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Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsKrugman: It’s Health Care Costs, Stupid
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In todays column, I tried to emphasize a point that is weirdly absent from public discourse, at least among VSPs: the favorite VSP solution to the long-run budget deficit, raising the Medicare eligibility age, actually yields only minor savings. The point is that if you want to control Medicare costs, you cant do it by kicking a small number of relatively young seniors off the program; to control costs, you have to, you know, control costs.
And the truth is that we know a lot about how to do that after all, every other advanced country has much lower health costs than we do, and even within the US, the VHA and even Medicaid are much better at controlling costs than Medicare, and even more so relative to private insurance.
The key is having a health insurance system that can say no no, we wont pay premium prices for drugs that are little if any better, we wont pay for medical procedures that yield little or no benefit
But even as Republicans demand entitlement reform, they are dead set against anything like that. Bargaining over drug prices? Horrors! The Independent Payment Advisory Board? Death panels! They refuse to contemplate using approaches that have worked around the world; the only solution they will countenance is the solution that has never worked anywhere, namely, converting Medicare into an underfunded voucher system.
- more -
http://krugman.blogs.nytimes.com/2012/12/03/its-health-care-costs-stupid/
What Defines A Serious Deficit Proposal?
http://www.democraticunderground.com/10021914963
Warpy
(111,339 posts)no insurance company with a cadre of bean counters worth their name is going to write policies for anyone over 65.
That's why we got Medicare in the first place. Retirees couldn't find private plans anywhere at any cost.
WCGreen
(45,558 posts)jody
(26,624 posts)such things as research and ultimately production of drugs.
He also skirts the implication that "The key is having a health insurance system that can say no" means some form of health care rationing.
"Krugman avoids answering whether competition should be allowed to set prices or govt. will take over such things as research and ultimately production of drugs. "
...asked Krugman a question?
As for your point on rationing, I think it's utterly bogus.
jody
(26,624 posts)unable to pay for all health care procedures, hence rationing is necessary.
Please identify one government that is socialist that does not face rationing.
For that matter please identify any government that does not face rationing.
IMO there are none and that's why cutting costs are essential.
That leads to the other question I posed, does Krugman expect competition to reduce drug costs or a government monopoly drug department?
Please identify one government that is socialist that does not face rationing.
For that matter please identify any government that does not face rationing.
...as opposed to paying 17 percent of GDP in health care costs and having 50 million (expected to climb to 70 million pre-reform) citizens without insurance?
Oh, and the rationing debate happened leading up to the health care reform bill being signed into law. On one hand were the single-payer advocates and on the other were the RW nuts screaming about long lines and rationing in Canada. Look up some of the posts addressing the issue.
jody
(26,624 posts)sure anyone will be remotely happy with the outcome.
http://www.pnhp.org/resources/moral-hazard-the-myth-of-the-need-for-rationing
jody
(26,624 posts)Skittles
(153,193 posts)please
jody
(26,624 posts)mucifer
(23,565 posts)ventilator and months in the ICU for their final days. That's what's happening in our system now and that's NOT what happens in a lot of single payer countries.
Sorry, we need some rationing. Doctors and patients and families need lots of education on end of life care. That in the long run (and maybe the short run) would save us billions.
A bigger issue is it could save a lot of suffering.
stopwastingmymoney
(2,042 posts)The real moral dilemma here is whether it rationed fairly or have it totally based the profit motive rather than actual efficacy. I'm sick of the "I paid into the system all my life" argument when the truth is due to the ridiculous rise in costs a lot of people are taking out far more than they put in. Medicare and Medicaid are social safety nets and we need to be reasonable and fair about it, not have this stupid "me first, screw the future generation" attitude the baby-boom generation has. The only real savings is to lower overall healthcare costs and get the rent-seeking private sector leeches off the government tit. Doctors and practitioners should be compensated fairly for their valuable skill and expertise, but the profiteering middle-men need to get the hell out.
ProSense
(116,464 posts)Skittles
(153,193 posts)you do realize we are getting screwed too, right?
mucifer
(23,565 posts)Then while people can still make their own decisions, or their relatives have more time to think about it. It should be explained what spending final weeks or months in an ICU is like and what CPR vs dying at home with family is like. The other thing some people are proposing that I like is changing the term DNR do not resuscitate to AND A Natural Death. This might make it easier for people to think about it as a natural process as opposed to withholding important treatments.
You don't even have to discuss the money aspect.
ProSense
(116,464 posts)This notion that government should decide is ludicrous, and that's evident because of the ageism aspect. It's one of those idiotic slippery slopes that people tend to push in age discrimination. What about a younger person, or a child, in a similar situation?
mucifer
(23,565 posts)Many parents when given the choice chose to take their children home to die with family and the help of hospice care.
ProSense
(116,464 posts)As it should be. I still say that's between a family and their doctor.
mucifer
(23,565 posts)We shouldn't force a body to stay alive for months or years when there truly is no hope and the person is unresponsive. In EXTREME CASES I don't think doctors should have to give the families a choice.
"In EXTREME CASES I don't think doctors should have to give the families a choice."
...advocating that the decision be left to the family (choice) and in the most "extreme cases" the family's doctor.
That's not the same as letting the government decide.
mucifer
(23,565 posts)It's an ethical question. I know not everyone agrees with me. I do believe many single payer European medical systems couldn't thrive the way they do if the government didn't say "no" sometimes.