Hits & Misses – 2009/8/27
New York Times defends Zeke Emanuel.
Online communities have the potential to transform medical research.
The CBO often gets health care forecasts wrong.
Private health insurance added 100 million outside US: Single-payer systems are declining world-wide…while private insurance is growing rapidly.
I respectfully suggest that Professor Gabel has selected CBO reports that buttress his argument that it “overplays” its hand, and ignores others. Medicare’s costs in its first 30 years, 1966-1996, were 9 times greater than Congress’ initial forecasts, produced when the bill was introduced.
Furthermore, one of Professor Gabel’s examples, the Medicare Part D prescription drug benefit, is an “anti-public option” because the key difference between Part D and Parts A or B is that beneficiaries must get it through a private insurer, a condition against which its opponents continue to rail.
Online medical communities — patients talking to other patients and sharing personal experiences on symptoms, therapies, side-effects — have been around for more than a decade now. I've heard doctors argue online communities are not beneficial because patients are not a good source of medical information. This article explores how integrating researchers into the group allows them to discover more than they ever could by merely seeing individual patients. Even though self-report data is always suspect, I believe there are more benefits than risks to online communities.
I respectfully suggest that Professor Gabel’s claim that the CBO routinely “underbids” the savings achieved by government action on health care relies on a few selectively chosen examples. I’m pretty confident that a systemic review of CBO reports would show the CBO “overpromising” savings.
For example, Medicare spending from 1966 through 1996 was nine times greater than that which the CBO’s predecessor had forecast when the Medicare bill was debated.
Also, one of Professor Gabel’s examples is the analysis of the Medicare Part D Drug Benefit, established by the Medicare Modernization Act of 2003. Part D is unique because it is only available via private insurers, as opposed to Part A (hospital) and Part B (outpatient) coverage, which three quarters of Medicare beneficiaries still get via the direct government plan.
President Obama’s faction intends to eliminate such incentives from Medicare, and impose direct government control over pharmaceutical prices and access. Whatever one thinks of Part D (to which I was largely opposed), the reasons for the unanticipated savings will disappear if the president gets his way.
Interesting post about worldwide developments. Does this mean that socialism is in retreat?