In 1965 in Massachusetts there were 25,000 people hospitalized in mental hospitals and 20,000 at any one time in non mental hospitals, for all sorts of problems from cancer through delivery. By 1975 the mental hospitals dropped to about 5,000 and today it is just above 1,000 for the full time residents. Thanks to Thorazine and the like.
But as any medical student in that period remembers it was less finding out the problem and more bringing the patient to a cost effective controllable state. Drugs helped. But a second thing one noticed was that the insane had the very specific habit of trying the same thing over and over, despite the omnipresent and consistent past negative outcomes, assuming that this time it would work. Sound familiar, well it is and we call it a Government health care alternative. Why if you decry Medicare and Medicaid would you ever assume that a Government plan, if operated on a "level playing field" to other plans would ever be a true competitor. Yet we know that first the Government will cheat, and prevaricate, and secondly if the plan were truly a level playing field plan it would deteriorate quickly.
Remember my arguments on Medicare. First those who make it to 65 and have on average 12 more years have contributed an amount to the Medicare fund well in excess of the cumulative costs on average that they will incur over the remaining 12 years of their life. The question should be, where did the money go! The Government collected it and spent it! Now they blame the Medicare recipient for their incompetence and in some ways theft of the recipients own funds.
In the New York Times today is another shot at trying to patch the leaking craft. They say:
"A better public plan would not be a new government-run insurer at all, but rather a government-chartered mechanism that would let employers and individuals buy health coverage from private insurers in a manner that uses the three most essential market forces — choice, competition and incentives — to reduce the price and improve care.Congress is already looking to create federal or state “exchanges” through which individuals could comparison shop for health insurance. Exchanges pool large numbers of people and give them access to various health care plans — so that individuals can enroll in the plan of their choice, and so that risks and administrative costs can be spread widely."
The issue is not an exchange, it is a restructuring of payments, eliminating the company sponsored plans and then having people buy their own from private entities. The states may control rates as is done in auto insurance but it is essential to eliminate the collusive behavior of the insurer and large corporation. That collusion leads to the costs being off loaded to those who are in small companies or self employed. Combine this auto insurance approach with a demand for universal coverage and you get what we have already in many other insurance plans. The perhaps this cooperative may function.
A similar set of remarks is made by Cutler, the Harvard based economist Administration mouth who states:
"...Second, creating insurance “exchanges,” local or national organizations designed to act as clearinghouses for health insurance policies, could foster competition and drive down administrative costs for individual and small group policies. We estimate these reduced costs could bring in additional federal revenues of $64 billion over the next 10 years..."
The same problem exists in that the large companies will still control the push down costs.
Finally Roberts at Cafe Hayek speaks of a blog by Mankiw. The issue is why are physician salaries so much higher here in the US as compared to elsewhere. Well guys why not deal with the facts. In countries like Israel, Italy, Czech Republic there is no undergraduate training and there is no capping of the number of physicians, and there is limited vetting of physicians. In the Czech Republic for example there are probably four to five times the number of physicians as compared to what would be needed. The rich get German specialists at Spas and the rest get a somewhat limited capacity GP. Also all of these countries charge little to no tuition for the education. You are comparing apples to oranges. Getting to Med school is not the same as getting into a teaching program at a state school. Having spent time in these other countries I see the difference. If I were ill in Russia I would take a flight back to Boston and possibly die on the plan than go to a Russian hospital. Have you ever seen Russian dentistry, steel not gold!
What seems to be happening is that the mouths are spouting off with little or no knowledge. If these academics spoke this was as an MIT EECS student about some project they would likely find themselves installing cable boxes in Medford.
But as any medical student in that period remembers it was less finding out the problem and more bringing the patient to a cost effective controllable state. Drugs helped. But a second thing one noticed was that the insane had the very specific habit of trying the same thing over and over, despite the omnipresent and consistent past negative outcomes, assuming that this time it would work. Sound familiar, well it is and we call it a Government health care alternative. Why if you decry Medicare and Medicaid would you ever assume that a Government plan, if operated on a "level playing field" to other plans would ever be a true competitor. Yet we know that first the Government will cheat, and prevaricate, and secondly if the plan were truly a level playing field plan it would deteriorate quickly.
Remember my arguments on Medicare. First those who make it to 65 and have on average 12 more years have contributed an amount to the Medicare fund well in excess of the cumulative costs on average that they will incur over the remaining 12 years of their life. The question should be, where did the money go! The Government collected it and spent it! Now they blame the Medicare recipient for their incompetence and in some ways theft of the recipients own funds.
In the New York Times today is another shot at trying to patch the leaking craft. They say:
"A better public plan would not be a new government-run insurer at all, but rather a government-chartered mechanism that would let employers and individuals buy health coverage from private insurers in a manner that uses the three most essential market forces — choice, competition and incentives — to reduce the price and improve care.Congress is already looking to create federal or state “exchanges” through which individuals could comparison shop for health insurance. Exchanges pool large numbers of people and give them access to various health care plans — so that individuals can enroll in the plan of their choice, and so that risks and administrative costs can be spread widely."
The issue is not an exchange, it is a restructuring of payments, eliminating the company sponsored plans and then having people buy their own from private entities. The states may control rates as is done in auto insurance but it is essential to eliminate the collusive behavior of the insurer and large corporation. That collusion leads to the costs being off loaded to those who are in small companies or self employed. Combine this auto insurance approach with a demand for universal coverage and you get what we have already in many other insurance plans. The perhaps this cooperative may function.
A similar set of remarks is made by Cutler, the Harvard based economist Administration mouth who states:
"...Second, creating insurance “exchanges,” local or national organizations designed to act as clearinghouses for health insurance policies, could foster competition and drive down administrative costs for individual and small group policies. We estimate these reduced costs could bring in additional federal revenues of $64 billion over the next 10 years..."
The same problem exists in that the large companies will still control the push down costs.
Finally Roberts at Cafe Hayek speaks of a blog by Mankiw. The issue is why are physician salaries so much higher here in the US as compared to elsewhere. Well guys why not deal with the facts. In countries like Israel, Italy, Czech Republic there is no undergraduate training and there is no capping of the number of physicians, and there is limited vetting of physicians. In the Czech Republic for example there are probably four to five times the number of physicians as compared to what would be needed. The rich get German specialists at Spas and the rest get a somewhat limited capacity GP. Also all of these countries charge little to no tuition for the education. You are comparing apples to oranges. Getting to Med school is not the same as getting into a teaching program at a state school. Having spent time in these other countries I see the difference. If I were ill in Russia I would take a flight back to Boston and possibly die on the plan than go to a Russian hospital. Have you ever seen Russian dentistry, steel not gold!
What seems to be happening is that the mouths are spouting off with little or no knowledge. If these academics spoke this was as an MIT EECS student about some project they would likely find themselves installing cable boxes in Medford.
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