Who says there's nothing good in the Senate healthcare bill?

Atul Gawande in the New Yorker:

Among the most important, and least noticed, provisions in the reform legislation is one in the House bill to expand our ability to collect national health statistics. The poverty of our health-care information is an embarrassment. At the end of each month, we have county-by-county data on unemployment, and we have prompt and detailed data on the price of goods and commodities; we can use these indicators to guide our economic policies. But try to look up information on your community's medical costs and utilization--or simply try to find out how many people died from heart attacks or pneumonia or surgical complications--and you will discover that the most recent data are at least three years old, if they exist at all, and aren't broken down to a county level that communities can learn from. It's like driving a car with a speedometer that tells you only how fast all cars were driving, on average, three years ago. We have better information about crops and cows than we do about patients. If health-care reform is to succeed, the final legislation must do something about this.

Atul Gawande in the New Yorker:

The bill tests, for instance, a number of ways that federal insurers could pay for care. Medicare and Medicaid currently pay clinicians the same amount regardless of results. But there is a pilot program to increase payments for doctors who deliver high-quality care at lower cost, while reducing payments for those who deliver low-quality care at higher cost. There's a program that would pay bonuses to hospitals that improve patient results after heart failure, pneumonia, and surgery. There's a program that would impose financial penalties on institutions with high rates of infections transmitted by health-care workers. Still another would test a system of penalties and rewards scaled to the quality of home health and rehabilitation care.

Atul Gawande in the New Yorker:

Medicine involves hundreds of thousands of local entities across the country--hospitals, clinics, pharmacies, home-health agencies, drug and device suppliers. They provide complex services for the thousands of diseases, conditions, and injuries that afflict us. They want to provide good care, but they also measure their success by the amount of revenue they take in, and, as each pursues its individual interests, the net result has been disastrous. Our fee-for-service system, doling out separate payments for everything and everyone involved in a patient's care, has all the wrong incentives: it rewards doing more over doing right, it increases paperwork and the duplication of efforts, and it discourages clinicians from working together for the best possible results.

I believe people are mincing words talking about how there is no "right to health care."

There is no right to public education, and yet we preserve and enforce the right. In fact, we find it irresponsible and illegal for a parent to not make their children go to school.

If Ron Paul went out talking about how there is no right to public education instead of no right to health care, many more people would think he's a lunatic.

We choose what we have a right to.

From Tim O'Reilly:

Driving home from work, listening to NPR's story about health care costs, I couldn't help but be struck by a couple of numbers. The Obama health plan will cost a trillion dollars we're told. A TRILLION sounds big enough to end the debate, doesn't it?

Then I hear, almost as a footnote, that that trillion is over ten years. That's still a big number to be sure. A hundred billion dollars a year. But then later in the story, I hear that US total health care costs are $2.2 trillion a year. Suddenly, that $100 billion a year doesn't sound so big. That's only a 4.5% increase.

Interesting article in Newsweek

During the month of hearings on rescission, the health insurance companies said that they only rescind 0.5% of plans. But if you think about it, how many years do you have your health insurance plan for? If you have it for 20 years, that's a 10% of rescission. A 90% chance of getting the payment you need for healthcare is not "insurance." One mathematician makes the numbers even scarier in Unconsciounable Math

Great title from a reddit thread of the same name

From a Reddit thread of the same name.

An activist turned to his fellow attendees and asked if they "oppose any form of socialized or government-run health care." Nearly all did. Then Representative Green asked how many of those present were on Medicare. Almost half raised their hands.

From a reddit thread of the same name

Inspired by my friend telling me a story about how many hours she put into dealing with the claims related to her pink eye treatment eight months ago.

Often when I explain that we have the highest healthcare costs of all industrialized nations and the lowest life expectancy, the opposition mentions that it could easily be explained by how obese we are. That to me is similar to how global warming deniers like to mention solar this or ice age that which could be the real explanation. Usually this ends the conversation.

Reply with, "yes, it could be a factor, but its explanatory power turns out to be much weaker than you make it out to be."

26% of Americans are obese, whereas 22% of Britons are obese. In 2005, the US spent 15.2% of its GDP on healthcare, while as the UK spent 8.2%.

So we're 18% more obese, but have spent 85% more on healthcare. The obesity argument doesn't have enough explanatory power to be the main reason American healthcare is so expensive.

Meanwhile, 22-31% of the American healthcare costs are in administrative, marketing, and profits. Single-payer systems (including Medicare) only spend 3%. If you cut out the costs associated with the capitalist friction, you bring our healthcare costs to 11.1% to 12.3% of our GDP, which brings us more than half as close to how much the average non-US industrialized nation spends (9.1%).

This just in from Krugman:

The budget office says that all this would cost $597 billion over the next decade. But that doesn't include the cost of insuring the poor and near-poor, whom HELP suggests covering via an expansion of Medicaid (which is outside the committee's jurisdiction). Add in the cost of this expansion, and we're probably looking at between $1 trillion and $1.3 trillion.

There are a number of ways to look at this number, but maybe the best is to point out that it's less than 4 percent of the $33 trillion the U.S. government predicts we'll spend on health care over the next decade. And that in turn means that much of the expense can be offset with straightforward cost-saving measures, like ending Medicare overpayments to private health insurers and reining in spending on medical procedures with no demonstrated health benefits.

In case you get asked for specifics, refer to this handy grid from SF Gate about the healthcare reform proposals on the table.

Several polls have shown the majority of Americans like the idea of a public plan. Between 65 percent and 67 percent of the 1,205 people surveyed in June supported the concept of a public plan, according to a Kaiser Family Foundation poll.

Indeed, they [Economic Policy Institute] point out, one independent analysis found that having a public plan could actually save the US up to $1 trillion over ten years, while providing health care to all. Some of the elements of the plan contributing to that figure include increased competition among health care providers and lower administrative costs.

Maybe we can start talking about the government's role in consumer protection.

Congressional investigators said Wednesday two-thirds of the U.S. health insurance industry used a faulty database that overcharged patients for seeing doctors outside their insurance network, costing Americans billions of dollars in inflated medical bills.

The flawed database is operated by Ingenix, a subsidiary of health insurer UnitedHealth Group, which agreed in January to pay $350 million to settle allegations that it deliberately kept rates low to underpay doctors, driving up expenses for patients.

The libertarian argument is: "let individuals sort it out for themselves." However, what individuals do in those situations is they form consumer advocacy groups, and in a democracy, they give those consumer groups legal force. For example, the FDA is a consumer advocacy group with legal power. The current issue is that healthcare is dinging consumers too much money and we don't even have universal coverage. A National health plan is one form of consumer insurance against fraudulent and wasteful health insurance providers.