Wednesday, January 23, 2013

Will Reeps Use Nate Silver's Health Stats to Try To Gut Medicare?

The ominous notes sounded yesterday, from Mitch McConnell and other Reeps, signals they are determined to carve out as much as they can from Medicare - either forcing the program to delay enrollment of seniors until 67, or imposing steep cuts and premium hikes.

After seeing all my recent copies of paid for Medicare bills, the very thought gives me nightmares as it should anyone approaching Medicare enrollment age.

No one certainly wants to go back to the pre-Medicare era, as depicted in the accompanying image- when oldsters had to sign away their homes, to get medical help or to depend on their grown children to co-sign loans or take 2nd mortgages.

Thus, it has to disturb many true liberals to know that just 4 days ago, Nate Silver- in a much-discussed post in The New York Times  “What Is Driving Growth in Government Spending?”   -  made a statistical case that can easily be appropriated and exploited by the Republican House and its Tea Party Cabal. After going through assorted healthcare numbers, Silver wrote:

"All of the major categories of government spending have been increasing relative to inflation. But essentially all of the increase in spending relative to economic growth, and the potential tax base, has come from entitlement programs, and about half of that has come from health care entitlements specifically.

The growth in health care expenditures, for better or worse, is not just a government problem: private spending on health care is increasing at broadly the same rates and is eating up a larger and larger share of economic activity. It’s an immensely complicated problem, but the arithmetic is simple: if we can’t slow the rate of growth in health care expenditures, we’ll either have to raise taxes, cut other government spending or continue to run huge deficits. Or we could hope to grow our way out of the problem, but health care expenditures may be impeding private-sector growth as well."

For sure, Silver in exclusively looking at the hard numbers is quite correct, and health care is driving inflation. It is also a no-brainer that as a country we have to get health care costs under control. But that doesn’t necessarily mean what diehard Tea Party folks or Paul Ryan types might think it means, i.e. massive spending cuts.  The reason is that to impose austerity-based medical spending cuts would be to treat the symptom, not the cause. We need to fix the cause.

If we instead are driven like lemmings to cut, then providing less health care only means people have to go elsewhere (or nowhere), which has terrible effects on the people — and ultimately on the economy.   How can sick people, impoverished people, be free people or contributors? They can't!

What is the solution? As I noted in an earlier blog, e.g.

It is to adopt the same model used in Grand Junction, CO for the whole nation. To summarize: The template provides the basis for a standard set of costs-prices for all procedures, whether appendectomies, gall bladder removal, or open heart surgery. Thus, according to a standard cost set, each procedure will have its assigned, designated prices- say $11,000 for an appy, $35,000 for open heart surgery...whatever. No more charging one guy $60 grand and another $30 grand for the same surgery. Also no more charging $34,000 in Miami for a cardiac procedure, and only $14,000 in Fairbanks, AK. ALL procedures are set with the same prices!

The model was popularized in T.R. Reid's  PBS effort,  "U.S. Health Care: The Good News" . Reid traveled to three distinct U.S. municipalities - not Communist Cuba or anywhere "socialist" - where every person including the uninsured received medical care, and no one was turned away....not even Medicaid patients! The places included Seattle, and Evergreen, Washington, and Grand Junction, Colorado. In the last, Reid found an eminently rational model in which all patients are pooled together in one risk pool to lower the cost for all. All physicians in Grand Junction sign on to take any and all comers, no one indiscriminately turned away for whatever reason....whether Medicaid (low rates of pay, paperwork) or the uninsured. Any physician who doesn't agree is excluded from the Main physician network. He can go it alone and catch as catch can. Readers can watch its implementation as portrayed on PBS:

Note also, that instead of separating all medical procedures and costs they'd be unified as one single cost - say for a prostate cancer HDR treatment. Thus, instead of a medical center or hospital expensing multiple items for a prostate cancer procedure, e.g., from anesthesia ($4,124), to radiology services ($16,768), to recovery room ($2, 090), to operating room services ($14,994) with the bill totalling $42, 776  for all added up, we see just one bill for all integrated services directed at the ONE primary procedure..   In effect, perhaps a bill for $28,000 instead.

Is this do-able?  Of course! If Grand Junction and the other towns -cities Reid visited could do it, so could the nation! One more thing, we can also help lower medical drug costs by allowing the government to bargain for prescriptions like the VA. No, those of us no Medicare didn't fight in any bogus "wars" - but that should not matter. We are all citizens and as citizens we certainly deserve the same standards of care as anyone who by choice served in the military! To separate citizens out on the merits of 'military' service is a fool's errand.

The final goal: "Medicare for all", as opposed to a private insurance company based plan where people who may not be able to afford it have to cough up for private insurance policies. Then halfwits saying this is "universal healthcare'.  No it is not, it is a weak semblance of universal private insurance coverage paid by citizens themselves!

We can do it! If we can blow $1.2 trillion a year on useless miltary BS we can help our citizens toward their own domestic security!


Albert said...

Hi Copernicus, I've read some of your interesting posts. I'd really like to contact you by e-mail but I'm not able to find any contact form in your blog. Please, my e-mail is:

I'd really appreciate if you could contact me, please... My name is Albert. Thank you so much!

Copernicus said...

Hello, Albert.

You (or any other readers) can reach me at:

Glad you are enjoying the blog!