Greg Roach's Berkshires Blog
Sunday, February 03, 2008
  Timing is everything
Hopefully the impending train wreck can be held off until after a national plan is passed and signed in DC. If the Commonwealth's plan blows up before then, you can bet that the notion of universal coverage, let alone universal healthcare, will be D.O.A. for another decade, or so.
The subsidized insurance program at the heart of the state's healthcare initiative is expected to roughly double in size and expense over the next three years - an unexpected level of growth that could cost state taxpayers hundreds of millions of dollars or force the state to scale back its ambitions.

State projections obtained by the Globe show the program reaching 342,000 people and $1.35 billion in annual expenses by June 2011. Those figures would far outstrip the original plans for the Commonwealth Care program, largely because state officials underestimated the number of uninsured residents.
I would suggest that many more things have been "underestimated" as well, not just the number of uninsured. Beacon Hill had best be prepared to take flak from both sides for the foreseeable future - at least until a national plan is in place.
So an apparently disastrous ("train wreck") statewide healthcare 'reform' is an argument in favor of rushing through a federal reform?

Perhaps you can make a convincing argument coming to this as a conclusion, but you cannot make a convincing argument using this as a premise.
You've evidently missed the preceding 2 years of my argument. This is just the latest off-the-cuff comment.

Romneycare is a recipe for disaster on many levels:
-State-by-state which creates an economic race to bottom.
-Reliance on an existing dysfunctional insurance system.
-Poor demographic and sociologic data.
-An entitlement benefit curve that is so steep that middle class folks end up paying full fare, while those just barely below pay nothing. (recipe for political disaster)
-Bad underwriting assumptions.
- and about 50 more

But, if the system were nationalized, many of the problems would disappear overnight. Those entrenched status quo interests who will fight a state by state (divide and conquer) strategy will be effectively neutered. Simple jurisdictional problems like my current BCBS issue will become irrelevant.

And most importantly, as a society, we will hopefully begin to see the benefits of proactive and cradle to grave care.

To your point about the UK system, it certainly has its flaws. Considering I have family over there who complain about it, I would be foolish to argue otherwise. But medical care rarely drives their citizens into bankruptcy (50% of all American bankruptcy filings have a medical component) and the British have a longer life expectancy along with lower infant mortality.

Personally I prefer the two tiered systems like the one in France which allows doctors to remain in private practice rather than become gov't employees. Just sayin'...
I remain unconvinced that a federal plan is likely to work better than "Romneycare," which after all was passed by an 80% Democratic legislature, and thus can't be seen as some Romneyish Trojan horse to impugn socialized medicine.

Note also that 54.5% of all U.S. bankruptcies were found by a Harvard study to have a "medical cause" -- not a primarily medical cause, or even any connection to an inability to pay medical bills. The study defined "a medical cause" to include all cases where the bankrupt person had any of the following:

* "uncontrolled gambling"
* "drug addiction"
* "alcohol addiction"
* the birth or adoption of a child

The study did not require any of the above to have resulted in medical expenses, so a person who gambled away his money was a bankruptcy with "a medical cause," as was any person who had a kid and just happened to go bankrupt for unrelated reasons. These events do have a medical component, but are not honest arguments for socializing medicine because medical bills are driving people bankrupt.

In addition to the above, a final category was indeed, for people with significant medical expenses: anyone with $1,000 in total expenses over the previous two years, who then went bankrupt, notwithstanding any other causes which might be orders of magnitude larger, was counted as a bankruptcy for a medical cause.

The study seems to have been designed to mislead people, as it indeed has.
I don't think you can garnish any relevancy to Gov. Accountability Statistics. Point example.....when you use up your unemployment insurance they no longer list you as unemployed. So for accountability purposes you have gone back to work and are counted as jobs gained even though you are still unemployed. A very strange way to keep the books.

If this is any indication of how statistical data is booked by governmental agencies then even their base data is flawed and any program relying on true real factual data will fail.

In the real world you cannot use make believe, feel good, politically motivated data. You get what you sew! Use phoney get a phoney program!
Dave - they had to determine criteria, and I think that OCD and Alcoholism certainly fall into the medical category. As I said in my post, 50% have a "medical component" not cause. And I'll bet my next six-pack that if you weeded out the categories that you complain about, you would still be left with a *very* sizeable percentage.

And if you need or want real world actual medically *caused* bankruptcy cases, I can introduce you to a few of them here in Berkshire County that I know personally. How many spaghetti dinner fundraisers would it take to convince you otherwise?
I have no doubt you can find real people who are bankrupt due to medical expenses. That does not make the study's claimed 55% anywhere near an honest figure.

The same study reported that the percentage of bankrupt people with even $1,000 in total unreimbursed medical expenses in the previous two years is 27% -- half of the headlined claim of 55%.

But no one declares bankruptcy because of a $1,000 expense. The study's authors chose not to release data on the percent of bankruptcies who had medical expenses above a more meaningful threshold, such as $5,000 or $10,000, or where medical expenses came to more than a third of total debt or some such figure.

Given the authors' stated a priori preference for nationalized health care, I think that these and other choices on how to perform and report on their study say more about their biases and desire to mislead people than about our health care system.

And yes, alcoholism and even gambling addiction might properly be called medical problems in many contexts -- just not in the context of claiming that more than half of bankruptcies are due to people not having their medical expenses paid by the government. It's just not true; the study overstates the case by a factor considerably larger than two.
Southview: "when you use up your unemployment insurance they no longer list you as unemployed."

No doubt, one can come up with a solid critique of many government statistics. But actually, they count you as unemployed for as long as you claim to be looking for work -- the ending of unemployment insurance has no such effect.
My point being.....if you use flawed, nonfactual, hand picked statistical data to reach a conclusion you get flawed results. And if you base any program on this type of data it is DOA. Universal Health Care is a very real probability with in the near future. It will only survive if it is run geared toward the patient and not run as a business venture. There has to be access to your doctor of choice, your hospital of choice and the ability to have access to all specialized procedures relating to your affliction. It will be a viable institution only when there is complete control of medical prices and drug prices, and the insurance companies are forced to take a back seat in managing the system.
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