The Times Editors On Health Care - Embrace the Fantasy

The Times offers a long editorial sharing their wisdom and insights on health care.  I found this to be unexpectedly honest and amusing:

Drug Prices. Compared with the residents of other countries, Americans pay much more for brand-name prescription drugs, less for generic and over-the-counter drugs, and roughly the same prices for biologics. This page believes it would be beneficial to allow Medicare to negotiate with manufacturers for lower prescription drug prices and to allow cheaper drugs to be imported from abroad. The prospect for big savings is dubious.

The prospect for big savings is dubious indeed (the Times thumped Kerry on the drug re-importation issue in 2004), but if we join Europe in refusing to pay for new drugs, who will deliver the next generation of breakthroughs?

The Times raises cogent objections to consumer sovereignty rather than dismissing it out of hand:

Skin in the Game. The solution favored by many conservatives is to force consumers to shell out more money when they seek medical care so that they will think harder about whether it is really necessary. The “consumer-directed health care” movement calls for providing people with enough information about doctors and treatments so that they can make wise decisions.

There would most likely be some savings. A classic experiment by Rand researchers from 1974 to 1982 found that people who had to pay almost all of their own medical bills spent 30 percent less on health care than those whose insurance covered all their costs, with little or no difference in health outcomes. The one exception was low-income people in poor health, who went without care they needed. Any cost-sharing scheme would have to protect those unable to bear the burden.

And consumer-driven plans have limitations. Most health care spending is racked up by a small percentage of individuals whose bills are so high they are no longer subject to cost sharing; they will hardly be deterred from expensive care they desperately need. Moreover, few consumers have the competence or knowledge to second-guess a doctor’s recommendations.

What they left out is that employer-sponsored health insurance is eligible for a tax deduction whereas privately purchased insurance is not; Ramesh Ponnuru discussed this in the prestigious pages of TIME (and two rejoinders).

Comments

[Ralph L]

who will deliver the next generation of brekathroughs?
The Brek Girl will sue Big Pharma into releasing new drugs. Otherwise, we must look to Chico Marx to produce brekathroughs.

My munchausen stepmother has apparently ruined her colon with endless prescription drugs. Of course, my father would have to have bought them, if their insurance hadn't.

[clarice]

The NYT is so full of it.
In the style section there is a big piece on how popular Costco has become with the rich. It begins and ends with quotes from a dear friend who is a generous host and a notorious bargain hunter. Near the end we have this editorial blather:"Against the backdrop of an unpopular war, rising oil prices and a subprime mortgage crisis, a certain thriftiness seems to have crept into the city’s dining rooms."

Trust me. This is utter nonsense.
The Costco near the Pentagon is one of the most luxurious to be found anywhere. It is next door to the Pentagon where about 100 big parties must be scheduled for every day of the week. And it is near enough all the Embassies which regularly must entertain--and where cost consciousness is required.
You will not find a better selection of well priced wine, champagne, filets, cheeses, smoked salmon, pates, anywhere in the world, and it has been a mecca for smart shoppers well before Iraq was a twinkle in Cheney's eye or the subprime mortgage boom even began.In fact, if you look the WaPo did a piece during the glorious Clinton era of all the Embassy chefs who did their buying there.

[AndyJ]

Perhaps the Times would follow through and -LIMIT- the drugs available in the US to those also available elsewhere. Perhaps the Times would promote the changes in law that would disallow class action lawsuits, restrict physician malpractice damages and institute a system of "Loser Pays" for all medical legal action-?

Of course, living in a fantasy land means free drugs, free doctors and the ability to suit for unlimited amounts at each and every disgruntled complaint-regardless of facts or merit...

Ask your family doctor how many babies they delivery-? How many patients they admit to hospital-?... Ask which states have the better malpractice rates and medical board license investigations-?

The -HEALTH ISSUE- is a hobby horse of political rewards...That brings all the suckers to get in their licks. The subject will rock back and forth long enough and the public tires and surrenders... Then when it fails, the program can join that long list of discontinued government programs...

[fed lapides]

the nation badly needs a health care system and one that works and also one that includes the millions with no coverage. Why? Because, dearheart, if I have no coverage,I go to emergency room. They take care of me. Then they try to get back some costs by charging more for those patients that have health plans. And then the insurance companies raise their rates so they can make money. What the candidates are talking about is NOT govt health care whereby the govt tells you which doctros to go to but govt INSURANCE...that is what Medicare is. That is what bank insurance is. You think those things don't work? prefer to deal with a bank not having govt insurance?

[Jim Glass]

Whether the cost of something is high or low depends of course on the quality of what you are getting, very obviously -- except, it seems, when prescription drugs are concerned.

Brand name drugs are deemed to be "high cost" in spite of study after study showing their high medical cost saving effects, which far exceed those of older generic drugs -- and in spite of the medical cost savings that all prescription drugs produce generally.

E.g.: "Overall, a $1 increase in prescription drug spending is associated with a $2.06 reduction in Medicare spending."
http://www.nber.org/papers/w13358

Hey, if my spending $100 will save me $206, that's too dang expensive! I want the government to spend that for me!

[Mark Buehner]

The fallacy is assuming that government run healthcare will be any better than the emergency room. But then again I deeply suspect this isnt so much about improving healthcare at the bottom end as putting every on the same level of misery. Kinda like every liberal program at the end of the day. Its ok for everyone (and by everyone i mean everyone except the Kennedys and Clintons of the world obviously) to be stuck with long lines, rationing, endless government red tape, and no private research for wonderdrugs- but not just a small minority. Because its unfair. The old share the misery argument.

[ic]

When the Canadians need urgent care, such as to remove a brain tumor, they come over the border. Be prepare to go to Mexico once "universal" health care is in effect. Someday, we may even achieve Michael Moore's nirvana, getting Cuba's level of health care.

[Jamie]

It's funny... as has been pointed out, at present there are (relatively) ready expedients for those in a real health care bind - by which I mean those on some national health system who can't or don't want to wait for their number to come up: they can go to private docs for better and more timely care. If the U.S. goes national too, is it just the drug industry worldwide that will be "dumbed down" in the process, or will innovative procedures also start to go by the wayside in med schools everywhere, and research hospitals lose, not interest, but ability to pursue them? And what will your cancer's anticipated survival rate have to be in order to qualify for more than palliative care?

The un- and underinsured problem is the tugger-at-the-heartstrings that makes the well-intentioned liberal want to "do something," but that person ought to have figured out by now that the Law of Unintended Consequences is never denied. I had a filling replaced on the National Health in Britain in my impoverished youth; when I got back to the States and a decent health plan (through my employer, which has its own problems), my dentist practically recoiled when she saw it, exclaiming, "What is that?!?"

[bio mom]

It interests me that so many people are promoting drug reimportation as a way to lower costs yet are likely to be among those most suspicious of anything coming out of China (toys, toothpaste, etc). Why should reimported drugs be trusted as the real thing? Why no skepticism about that yet so much about everything else?

[amr]

Obvious there is no perfect healthcare system, but the national healthcare systems we are most familiar with are failing. Then why do our politicians and citizens believe that we can do it better. If a country with such a homogenous citizenry and social structure as Japan is having serious problems with their national health program, why should we expect a different result? Canada is now permitting private healthcare after their highest court looked that the lack of services for those with severe needs; they had inadvertently moved to a rationed care system because of government fiscal policies and sluggishness in adapting to the incidences of serious illnesses/diseases in different areas of the country. Government regulations and interference in the US have already distorted our system and politicians don’t seem to want to correct that aspect of it.

The bureaucracy of the government has in many areas failed in providing the needed stateside treatment and after patient services for our wounded warriors that some of our veterans are seeking private care; caring for our wounded warriors one would think would be so very easy for the government to handle and would have the support of every politician and bureaucrat in our country. View that situation and mentally compare it to the government controlling the medical treatments for the general public.

Anyone who believes that a country as diverse as ours can succeed in perfecting the same type of a program as our Western and Japanese friends have instituted and expect different results are at best fools.