From: an030@cleveland.Freenet.Edu (Broward Horne)
Newsgroups: talk.politics.misc
Subject: Re: Busting Conservatives' Myths re Healthcare
Date: 28 Jan 1993 19:08:37 GMT
Organization: Case Western Reserve University, Cleveland, OH (USA)
Reply-To: an030@cleveland.Freenet.Edu (Broward Horne)
NNTP-Posting-Host: hela.ins.cwru.edu


In a previous article, jpr1@ns1.cc.lehigh.edu (James P. Reynolds) says:

      Hey, *I* am converted.  On record:

      We should absolutely have a national health care policy, which
      neither discriminates or burdens our people.

      I'm on THE BUS!

>
>So you see, "unleashing competition" among providers does not mean lower costs,
>since the person who gets the health care is not the same person who directly
>foots the bill, like if you went out to buy some drill bits or something.
>That's where your competition model breaks down.
>
>So, if you want to get it back, you have two choices:  You can do away with
>insurance companies entirely and just have people pay for their own bills, or
>have the insurance companies decide for you who your doctor will be, what
>tests you will undergo, what treatments you'll accept and where, etc.  Neither
>is a pretty picture, is it?
>
>Also, starting more insurance companies (somebody complained it's illegal)
>doesn't mean more efficient, or less, bureaucracy due to competition among
>those companies, either.  Here's another excerpt:
>
>
>- - - - - - - - - - - - begin quote - - - - - - - - - - - - - - - - - - - - -
>Ultimately, our cumbersome, inequitable system of reimbursement raises the
>costs for all of us - insured and uninsured alike - and causes problems for
>physicians as well.  "In order to preserve the mirage of a private system,
>we've created the most bureaucratic, regulated system of any in the world,"
>says David Mechanic, director of the Institute on Health Care Policy at
>Rutgers University.
>
>A key characteristic of the U.S. system is its obsession with making sure that
>patients get only what their insurance entitles them to, and nothing more.
>That means, for instance, that hospitals must keep meticulous trank of
>everything used by a particular patient, down to individual gauze sponges or
>aspirin tablets - all adding to administrative costs.  More important, the
>burden of dealing with multiple forms from a huge number of insurance
>companies requires a lot of clerical manpower.
>
>[ ... ]
>
>Hospitals in the U.S. spend fully 20 percent of their budgets, on average, on
>billing administration - compared to only 9 percent for Canadian hospitals.
>To run a health plan covering 25 million people, Canada employs fewer
>administrators than Massachusetts Blue Cross, which covers 2.7 million.
>
>Our nation's more than 1200 private health-insurance companies add to the red
>tape by the necessary maintenence of their underwriting, marketing, and
>administrative staffs.  This overhead consumed an average 14 cents out of
>every premium dollar in 1990, according to the Health Care Financing
>Administration.
>
>Private physicians, too, have been forced to hire extra office help to cope
>with the ever-enlarging demands of third-party review, regulations, and
>paperwork.  Drs. David Himmelstein and Steffie Woolhandler, internists at
>Harvard Medical School who are prominent critics of the U.S. health-care
>system, have calculated that the average office-based U.S. physician employs
>twice as many clerical and managerial workers as the average Canadian doctor.
>Dealing with the bureaucracy has become so intrusive that doctors have
>developed a name for it:  the "hassle factor."
>
>[ ... ]
>
>Drs. Woolhandler and Himmelstein, who favor a Canadian-style system, have
>calculated that about 20 percent of U.S. health-care spending goes for
>administrative costs:  insurance overhead, hospital and nursing
>administration, and physicians' overhead and billing expenses.  Not
>surprisingly, the private health insurance industry says this estimate is too
>high.  However, industry representatives decline to offer their own figure.
>
>Universal coverage and uniform fee schedules enable other countries to avoid
>most of the administrative expense of the U.S. system.  The single-payer
>Canadian system, where all health-care costs are ultimately paid by the
>Government, devotes about 10 percent of expenditures to administration.  The
>General Accounting Office calculates that if the U.S. were to adopt a
>single-payer Canadian-style system, we would ave about $70 billion a year in
>insurance overhead and the administrative costs to doctors and hospitals.
>- - - - - - - - - - - end quote - - - - - - - - - - - - - - - - - - - - - - -
>
>
>So, do you want to create even *more* different sets of forms and requirements
>for physicians to deal with, all in the name of competition?  To have doctors
>need even more insurance clerks?  Wouldn't it be wider just to have one
>standard claim form that could be submitted electronically?  To have one payor
>which negotiates a set fee schedule (adjusted for the cost of doing business
>in each city) directly with the providers?
>
>*Think*, instead of just bashing government.  We spend nearly twice the money
>(as a percentage of GNP) on healthcare than nearly all the countries with
>those national health insurance plans for basic care that you hate so much.
>Western Europe, Japan, Canada ... they've all gone to universal coverage and
>they are doing BETTER than us both in terms of spending less and having better
>general public health.
>
>Doesn't that make you as frustrated as it makes me?  How can we deal with the
>deficit if we keep encouraging our hospitals and doctors to traffic in
>superfluous equipment and our administrative system to get bloated with more
>and more sets of rules and paperwork?
>
>It's time to face up to reality.  Let's do it *now*, not four or five years
>down the road when health care has swollen to 20 percent of our GNP.  It'll
>just erode the financial health of our government, industry, and consumers
>even more.
>
>And I'm not even asking for the whole system to go public, a la Britian.  Just
>the basic health coverage pool.  Let the doctors, hospitals, medical supply
>companies, etc. stay private ... I think that's where they belong.
>
>Please, just think about it.  Save this posting and sleep on this matter, then
>come back and read it again.  Get the Consumer Reports series and read it.
>Start informing yourselves.  This is the most important domestic matter we'll
>be facing this year.
>
>
>Jim Reynolds
>
>-- 
>James P. Reynolds       (that's Jim to you and me.)     jpr1@lehigh.edu
>     Lehigh University Materials Science Rules          jreynolds@igc.org
>

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