Bruce wrote:
>What exactly *do* you propose as an alternative to public-option health care >for people who aren't fortunate enough to be able to afford health insurance that >will actually cover treatments? You didn't ask me; but I thought I'd actually propose something that makes sense. First, it makes sense for leverage to be used on folks making tons of money on health care. A surgeon can, in an 8 hour day, do 3 surguries and the associated follow up care for about 8k. I've seen what Blue Cross/Blue Shield pays, and I base it on that. We can pay hospitals, physicians, etc. a lot less...other countries do while maintaining superior measurables. Second, reasonable tort reform makes sense. I know from family experience that, when there are two studies out within a few months, one indicating physicians should stop a med; the other suggesting it be continued, the physician can be sued and be forced to pay money. We are unique in the developed world in how often we sue. I can understand the oppositon to upper limits on damages: if a drunk physician were to kill someone and folks knew he was drunk beforehand (coverups have existed), the folks deserve to pay triple lost earnings and punative damages. The amount of malpractice awards is a minor part of the cost. It's the time spent jumping through hoops that costs so much. A physician should be protected by providing a reasonable standard of care; and if studies are inconclusive on a drug...neither using it or not using it should be grounds for a suit. We need to have a reasonable approach to end of life. We spend more than any developed country streatching the last week into the last month or two. Coding a patient with multiple strokes and virtually no functionality and no hope for recovery twice a day for months is crazy. On this point I agree with John; it makes no sense to have a money is no limit view towards expensive procedures for those about to die even with the procedures. Realizing this fact is probably poltically impossible. We need a way to get the rest of the developed world to help pay for innovations. How, I'm not sure. If we cut costs; R&D will dry up; drug companies spend on it like AT&T use to when it was a monopoly. If they follow more typical companies; we'll have few new drugs. We need to trade off governments helping to study phase III results, with the immediate right to pull the drug, for drug company's agreements to only sell the meds. for the intended purpose. We need to offer affordable insurance for everyone. Brad DeLong's arguement, IIRC, is to have health savings accounts required for X% of income, and after that government insurance can take over. This would have to include Medicare; which can't function as it's going for another 10 years. Well, that's a starting point, although it's not fleshed out. Dan M. -------------------------------------------------------------------- mail2web - Check your email from the web at http://link.mail2web.com/mail2web _______________________________________________ http://mccmedia.com/mailman/listinfo/brin-l_mccmedia.com
