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Monday, October 24, 2016

No issue affecting taxes so clearly divides the two parties in the U.S. election as healthcare. The two parties, in their platforms, describe very different approaches to healthcare economics. Both use political plastic surgery to cover up ugly truths.

The stakes are huge. Americans spend $2.64 per person for healthcare for each purchasing power equivalent dollar spent by the 33 other countries that make up the Organization for Economic Cooperation and Development. The OECD data shows the U.S. spends $8,233 per capita compared with an average of $3,118 in the other 33 countries.

A growing share of federal tax dollars, in direct spending and in tax breaks, is going to U.S. healthcare as the population ages, even though about one in six Americans lacks health insurance.

America‘s healthcare system, more accurately described as a non-system sick care system, totaled 17.6 percent of the economy in 2010, compared to an average of 9.2 percent in the other 33 countries, as the OECD data shows.

In the United States, total public and private cost of healthcare is significantly greater than the total of corporate and individual income taxes, as well as payroll taxes. For each dollar paid in all three of those taxes in 2010, healthcare came to $1.29.

If we just lowered our costs to those of France, which has universal care in what is widely regarded as one of the best systems if not the best, it would save almost as much money as Americans paid in individual income taxes in 2010. The French spend 6 percentage points less of their economy on healthcare. In the United States, the individual income tax in 2010 came to 6.3 percent of the U. S. economy, the lowest since Truman was president.

Take a look at your pay stub to get an idea of the kind of money being spent on a system that fosters bankruptcy, bedevils small business and ranks 31st among the 34 OECD countries in preventing premature death.

The Republicans say the federal government is “structurally and financially broken” and that “three programs – Medicare, Medicaid, and Social Security – account for over 40 percent of total spending,” which is “harming job creation and growth, (while) projections of future spending growth are nothing short of catastrophic, both economically and socially.”

The Republicans promise to “empower millions of seniors to control their personal healthcare decisions,” a vow immediately followed by a promise to cut federal spending.

The clearest explanation of what that would mean comes from Representative Paul Ryan, the Republican vice presidential nominee. Before he started obfuscating, Ryan laid out his plans in detail. He boasted that by changing Medicare from a plan that provides treatment for every older American into one that gives seniors a fixed sum to buy their own health insurance, taxpayers would save through 2084 the present equivalent of $4.9 trillion.

What Ryan did not mention is that his plan would also mean $8 of increased private spending by seniors and the disabled for each tax dollar saved.

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Copyright 2012 The National Memo
  • Addressing the issue of the ever rising cost of health care should be job one. Unfortunately, for our legislative branch job one is their own job and nothing else. It is painfully obvious that the hyperbole tossed about by all sides is a distraction. The competing plans seem to ignore factual information in favor of political points. Doing nothing, or worse yet going back to the status quo, is certainly not productive or promising. Switching to vouchers or other such pie-in-the-sky solutions ignores the basic problem. This country is paying far more than our competitors and getting less. Rising costs have to be addressed before any kind of reform should be discussed. These are serious times and we need serious discussion and solutions.

  • ACA has provisions to control the rising cost of healthcare in the USA, and the ability to reduce projected MEDICARE spending by $716B, mostly by exercising better control over service providerclaims and elimination of duplication, is a step in the right direction.
    The tale of ACA Vs the unspecified healthcare system that Mitt Romney has in mind after he repeals Obamacare…with a few – unspecified – exceptions is anyone’s guess, and as nebulous as his promise to create 12 million jobs without telling us how will accomplish that laudable goal.
    Healthcare costs in the USA have been rising since we became a nation, and in addition to being a tremendous burden on Americn households, they are an important element in our inability to compete with other countries.

    • You Got That Right And The Fact The Lying Ryan Is Planing To Replace Medicare As We Know It And His Whole Budget Bill Is IMMORAL His Own Catholic Church Ripped Him A New Butthole On It!!

      • I would like to see that article. I am glad to hear that the churches are setting the record straight or at least I hope it is and not just more lies. Hard to trust anyone these days.

        • Unless You Was Out Of The USA Or Living In A Cave This Was On All Media Last Year!! There’s No Reason For Me To Lie I’m Not Ryan And I’m Not Running For Office!!

        • cobra614

          Just google “Nuns on the Bus”….you can trust them……

    • From what I am understanding about those 12 million jobs is that they are already projected for the next four years anyway and Romney would not have to do a thing. Nice of him to take credit for something he did not do. What character. What hutzpah.

      • Well Dana he is consistant…remember he “Saved” the auto industry lol!

    • Elsa

      Actually health costs were very low and never much of a concern until the 1920’s and were pushed up further by the growth of the employment based health insurance industry that was encourage by Conservatives in the 30’s and 40’s through tax breaks.

  • chisolm

    Health care reform that doesn’t include tort reform will never reduce costs. Frivolous lawsuits not only increase the cost of healthcare they also force medical professionals to practice defensive medicine. Our legal system should force those filing frivolous lawsuits to pay for the cost of defending those suits if the case is decided in favor of the defendant medical facility. Most, if not all, countries use this system. However, good luck getting democrats to even consider such a system, since the trial lawyers are one of their largest contributors.

    • english_teacher

      Can you cite which countries use the system you described which shifts the costs of defending the suits to the litigant?

      Also, a 2007 Towers Perrin study showed that puts medical malpractice tort costs were $30.4 billion out of a $2 trillion health care system, putting litigation costs and malpractice insurance at 1 to 1.5 percent of total medical costs, a percentage that, in my opinion, does not represents a significant reduction in overall costs of the health care system.

      • chisolm

        And how about defensive medicine costs? You can look up which countries require those filing and losing frivolous lawsuites on the internet.

        • english_teacher

          As for defensive medicine costs, according to a 2010 Robert Wood Johnson study, estimated savings resulting from a 10 percent decline in medical malpractice premiums would be less than 1 percent of total medical care costs in every specialty.

          As I’ve given you references for my statements and as I’ve tried searching under various key words and haven’t found anything that comes close to what you’re talking about, would you please be so kind as to indicate some non-partisan references that back up your statement?

      • chisolm

        The commonwealth nations.

        • english_teacher

          There are 54 commonwealth nations and 195 nations in the world according to the State Department. Therefore, your statement that “Most, if not all, countries use this system” is a little overstated.

          • chisolm

            I doubt there are a whole lot of medical malpractice suits in third world dictatorships, etc. so no need for tort reform.

          • english_teacher

            You’re probably right but I didn’t make the statement about most, if not all, countries and you didn’t qualify which countries. So it was an overstatement.

    • davidcayjohnston

      Reuters columnist here,

      While malpractice insurance and litigation costs and awards amount to less than 2 percent of health care costs, you make a good point about defensive medicine, Chisholm.

      I once ran up $23k in hospital costs because doctors following protocol focused on a presumed heart attack and ignored my saying the problem was something else quite minor that could be, and later was, solved at almost no cost. Excellent doctors (teaching staff at an excellent hospital) just following protocol partly adopted to reduce the risk of litigation.

      Strikes me that if we had universal healthcare with no out-of-pocket expense, as with France (see column), then the need for redress through litigation would fall sharply and we cold cutback defensive medical decisions.

      Imagine a minor surgical procedure goes awry and you become paralyzed from the neck down at age 25 and what your lifetime medical costs would be. Instead of spreading those risks across society, we concentrate them on the physician, staff and hospital where the tragedy took place. That distortion would be reduced if we had universal health care as freely available as the street passing your home.

      Surely we should also end our current system of basically saying if this tragedy happens to you on the job you will live out the rest of your life in poverty (take a look at real workers compensation rates) instead of continuing your life at a decent level commensurate with your work, training, etc. My new book THE FINE PRINT, out next week, has a chilling tale about this very issue as well as proposed solutions to a number of our economic problems.

  • PingMan0843

    Our health care system is very complex and inefficient. The causes of inefficiency are also multivariate. I’ve not heard anyone talk about addressing the many root causes of the inefficiencies. Law suits cause defensive medicine adding unneeded testing and procedures; third party payers introduce large costs, restrict medical options and take the health-care provider and patient out of the decision making process; state regulations on insurers restrict competition and keep innovation out; government regulations and the third party payer role makes the situation worse by further restricting alternatives and adding huge administrative costs and opportunities for fraud. Governments do nothing well; they are a large part of the problem and the more they are involved the more prices go up or the service and innovation go down. To see the differences, just compare the rise in non-insurance covered treatment (plastic surgery, vet medicine, dental) with medicine where third party payers have been involved — in those areas where insurance is limited or unavailable, the costs match inflation; in all other areas (and especially where Medicare is involved) the costs are multiples of inflation rate. This is because the patient or customer is making the economic decisions. If something is too expensive for the perceived value, the patient takes a pass. That is the way it should be; any solution that works will somehow preserve individuals making these economic decisions. Something will also have to been done to limit legal liability for medical practices — fear of lawsuits drive costs up for everyone and cause practitioners to order too many unnecessary procedures and testing to protect themselves — not the patient. One final point, where did the idea of health care as a right come from? Throughout the first 180 years of the USA it was no where to be found. Only after the Federal government got into health care in the 60’s did this idea take hold — it is a stretch to include healthcare in our Constitution’s vow of having the right to life, liberty and the pursuit of happiness.

    • english_teacher

      Tell me how happy you would be if you were facing bankruptcy because you couldn’t pay for health coverage that would save your life. Or had to choose between eating and going to the doctor. Or being able to afford the heart medication that is keeping you alive.

      I think a case could be made that health care falls under the definitions of both life and pursuit of happiness.

      As for the legal liability issue, according to a Tower Perrins report, this aspect represented 1-1.5 percent ($30.4 billion) out of a total of $2 trillion in 2007. Hardly what I would call a significant impact.

      • JSquercia


        • Germansmith

          well….How about in instead of limiting the awards we modify the system instead of using a jury system, we use an independent arbitration board for all complains?

          It is not the amount of tort and liability, it is the FEAR of being sue that triggers doctors to do more tests than necessary, require hospitals and doctors to buy malpractice insurance and therefore increase the cost of healthcare

      • Germansmith

        Well remember what Ben Franklin said “a Billion saved is a billion made”

        $30.4 billions is a significant amount !!!. That does not take in consideration the cost of “fear of being sue” (additional unnecessary tests, having to buy malpractice insurance and so on) Who do you think it pays for that?
        WE DO

        • english_teacher

          Yes, it is a significant amount but not as a percentage.

          This is an example of nickel-and-dime-ing. You want to make significant cuts, then start looking at the military and the tax structure that lets companies like Exxon and GE get away with paying hardly any taxes.

          • Germansmith

            Yes, I agree, every little bit helps. But our justice system (where lawyers makes lots of money and politicians are born) eats a lot of our resources. A great deal of doctors I know, order more tests than are really needed just to protect themselves (or to make more money)

            Everything where government is involved is by nature wasteful and in most cases not run efficiently. If you are really a teacher (and my daughter is) quite well you see where lots of money and resources are wasted in our public school system without really increasing our children’s education level.

            I am not an anti-government person, but I see the need for periodic reform to avoid any system from becoming sclerotic

            Our military can not be inmune to cuts and reform as well as our tax system

          • english_teacher

            I agree with some of what you said. I agree that periodic reform is needed. Although I do agree that there is usually always room for government to be more efficient, I don’t believe that everything in which the government is involved is wasteful.

            I’ve read of studies that show that there are greater cost savings from a service being run by government workers instead of contracted out. Cost-benefit studies have been done that show that it isn’t always the best solution to contract out a service. Private doesn’t always mean better.

          • Germansmith

            The primary objective of government is to do the things that we all need (roads, commerce and enviromental regulation, defense, etc) but that there are no profits to be made.
            Government institutions in the US (specially after the creation of government workers unions) are wasteful by the nature of the fact that their funds come from taxes and politicians have (until recently) very little incentive to keep labor expenses down and efficiency up (since some of them get their political funding and other support from those labor unions themselves)
            The problem that we face is that both parties always tend to go to the extremes
            Democrats wants a world that revolves around government institutions
            Republicans wants a world with no regulations and minimum government

            Both extremes are wrong

    • Germansmith

      so true
      Everytime you add government money to anything, it gets more expensive.
      Let us keep Medicare for those who paid their dues, but let us reform it to avoid fraud and overpayments (yes, doctors and hospitals always complain, but overall, Medicare pay more for services and products that insurance companies negociate)

      If you need to take care of the poor and those who chosed not to buy insurance , a chain of government clinics maned by government employees/doctors under salary or by those who needs experience to be certified.

      • You are making some sense here but you really need to check the facts about medicare being more expensive….also back to the actual article we pay twice as much as #1 and get #49 care…why doesn’t that raise your IRE???…it does mine. We have example after example of how to do it right we are just so sure we invented every good thing that we fail to notice how well others have solved this problem. Look it’s been solved all over the world. What is the problem? Great highschool coaches go to clinics at colleges and pro camps so they can become greater coaches. What is so difficult about looking at the french system and just saying hey they got it right, lets do that?

        • Germansmith

          In my experience there is so much fraud in Medicare because of the population it serves, the complexity of our healthcare system and the fact that is managed by federal employees with no incentives to find savings or uncover fraud

          I will agree, a lot of other countries use their resources much better than we do in most aspect…maybe because we are so rich, we are also wasteful

          Maybe because there are so many people depending on that waste that have political leverage (doctors, hospitals, billing specialist, insurance companies)

          And maybe for the same reason we did not accept help from the Dutch when we need it to rebuild the seawall after Katrina…we are more than a little arrogant

    • JSquercia

      A stretch to include the right to Healthcare as part of our Constitutions vow about having the right to life , liberty and the pursuit of happiness NO not really .

      The idea of health care as a right has evolved among Civilized nations. We are the ONLY industrialized Nation that does NOT provide Universal Coverage Interesting enough this right is enshrined in NEW Iraqi Constitution which we wrote for them .

      I loved it when Senator Al Franken asked about how many people went Bankrupt in countries like Great Briton and France the answer was NONE .Here a significant part of our Bankruptcies are the result of Medical Costs and many of those HAD Insurance . Everyone thinks they have good insurance until the become SERIOUSLY ill . One of the biggest problems is the policies only pay for “Reasonable and Customary costs ” So if your surgeon costs MORE than the INSURANCE Company decides is Reasonable and Customary sorry Charlie you’re on the hook for the balance . How dare you think you should have the top guy in the field operate on you

    • hilandar1000

      PingMan, Your arguments are so full of holes, I have trouble figuring out where to start in refuting them. Of course our health care is too expensive, but not because of the government. Ask anyone who is on medicare and I think they will set you straight on whether or not they feel that medicare is ineffective and should be dropped. It has been the saving grace that has put some caps on medical costs for Americans. Of course it has had some glitches that had to be dealt with, but, for most Americans who are on medicare, it works well, and is getting better under the new legislation in the Affordable Care Act.

      The types of medical care that you mention as being non-covered by insurance are optional — not generally considered to be life-threatening. Are you really suggesting that something like cancer treatment should have to be a decision that patients make based solely on whether or not they feel they can afford the treatment? Most of us find that kind of thinking totally repulsive. Most countries in today’s world realize that their people are the most important resource of a country, and have instituted programs to protect that resource with affordable health care. America is one of the few countries in our modern world which does not offer affordable health care to all its citizens.

      Perhaps, instead of always being ready to blame the government for any problems, you should look to the corporations that have taken over the health care system in our country. This is not the way it is in other countries. Health care has gotten so expensive here because corporations have taken over almost all the components of the health care field. It was not when medicare legislation was passed that medical care costs started to sky-rocket. It was when corporations began to get involved in the health care field.

      Must I remind you WHY corporations exist? — The ONLY reason a corporation exists is to make as much profit as possible for their shareholders (and top executives). Of course, medicare is forced to pay some of the outrageous charges of the corporations, just as we are forced to pay those charges if we are not on medicare. Let me give you one example of a charge that most of us could understand fairly easily. I recently was going over the cost of a hospital stay for a relative. I saw one charge for self-administered drugs. This seemed like a strange charge because all drugs had been brought to the patient by hospital personnel and given to the patient at the appropriate time. When I questioned the charge, it turned out that the hospital had charged $250.00 for a tube of hand cream that could have been purchased in any drug store for 5 – 10 dollars — a neat profit markup of at least 25 times the retail cost. This was, of course, a small charge compared to the other hospital charges, and medicare and/or supplemental insurance paid for it without question. Like the individual, medicare is not immune to the greed of corporations either. Perhaps it is time to consider putting a 20 percent profit cap on all facets of medical care as Obamacare has done with medical insurance providers. We must somehow look forward to find some solutions to ways of providing health care to all our citizens, instead of looking backward to the “way things were” 180 years ago before modern, life-saving technology was available and before people had to chose to “take a pass” on accepting the benefits of that new technology because they could not afford it.

    • Ed

      So you don’t have a right to life if you get sick?

    • Ed

      Just another republican rant!

    • Don

      There were many people who have cancer who could not get help until Obama came along with ACA also giving help with families members who were disabled and could not get help on their own as they were mentally and physically handicapped and that is something the Republicans are not caring about.

    • phantomoftheopera

      and yet government health care works everywhere else. hmmmmm another ‘let them die’ if they don’t have health care person

    • mjw1952

      In the 21st century we feel it is a moral obligation for people to have their health care covered-like the rest of the world does. Back in the good ‘ole says we also had slavery and child labor. You failed to mention another root cause of the costs, greed. Yes, all those large corpoations and pharmaceutical companies making millions of dollars every year. To say that the market will take care of it, as in plastic surgery, well, not if you don’t have thousands to spend on cancer treatment. And those states that have limited lawsuits have not seen a lot of savings, although I admit many tests are done to avoid lawsuits. Perhaps a better way is like the rest of the world does, as well as the MAYO Clinic and others, I believe. The doctors are not paid per service but paid a salary. They may not get rich, but it would save our country billions.

      • Germansmith

        I am confused…
        If we do not guarantee our citizens a meal everyday
        If we do not guarantee that everyone of our citizens have a roof over their heads.

        Why do you feel a “Moral Obligation” to guarantee access to the most expensive healthcare system in the world to all our citizen?

        Feed everybody, guarantee a home for all, make sure all get a proper education so they can rise above poverty, fix our disfuntioning costly health system, them worry about giving Medicaid to everybody

        • rustacus21

          If U were hungry & w/out a job, what would U do? If U had no home in winter, where would U go? If U were crossing the street & a drunk driver ran U down, no witnesses, would U go to the hospital, or just lay there & refuse treatment or transport, in spite of broken bones & profuse bleeding? What about getting a job after being down-sized (U’r company was off-shored, by the way), w/just an associates degree to depend on? The ‘Social Contract’ was an ingenious concept. It inspired our own Constitution. Out of that, we are in an unspoken agreement to care for each other collectively, in order to achieve a degree of ‘CIVILIZATION’ unseen in human history. It, by the way, isn’t a cost, but rather an ‘INVESTMENT’ so people like Ben Carson (google him sometime) could go to school & do amazing things w/an otherwise hopeless life… according to people like Romney, McConnell, Ryan, Bush, Reagan, Nixon, etc…

          • Germansmith

            I believe in helping our fellow man as long as it does not become an institution or an obligation. People have their up and downs and good planning and a little luck helps you survive.

            Let me tell you a little about myself and maybe you will understand where I am coming from.

            Partially due to American Government policies my country Cuba became a Communist country. I was the heir of a well to do family. our family business was taken over and as a 15 year old I joined their army. I defected in Congo and due to my family connections here I was allowed to enter the US in 1968 after living in Franco’s Spain for about a year. Came in as a resident and being of age, I signed for the draft which promptly call my number….Do you want to guess where I end up?

            Trained as an electronic technician, but due to economic winds and opportunities and downsizing I have changed career 5 times and now I am my own boss and nobody is downsizing me again. My history is not unique, I have seem plenty of people that do not give up and they keep getting up when they are knockdown…but mostly inmigrants that understand the value of education.

            Yes, I know the taste of government cheese (no fancy debit cards or food stamps back them). I have eaten meat after a bull fight (obviously in Spain’s refugee camp) In the US I just received unemployment benefits for 3 months, so I know what it is being in the dump with no assets to my name. But everytime I found the way to stop depending on others and create my own opportunities

            Poverty and ignorance is pernicious. I would not spend a penny giving people anything but the basics to survive, but I am willing to pay more taxes TO MAKE SURE all our citizens receive an adequate education. The problem with “social contract” is that people being what they are would not work or struggle for that that is given for free.

          • rustacus21

            Again, I suggest U read up on the bio of Ben Carson…

          • Germansmith

            I will.Thanks

          • Germansmith

            Ben Carson. Gifted neurosurgeon that grew up in Detroit from a single mother?

            Another gifted individual that lifted himself from poverty with talent and education.
            I grew up in a Cuban neighborhood…I have seem similar stories quite a few times

            I am sorry, I am missing the point you are trying to make and I lost your previous post….please elaborate

    • Elsa

      You are wrong on two points. Lawsuit plays a very small part in the rising costs of healthcare; According to the CBO less that .05%. And the Government does a better job of keep down inflation in Medicare than the private insurers in our employment based system for those under 65, since the 1970 the inflations rates of Medicare have consistently been lower than those in the private sector, if they private sector has done as well their premium would be a third less than are currently. It is important to remember that Medicare has beaten the private sector inflation rates in spite of covering the most expensive age group of people. You know the old folks the private insurers will not cover.

  • Germansmith

    ACA has done nothing to reduce the cost of healthcare, in fact most of my clients have experienced an increase in premiums. Young healthy people are opting out of health insurance leaving those old and sick to participate in the system (this is in insurance is called “Adverse Selection”) …combine this bad law with a serious slowdown in the economy and you have many employers opting out of offering health insurance.
    In 2014 when you add the currently uninsurables and force insurance companies to accept them, it is going to get worst not better.
    Until we modify the way we pay our providers, ration healthcare procedures for those who would die anyway and have a National System paid by payroll taxes anything else is just adding dead weight to a sinking ship

    • hilandar1000

      “Ration healthcare procedures for those who would die anyway”?????? Wouldn’t that be making an end-of-life decision for myriads of people? — or, as the rest of your ilk phrased it, “Killing your granny”? which you all had such a frenzy over when you chose to misread the part of the Affordable Care Act that dealt with making end-of-life decisions? Or are you saying we should ration healthcare for all with no exceptions? After all, we are all going to die sometime anyway. So why bother with healthcare for anyone? Am I the only one who finds this statement totally senseless?

      • Germansmith

        Why are you taken issues to extreme? I just want people to be pragmatic
        It is a simple question of ROI. If a person is 50 years old and need 500K of medical service to be able to live another 30 years in good health, that is a reasonable expense.
        If a person is 75+ and we spend 50K+ a month to keep it alive for a few more months with poor quality of life if any, that is a wasted amount of money that could be better spend in nutrition for young childrens and better prenatal care.
        Medicare spend 50% of their money in the last year of a person life and that is a shame…If you want to call it rationing, be it
        Most countries that have National Health Systems are more careful how the money is spend

        • hilandar1000

          I was responding to a previous post by someone who had suggested “rationing health care for someone who was going to die anyway”. It is, in my opinion, a very dangerous suggestion. There are too many variables. — who is to decide this for someone else? what criteria is that decision based on? who is to evaluate conclusively what the ROI will be? who sets the price and age limits for receiving medical care? How would anyone be able to determine what the “return on investment” would be for another person? IF a person decides for himself that he does not want to undergo any more painful procedures and decides to refuse those procedures, that is acceptible. For anyone else to make that decision for him is barbaric. In a civilized society, it is unfathomable that anyone should think that certain death should be forced on someone because of financial considerations.

          • Germansmith

            Our scientific advances have outstep our resources. If you throw enough money at something you can keep any person alive, but the money you spend keeping an 80 year old paralized person alive is money you are taking away from children having the appropiate preventive health services they would need to fulfill their full life potential……
            If a person is rich and can afford to throw his money away to squezee a few more month…that is his money. The “people” should make the decision on how their tax money is spend…the problem with Medicare and SS is that old people have time and nothing better to do than exercise their voting rights…..and by the way I am an old, but working guy that pays for my own health insurance.
            The Constitution does not guarantee health care no matter what the cost. If a medicine or a procedure have the only objective to prolong life for a period no longer than a year, Medicare/Medicaid should not pay for it

  • Germansmith

    You are complaining about the symptoms, not the disease. Those are economic decisions faced by all humans beings since the begining of history.

    The moment you are detached from the real cost of a service (not paid by you, but by your insurance company) you are unable to make an educated decision.

    Where is it OK to pay $10,000 a month for a medicine that would keep you alive 3 extra months? Where is it OK to pay $300 for a visit to the doctor that made you wait 2 hours and see you for 15 minutes to tell you you have to lose weight?

  • Germansmith

    Bad things happen to individuals ALL the time even if you make the all the right decisions.
    We should not have a system where lawyers get rich by looking to cash in any minimum mistake to extract millions of dollars. We have a legal system in this country where most people are more interested in covering their A– than to get anything accomplish, this is WRONG. If a situation like the one you mention happen due to a proven negligence, those guilty should lose their license to practice/maybe jail time and lose their assets to the victim. The victim should carry on and maybe write a book.

  • howa4x

    No canidate is talking about the root cause of health care spending, and it is us. We are the ones consuming more sugar than any other country. We have one of the highest rates of obesity in the world and we are growing larger. Supersize me is the slogan of the food industry. We have 14% of young people obese, and struggling with type II diabetes, a disease that usually hits in mid 40’s. They will have heart disease by the time they are 30 and consume more and more health resources. Our food supply is killing us,and we look to the illness care industry to cure us magically and control costs at the same time. It is hard to control costs when the people need a higher ddegree of medical interventions. We also lack a good primary care system,especially in lower income neighborhoods, to catch people before they need that higher degree of care .We also have a pharma industry that makes drugs that don’t really cure us since that would lower their profit margin. They rather make drugs that maintain our illness so we can keep working and are able to afford them. The war on cancer started during Nixon and it is still one of the top two killers of Americans. Where did the hundreds of billions raised to fight this disease go? There is no cure because too much money is being made by doctors, hospitals, and big pharma to cure it. That’s right we have a for profit health care system where even the doctors are corporations, and this is one of the major reasons health/illness care costs so much. We spend 80% of treatment dollars in the last yr of a paitents life, yet we can’t have a conversation on this subject with out calling it death panels. We practice heroic interventions to save an 80 yr old in heart failure but debate funding childhoood immunizations. We are addicted to life and can’t accept that one day we will all die. We don’t exercise as a country and the right wing criticzes Michelle Obama for trying to get young people off their much larger rear ends. We consume way too much fast food instead of preparing a good balanced meal and expect some pill somewhere will save us. Our lifestyle is to blame for high medical costs, coupled with an industry that makes huge profits off our illness.

  • marriea

    Why do we always compare the USA to other countries when the USA is really a conglomerate of 50 small countries each with their own laws and constitutions and mostly independent of the country’s interference except in some issues that effect the country as a whole. Each state has its own health plan and agenda…..sometimes the language just confuse me.

  • Don

    Make no mistake, both Romney and Ryan are on a collision course. Ryan even applied for ACA back in 2010 and i have the letters to prove that Ryan did this and I found it on the internet and saved it . All I am hearing is a bunch of lies from these two, some saying Obama has already spent 700 million dollars on ACA when it doesn’t even take affect until 2014. This seems to be the ONLY time in history that the Republicans and the Tea party are choosing to lie to the American Public and they are the only ones pushed for the ID Law so that many would be disenfranchised because they are poor or living in a nursing home. They are not true people like Abraham Lincoln and Dwight David Eisenhower, two of my favorite Republicans who did not choose to tell tells and chose to go on their own record. So vote for Obama for a free country.

  • hilandar1000

    Sorry my posts are appearing more than once. I don’t know why that’s happening.

  • Elsa

    The cost of healthcare will continue to rise until we wake up as a Nation and put a stop to the idea that it is OK to make a profit from selling health insurance. Providing health care for people is a service not a product. The only person who should make any money is the person doing the service. It is a service that is vital for health and wellbeing and should not be about decisions that affect a third parties bottom line. Our current system not only hurts the patients, it also hurts the doctors, nurses and other health professionals who take oaths to “do no harm” by interfering with their decision making process; Why do they need permission to do what is right for the patient? Before “health insurance” the cost of health care was between the doctor and the patient and it was affordable. In fact before the 1930’s the majority of the insurance industry refused to even cover health care, because they felt they could never make a profit from it; It was Blue Cross, a nonprofit insurer at the time, who showed them the way to make a profit and so our employment based health insurance system was born. It was helped along with Tax breaks from Conservative law makers whose fear of “Socialistic Medical Care” was bigger than their common sense. We would be better off today if we had followed Europe’s lead into a Single Payer System, we had done that we may not have ended up with the low rated, high cost system we have today. We will never be able to get the cost of health care under control as long as “third party profit” is involved in the mix. Let’s face it that profit is not making our system better it is making it worse as is demonstrated by our continued low, low rating in infant mortality, outcomes, longevity and health outcomes. Nor can we be proud of our ethics or values as long as we allow our fellow citizens to be denied access to needed health care base on how much money they have. The truth that is hardest to face is we do not have the best healthcare in world; we only have the most expensive.

  • My opinion is if the Democrat or Republican establishments wanted to promote the health of the American people Obamacare, or any other plan would be about looking into the history of pharmacology and food industries who are littered with corruption, and this D&R government has ALWAYS been involved in that corruption. If this government was about healthcare it would be promoting preventative medicine; avoiding toxic emissions, avoiding drugs, and having/helping people find the financial means for nutrition that has been taken out of food, even more with more and more GMO’s, that is the recipe for beating the illnesses toxic exposures working with conventional medicine eventually turns into diseases. Unfortunately this government, the medical establishment, and big pharma’s definition of prevention is not prevention or healthcare, its only the highly profitable and unsuccessful expensive process of screening, diagnosis, and treatment with drugs and more drugs, not health care or prevention in any way at all for people, just about creating healthy businesses for Big pharma and the medical associations, just what the globalists want for the people/peasants.

    Obamacare is anything but taking care of the people’s health, its about destroying health, seizing totalitarian power, and taking away constitutional rights. Its endgame is the same with the global warming scam, agenda 21, and sustainable development, both partys support this, wake up America.

    • Dave_dido

      Our current system has caused close to a million bankruptcies in recent years, Jeff. Also, it is estimated that thousands of Americans have died because they were uninsured and not going for regular medical care. Do you think these things are good for our society? How many more must go bankrupt or die before you realize that changes are absolutely necessary? The rest of the world has figured out how to assure that healthcare is available to all of their citizens. But because of American chauvinism and hard-headedness, we are too proud to admit that we have a disgraceful healthcare system. The only problem with Obamacare is that it doesn’t go far enough.
      Many brave political leaders stuck their necks out to do something good for the American people in passing the ACA, and you have the audacity to say they are destroying people’s health and to accuse them of totalitarianism.
      Join the real world, recognize the real problems that are causing real people to suffer needlessly, and quit copping out with your conspiracy theories. You have the potential within you to do good. What good does it do to see a conspiracy in everything?

  • Javier Lopez

    Our money is being used to support at least three very profitable industries: doctors (health care providers, in new-speak), the insurance industry and the pharmacological industry. As far as I can see, the insurance industry takes a huge chunk of money simply because it can. And, there is no incentive for that industry to reduce costs, since it takes its cut off the top. With a single payer system, we could take out the most costly of the three industries. This is why Justice Roberts supported the healthcare act; he knew that if he did not, the next plan would be a single payer system in the European model. He acted to preserve the insurance industry, very substantial campaign contributors, by the way, and was reviled by the right and applauded by the left. Masterful.

  • adriancrutch

    I would prefer a great big ASTEROID just hit about where the ghetto begins in D.C.

  • greghilbert

    I wish this article had provided some factual information as to WHERE the USA healthcare dollars are going, as compared to the average of other countries. In other words, what explains the huge difference? I’d like to see data, not characterizations. Does anyone know where such information can be obtained?

    • ralphkr

      Well, greghilbert, I can point out one problem with our system that could be easily fixed. In the US we spend from 20% (entities such as Kaiser which is basically a self-insurer) to 40% of our health dollar on paper shuffling. The tiny country of Taiwan (with a really strange and bollixed up health care delivery system) does do one thing better than any country and that is that they spend between 2% and 4% of their health care dollar on paper shuffling. You ask how do they do this? Very simple EVERY person in Taiwan has a ‘Smart Card’ that contains their entire medical history. This card is presented to the health care provider and gives the provider the medical history and also pays the bill IMMEDIATELY. Just think how happier you would be as a health care provider getting paid on the day of treatment instead of having to wait months for reimbursement (as well as having hire a large staff just to administer claims). My wife’s doctor and his partner had a clinic that employed over 75 doctors and he told her that he had more people working in the insurance department than all the rest of their employees combined.

  • lavorne46

    We have been struggling in the wilderness so long with our healthcare.Greed is preventing
    our country from taking care of our citizens. Medical insurance cost has skyrocket
    and coverage stinks with these co-insurance which cost more out of pocket for
    patient.Co-payment was better because once you paid that your bill was paid now
    you always getting medical bills if you have surgery. We need a healthcare that prevent
    stress from people who cant afford to pay. The victories we are believing for will come,
    but we have to work hard to fight for them, because its is responsibilty time now. We have
    to hold our government officers accountable because we voted them in for the will of the

  • joceandre

    If you could put a face on rabies it would be Mitt Romney and Paul Ryan.

  • ridemybroom

    another idiot that needs to shut up and just go away…

  • daniel bostdorf

    Oh–by the way…if anyone mentions “Gateway pundit” as a rebuttal, know this;
    Gateway Pundit” is a “news aggregator” , primarily tasked to discredit Obama.
It sifts though anti-Obama articles and posts them as fact.
They dont fact check.
Their George Orwell motto is; ” where hope finally made a comeback.” That state means ment that they really mean the opposite.
    “hope finally made a comeback ” is realized when Obama is re-elected.
    What is even darker is that Rassmussen Polls are utilized to justify that Romney is ahead in the polls.
    Darker side?
    Maybe he and karl rove have employed Rassmussen to create false polls.
    Rassmussens done it before…
    Do a google search..

  • cobra614

    Yet…R/R wants us to believe that Obama stole when it is they who will be stealing if they are elected..ironically the same 716 billion dollars. Liars they are and now the neo-cons are trying to finish what they started…

  • cobra614

    How very clever they are…getting us to believe that both parties are evil when the facts are one party who represents the monied have managed to make whores out of them. Gutting our education system to keep the masses misinformed and stupid. This is why educated people do not buy their BS. Half the country is going to vote against our president because of that stupidity. An Australian owned media tells us lies to maintain the status quo. In the UK, he is despised but here he is still able to separate and divide us. We are so worried about those who really can’t hurt us inside our country but we have the biggest Domestic Terrorist right in our mist…Fox News…despicable

  • cobra614

    You really need some serious intervention. How did you become so delusional? Having posted this before, they have managed to convince many that both parties are the problem just like they want to get back the WH even though their policies have done more to decimate the middle class than any WMD could do. Like those who are more informed, waiting for the other shoe to drop, they are planning something so heinous so they won’t have to put up with any of us. Coffins in Georgia, Indiana, Arizona with detention camps. Amazingly we have wingnuts out there like Alex Jones who are telling those on the extreme right that a civil war is coming..telling you to store food, water etc. Telling the country this is what Obama is planning but this another LIE. Remember when
    Great Grandfather Bush supported the Nazis which is why we have the disparity in our country. At the RNC, they had JEB BUSH on the same banner as ROMNEY/RYAN which means they want a BUSH back in the WH especially if R/R loses…take heed and be prepared!

  • daniel bostdorf

    This article is about the Republicans “healthcare plan” and nothing more….

    Johnston correctly states:
    “The Republicans promise to “empower millions of seniors to control their personal healthcare decisions,” a vow immediately followed by a promise to cut federal spending. The clearest explanation of what that would mean comes from Representative Paul Ryan, the Republican vice presidential nominee. Before he started obfuscating, Ryan laid out his plans in detail. He boasted that by changing Medicare from a plan that provides treatment for every older American into one that gives seniors a fixed sum to buy their own health insurance, taxpayers would save through 2084 the present equivalent of $4.9 trillion. What Ryan did not mention is that his plan would also mean $8 of increased private spending by seniors and the disabled for each tax dollar saved.”

    Romney and Ryan are perpetuating lie pretending to care about healthcare.

    Nazi propagandist Joseph Goebbels (like Linmbaugh, beck and Rove believe) said it best:

    “If you tell a lie big enough and keep repeating it, people will eventually come to believe it. The lie can be maintained only for such time as the State can shield the people from the political, economic and/or military consequences of the lie. It thus becomes vitally important for the State to use all of its powers to repress dissent, for the truth is the mortal enemy of the lie, and thus by extension, the truth is the greatest enemy of the State.”

    or as Adolph Hitler stated:

    “Make the lie big, make it simple, keep saying it, and eventually they will believe it”

  • daniel bostdorf

    Ecomonic Partriotism!

    Grow the economy with middle class….not the 1% class!

    Romney’s own words:

    “here are 47 percent of the people who will vote for the president no matter what. All right, there are 47 percent who are with him, who are dependent upon government, who believe that they are victims, who believe that government has a responsibility to care for them, who believe that they are entitled to health care, to food, to housing, to you-name-it — that that’s an entitlement and the government should give it to them. And they will vote for this president no matter what. … These are people who pay no income tax. Forty-seven percent of Americans pay no income tax. So our message of low taxes doesn’t connect. And he’ll be out there talking about tax cuts for the rich. I mean, that’s what they sell every four years. And so my job is not to worry about those people. I’ll never convince them they should take personal responsibility and care for their lives.”