information, however, consumers are less able to determine the best value. Insurance masks the actual costs of goods and services, providing little incentive for consumers to be cost-conscious. Similarly, clinicians must often make decisions in the absence of universal medical standards of practice.
Insurance companies enable the health care consumer to lose touch with the real market costs of goods and services. In other words, they do not all the healthier dynamics of capitalism to work, i.e., consumer incentive to control costs.
http://www.gao.gov/new.items/d07497t.pdf
The elderly population increasing
http://www.gao.gov/new.items/d07497t.pdf
Medicare Part D – Prescription Drug Bill
Needs to be modified to allow the government to negotiate bulk purchasing reductions with the drug providers.
Group Purchasing Organizations: Research on Their Pricing Impact on Health Care Providers
http://www.gao.gov/products/GAO-10-323R
Medicare Part D: Spending, Beneficiary Out-of-Pocket Costs, and Efforts to Obtain Price Concessions for Certain High-Cost Drugs
http://www.gao.gov/products/GAO-10-529T
Prescription Drugs: Overview of Approaches to Control Prescription Drug Spending in Federal Programs
http://www.gao.gov/products/GAO-09-819T
Medicare Advantage
It needs to be eliminated or cut back. It was always a boondoggle for the insurance companies.
Payments to MA plans have been estimated to be 12 percent greater than what Medicare would have spent in 2006 had MA beneficiaries been enrolled in Medicare FFS.
Medicare spends more per beneficiary in MA than it does for beneficiaries in Medicare FFS, at an estimated additional cost to Medicare of $54 billion from 2009 through 2012.
http://www.gao.gov/new.items/d08359.pdf page 2 in pdf
Other reading…
Medicare: Financial Challenges and Considerations for Reform
http://www.gao.gov/products/GAO-03-577T
Health Care Spending
http://www.gao.gov/docsearch/featured/healthcare_spending.html
The current Gross Domestic Product in billions is 14,677.