Health Care in Crisis: Zeke and Gerard Weigh in Live from Aspen

-- "Cuba is doing better on some cancers than the US"

-- Technology is responsible for 50% of the increase in health care costs

-- NOT TRUE that 80% of health care costs are spent in the last year of life.
Only 10-12% of costs go to individuals in the year they die

Ezekiel Emanuel, the health care expert working for Obama and brother of Rahm Emanuel addressed health care reform today at the Aspen Ideas Festival along with a panel of experts.

The panel included Gerard Kleisterlee, the CEO of Philips, makers of electronics including medical technology and Tina Staley. Walter Isaacson, head of the Aspen Institute kept things lively as the moderator.

A controversy broke out between Kleisterlee and Emanuel about the role that technology plays in health care costs. Emanuel claimed that technology is responsible for 50% of the increase in costs.

"In every other field technology drives costs down except in health care," he said. "The rise in health care costs is not mainly from the aging population," he continued.

Kleisterlee disagreed and stated that "[device] technology is only 10% of the costs of health care, and of that imaging is only two percent."

Emanuel was included medicine in the technology bucket as well.

Emanuel said that "I don't want to be a reductionist, but the primary problem in health care is the financial incentive system." According to Emanuel, paying doctors as you would a seamstress -- by the piece-good -- is not the right system.

Kleisterlee added that "in Europe we spend 10% of GDP on health care and the US spends 17% of GDP." Emanuel explained this is due to: higher drug costs, more procedures, higher doctor wages. Emanuel said that this is not necessarily giving Americans better health care. "Cuba is doing better on some cancers that in the US."

On the dwindling numbers of GP's Emanuel said that it is remarkable that "most primary care physicians are not in long-term therapy."

According to Emanuel, the gap between GP's and specialists is so large that it is amazing we even have any GP's left.

Kleisterlee wrapped up the panel with the company line that "we want to help doctors provide patients with better outcomes."

The panel helped debunk some myths about healthc are costs, but did not really offer the outlines of a better system except to conclude that it is definitely not what we have today.

What should Obama do? Let me know your thoughts.

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Comments

[Derelict outlaw]

What should President Obama do about the health care crisis?

Have the HELP Committee demand that the Congressional Budget Office do a costs analysis of a single payer program, equivalent to France's or Switzerland's or even Taiwan's.

Then he would be closer to being in integrity in making statements like he did the other day at the town hall meeting when he said that "a single payer plan would be too disruptive". How does he or anyone in this Congress know? They haven't crunched the numbers by the most credible and reliable agency that is respected by both parties.

Never mind the fact that we elected this leader to be exactly that, disruptive, just get the CBO to show us that a single payer plan would be much less expensive to operate for the next 2 decades, and that he's not considering it because it would be cheaper.

Be credible Mr. President, until all avenues and possible solutions are investigated, we will not believe you.

[RMankovitz]

The reason we have a health care crisis is because we have a "health" crisis. People are getting sicker sooner. The present generation is predicted to have a shorter average lifespan than the previous generation. As a holistic health practitioner, research scientist, and author of several books on illness prevention, I offer the following approach.

I suggest an Office of Illness Prevention (OIP). It must be independent of: the food industry, the industry-controlled FDA/EPA/USDA triangle, Big Pharma, the medical community, the Surgeon General, the NIH, and even the herbal and supplement industries. It would conduct government funded university research into areas that have been completely ignored, such as using nature as a paradigm for health. I have personally already funded such research with great results. Ask your librarian for a copy of "The Wellness Project" or "The Original Diet – The Omnivore's Solution" for details.

The OIP would include an anti-revolving-door policy to avoid being compromised by other institutions. All of the research would be posted free to the world community, and there would be open dialog between consumers and the OIP via the web. New professional designations would be created for Illness Prevention Practitioners. Prevention should be part of a mandatory curriculum taught in every medical school. Ultimately, Illness Prevention would become a worldwide initiative, changing the face of health and health care as we know it.

Roy Mankovitz, Director
http://www.MontecitoWellness.com

[MDCambridge]

What should Obama do?

Stop treating Heathcare like a fair market; it's not. A fair market implies choice regulated by supply and demand. If it were, choices would be on the patients' side. We're not purchasing the latest jogging shoes or a better car; the present system is designed to profit from the sick, bankrupt the families of the terminally ill, and pit profits against life and death.

It does not make us a socialistic country to socialize medicine. We have socialized our police force, our highway system, fire protection, our military, yet these do not make us socialists. They are the only practical solutions to the given problems.

I am not for socialism: pure socialism stifles creativity and the individual; pure capitalism permits (note that I didn't say "promotes) greed, and completely unchecked, creates our present healthcare (and economic) debacle. A balance is mandated.

The fear of realizing that healthcare is not a fair market economy isn't driven by an adherence to a capitalistic ideology, it is driven by the very real profit opportunity that will be lost if we change.

However, Healthcare should never be anyone's profit opportunity.

Obama should make the ethical decision.

[Derelict outlaw]

Socialism, smocilaism, we "socialized" medicine here in the USA in 1966.

We just discriminate outrageously as to who will be covered

This is indeed a civil rights issue, end the discrimination, universal health care for all US citizens, not based on age, race or gender.

[Derelict outlaw]

Nothing makes money apparently like human suffering.­.....and prisons...­..two industries the US excels in.....

[Lee41]

Re-structuring Health Care: The Simple Three Layered Cake:
•1) Social financing of an all-in-the­-same-boat insurance pool for a basic benefit plan. Those who want Cadillac (or even Pontiac) level care can purchase supplemental insurance, just like the current “gap” insurance available for Medi-Care.

•2) Convert for-profit insurance companies into non-profit funds, following Germany’s Bismarckian model. (The Commonwealth Fund ranked Germany #1 when compared to the five, industrialized English-speaking countries.­) These companies would design competing plans packaging the core benefit with other features. The companies would be able to make a profit on the non-core elements, as is the case in Switzerland. As opposed to the rebellion against HMO’s in the 1990’s, consumers would accept being limited to a core package if:
o The benefits have been negotiated as a part of a national conversation
o no one is making a profit off such a limitation.
•3) Group practices of salaried doctors, following the successful model of the Mayo Clinic and a dozen other leading community-level medical organizations across the country. (See Gawande, New Yorker, June 1, 2009.) Each of these groups are currently partnered with non-profit insurance entities as described above. Everyone should leave it to these groups of doctors to define best practices from the bottom up.
The money that this structure would save would be more than enough to
finance universal health care.
----John M Lee, MD

[PhilipTaylor]

MAIN STREET AMERICANS Urges Obama to put Single-Payer as his # 1 Priority!

Main Street Americans, strategizing yesterday with their leaders about health-care reform, complained that Obama and moderate groups ought to drop their attacks on Single-Payer Healthcare and devote their energy to promoting passage of comprehensive SINGLE-PAYER legislation.

It is time to see WHERE YOU STAND CHIEF!

[PhilipTaylor]

Why is this happening?

USA Quality of Healthcare = Cuba Quality of Healthcare!

World Health Organization has US at 37th below Chile and Costa Rica AND ON PAR WITH CUBA!

Rank Country

1 France
2 Italy
3 San Marino
4 Andorra
5 Malta

..........­..........­.

33 Chile
34 Denmark
35 Dominica
36 Costa Rica
37 United States of America
38 Slovenia
39 Cuba

http://www.photius.com/rankings/healthy_life_table2.html

[tompoe]

Obama is quickly becoming a joke. He campaigned on change. First change is to run the crooks on Wall Street out of town on a rail. He rewards them with literally trillions of taxpayer dollars. Second change is to kill the insurance industry and run them out of town on a rail. He rewards the industry with "public option", which will make the handy dandy "doughnut hole" pale in comparison to the riches it will give to the insurance industry. Third change is to create green jobs and lead the world in saving our planet from global warming. He's done absolutely nothing on this. Is Obama the next leader to follow Bush's policy of utter arrogance?

[Derelict outlaw]

I agree completely with this poster that the public option is a giant boondoggle that will quickly be adopted and easily passed, because it will enable corruption and extortion on a scale never imagined even by Goldman-Sachs.

[bumpmeister]

Oh, gee, let's see, is the system broken? Yes, when more than half of all bankruptcies have their antecedent in health costs, and more than half of those filing ACTUALLY HAD INSURANCE. Scary!! It is way past time to enact a single payer (or it's Trojan Horse brother, a public option). It's amazing that the insurers offer the argument that this would drive them out of business because it creates an uneven playing field, but also argue that theirs is the most efficient and patient friendly plan. Anybody who buys this must be the head of manure buying for a nursery or something. It is crap!! The other argument is that you won't be able to keep the family doctor you have (in Canada everybody continued to see their same family physician!!). Their arguments are nothing but red herrings and smoke and mirrors supported by millions in advertising and lobbying.

It's high time for a revolt. Armed if it must be, not, if it would work. I feel a little like an Iranian, in that a great majority of the public and the providers favor single payer. Everyone needs to read the Wikipedia article comparing Canadian and American health care systems (you can't really call ours a system).

[jmpurser]

President Obama should immediately announce his support for a genuine single payer health care system and get to work making it happen! Start with an educational tour about what this would mean for our country, the benefits and costs. Put a lot of himself into delivering this REAL HEALTH CARE REFORM! Make it an honest center piece of his administration. Hold congressmen accountable and if they don't work with him on this make sure their constituents know why they still don't have health care.

It's perfectly acceptable to fail to accomplish a difficult task. It is not acceptable to fail to even TRY to make a difference.

[JustBNice]

Obama should support a Single Payer system like Medicare. Unfortunately he does not, nor do many Democrats in the House or Senate. They support a system that will force heath insurance on the uninsured and penalize them $1,000 or more them if they don't buy the new "public option" insurance or have health insurance elsewhere. They estimate they will raise 36 billion from these penalties to help pay for the "public option" plan.

This is a prescription the health insurance companies like, it keeps them in business and will probably increase their profits. They will come up with cheap plans comparable to the government option plans that make money for them the old fashioned way by dropping clients went they get "too sick", high deductible, little coverage, etc. etc.

Don't expect any meaningful changes to what we have now based on the latest bill announced from the HELP Committee of 13 Senators . Most of us will continue with our overpriced health insurance and the US economy will continue to sink.

This country deserves a true Single Payer plan like Canada, France, Japan have had for years. Only that will keep the costs down and provide medical care for everyone. The rich can still have their private insurance and private doctors if they want under a single payer plan, other countries do that also.