Healthcare & Cost Control 2

It is clear that the President's healthcare reform policy is in trouble. Despite Speaker Pelosi's bold assertions, it's stuck on the Hill, and the President's popularity is sinking faster than the Washington Nationals.

The Washington Post has some clues about why this is so.

PRESIDENT OBAMA sometimes presents health-care reform as a pain-free proposition, as simple as choosing the red pill over the blue -- one that's no more effective but costs twice as much… This all-gain-no-pain stance may be politically advisable; people are increasingly edgy about how reform will affect their own health care… But Mr. Obama's soothing bedside manner masks the reality that getting health costs under control will require making difficult choices about what procedures and medications to cover.

In other words, the President isn't being candid, and pretty much everyone knows it; and what he is not being candid about is worrisome.

My favorite economist, Robert Samuelson, does something in his current column that I have seen no one else do: he explains why extending health insurance coverage to the uninsured will cost so much. That may seem obvious, but it isn't. We hear a lot about how many people are uninsured, but not about how many people are not getting adequate healthcare, or how inadequate it is for how many people. If tales of people denied basic healthcare because of a lack of coverage were available, they would be all over the news.

The health care conundrum involves a contradiction that the administration steadfastly obscures: In the short run -- meaning four to eight years -- government cannot both insure the uninsured and rein in health spending. Here's why. The notion that the uninsured get little or no care is a myth: They now receive about 50 percent to 70 percent of the health care of the insured. If they become insured, their health care would rise toward 100 percent; that would increase both government and private health spending, depending on how the insurance is provided.

So the healthcare legislation would extend more treatments to more people. Whatever the costs, at least the aim looks worthy. But critics of the current system (the President above all) incessantly complain that it costs too much money, and that Americans don't get better healthcare for that money. Well, maybe all those inefficiencies in the American system are to blame for the high costs. But is this in fact the case?

Not according to a front page piece in the Washington Post focuses on treatments for the leading cause of American deaths, heart disease. Here is a key passage:

Although inappropriate care, high administrative costs, inflated prices and fraud all add to the country's gigantic medical bill, the biggest driver of the upward curve of health spending has been the discovery of new and better things to do when someone gets sick.

Get that? The reason American healthcare costs have risen so fast are two: one is that we have a lot more old people. Another is that we coming up with new and more expensive medical technologies very fast. Of course the ones we have are always becoming cheaper. But it doesn't help. New high priced treatments are approved by the day.

The American system is more expensive than that of Europe because we have never learned how to say no. Cost control will require some of that. But the President, for good reason, doesn't want to talk about the real problem. Yet he can't make it go away. This is the root of his current difficulty.

Comments

[Gregg's Health Insurance News]

I think cost controls is a necessity for the greater good of the system. This is something not being discussed by the President, and it is disingenuous. I haven't seen real talk about reforming the drug companies. Their affect on the current system is enormous. Drug companies are profiting at 5,000% on some of their drugs. ...that just stinks to high heaven.

[Miranda]

Well, it wouldn't be quite so expensive if Obama is listening to Ezekiel Emanuel and if the rumors about Emanuel's views on the elderly and disabled are true:

http://www.nypost.com/seven/07242009/postopinion/opedcolumnists/deadly_doctors_180941.htm

I'm not sure how reliable the New York Post is, but I'm sure its writers know their facts as well as Obama knew his in GatesGate.

[A.I.]

Are the older treatments and technologies actually getting cheaper or is the cost of procedures that have been around for decades getting cheaper? I'm not sure they are or that they aren't rising faster than worker earnings too. And Googling historic cost of medical procedures, etc gets me current costs but no comparisons.