http://healthland.time.com/2013/02/20/bitter-pill-why-medical-bills-are-killing-us

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I hardly ever read TIME, where this article is from.  I happened upon it after researching another matter.  But even allowing for the liberal slant that I admit the magazine is often prone to, some of the information in here is very important to the overall debates about healthcare reform AND the budget deficits.

Aside from all of the politics, the ACA and so on, there remain many unexplained reasons for why the costs of medical care are so high and why 'retail' prices of that care vary so widely from place to place and from patient to patient.

Regardless of one's view on Obamacare (mine = it's too weak), the problem of spiraling costs for increasingly diminished value is mostly a separate one and still needs to be addressed.

Meanwhile, a rather confused conservative op-ed on Reuters on what they refer to as "free market health-care" points to the healthcare exchanges as "an important concession to the private sector" all while getting several aspects of Switzerland's model health insurance system dreadfully wrong.

http://blogs.reuters.com/great-debate/2013/02/20/the-future-of-free-market-healthcare/

And now Gov. Rick Scott wants to get the uninsured in his state onto Medicaid - termed a major "flip-flop" by conservatives re: his campaign against the ACA.  I think concerns over costs like those portrayed in this article are the main reason.

Yet several states have relinquished the matter of the exchanges completely over to the federal government to run as they see fit...in a sense giving up some of their "sovereignty".  It's hard for anyone - much less the uninsured people in those states - to see that as the best worst option.

 

 

In response to MattyScornD's comment:

 

And now Gov. Rick Scott wants to get the uninsured in his state onto Medicaid - termed a major "flip-flop" by conservatives re: his campaign against the ACA.  I think concerns over costs like those portrayed in this article are the main reason.

 

 

There are still about a dozen Republican governors who have refused the expansion.  They know full well that they are giving away billions of dollars, hurting their own low-income residents, and forcing taxpayers to subsidize Medicaid programs in other states but not their own. 

 

Rick Perry:    Texas will not expand Medicaid and said he was proud that Texas did not follow other states scrambling to grab every tax dollar they can.

Nikki Haley:   As long as I am governor, South Carolina will not implement the public policy disaster that is Obamacares Medicaid expansion.

 

 

"Yet several states have relinquished the matter of the exchanges completely over to the federal government to run as they see fit...in a sense giving up some of their "sovereignty" "

You have it assbackwards...the feds want to take over health care, period. They want to coopt state sovereignty by having states be their 'partners'. When the inevitable fiscal disaster ensues, the blame will be shared..

The federal government wants to make the state governments do their handiwork in becoming a "partner"  in the disaster that is ObamaCare..promising billions , of course, per usual...federal money is free! Like ObamaCare itself, Governors have to sign on, long before  any significant details about the "exchanges" are released...

Thanks, but no thanks!

Gov McDonnell:

"Republican governors would rather do things at the state level, rather than have the federal government do it, but the problem is we’ve been asking for months in writing for information and the rule-making to give us the information about how the state and federal exchanges are going to be set up. And we still have a great absence of information.”

“If they’re not going to provide the information . . . the only thing to do is to default and let the federal government set it up.  Either way, you comply with the law.”

“It’s a great concern with already an over-burdensome Medicaid program that is killing most governors’ budgets around the country, so we want to know what we’re getting into. If there’s no answers, we’re going to have a federal exchange. I can’t recommend that we set [a state exchange] up in Virginia.”

Read more: http://politicaloutcast.com/2012/11/obamacare-exchanges-being-turned-down-by-gop-governors/#ixzz2LdnDGcRU

One of the biggest reasons why health care is so high and inaccessible is because there are so few doctors compared t European countries:

 

http://www.pbs.org/newshour/rundown/2012/10/health-costs-how-the-us-compares-with-other-countries.html

 

"There are fewer physicians per person than in most other OECD countries. In 2010, for instance, the U.S. had 2.4 practicing physicians per 1,000 people -- well below below the OECD average of 3.1."

 

"Socialized" medicine works quite well in Israel  - in fact USA taxpayers pay for it.  It works just as well  in Europe and Japan.  Therefore, it can work here if we adopt the same system that they use in those countries.

 

 

In response to ComingLiberalCrackup's comment:

You are uninformed and ignore the entire theme of the article.  Typical.

Those governors have had every opportunity to take control at the state level - as the ACA allowed and encouraged.  The heavily GOP state of Idaho, for example, chose to take control of matters for themselves.  At least they were pro-active in their attempts at governance.

But no.  Instead, ideologues like Perry and Haley decided to wait until a non-existent strikedown from the USSC that never came.  Now, their citizens will suffer for their negligence.  Their "sovereignty", such as it is, means they preserve their right to deny even the minimum preventive care coverage to the most vulnerable.

But given that Texas has the worst health care delivery in the nation, why should Perry give a damm, right...?

 

Part of the reason we have comparatively fewer doctors than other countries is the cost of higher education.  Considering the long road one must take to become a doctor the costs to receive the training easily can put a person out over a half million dollars before they even start earning any money to pay down that debt, accounting for undergrad studies all the way through medical school.  This element prices out bright students who would be perfectly equipped for a medical career because they literally cannot get access to the schools due to cost and so they apply themselves elsewhere and the medical talent pool suffers as a result.   

Many of the best colleges overseas are tuition free:

http://www.usnews.com/education/best-colleges/paying-for-college/college-cheapskate/articles/2010/09/21/some-top-international-colleges-offer-free-tuition

 

Many colleges in the USA have billion dollar endowments and can easily grant full scholarships for future doctors.  Many of these schools have Christian affiliation but have yet to practice the Christian beneficence Jesus  preached.

In response to portfilio's comment:

Yeah, but our colleges have the best football teams.  Priorities, y'know.

 

In response to MattyScornD's comment:

 

It is a great shame that football and basketball coaches are paid so much more than professors who teach in medical  and dental colleges.  By contrast, European colleges spend far less on sports and use their resources to train medical practitioners and other professionals who work for society's good.

 

 

In response to portfilio's comment:

It's not the coaches' fault that schools care more about revenue from sports activities than they do about providing education to as many people as possible.  (Not sure how that relates to medical school enrollment.)

Re: the doctors, many have forgone family/general practices for more lucrative medical fields, like radiology, cardiology, etc.

 

 

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Great post Matty!! No doubt we need more transparency in health care...which is why most people believe in a holistic approach to reigning in health care costs. The blame for high health costs does not rest solely on one entity. Insurance company reforms are a start...transparency in costs for health care providers needs to happen. I've stated before the story of my nephew's wife being charged $200 for a tube of bacitratin dispensed from a Worcester hospital pharmacy. Even when insurance is paying the bill...patients should know exactly what they are getting charged for. Finally..people should make better decisions regarding their health. Getting regular exercise, trying to maintain a healthy weight..avoiding places like McDonalds...etc. will generally result in better health and less visits to the doctor or pharmacy.

In response to Newtster's comment:

Newtster..well said. Sadly..our society has been trained to take the "quick fix" or the easy way out. We are a society of excesses in every possible way.

 "By contrast, European colleges spend far less on sports and use their resources to train medical practitioners and other professionals who work for society's good"

Liberals just love Euro-socialism...become a doctor, work for the State...all for "society's good", comrade..

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Let me sum up all the echo chamber comments like this:

Our lives would be so much better, including health care, if we were just like France,  A place that has had uneployment over 7% for thirty years, and is swirling the drain economically.  or is it Spain, or is it Italy?  I guess anywhere i Europe is preferable to you folks on the left.

Socialism has failed ever time it has been tried, in Europe, and so on. Obama's  little socialist experiment will fail here as well, but you will blame Bush, or Halliburton, or those mean TEA party people.  Anything to avoid having to actually think about the harm being done to our health care by a bunch of liberal loons.

 

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In response to airborne-rgr's comment:

Conservative?  Who told you that?  Pierce Morgan?  The group currently in charge in Europe is called the "Conservative Liberal Demoocratic Coalition".  Sounds confusing, and the liberal terminology definitiely outweighs the conservative.

There are no conservatives in Europe.  The entire game is played on the socialist end of the field.

That spending continues to grow in all these countries, which you call austerity, is the problem.  I think Moody's stated that quite clearly.

But, keep trying to blame "conservatives".

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In response to Newtster's comment:

Yes and no.

As with anything human-related, there are genetic limitations to health...what I like to call the hereditary lottery.  Some of these conditions are genetic; some are environmental; still others are behavioral.

But doctors can't 'cure' a damm thing on a patient they haven't seen.  Avoiding the doctor (e.g. for fear of costs) should rank right up there with smoking and eating fried snickers.

But there's little doubt that some people don't have much of a natural defense to start out with.

 

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In response to FortySixAnd2's comment:

Agreed, though all are private universities...and most ivy leaguers, to boot.

I think it's safe to say that the majority of doctors did not attend the elite medical schools...else they wouldn't be so elite.

 

(I understand that JH has a fierce lacrosse program.  Point still taken.)

 

 

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In response to FortySixAnd2's comment:

Well, not those of us who do keep ourselves fit.

Fat tax for the rest, payable into an Obamacare fund?