No it doesn't. An example with PSA screening here [1] and elaboration on "number needed to treat" here [2]. When you factor in how many people need to receive the preventative care the cost savings vanish rapidly. So again, increased preventative care does not lower costs. It may be good, but it is not cheaper.
Do you have any supporting evidence? "Preventive care" is a non specific term. Perhaps, we are not talking about the same thing: If you give pregnant women, infants solid prenatal/pediatric care and they have healthy babies instead of preemies, the saving is incalculable.
When people have colonoscopies on a timely basis and their pre-cancerous polyps are removed- again, the saving is immense.
The list goes on. ..Help someone manage their diabetes /or end up with amputations Control high blood pressure /or foot the bill for a stroke victim. Regular dental care or/ infections and gum disease
Removing the subsidy will raise the cost of drugs. Again, this may be good but it will not lower costs. You fail to address ARCs point that your desired outcome will not reduce costs.
I don't know what you are talking about, here. U.S. taxpayers subsidize and protect the pharmaceutical industry. Removing these subsidies would certainly lower the price for Americans. Europeans/Brits /Canadians might be forced to renegotiate their prices upward but why do you want U.S. citizens to subsidize the prescription drug prices for all the other wealthy nations??
Mainly because preventative care has little to no savings, and comparative effectiveness research as proposed in the bills is not enforced. Enforcing CER is also difficult politically, see the HMO backlash in the 90s; not to mention it invalidates the assertion "no government bureaucrat will come between you and your doctor".
I would certainly hope that a board of medical experts (CER) would command more attention and respect from physicians than a board of business experts (H.M.Os). Frankly, I think Americans should get over the idea that physicians are all knowing and infallible. They are not and C.E.R. could be very useful as expert supporting evidence in cases of malpractice.
ALSO:
Perhaps you have not heard about MedPAC (medicare payment advisory commission)which the administration hopes to boost in power and influence.
We're paying an awful lot for that "slight" bar movement. This the faulty logic of "something must be done ... this is something ... therefore it must be done!"
We don't know what the final proposal will be but , for me, the bottom line is that if it helps small businesses, I am for it. I prefer a single payer plan. Alternatively, I would support the Weyden plan
Seriously, why do you care about Republicans? Democrats have a filibuster proof Senate, and more than enough votes in the House. Republicans cannot stop the Democrats if they unite. The only thing holding up these bills are that the Democrats are divided. Shouting "the Republicans helped with the problem" does not change the fact that NONE of the proposed solutions are any good.
I don't care about Repubs or Dems. I just want a plan I can support. My Senators are moderate Repubs so their position is of great interest to me.
Again, this is false. If employer's stopped providing health insurance they would replace the amount with increased wages. The same way that the "employers share" of payroll taxes really comes from the employee (in reduced wages) and is counted as such by economists.
The Wyden plan would eliminate employer based H.C. Good. Might employees receive higher wages? Yes, maybe, maybe not ..it would put small businesses and large businesses on an even playing field, force employees to confront the real costs of H.C., reduce H.C. inflation.
Manufacturing base is as strong as ever because our share of world manufacturing exports is ~12% (leading the 'industrialized nations' as it was in 1995 and 2000) according to UN Industrial Development Org [3] If GM was not providing health care then its workers would have demanded higher wages (or other benefits) so that GM's cost per employee would have been the same and it still would have disintegrated.
That is really unsupported by evidence. Ever fewer American are finding work in manufacturing .Those who have meager benefits do not demand higher wages unless market conditions make that possible. G.M. was doomed by its over -generous legacy H.C. expenses.
If you are being shafted by the system wouldn't you prefer all those other people lose their special privileges? If you don't want to pay for the poor, elderly, etc. why do you want other people to pay for you? A better approach would be to have everyone buy insurance in the individual market, thus forcing insurers and hospitals to respond to each unique consumer rather than homogenized businesses.
I highlighted in blue, the part of your statement that makes me want to throttle you. I don't want people to pay for me! I want the system to be fair so I am not asked to pay 3 or 4 times what I should, for health insurance (through the miracle of cost shifting) just because I happen to live in this state and am self-employed!! The individual market is highly inefficient and expensive.
The problem with medicaid is that it should have a sliding scale. Family H.insurance costs $25,000-35,000 a year in this state -with deductibles. Why on earth would someone earn $30-35,000 a year (too much for medicaid) if they can earn 25,000 and receive a highly valuable benefit in the form of medicaid?
I find it odd given your statement above that you disagree with my perspective on colonoscopies. First you (rightly) complain about paying for other people, then turn around and want other people to pay for your husbands colonoscopy. To be clear when I refer to "how many colonoscopies it takes" I don't mean how many one person has to sit through but the "number needed to treat" as referenced above [2]. MANY people need to have colonoscopies to find those few who have cancer.
In my family, alone, three people have had pre -cancerous polyps removed during the colonoscopy. I see that as an immense saving for the H.C. system since it is a preventive measure not a mere screening. The rest of your assumptions about my husband's care are pure speculation on your part. As it happens, he had symptoms masked by hemmoroids . The insurance co. denied payment based on the pre-existing condition clause.
CER "with teeth" is not in any of the bills proposed. As I pointed out previously President Obama's 'recommendations' have hampered the progress of the current bills. It appears your hope is misplaced.
CER is a new concept. The proposal I have in mind would give "teeth" to MedPAC. The President would have to approve or reject its recommendations as a package and Congress would have 30 days to reject them.
Of your false talking points you choose to poorly defend one of them ... with anecdotal evidence that merely demonstrates that you are out of your depth. Other self-employed doctors are experimenting with what boils down to self imposed capitation (sometimes called "concierge medicine"). One of the complaints in Dr. Gawande's article which you reference is that self-employed physicians are more likely to proscribe expensive testing since they turn a better profit ... how are Dr. Gawande's findings possible if there are "no self-employed physicians anymore"?
By all means provide evidence. What % of physicians are self-employed, today, versus, say 1965???
Republicans aren't "on board" with the Wyden proposal because not enough Democrats will support it. With a filibuster proof majority in the Senate no Republican plan will ever make it through ... why waste your time on a sinking ship? Republicans are in no way preventing health care reform.
You really believe that? Repubs had years in majority and they never lifted a finger. They waded into the H.C. waters to add a medicare drug benefit that is a gift to corporate interests. I applaud Wyden because he is one of the few who seems to treat this issue, seriously.
To everyone who's drudging up the tired UHC comparisons please look at the actual measures being proposed. Regardless of your opinion on UHC it should be obvious that the current proposed measures are largely useless.
You may be right about that. We will see.
