Health Care Reform or Sickness Care Financing Reform?

Frank,

Sorry, but you're completely wrong. The real problem is third-party payment in which consumers of services do not directly pay for what they routinely consume. While insurance can be feasible for unpredictable and high cost services, it cannot work for routine sevices. High cost services must be paid for in part by the insurance premiums paid by people who don't end up needing the service. Otherwise the  premiums will soon be unaffordable.

Imagine that food was sold using monthly foodcare premiums and food was then free in the supermarket. Within the first week of each month all the food that anyone wanted would have been shifted from the store shelves to consumers' freezers. And the foodcare premium woukld have to rise almost every month. If prices are not allowed to attract supply and moderate demand, supplies will be rationed by other means and severe shortages will result.

Regards, Don

sorry, but talking about supermarkets is complete obfuscation- we already have single payer (VA and medicare), as does Canada- so no need to speculate- single payer is cheaper with comparable outcomes- we just need to universalize it, like every other industrialized nation

Frank,

Maybe you would like Canadian healthcare, but that doesn't mean you would like it if it no longer it no longer could ride on the back of the US system, as abysmal as it is. Canada is able to charge low prices for drugs because it, and Europe, provide virtually no support for the development of new treatments. Drug manufacturers are willing to sell to Canada at low prices (still above marginal manufacturing costs) to get incremental revenue, but can only do so as long they do not leak back into the US in large enough quantities to destroy US pricing. If the US system changes in such a way that the profits needed for new development are  damaged, new development will disappear. A single payer is also the sole rationer of services and when push comes to shove, who is to say that the relatively smaller outcome cost effectiveness of diabetes treatments will not restrict diabetes treatment in both the US and Canada?

Regards, Don

it's not about liking Canadian healthcare, it's about disliking exorbitant drug and insurance company profits, while 40 million American citizens have no insurance (and so go to the ER, where we all pay exorbitant amounts for their care)- and you are propogating the drug industry's propaganda about drug prices and R+D- first of all, Canada is able to charge low prices because they buy in bulk, and can negotiate purchase prices downward- the American government, which buys drugs in the largest bulk in all of history is not allowed to negotiate cost because the drug company's lobbied to make price negotiation illegal! (so much for the free market)- and the drug industry's claims about R+D are belied by the actual cost of their marketing- take a walk outside, or turn on the TV, or open a magazine, and you'll get deluged with drug ads- the other omission here is that the NIH also develops new drugs, which are then expropriated by the drug companys for private profit- ever heard of the cash cow Taxol?- it was developed by the NIH with both of our money, and then was given over to Squibb, who privatized the profits on it- and finally, it's a myth that new diabetic treatments are better than the old- check out all the major studies- insulin and the sulfonuyreals bring down A1C signifantly lower than the TZDs and DPP blockers, and are much cheaper

Frank,

I can't expect you to understand economics, but buying in bulk has nothing to do with it.

Your understanding of marketing and advertising is backwards. They are not costs, they are investments. Do you really expect the drug companies to make large marketing outlays without an expectation of a positive return?

Regards, Don

I can't expect you to understand why drug ads are unethical, but 'positive returns' have nothing to do with it- your understanding of politics and economics are backwards- politics drives our drug pricing, not economics- do you really think that US medicare legislation disallowing price negotiation wasn't bought and paid for by drug industry bribes?- again, Canada has no such corruption and so can negotiate the price downward

What a silly claim. Of course it will be necessary to impose some controls and arrange the incentives for providers and consumers to encourage sensible choices.

Check out what George Halvorson has to say in his "Health Care Reform Now!". He is in a really good position to understand the essence of the problems. He understands that private insurance in our present arrangement is truly a stupid way to proceed.