"Are we talking about real savings, or just window dressing? Well, the health care economists I respect are seriously impressed by the cost-control measures in the Senate bill, which include efforts to improve incentives for cost-effective care, the use of medical research to guide doctors toward treatments that actually work, and more. This is “the best effort anyone has made,” says Jonathan Gruber of the Massachusetts Institute of Technology. A letter signed by 23 prominent health care experts — including Mark McClellan, who headed Medicare under the Bush administration — declares that the bill’s cost-control measures “will reduce long-term deficits.”"
Well as I stated yesterday after reviewing Gruber, he is wrong. The devil is in the details. Let me restate a few facts:
1. Comparative Clinical Effectiveness is in and of itself a good and necessary process. It has been done and continues to be done in the profession. The problem is a centralized Government controlled and dictated CCE effort which the Bills, all of them, mandate. The problem is you do not want a rigid process controlled by some GS 13 dictating what can and cannot be done, no less paid for,
2. Medicare is in default because the money was stolen by Congress. Any economist should know this. It is NOT because Medicare is running out of money, the money was taken. Look at the US debt my economist friends, follow the money. It was spent on the type of Krugman like excesses which got us where we are today!
3. Gruber is all opinion. He has not as best as I can determine by looking at his work detailed any numbers, laid out any plan, analyzed any alternatives. Somewhere and sometime you must back up your generalities with facts. I have done so, read my reports and my books. here are facts and audit trails. I am no Brit hiding temperature data. Gruber just fails on that account in my opinion.
4. Cost control is half of the problem. Demand control is the other half. Where is that discussion. We have incorporated that in our plans and the Government has not done so as not to offend. Offend away I say, tax the fatty, the smoker, the drug user, and those whose lifestyle choices cost the rest of us. Yet for those who face a catastrophic illness, the child with ALL or osteosarcoma, the adult with multiple myeloma, the young person with multiple sclerosis, they should be treated with care, dignity, and should not be thrown to the economic wolves.
Krugman says that the Bills are great and will reduce costs because:
"First, the uninsured in America are, on average, relatively young and healthy; covering them wouldn’t raise overall health care costs very much.
Second, the proposed health care reform links the expansion of coverage to serious cost-control measures for Medicare. Think of it as a grand bargain: coverage for (almost) everyone, tied to an effort to ensure that health care dollars are well spent."
What is he saying in the above? First by taxing the young we use that money to pay for others. Second by taking money away from the old we reduce the burden on the Government. None of this reduces costs. This is typical Krugman in that it moves money from the taxpayers pocket to the Government. The good Professor would never make it in a real company. One must reduce costs as well as reduce demands. We have shown repeatedly how this is done. Krugman has, as best I can ascertain, never addressed the demand side, nor has Gruber, I believe. In addition when either of these gentlemen address costs, they do so by removing money, not by any means that a rational business person would do.
Academics have for the most part never had the burden of meeting a payroll. I can see that as I have returned to academia. The nights I spent worrying about some switch, some customer, in some hotel room in Athens, or Moscow, is not something these people have ever experienced. It is the "duty" one has when one must provide for one's employees, one's troops, and the like which gives a person the perspective of reality. That is a truly foreign element to almost all academics. Thus one seriously questions their preachings and their wisdom.
Posts
