Sleeping with the Enemy, Part II: PhMRA is pouring money into Harry Reid’s campaign. AHIP is joining Families USA to support ObamaCare.
Why FDA expert panels are less and less expert: Research physicians who know the most are barred from FDA expert panels by conflict-of-interest rules.
Most providers don’t compete for patients either on price or on quality. Since out-of-pocket payments by patients are well below the true cost of their care, demand exceeds supply and services are rationed by waiting — just like in Canada. In such an environment, quality improvements do not increase provider income and quality degradation does not decrease it. That’s why so much of the health care system resembles the Department of Motor Vehicles.
In some specialized markets, however, providers actively seek more customers, often advertising directly to patients — on TV, in magazines, etc., sometimes in other cities and sometimes nationwide. For example, New York’s Mount Sinai Medical and Memorial Sloan-Kettering and Massachusetts General in Boston are all aggressive advertisers on cancer care. In these markets, third-party payment significantly exceeds the marginal cost of care, and supply often exceeds demand.
Providers in these markets typically compete for patients based on quality. They need patient-pleasing services in order to attract their clientele in the first place and to retain them as ongoing customers. And their activities raise an obvious question: Why can’t we have quality competition system-wide?
Poetry in the Waiting Room was the brainchild of a poet who discovered many of his friends were spending lots of time in NHS waiting rooms. It’s funded by the British Arts Council and the NHS and aims, according to a brochure, “to comfort those waiting to see the doctor through poetry.” An informational footnote declared that the pamphlets were described “in a House of Lords debate as the most widely read national poetry publication.”
This is from an article praising British health care vis-à-vis U.S. health care. It appears in Kaiser Health News. No reference to all the premature deaths in Britain due to substandard cancer care.
Have you ever thought about what our health care system has in common with our systems of public roads, thoroughfares and highways? In both cases the service is mainly free. Sure, toll roads are increasingly common and copays at the doctor’s office are too. But in both cases, the fee we pay is well below the true social cost of what we get in return. And most people pay nothing out-of-pocket when they use either of these services.
What difference does that make?
httpv://www.youtube.com/watch?v=oYS0Epyyu3k
Ain’t Gonna Pay No Toll
This is Scott Gottlieb, writing in the Wall Street Journal:
Take the agency’s tortured decisions concerning the use of implantable defibrillators that jump-start stopped hearts during cardiac arrest. Medicare sharply restricted their use in the 1990s. Mounting research proved that the $30,000 devices could be saving many more lives. So in 2003 Medicare adopted a novel theory to expand coverage to some, but not everyone, who needed one. The agency said only patients with certain measures on their electrocardiograms (called “wide QRS”) seemed to benefit.
Continue reading The Government is Already Rationing Health Care
“Lies and distortions,” says David Axelrod. “The 26 lies about H.R. 3200,” headlines an Annenberg report. “The Five Biggest Lies About Health Reform,” is the lead in a Newsweek article.
You would think we were living in some foreign country.
There are many contentious issues, of course. But towering above all others, THE ISSUE is denying people care. Or, if you like, health care rationing.
At the National Center for Policy Analysis we have brought this issue up frequently — but, I believe, in a responsible way. For that matter, Barack Obama has brought the issue up frequently — also in a responsible way.
Yet what is driving the defenders of Obama Care crazy is that this issue is being discussed at all. For one thing, the President is saying things most Democrats never say when they talk about health care. For another, the opponents have passed up not a single opportunity to distort and exaggerate to the hilt. To get one absurd statement out of the way, let’s admit that none of the bills before Congress contain the words “death panel.”
Still, is there something here we should be worried about? Answer: Yes. You should be very worried.
httpv://www.youtube.com/watch?v=b0yLVfauPNc
Get back, get back
Get back to where you once belonged.
Here is Joe Flower, writing at The Health Care Blog:
The forthcoming fight for real change in healthcare: It will be viciousness at the top of the lungs. It will be a scorched-earth campaign. Its main weapon will be fear. It will be unencumbered by any actual knowledge, subtlety, awareness of history, or access to the thoughts of people who actually know what they are talking about. Its fury will be unloaded not just in service of narrow and inflexible political nostrums, but in the service of sectors of the industry which fear that a truly efficient and effective healthcare system would cripple their profit margins. The fulminating rages across Rush Limbaugh’s radio rants, Matt Drudge’s blog, the editorial pages of the Wall Street Journal, and commentaries issued by conservative think tanks, all echoed around the blogosphere.
And what, you may ask, provoked this hysterical diatribe? It was Flower’s reaction to his perceived conservative reaction to $1.1 billion in the stimulus package for “comparative effectiveness research.” I’ll explain why he is wrong below the fold. Continue reading This Debate Needs More Adult Supervision
Princeton economics professor, Alan Krueger, calculates that Americans spend about 66 minutes per week, on average, obtaining health care. Using a wage of $17.43 per hour, the time costs of obtaining medical care totals nearly $1,000 per year per American (aged 15-years and above). That's equal to roughly 11% of total health care spending. [link] This implies that patients spend almost as much in time costs to get care as they spend in out-of-pocket cash.
Uwe Reinhardt thinks this is consumer directed fire service. I think it's entirely political. The victims are offering to donate to the mayor's reelection campaign.
This is from a Wall Street Journal editorial:
There are more than 100,000 Americans waiting for an organ transplant. If recent history is any guide, more than 6,000 of them will die waiting this year.
Donors and patients [are subject to] criminal penalties of up to five years in prison and a $50,000 fine if "valuable consideration" was provided to a donor.
While the chilling effect of the federal ban has remained since 1994, the national transplant waiting list has more than quadrupled.