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Health Care in MA Is Bad Omen for Obamacare

Opponents of the Affordable Care Act predict the law will play out in four steps:

  1. Put government in charge of healthcare.
  2. Be shocked by rising costs.
  3. Begin micromanagement and cost controls.
  4. Endless pain.

Massachusetts, the model for the federal law, seems to have moved to step three, with a vote set this week on measures to contain runaway healthcare spending. We’ll see if step four is next.

As the Wall Street Journal report suggests, the legislation involves significant government oversight of the healthcare system and a major expansion of government bureaucracy:

If the measure is approved . . . [a]ll health-care providers would be required to report financial performance, market share, cost trends, and quality measures to the state.

A new oversight agency would monitor how providers are doing at controlling costs and provide reports on cost trends—information that will be used to develop further policy.

In addition, the bill charges the state’s attorney general, Martha Coakley, with monitoring trends in the health-care market, including price variation, though it doesn’t require her to take action. Ms. Coakley, a Democrat, has been a critic of hospitals that use their brand and clout to charger higher prices that aren’t justified by quality.

Nobody really knows what the answers to America’s healthcare problems are. Rapid technological change means that any system that exists now will likely be unworkable in 30 years. As the population gets older it will require more healthcare per capita. Scientific advances will make more sophisticated treatments available, threatening to drive all existing healthcare systems to bankruptcy sooner or later.

Radically restructuring the way healthcare works seems to be the only way out.

Existing economic interests—pharmaceutical companies, employee guilds like doctors and registered nurses, insurance companies, state and local government, and so on—can create political gridlock and stop real change. Thus markets, rather than government planners, seem most likely over time to create the innovation we need.

Backers of government-run healthcare, including the single-payer concept, think regulation by government and intelligent planning will work better. I think that these people are well-intentioned but wrong. If we follow their suggestions, we are more likely to end up with something like the U.S. Postal Service than a high-tech, streamlined medical system that can work in the future. This is not because governments can never do anything right, but because the American political system works the way it does. Other countries, usually smaller and more homogenous ones, can do these things better. Approaches that might work in Denmark don’t work well here. The messy compromises and one-size-fits-all solutions that usually come out of Washington generally can’t provide the kind of guidance our healthcare system needs.

But nobody knows how things will work out. Given political and social realities, government has a role to play. There is no way that the United States can come up with a true free market approach. It is conceivable theoretically but impractical from a political point of view. So we are stuck with a messy, mixed system.

Massachusetts, thanks in part to Governor Romney, offers us a picture of what the future might look like if the Affordable Care Act survives to shape the future of American healthcare. I don’t think the picture is going to be a pretty one.

How do you cut health-care costs in a system with universal insurance and individual mandates guided by heavy government regulation? The issues that Massachusetts is working on now are exactly the questions the country will have to confront next if we continue on our current track.

Let’s watch and learn.

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  • Walter Sobchak

    The Feds have already started:

    “… the United States Preventive Services Task Force, … recommending against routine testing with electrocardiograms, or EKGs, in people who have no known risk factors or symptoms of heart disease, like shortness of breath or chest pains. … the latest addition to an expanding list of once routine screening tools … Earlier this year, the task force advised against regular screening with the prostate specific antigen, or P.S.A. … for early detection of prostate cancer … annual Pap smears for many women and regular mammograms for women in their 40s.”

    h/t instapundit.

  • MarkE

    Great post!
    The middle class on-up can probably be managed with a market based solution, e.g., high deductible insurance. The poor, indigent, and opter-outs could be managed with a subsidized solution,e.g., contracted-out, but regulated HMO insurance.
    This allows market prices and valuation to set priorities rather than elite but isolated public health planners. Also allocation to the medical sector as a whole would be determined by market forces for those with private insurance and by proportional budgetary control of the government sudsidized portion.

  • dearieme

    “Earlier this year, the task force advised against regular screening with the prostate specific antigen, or P.S.A. … for early detection of prostate cancer … … and regular mammograms for women in their 40s.”

    Bloody right. Read Gerd Gigerenzer’s book on Risk to see why these two mass screenings are a lousy idea.

  • thibaud

    We do advanced medical treatments very well, and deliver them to a few. We do routine care OK, but can’t figure out how to provide it to everyone. Other countries do well on both counts.

    This is why the backstop of universal health *insurance* – not government-*run* *healthcare*, as Mead mischaracterizes it – is so important.

    Mead repeats some other myths as well, such as the canard about “single payer” as the desired outcome by reform advocates.

    In reality, most reform advocates want a universal public OPTION, ie universal health insurance that co-exists alongside well-regulated private options that supplement the universal insurance. Many countries, large and small, diverse and less so, federal as well as centralized, have such a model, and it works well for both “serious” and “routine” medicine.

    It’s more relevant to point out that the US in fact already has elements of many different countries’ systems – but we have kludged them together in such a ridiculously confusing, wasteful, inefficient manner that we both spend far more per capita than other nations and get worse or no better results. Plus ~700,000 bankruptcies per year and millions left without insurance at all.

    What Mead, and other “free market” defenders fail to grasp, is that the biggest obstacle to reform of our kludge is that uniquely American dinosaur, the for-profit health insurance system.

    As TR Reid notes, “the key difference [with other nations that also have large private insurance systems] is that foreign health insurance plans exist only to pay people’s medical bills, not to make a profit.

    “The United States is the only developed country that lets insurance companies profit from basic health coverage.”

    For a deeper analysis, look at Reid’s excellent global survey, “The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care”.

    Shorter version here:

  • Andrew Allison

    The problem with healthcare is exactly the same as the problem with other so-called “entitlements”, namely that money doesn’t exist to pay for the desired level of service.
    It appears to me that, just as with education, we provide a (hopefully) acceptable level of service to all and allow those who want more to buy it. Socialized medicine has its problems but, arguably, does the best for the most.

  • Don

    If this post were dated four years ago, it might have been effective right wing alarmism. However, it is obvious sto all who care to look that Massachusetts is doing quite well with Obomny Care and serves as a model for moving forward with what the Republicans were proposing in the 1980s. Mass has a lower fraction of for-profit, entrepreneurial medicine than most states. Owing to the lesser profit driven corporate medicine, Massachusetts is better able to rein in unnecessary diagnosis and procedures. It is better able to prevent overly expensive devices that contribute no improvement in long term wellness. The pain of Obomney Care is to the bottom line of the for-profit health insurance industry and to the entrepreneurial activities of needless expensive procedures of specialist physicians.

  • thibaud

    Walter S should actually read his anti-big gum’mint links before he breathlessly re-posts them.

    Unless, of course, he actually favors a very high rate of false positives generated by expensive procedures whose benefits have been shown to be outweighed by their costs.

    Of course, under a public option + private supplemental insurance system, the rest of us would be spared the costs of such dubious treatments while leaving Walter the freedom to waste his own money on private plans that charge him for the privilege.

  • Jacksonian Libertarian

    “There is no way that the United States can come up with a true free market approach. It is conceivable theoretically but impractical from a political point of view.”

    I disagree that this is politically impractical, the Republicans managed to pass the High Deductible Health Insurance with Health Savings Account market solution. Governor Daniels of Indiana offered HSA’s to State employees and is saving millions of state dollars. Here is an article from over 2 years ago:

    “It’s the feedback of competition that forces continuous improvements in Quality, Service, and Price in the Capitalist system.” Jacksonian Libertarian

  • Walter Sobchak

    The commentors here seem to have missed my point. I do not know, and indeed have no way of knowing, whether the substance of the Federal Panel’s advice is correct. It may very well be.

    The point is that the Federal government is already at what Mead identified as step 3: “Begin micromanagement and cost controls.”

    I am sure they will do a wonderful job of it, and that their efforts will meet with thibaud’s and dearieme’s approval. Although, I do note that the position on mammograms had drawn quite a bit of negative commentary.

    Again, my point is the exercise of authority by the Federal government, not the medical wisdom expressed.

  • thibaud

    Speaking of private plans, Walter might want to give his business to these noble paragons of for-profit insurance – they’re spending millions each year to try to gut the ACA’s provisions.

    Also scr3wing their customers, but hey, enemy of my enemy etc:

  • August Ruthenberg

    Solutions? I recently gave myself a 12 hour glucose tolerance test. Just read up on it on wikipedia and borrowed a blood sugar tester.
    How many other tests can be easily self administered at little cost compared with the doctor ordering it and having to set up appointments and all the other stuff necessary.

    If you want to contain costs, find useful tests with minimal tools. Let the doctor send out a sheet with test he recommends and if necessary, mail the tools for the easily adminstered tests. Maybe drug store or someone could do more complicated procedures.

    do the tests record the results or mail to doctor recommended testilng facilities.
    Doctor saves on billing and staff time as will the patient.
    Is it possible now? Not without trying alternatives.

  • bob

    we already have one of the world’s largest universal health care programs… medicare. And it’s on path towards bankruptcy.

  • The Reticulator

    “such as the canard about “single payer” as the desired outcome by reform advocates.”

    I think those are known as reform obstructionists.

    Ein Volk, Ein Reich, Ein Payer!

    I challenge Dr. Mead to come up with one of these single-payer advocates who is well-intentioned. They want power and control, not better health care for the nation. If they really wanted better health care, they wouldn’t have fought off all attempts to give the same tax advantages (or disadvantages) to those who aren’t employed by big (i.e. controllable) corporations as to those who are.

  • John Bocchicchio

    Anyone else see the irony in a government that wants all it’s citizens to procure health insurance by sorting through inumorous plans and then paying for and enrolling their families in said plans and waiting to be paid back through tax credits. But they believe that obtaining a birth certificate, and then a proper identification is too much a burden to ask of that population so they can cast their vote? Amazing.

  • Lea Luke

    “Nobody really knows what the answers to America’s healthcare problems are.”

    Least of all our neighbor to the north. I hear the Canadian people hate their healthcare system.

  • thibaud

    bob – Medicare isn’t universal.

    You do however bring up an interesting point, one addressed well by TR Reid: our Rube Goldberg non-system actually kludges together many distinct systems. Here’s Reid:

    “…foreign health-care models are not really “foreign” to America, because our crazy-quilt health-care system uses elements of all of them.

    “For Native Americans or veterans, we’re Britain: The government provides health care, funding it through general taxes, and patients get no bills.

    For people who get insurance through their jobs, we’re Germany: Premiums are split between workers and employers, and private insurance plans pay private doctors and hospitals.

    For people over 65, we’re Canada: Everyone pays premiums for an insurance plan run by the government, and the public plan pays private doctors and hospitals according to a set fee schedule.

    And for the tens of millions without insurance coverage, we’re Burundi or Burma: In the world’s poor nations, sick people pay out of pocket for medical care; those who can’t pay stay sick or die.

  • thibaud

    [Snark deleted.]

  • Jordan

    I have a HDHP+HSA from work by choice (and shockingly have only spent $75 out of pocket this year with having young child in the house).

    But my back hurts like heck. It always has since I was young(er). Now, I could score myself some physical therapy, but I know I’ll be paying the first $3000 of it.

    So instead I go for walks almost every day and stretch and do exercises when I can. In the past, that has kept my back in good shape, I’ve just slacked off in that department recently.

    I’ll let you decide whether you think my course of action is desirable for me and the healthcare system in general if writ large.

  • Jim.

    @The Reticulator-

    I think it would be easier to find single-payer advocates who simply wanted to practice a little self-interested regulatory capture — to get their bills paid by someone else — than it would be to find well-intentioned ones.

  • Kris

    Lea Luke (?) @15: “I hear the Canadian people hate their healthcare system.”

    The standard joke is that Canada has a two-tier healthcare system: the Canadian one, and the American one for the rich or desperate.

  • Susan

    The cosmetic surgery industry in America is booming because it is neither tax-funded nor part Medicare/Medicaid program. The cost for most procedures have decreased and there is competitive marketplace for both doctors and consumers.

    I am fascinated by the fact that people will send money on cosmetic procedures yet they expect tax-payers to provide healthcare. For example, a woman will spend $6000-$10,0000 on breast enhancement procedure yet is unwilling to pay $9 per month purchase birth control pills to alleviate menstral cramps.

    Let’s take the cosmetic surgery industry route-employ free market/consumer-patient based principles- and get the government out of our healthcare.

  • M. Simon

    The price of Lasik is going down. The rest of health care costs are going up.

    I don’t understand why. /sark

  • thibaud

    Kris – have you read TR Reid’s book yet?

    I also posted a quick summary above – see Reid’s WaPo op-ed piece.


  • JC

    Many don’t realize it but supply and demand applies to money too. And so when you heavily subsidize something, the price goes up. Too much cash chasing too few services. Over the years the Federal government has taken on a larger and larger role brokering healthcare payments. It’s like accelerant on a fire. As the system gushes money, everyone demands more.

  • Artie

    Mitt Romney was in Israel this week praising their national health service.

    Either he is lying to the Israeli’s or he is lying about repeal.

  • Vickee

    Mitt gave the liberal state voters what they wanted. Even though it was a bad decision.

    Now Obama has made it COUNTRY WIDE… imagine… think it will cost us more than estimated? I have a bridge to sell you. LOL
    Mitt Romney… bring sanity back to the WH.

  • Bill Baar

    Great post.

    It seems to me a truely progressive response to scarcity of health care/health insurance would be to create more of it.

    For example to turn over what could be turned over to folks like Walmart who know how to drive down unit costs. I think there is a surprizing amount of such care that could be placed into their hands and make it so cheap as to eliminate the need for insurance.

    Instead we get pandering to constitutencies on free preventive services which should really need insurance in the first place, at the expense of the really costly stuff. The response then becomes more controls.

    Thanks again for bringing this up. Your blog much appreciated.

  • Bill Baar

    I meant to write: Instead we get pandering to constitutencies on free preventive services which should really NOT need insurance in the first place,

  • What name

    There is a simple fix to the healthcare problems. Make health insurance like car insurance. Car insurance does NOT cover maintenance and neither should health insurance! Health insurance should only cover accidents, emergencies and if you come down with a chronic condition but only if you maintain insurance. If you drop it, like car insurance, you go into a high risk pool and pay a lot more for 3 years! If you want pregnancy insurance, you add the rider and pay extra, if you want mental health insurance, you add a rider and pay extra, if you want prescription, you add a rider and pay extra! Just remember, if you add pregnancy AFTER you are pregnant you go into the high risk pool.

    If insurance didn’t pay for routine doctors visits and extras like dermatologist and hair plugs, it would be much cheaper. And don’t even give me the argument that if insurance didn’t pay, people wouldn’t have checkups. So you are saying when someone’s tires pop they don’t get new tires? Or when their brakes are done they dont get new brakes? Come on! People need to take responsibility for theirselves, stop giving them everything! People should be paying for their own doctor visits with cash. Most of these same people pay their dogs vet bills!

  • ibeeducky

    In the mid 1990s Washington State passed legislation that all residents were eliglble for healthcare. The immediate result was that all the health insurance companies left the State. (Another potential possibility is that people moved to Washington to get health insurance…I have no actual facts to support that one way or another.)
    Thus the State had to create their Basic Healthcare program. Families like mine were forced into it as our insurance company moved out. Ee payed full premiums however, but many families most likely met some kind of subsidizing. To get the health insurance companies back into the State, a questionnaire was developed..if someone went over 200 points of the questionnaire, they had to go into a high risk pool..Washington State ultimately did some good for healthcare.

    All obamacare has done is increase premiums more than had been occurring. I changed my plan last year to avoid a $60+/mo increase…this year I am not so fortunate. A $54/mo an increase and switching out to a $5000 yearly deductible vs the $2000/yr deductible isn’t worth it.

    Obamacare is a disaster in the making.

  • Matthew Hall

    The answer is clearly a tax-deduction/tax-credit system much like mortgage interest deduction, but no republican in Congress is willing to fight for it despite it being much closer to their principles.

  • Chris

    With all the talk of ‘skyrocketing healthcare costs,’ why isn’t there similar caterwauling over ‘skyrocketing medical school expenses?’ It seems that the left wants doctors to do their job for free…sans ‘profit.’ Yet the left is silent over the cost to get a medical degree. No one believes that ‘Big Academe’ is benevolent and profit-free themselves, so why the selective outrage by the left over ‘skyrocketing costs?’ Why isn’t the attempt to ‘rein in’ health care costs coupled with a similar effort to ‘rein in’ the cost to get a medical degree? Well, we know why. The Left is in bed with ‘Big Academe’ and that’s where all their ‘friends’ are.

    At some stage, the real ‘pain’ will come when that annual physical you could depend on will come every two or even three years. Why? For two reasons. First, the crack-addicted woman who now can get her ‘free’ health care just slid in front of you in line. Then her daughter slid in front of you. And then her boyfriend. You’re no different than those crack-addicted layabouts. Welcome to ‘fairness.’

    Second, the supply of doctors will go down while the demand for their services will go up. Doubt me? If you’re contemplating a medical degree, you’re first realizing that it’s a half-million-dollar expense to get it. Once out with your newly-minted degree, you’re told to ‘give away’ your services to the ‘needy.’ How unfair of you to ask for a lot of money for your services. So, you decide that if this is your world, maybe you’ll become a violinist. Or an airline pilot. Or a chef. The left doesn’t see this train coming, but it’s on its way. Will government have to ‘force’ people to enter the field of medicine? Will they need to implement a ‘draft’ so that there will be someone to take care of that crack-addicted woman (and her whole family) who just got their ‘fair’ place in line?

  • T Tor

    America is nothing is nothing if not rabid shoppers. Require medical costs to be published up front. Require flat pricing across the board. Require most everyone pay X percent of their bill. These three changes will reduce costs and set the economy in high gear with new businesses.

  • rpm

    Back in the mid 70’s, when insurance mostly was just that, insurance, my company had a pretty good year or two. We were pretty health oriented, for the times. Middle management and up got an annual first class physical at company expense; membership at the health club across the street was company paid. We ran smoking cessation programs on site.

    We wanted to pass on some of the good results. So–we signed up for a first class health insurance program. More like a “Cadillac” PPO of today. Basically, you could go to any MD, little or no co-pay. Company picked up all of the increased premium for the Cadillac plan; employees share was pretty minimal. I think about $50/mo/family.

    It was wildly popular. My family never went to the MD that year–at that time of my life if I saw a MD (other than the mandatory annual physical) once every five years or so it was a lot.

    Then, at the end of the first year–we got the new premium rates. The CEO went ballistic. Called in the Insurance big wigs. They brought in redacted medical records. We had people that essentially lived in the waiting room. After looking at the facts, the boss stayed ballistic, but his ire went from the insurance company–who just paid the bills–to anonymous members of our employee group.

    We held a couple “focus groups” as to whether people would be willing to pay the extra (large) freight, or go back to the old plan. We went back to the old plan.

    This was about 2000 people. Extrapolate to 330M.

    What amazes me is that people that hate and distrust the insurance companies (who, by the way are not especially profitable) are quite willing to turn their health care over to unelected and unaccountable insurance companies. If you don’t like the insurance company, or the plan it provides, you can change. Changing governments, while lovely to think about, is much harder. Ask the short lived CSA (1861-1865).

  • Phantomorphan

    Singapore’s system makes much more sense than U.S. pre-ObamaCare, post-ObamaCare or single-payer:
    Not perfect, but harnesses forces intelligently to get incentives right while cutting down on stupid inefficiencies. Also deals out trial lawyers, which Ocare doesn’t (but eventually will have to do if it stands; sorry, all you “Truth and Justice League” members who supported O).

  • rpm

    in my last paragraph, it should say “unelected and unaccountable government bureaucrats”. In insurance companies are certainly unelected, but you can change to a different one.

  • JRR

    “Nobody really knows what the answers to America’s healthcare problems are. ”

    This is standard line used by opponents of ObamaCare. When a medical center bills $1299 for procedure for a patient who pays himself or herself, and 60% less for a HMO patient, we know where the answers lie! Why does a scholar of Dr. Mead’s stature buy the horse manure that we have to rely on the “markets” to deliver cost-effective solutions!

  • Russ

    Isn’t this the same business that Tennessee already went through in the early 00s? Only instead of “endless pain,” they went with “repeal that turkey?”

  • Rene 591

    yep singapore or swiss model is better. we need to move to a single payor and set up rationing to reduce to 10-12% of GDP.

  • pottfullofpith

    “This is not because governments can never do anything right, but because the American political system works the way it does.” It might be more useful to note that, once started, it is nearly impossible to get government to stop doing anything, right, wrong or pointless. Even if they start out well, when circumstnaces change, they are unable to change along with them. Very hard to turn Leviathan, takes miles to slow it down or stop it.

    @32. Chris. There is caterwauling and there will soon be more. Like the housing bubble, there is a diploma bubble, and deflating it will be ugly.

    The feds took over student loans a couple of years ago. Then we started to hear about how much debt students have piled up, more than $1Trillion. Then we started to hear about how hard it was to repay. Then we got an extension of low student loan rates ahead of the election. And when needed, expect a student debt forgiveness, courtesy of the taxpayer, who pays taxes to build public instituions, pays tuition when he is able, and will now pay for his neighbor’s kid’s tuition, as well. Rick Santelli could have said, “Show of hands, who wants to pay off their neighbor’s student loan?”

    The net effect has been to fleece the taxpayer, make the lives of cosseted higher ups in ivory towers ever more luxurious, and to debase the value of a college degree. This comes right back around to WRM’s point about what happens when government intrudes where it oughtn’t.

  • geoffrey

    walter russell meade doesn’t have a clue what he is talking about. He starts with the answer he wants and then makes up the rest to suit his story. Come to massachusetts and objectively study the issue and you will come away with a totally different view. The plan works well in many different ways and is widely popular, not only among the citizenry ,but the medical profession too.There is zero debate here about getting rid of the plan , instead the issues that arise are being dealt with each year. Yes there are problems that we face with the program but we are ahead of the rest of the country in this, and let me assure our fellow citizens that the country [like massachusetts] will be in a far better place healthcare-wise in just a few years. The alternative Mr Meade is texas where 25% of the popluation [and rising] is uninsured.

  • John Lynch

    Your premise of “endless pain” under Obamacare implies we face a different future without it. Newsflash: Our future without Obamacare is likely to be a lot MORE painful because all these free-market “solutions” simply don’t work with healthcare.

    Why? Because doctors are the only suppliers of services able to create their own demand, which distorts fundamental market principles of supply-and-demand.

    The other missing requirement for an efficient market is informed consumers able to make rational choices among competing suppliers. Patients have no clue whether they actually need whatever their doctors recommend, which leaves them ripe for plucking. And plucked they often are in a system that rewards over-treatment.

    Yes, we face exploding healthcare costs with Obamcare – and even more explosive costs without it, although the transition to a more rational system may indeed cost more in the short term. The thing that all the more effective and less expensive healthcare systems have that we don’t is that they’re better organized and managed.

    In this regard, the Veteran’s Health Administration (VHA) is a better example than the Post Office – which has none of the complexities of healthcare. Despite these complexities, the VHA outperforms our private healthcare system on all fronts – quality, safety, cost, and customer satisfaction. All this despite having an older and sicker patient population.

    Medicare – which Obamacare gives a stay of execution by prolonging its fiscal viability – also receives much higher customer satisfaction scores than private health insurance in America.

    In both instances, the market’s telling us, contrary to ideological OPINIONS, that when it comes to healthcare the government is, in fact, quite capable of providing a superior service than our fragmented and dysfunctional private healthcare system.

    And mostly that’s simply because it’s managed at all. Even a poorly managed system of care is more efficient than an unmanaged one, which is what we have now and will have even more so if unproven free-market theory is applied to our healthcare.

    This is borne out by the fact that our least efficient, most expensive, and lowest quality states – what I call “Rip-Off States” in my book – are mostly the least regulated states. This is what happens when there’s no one guarding the chicken coop but them there foxes.

    One healthcare system in America – government-run VHA and Medicare – is proven with actual market feedback to work, the other has only negative market feedback and is our fastest route to bankruptcy.

    It’s a steep price to pay to satisfy the egos – or is it the incomes? – of those who’d foist their unproven market theories on a country that can’t afford to screw this up any more than we have already.

  • jhc

    The shameless liberals love to hoot about Romneycare and at the same time denegrate him for leaving office with $800 million in state debt. Can’t they see the connection?

  • Yoav Michaely

    1.Ma healthcare reform was not prompted by “liberal voters” but by pressure from healthcare insurers that told Mitt the system has to change since they are being crushed by the uninsured appearing at the ER.
    2.Dealing with the cost escalation today is not a bug but a feature of the plan. At the time there was an understanding that there are two main problems: the uninsured and the rising costs. The political view was that they could not get a majority to tackle both and thus they decided to tackle universal coverage first and cost at the second round which is where we are now.

    This is not my “opinion”. I heard it first hand from the heads of the MA health providers and the politicians involved, at a North-eastern University seminar two years ago.

  • CobbleHill

    Professor Mead,

    Please read this. Denmark has a horrible health care system. They provided horrifically bad care to my parents in law. And until the new Socialist prime minister came into power, who is married to the son of Neil Kinnock, the tabloids would regularly report on the monstrosities that result from their single payer system. At least according to my wife, who regularly follows the Danish press. My Danish is pretty weak.

    Yes, their health care system is cheap. And maybe given the impending bankruptcy of third way democracies, that’s not something to sneeze at. But please, study more economics. Health care is not a public good. It’s excludable and rivalrous.

    Please. You’re a smart guy, but way too many pundits write without doing the requisite intellectual homework.

  • CobbleHill

    I read these comments more carefully.

    Some were good. I liked the reference to home testing. Of course, that’s good. I can go into a drug store now, and test my blood pressure.

    Back to Denmark, when I first went there, you couldn’t get aspirin at a pharmacy.

    When I was a student in France, I remember, I had a horrible heachache, and the drug stores were closed that Saturday in my neighborhood, but no worry, several miles away, I could buy aspirin, maybe, if I could figure out my Plan de Paris.

    But that’s not actually my point.

    My point is that if you look at GDP growth in the United States, it’s a disaster. We are going back into a recession probably, or something close. The NYT said today per a report from the left wing Controller that lots of local governments are going broke.

    All these left wing commentators have to wake up. For whatever reason, and it’s confusing, particularly in the case of the United States, but the economy is horrible.

    More socialist, left wing nonsense is exactly not the right recipe.

    Cause if Obama gets re-elected, and he might, this whole thing could break.

    In the past, it was wars that broke the fisc. Now it’s culture.

  • alex scipio

    2 ideas for the readers:

    1. Immediately STOP paying the defense bills of the entire West and see how fast their universal HC systems end. (They only have them because we pay their defense bills, BTW.)

    2. If we put the gov in-charge of HC (single-payer, as the Left wants), we’ll need lots more HC workers. We have a very large pool of govt workers we are trying to figure out how to keep employed: the USPS. I’d recommend we allow all Blue states to move all USPS employees to Obamacare adminstration in their states and see how that works for them. Anyone thinking federal HC workers would be any better, more motivated or more intelligent than federal USPS employees would be instantly disabused of that (nutty) opinion.


    “those who can’t pay stay sick or die.”

    Cue violins. Am I to understand that people are turned away from the hospital based on their ability to pay? Because that is specifically against federal law. (Which is part of how we got in this mess.) Additionally, there are private institutions that provide healthcare to people who can’t afford it, including the *gasp* Evil Pharmaceutical Companies.

  • K2K

    Just had a medication mistake in Massachusetts. Seems that the e-Rx system has zero capability to catch mistakes – the pharmacy had previously filled the Rx as “No Subsititutions”, but when the next RX came thru without that, I was startled to discover that there is no feedback loop wherein the pharmacy would question why the change, which was a doctor mistake.

    and, do not get me started about the wait for specialists in Massachusetts. I consider living here a death sentence, but am simultaneously trapped in a real estate nightmare. This has created a situational depression where I am not eating, and have been losing weight too fast. Yet, my doctor sent a note of congratulations for having lost so much weight, ignoring the fact that I am near suicidal over a legal matter I can not alter.

  • guydreaux

    Step 5: the only way to “save” the system will be formal government control and elimination of “outside the system” options, like the Canadian system

    Obamacare is simply an intermediate step to the ultimate goal. This will be fantastic for nurses (politicians like them and will ensure they are paid like firemen) and government administrative bureaucrats, but will not be good news for doctors or patients.

  • RobM1981

    One chilling fact to keep in mind: Massachusetts is one of the richest states in the nation, and has been throughout this failing experiment. If the MA economy can’t swing this, what makes anyone think that Maine, Louisiana, Illinois, Nevada, Oregon, etc. can?

    MA is *above* average. If above average can’t do it, what makes us think that average-average can?

    Another Obama triumph…

  • Carmen

    @Arthur Ruthenberg. You borrowed a blood sugar meter? I assume that means you also borrowed the testing strips. Reminds me of those people who only smoke OPC brand cigarettes. LOL. This product was designed for diabetics who have need to check their blood sugar level every day – usually twice a day. A month’s supply of testing strips costs them about $300. There’s a reason why your doctor wants you to fast for 9-12 hours before being tested for diabetes, which usually includes a urine sample taken in the doctor’s office in addition to a blood test. IMO, a blood sugar meter is not a good candidate for DIYS diagnostic medicine for what I hope are obvious reasons.

  • P_Legion

    The version of HealthCare legislation Gov. Romney signed (with several vetoes) was modified by the legislature full of Democrats and Gov. Deval Patrick (Obama buddy). I’m a resident of MA to advise you that the wacko-wing of the Democrat-Party produced the Health-Care failure in MA; not Romney.

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