tag:blogger.com,1999:blog-20692053.post116880673011486931..comments2023-11-03T06:35:48.003-05:00Comments on Shark and Shepherd: WPRI has something to sayRick Esenberghttp://www.blogger.com/profile/07280070509167910367noreply@blogger.comBlogger2125tag:blogger.com,1999:blog-20692053.post-1168880596458377042007-01-15T11:03:00.000-06:002007-01-15T11:03:00.000-06:00In addition to savings through negotiation, centra...In addition to savings through negotiation, centralizing (or, better yet, reducing) payers in the system would save tremendously on administrative costs. In the US <A HREF="http://content.nejm.org/cgi/content/abstract/349/8/768?hits=20&where=fulltext&andorexactfulltext=and&searchterm=administrative+costs&sortspec=Score%2Bdesc%2BPUBDATE_SORTDATE%2Bdesc&excludeflag=TWEEK_element&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT" REL="nofollow">about 30 percent</A> of our health care spending goes toward administration -- it's half that much in most other industrialized nations who offer universal coverage because they have fewer or only one payer.<BR/><BR/>I explain in more detail how administrative costs impact the system <A HREF="http://ineffect.blogspot.com/2006/07/physicians-looking-for-relief-from.html" REL="nofollow">here</A> and <A HREF="http://ineffect.blogspot.com/2006/04/efficiency-of-single-payer-system.html" REL="nofollow">here</A>.<BR/><BR/>And while conservatives frequently like to bring up Canada when talking about a single payer system, they often opt to ignore other single payer nations like France (which actually has a public-private hybrid system that I think would be the best for the US), Germany, Japan, Switzerland, Holland, etc., who experience virtually no rationing and still pay much less than the US for health care while covering all citizens. And if you think the US system doesn't currently ration health care, <A HREF="http://ineffect.blogspot.com/2006/11/how-us-health-care-system-rations.html" REL="nofollow">guess again</A>.<BR/><BR/>Lastly, on the question of what's covered, I think it's a question that needs to be answered by what's considered medically necessary by the medical profession -- specifically a nonpartisan state commission set up to establish and maintain the definition of "medically necessary" as it applies to the state health plan.<BR/><BR/>I know some have a concern that the definition of "medically necessary" will continually be ramped up by the likes of the chiropractic and sex-change lobbies (although that hasn't happened with the existing state health plan for state employees). And, the fact is, there isn't any way to guarantee that those attempts won't be made (lobbyists will always be free to lobby), although guarantees can be made that they won't be successful without public knowledge and input.<BR/><BR/>And, for me, when weighed against the consequences of not doing anything to provide health coverage to the hundreds of thousands of Wisconsinites who currently lack it, not to mention those who currently don't have enough of it, the obscure possibility that the public won’t be able to stop irresponsible increases in what’s deemed “medically necessary” is a chance I'm willing to take.Seth Zlotochahttps://www.blogger.com/profile/16391875601892087685noreply@blogger.comtag:blogger.com,1999:blog-20692053.post-1168873753320053992007-01-15T09:09:00.000-06:002007-01-15T09:09:00.000-06:00Yah...You nailed it--"plan design" will be the sal...Yah...<BR/><BR/>You nailed it--"plan design" will be the salvation of the State's plan if they wish to maintain a 12% tax.<BR/><BR/>There's a lot that a plan does NOT have to cover: birth control, abortion, cosmetic, chiropracty, sex-enhancement.<BR/><BR/>Another problem with the "social medicine" folks is that they really like preventive care (and for good reason.) Only problem--they cannot <I>force</I> people to accept preventive care---yet.Dad29https://www.blogger.com/profile/08554276286736923821noreply@blogger.com