At one of the town hall meetings that preceded the passage of the Affordable Care Act (ACA), President Barack Obama read an exhortation from a woman enrolled in Medicare: "I don't want government-run health care. I don't want socialized medicine. And don't touch my Medicare.'" This woman should perhaps now count herself fortunate that the ACA is law. She will be eligible for preventive health care with no out-of-pocket expenses as part of an ACA program that will save tens of thousands of lives per year and generate huge health care savings.
Long before the passage of the law, the government was highly involved in the US health care system. In 2008 public expenditure on health care was $3,507 for every man, woman and child in the U.S., and private expenditure was $4,031. The United States spends far more on health care than any other country, but the main discrepancy is in private spending, not public spending. Compared with France for example, in 2008 US public expenditures per capita were 22 percent higher, but private expenditures per capita were 391 percent higher. Yet, in contrast to France and other European nations which provide universal medical coverage, about 47 million Americans - some 16 percent of the US population - were uninsured in 2008.
The United States clearly has a problem of out-of-control health care costs. The problem resides, however, in the business component of costs, not in the government component. What Americans should be worrying about is how to regulate the businesses that get rich when we get sick.
The ACA takes steps to limit the boundless profiteering that has become customary in the U.S. health care system. By tackling key sources of waste, fraud and abuse, the law starts us on a road to cost containment. Here are some examples:
Overcharging for health insurance. The leading health insurers in the United States deliver low-quality, high-cost coverage. The biggest among them use virtually all of their enormous profits to do enormous stock repurchases. That means that a significant percentage of an insurance premium goes simply to boost the insurer's stock price, which in turn jacks up executive pay. During the past decade four of the biggest insurers -- UnitedHealth Group, WellPoint, Aetna, and Cigna -- did combined stock buybacks of $62.9 billion, more than their combined net income.
States have two new tools to prevent health plans from gouging consumers. First, 46 states have received grants from the US Department of Health and Human Services to investigate premium rate increases. This funding will give states the resources to review the complicated actuarial explanations filed by insurance companies and to judge whether premium increases are justified. In addition, plans will now be required to devote a minimum percentage of their premium revenue to medical care instead of administration, executive salaries, profits, lobbying and administrative waste. Plans will owe their customers rebates if they fail to spend at least 80 percent (individual and small group) or 85 percent (large group) of premium dollars on medical expenses.
Over-investment in expensive equipment. The U.S. has about 26 magnetic resonance imaging (MRI) units per million population, more than double the average of 11 units in all economically advanced nations. Japan has 43 units per million population, but under the country's single-payer insurance system, the cost of a scanning session in Japan is about one-tenth the typical charge in the United States. The ACA addresses this problem by adding a new sales tax on the purchase of expensive equipment and changing the formula that Medicare uses to pay for imaging services in order to avoid overpayment. In addition, there are new disclosure requirements so patients will know if their doctor is rewarded financially for prescribing a particular imaging test.
Overcharging for prescription drugs. The prices that Americans pay for drugs are about double the prices in other advanced countries. Since the 1980s, major pharmaceutical companies have successfully argued in Congress against the regulation of drug prices, claiming that high profits are needed to fund research and development. Yet a large portion of the profits of these companies is devoted to repurchasing their stock. For the decade 2000-2009, Pfizer bought back $50.6 billion, equivalent to 65 percent of its profits and 66 percent of its research spending, and Amgen repurchased $25.8 billion, about equal to its net income and R&D.
While we await regulation to confront this troubling inconsistency, the ACA takes steps to reduce the cost of drugs. Already this year more than one million Medicare beneficiaries have received $250 checks to help offset drug costs after falling into the prescription drug donut hole, and starting next year, seniors will get a 50 percent discount on brand name drugs when they enter the donut hole. The ACA also expands access to a prescription drug discount program for children's hospitals and other community providers.
At the root of the high cost of health care in the United States is a highly financialized business system. The ACA is an important step toward significant health reform. Until we control the behavior of business corporations in the health care sector, as parts of the law begin to do, Americans will continue to grapple with extraordinarily high health care costs.
Examples: Government sponsored monopolies which include licensing of professionals, certificates of need to build facilities, preventing insurance from being sold across state lines, allowing lawyers to sue for any frivolous idea which pops in their head, etc. (I was once sued by an elderly gentleman with a post-op numb finger and part of his complaint was his sex life had been disrupted. Never mind the two hip replacements and two knee replacements. Sex just cannot be accomplished now that I have a numb finger.)
To summarize, those who feel that medical care is too expensive believe that Obamacare will make it cheaper despite insuring 47 million new americans and creating 157 new regulatory bureaucracies on top of the medical care previously provided.
People want lower costs and better quality. Obamacare accomplishes neither which is why the more people learn about the obama plan, the more they will hate it. Obama keeps complaining he is a poor communicator on health care. It is obvious he is a great communicator, and people understand his medical care takeover exactly, and this is why people are opposed.
We hear all the time how our businesses need tax relief and deregulation to help them be competitive on a global scale. Wouldn't relieving them of the burden of providing/administrating health care coverage make them more competitive w/companies from countries w/national health insurance?
Why can't we afford 10 trillion over a decade for health care, but we can spend damn near a trillion a year on the Pentagon, and that doesn't include the added expense of the war we wage to put all that defense spending to use, then, add to that subsidies for foods that end up making us sicker than we might be otherwise. Medicare for all begins to pale in comparison.
Insurance companies are just big financial institutions like our OH HOLY investment banks. Sometimes they are one and the same. Now do you see why we can't do anything that might affect their business? Check out where the people who represent you get their campaign cash and what stocks they hold, then ask yourself why this 1/5th of the US economy is defended so vigorously.
Another is the thought process of "using up the deductable", so some go to a provider more often that might be necessary.
Now we have mandated insurance - THAT otta drive down costs. :0
Check out this great report on Bill Moyers Journal. It is a documentary that I believe he played almost in it's entirety called Money Driven Medicine.
http://www.pbs.org/moyers/journal/08282009/watch.html
The most damning thing that was said was that if there was an Official Bird of the Health Care industry it would be the Crane because every Hospital is expanding so they can service more patients, More Patients + More Procedures = More Profits!
Any wonder that health care costs havebeen rising at a faster [pace than inflation for decades?!
There are still some great doctors but yes, the pharmas are feeding most that the answer to every ill is pills. It's actually strange to bump into the salesmen in the waiting rooms.
Some doctors are honest and talk about good food etc and provide pamphlets, and info from American Medical and Cancer societies! Not many follow. But many also take millions of dollars worth supplements and vitamins, that are indiscriminately sold and advertised. This should stop! Women in those shops pretend to be pharmacists and give advice! It is illegal to practice medicine even for well educated nurses and pharmacists.
and mild head aches, spending hours in the ER, where they have to make $$ and order X rays and lab. Two services the hospital make most money in. Some one said," I pay for my insurance and I will use it" This kind of ignorance is pervasive. This great nation was built by hard working men and women who often lived to be ninety without doctors and medicines!
They did exercise and ate home made items.
In addition, as several people have mentioned, pharmaceutical companies, health insurance companies, etc. are all businesses trying to maximize profits. They must please their Wall Street handlers so every quarter must be better than the last.
The ultimate (and only real) solution is to get rid of private insurance and institute a single payer, non-political system. That we could have real experts making decisions and a system with enormous clout over purchasing and pricing.
Remove the tax deductibility of health benefits from corporations, separate insurance (protection against accidents and disease) from basic care and allow cross state competition of insurance companies and the consumer would "control the behavior" very well, thank you.
A public option could create a "no frills" health care system that rich people wouldn't go near. We tried this, but the insurance industry didn't want any competition. So they managed to kill it not onlly with lobby money but with PR ads falsifying the reality, and calling it "socialized" medecine... what insurance is in the first place - a society where everyone chips into a pot to cover the medical expenses of anyone who gets sick. However, the health care brokers, who call themselves "providers" but don't actually provide anything, take so much out of the pot that the system cannot work (multimillion dollar salaries, skyscrapers, private jets, executive golden parachutes, offshore resort properties disguised as investiments, conventions... you name it). But sadly enough, most Americans respond to meaningless buzz words and catch phrases rather than reality. Until Americans wake up to the BS, we will continue to be bled dry.
Insurance is not "everyone chipping in" for the good of everyone,that is what is called communism - Insurance is a paid for transfer of Risk by a company to a person -for a profit.
Two things that are left out when speaking to the "left" on Healthcare.
1. Tort reform- getting rid of the "Business" of suing medical providers for frivolous issues. ( This is why every test is run and the cost goes up i.e CYA expense ) Out of court settlements which are under the radar- are HUGH.
2. Eliminate the cross state policy barriers