Recipe For Out of Control Costs
I do like Anderson's Krugman-in-Wonderland blog. I was reading Krugman's blog for a very short time, but I couldn't stand the nonsense in it.
I like the way Anderson describes "a recipe for permitting costs to get out of control" with health care. Certainly the US is insane in how much it pays for health services, and insane to have what, about 1/3rd of the costs going to paper pushers? I digress...
Canadian health care costs are much more under control, except dental, which is probably more like the American model.
There are two ways to control costs, and Canada tends to control costs in that there is one main source of income for the health care industry and that is government and services are billed at a fee for service basis. Canadian doctors complain about what they make and their comparison of what is reasonable is to point to the US. I can not see the US health care system as it is surviving much longer without major restructuring. Near as I can figure the insurance companies have promise people services they don't have a hope in hell of delivering. The system has been one where those managing and selling it have been there for the day, what goes into their pocket, and much like government, the long term obligations are someone else's responsibility. And right now, who is making the most in the health insurance industry? Those that come up with the most creative ways to cut people who have been paying for insurance for years that actually need to use services. And those who are healthy are choosing to opt out because of declining disposable income. More digressing...
The demand side of health care services is unrestrained. Services are either "free" (Canada) or "I paid for it," (US health insurance) that the actual cost is never real considered. So in Canada you get stuff like this, an unemployed couple who have a baby that is so severely brain damaged it does not breathe on its own has been on a ventilator for about 4 months now and the parents have won a court order preventing doctors from taking the baby off life support. So, not only is the tax payer on the hook for the outrageous health care bill for a lost cause, the tax payer is probably also going to end up on the hook for lifetime care of this child.
I think a universal system where the user pays part of the cost would put some restrain on demand.
Here is how insane costs are where I am. The community I am in has no doctors, dentists or specialists of any kind. We have nurses and that is about it. About once or twice per month a doctor comes to town, I think 3 times per year a dentist comes to town, same kind of thing for an eye doctor. If you need to see a doctor for an emergency you are flown out to a medical centre and the same for if you need to see a specialist. I saw the bills on one of my flights to Yellowknife and it was about $3000. That flight was a private charter to Ft Simpson and then picking up the daily flight between Ft Simpson and Yellowknife. We have either direct charters to Yellowknife, or we go to Ft Simpson and then transfer from there. Twice I have known in advance that I would be in a place where there would be no transportation costs to see a specialist and I tried to arrange appointments and they system would not allow it. Well, first time the system would not allow it, and the second time the doctor did not see patients any of the 3 days I was in the city she lives in and only saw patients under what ever category I was stuck in every other week. No exceptions made for saving taxpayers that really expensive flight. On top of that, I'd probably need coverage for my classes two days because often you end up having to stay over night at a hotel covered by taxpayers as well. I have yet to actually go to Yellowknife for a doctor's appointment. I just can't support such waste. I am also pretty fed up with the arrogance of the medical profession for taking so little responsiblity to control costs.
Americans spend something like 1.5 times more money on health services and they do not have better health outcomes and have a growing population without health insurance and can not afford health care. It suggest to me that the Canadian model is superior to the US model in that everyone has health services. We need to rein in costs, like a means test for helping people who can't afford subscriptions. Everyone else should just pay them.