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Jeffrey Sachs: America can save $1 trillion and get better health care


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This makes way to much sense.

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Jeffrey Sachs: America can save $1 trillion and get better health care

Editors note: Jeffrey Sachs is a university professor and director of the Center for Sustainable Development at Columbia University. The opinions expressed in this commentary are his.

(CNN) US health care costs are out of sight, more than $10,000 per person per year, compared with around $5,000 per person in Canada, Germany and France. Obamacare expanded coverage without controlling costs. The Republican plan would ruthlessly and cruelly limit coverage without controlling costs.

Of the two options, Obamacare is vastly more just. The Republican plan is ghastly. But America has a much better choice: health for all at far lower costs.

This might seem like an out-of-reach goal or a political slogan, but it is neither. Every other rich country uses the same medical technology, gets the same or better health outcomes, and pays vastly lower sums.

Why the disparity? Health care in America is big business, and in America big business means big lobbying and big campaign contributions, the public interest be damned.

Health care is our biggest economic sector, far ahead of the military, Wall Street and the auto and tech industries. It is pushing 18% of national income, compared with 10% to 12% of national income in the other high-income countries.

In line with its economic size, it ranks first in total lobbying, with a recorded $152 million in lobbying spending in 2017 and an estimated $273 million in federal campaign contributions in the 2016 election cycle, divided roughly equally between the parties.

Both parties have therefore ducked the hard work of countering the health care sector's monopoly power. Health care spending is now at $10,000 per person per year, roughly twice or more the total of other high-income countries, or a staggering $3.25 trillion a year.

We should aim to save at least $1 trillion in total annual outlays, roughly $3,000 per person per year, through a series of feasible, fair and reasonable measures to limit monopoly power. Our system would look a lot more like that of the other more successful and less expensive nations.

Here's a 10-point plan Congress should consider.

First, move to capitation for Medicare, Medicaid and the tax-exempt private health insurance plans. Under capitation, hospitals and physician groups receive an annual "global budget" based on their patient population, not reimbursement on a fee-for-service basis.

Second, limit the compensation of hospital CEOs and top managers. The pay of not-for-profit hospital CEOs and top managers, for example, could be capped at $1 million per year.

Third, require Medicare and other public providers to negotiate drug prices on a rational basis, taking account of research and development incentives and the manufacturing costs of the medicines.

Fourth, use emergency power to override patents (such as compulsory licensing of patent-protected drugs) to set maximum prices on drugs for public health emergencies (such as for HIV and hepatitis C).

Fifth, radically simplify regulatory procedures for bringing quality generic drugs to the market, including through importation, by simplifying Food and Drug Administration procedures.

Sixth, facilitate "task shifting" from doctors to lower-cost health workers for routine procedures, especially when new computer applications can support the decision process.

Seven, in all public and private plans, cap the annual payment of deductibles and cost-sharing by households to a limited fraction of household income, as is done in many high-income countries.

Eight, use part of the annual saving of $1 trillion to expand home visits for community-based health care to combat the epidemics of obesity, opioids, mental illness and others.

Nine, rein in the advertising and other marketing by the pharmaceutical and fast-food industries that has created, alone among the high-income world, a nation of addiction and obesity.

Ten, offer a public plan to meet these conditions to compete with private plans. Medicare for all is one such possibility.

There really no mystery to why America's health industry needs a drastic corrective.

Visit the website of your local not-for-profit hospital system. There's a good chance the CEO will be earning millions per year, sometimes $10 million or more. Or go to treat your hepatitis C with Gilead drug Sofosbuvir. The pills list for $84,000 per 12-week dose, while their production cost is a little over $100, roughly one-thousandth of the list price. Or go in for an MRI, and your hospital might have an $8,000 billable price for a procedure that costs $500 in a discount clinic outside your provider network.

All of these are examples of the vast market power of the health care industry. The sector is designed to squeeze consumers and the government for all they're worth (and sometimes more, driving many into bankruptcy).

As a result, the sector is awash in profits and compensation levels, and the stock prices of the health care industry are soaring. In the meantime, human and financial resources are pulled away from low-cost (but also low-profit) disease prevention, such as low-cost community health workers and wellness counselors who work within the community, including household visits.

The health care sector is a system of monopolies and oligopolies -- that is, there are few producers in the marketplace and few limits on market power. Government shovels out the money in its own programs and via tax breaks for private plans without controls on the market power. And it's getting worse.

Every other high-income country has solved this problem. Most hospitals are government-owned, while most of the rest are not for profit, but without allowing egregious salaries for top management. Drug prices are regulated. Patents are respected, but drug prices are negotiated.

None of this is rocket science. Nor is the United States too dumb to figure out what Canada, the UK, France, the Netherlands, Germany, Japan, Sweden, Norway, Denmark, Finland, Austria, Belgium, Korea and others have solved. The problem is not our intelligence. The problem is our corrupt political system, which caters to the health care lobby, not to the needs of the people.

http://www.cnn.com/2017/06/27/opinions/fixing-americas-health-care-sachs/index.html


 

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1 hour ago, Mileage Psycho said:

This makes way to much sense.

Jeffrey Sachs: America can save $1 trillion and get better health care

Editors note: Jeffrey Sachs is a university professor and director of the Center for Sustainable Development at Columbia University. The opinions expressed in this commentary are his.

(CNN) US health care costs are out of sight, more than $10,000 per person per year, compared with around $5,000 per person in Canada, Germany and France. Obamacare expanded coverage without controlling costs. The Republican plan would ruthlessly and cruelly limit coverage without controlling costs.

Of the two options, Obamacare is vastly more just. The Republican plan is ghastly. But America has a much better choice: health for all at far lower costs.

This might seem like an out-of-reach goal or a political slogan, but it is neither. Every other rich country uses the same medical technology, gets the same or better health outcomes, and pays vastly lower sums.

Why the disparity? Health care in America is big business, and in America big business means big lobbying and big campaign contributions, the public interest be damned.

Health care is our biggest economic sector, far ahead of the military, Wall Street and the auto and tech industries. It is pushing 18% of national income, compared with 10% to 12% of national income in the other high-income countries.

In line with its economic size, it ranks first in total lobbying, with a recorded $152 million in lobbying spending in 2017 and an estimated $273 million in federal campaign contributions in the 2016 election cycle, divided roughly equally between the parties.

Both parties have therefore ducked the hard work of countering the health care sector's monopoly power. Health care spending is now at $10,000 per person per year, roughly twice or more the total of other high-income countries, or a staggering $3.25 trillion a year.

We should aim to save at least $1 trillion in total annual outlays, roughly $3,000 per person per year, through a series of feasible, fair and reasonable measures to limit monopoly power. Our system would look a lot more like that of the other more successful and less expensive nations.

Here's a 10-point plan Congress should consider.

First, move to capitation for Medicare, Medicaid and the tax-exempt private health insurance plans. Under capitation, hospitals and physician groups receive an annual "global budget" based on their patient population, not reimbursement on a fee-for-service basis.  Yeah, that will work. Chicago would be fucked.

Second, limit the compensation of hospital CEOs and top managers. The pay of not-for-profit hospital CEOs and top managers, for example, could be capped at $1 million per year.

Slippery slope on this one. How about ceo's of collage's and owners of small business too?

Third, require Medicare and other public providers to negotiate drug prices on a rational basis, taking account of research and development incentives and the manufacturing costs of the medicines. 

Who's rational?

Fourth, use emergency power to override patents (such as compulsory licensing of patent-protected drugs) to set maximum prices on drugs for public health emergencies (such as for HIV and hepatitis C). 

Seriously? Do you want to completely curb development of new drugs and equipment?

Fifth, radically simplify regulatory procedures for bringing quality generic drugs to the market, including through importation, by simplifying Food and Drug Administration procedures.  

Okay

Sixth, facilitate "task shifting" from doctors to lower-cost health workers for routine procedures, especially when new computer applications can support the decision process.

So said lower cost employees are now saddled with insanely expensive insurance??? 

Seven, in all public and private plans, cap the annual payment of deductibles and cost-sharing by households to a limited fraction of household income, as is done in many high-income countries. 

Thats an invitation for abuse of the system.

Eight, use part of the annual saving of $1 trillion to expand home visits for community-based health care to combat the epidemics of obesity, opioids, mental illness and others. 

You want to see cost skyrockett even more? Send the doctors to the patients... That's a great idea.

Nine, rein in the advertising and other marketing by the pharmaceutical and fast-food industries that has created, alone among the high-income world, a nation of addiction and obesity. 

Where do we stop on this one? Snowmobiles are dangerous thus they shouldn't be allowed to advertise.

Ten, offer a public plan to meet these conditions to compete with private plans. Medicare for all is one such possibility.

 I'm sure a government run plan running aside a privet run plan will do just splendid. The government definitely knows hoe to run a tight ship.

There really no mystery to why America's health industry needs a drastic corrective.

Visit the website of your local not-for-profit hospital system. There's a good chance the CEO will be earning millions per year, sometimes $10 million or more. Or go to treat your hepatitis C with Gilead drug Sofosbuvir. The pills list for $84,000 per 12-week dose, while their production cost is a little over $100, roughly one-thousandth of the list price. Or go in for an MRI, and your hospital might have an $8,000 billable price for a procedure that costs $500 in a discount clinic outside your provider network.

All of these are examples of the vast market power of the health care industry. The sector is designed to squeeze consumers and the government for all they're worth (and sometimes more, driving many into bankruptcy).

As a result, the sector is awash in profits and compensation levels, and the stock prices of the health care industry are soaring. In the meantime, human and financial resources are pulled away from low-cost (but also low-profit) disease prevention, such as low-cost community health workers and wellness counselors who work within the community, including household visits.

The health care sector is a system of monopolies and oligopolies -- that is, there are few producers in the marketplace and few limits on market power. Government shovels out the money in its own programs and via tax breaks for private plans without controls on the market power. And it's getting worse.

Every other high-income country has solved this problem. Most hospitals are government-owned, while most of the rest are not for profit, but without allowing egregious salaries for top management. Drug prices are regulated. Patents are respected, but drug prices are negotiated.

None of this is rocket science. Nor is the United States too dumb to figure out what Canada, the UK, France, the Netherlands, Germany, Japan, Sweden, Norway, Denmark, Finland, Austria, Belgium, Korea and others have solved. The problem is not our intelligence. The problem is our corrupt political system, which caters to the health care lobby, not to the needs of the people.

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39 minutes ago, Mainecat said:

Good post Vince I have been pushing for this for years.

Fuck man, the only thing you've been pushing for years is runny stool out yer ass and verbal diahrea on us. Give it a rest. :lol:

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57 minutes ago, Biggie Smails said:

Fuck even Eric Bolling on Fox News says that the Dems are right about controlling the cost of services.

 

At the end of the day , that is the biggest problem in this whole mess .......... and nobody in DC wants to touch it with a 10 ft pole .  Gotta wonder just why that is . :bc: 

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2 hours ago, Biggie Smails said:

Fuck even Eric Bolling on Fox News says that the Dems are right about controlling the cost of services.

That is what the whole article is about :thumb:

And without question it's where it has to start:

Quote

 

There really no mystery to why America's health industry needs a drastic corrective.

Visit the website of your local not-for-profit hospital system. There's a good chance the CEO will be earning millions per year, sometimes $10 million or more. Or go to treat your hepatitis C with Gilead drug Sofosbuvir. The pills list for $84,000 per 12-week dose, while their production cost is a little over $100, roughly one-thousandth of the list price. Or go in for an MRI, and your hospital might have an $8,000 billable price for a procedure that costs $500 in a discount clinic outside your provider network.

All of these are examples of the vast market power of the health care industry. The sector is designed to squeeze consumers and the government for all they're worth (and sometimes more, driving many into bankruptcy).

As a result, the sector is awash in profits and compensation levels, and the stock prices of the health care industry are soaring. In the meantime, human and financial resources are pulled away from low-cost (but also low-profit) disease prevention, such as low-cost community health workers and wellness counselors who work within the community, including household visits.

The health care sector is a system of monopolies and oligopolies -- that is, there are few producers in the marketplace and few limits on market power. Government shovels out the money in its own programs and via tax breaks for private plans without controls on the market power. And it's getting worse.

Every other high-income country has solved this problem. Most hospitals are government-owned, while most of the rest are not for profit, but without allowing egregious salaries for top management. Drug prices are regulated. Patents are respected, but drug prices are negotiated.

None of this is rocket science. Nor is the United States too dumb to figure out what Canada, the UK, France, the Netherlands, Germany, Japan, Sweden, Norway, Denmark, Finland, Austria, Belgium, Korea and others have solved. The problem is not our intelligence. The problem is our corrupt political system, which caters to the health care lobby, not to the needs of the people.

 

 

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1 hour ago, Sal Rosenberg said:

 

At the end of the day , that is the biggest problem in this whole mess .......... and nobody in DC wants to touch it with a 10 ft pole .  Gotta wonder just why that is . :bc: 

You know it Ronnie :thumb: 

From the article:

Quote

 

Health care is our biggest economic sector, far ahead of the military, Wall Street and the auto and tech industries. It is pushing 18% of national income, compared with 10% to 12% of national income in the other high-income countries.

In line with its economic size, it ranks first in total lobbying, with a recorded $152 million in lobbying spending in 2017 and an estimated $273 million in federal campaign contributions in the 2016 election cycle, divided roughly equally between the parties.

Both parties have therefore ducked the hard work of countering the health care sector's monopoly power. Health care spending is now at $10,000 per person per year, roughly twice or more the total of other high-income countries, or a staggering $3.25 trillion a year.

 

 

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44 minutes ago, Carlos Danger said:

The Dems had a chance to do all of the things listed but chose to have closed door meetings with the big wigs from Insurance, for profit hospitals, big pharm and just about anyone who was to profit off of the medical field.

WRONG

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51 minutes ago, Carlos Danger said:

The Dems had a chance to do all of the things listed but chose to have closed door meetings with the big wigs from Insurance, for profit hospitals, big pharm and just about anyone who was to profit off of the medical field.

 

7 minutes ago, Mainecat said:

WRONG

He is not completely wrong, the democrats had a small window to get things done just as the republicans now have a small window to get things done before the mid-terms, the dems chose to follow Romney's plan for Massachusetts and with that they needed the insurance, pharma, and hospitals on board as did Mitt in Mass.

The republicans have finally figured out that HC is complicated, but the truth is it can be simplified as the article I posted points out.

 

 

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President Obama actively courted Republicans to get on board, especially Maine's Olympia Snowe. Snarky asshole bloggers were pissed about his outreach. The bill was debated in the Senate Finance Committee before it passed from there to the Senate floor. That was after three House committees and the Senate health committee had vetted it, with Republicans able to debate it the whole time. This was followed by weeks of more debate and amendment votes. So if any dumbfuck conservative tries to ejaculate stupidly about how Democrats rushed through the ACA, shove that list from Congress up their idiot asses.

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5 minutes ago, Mainecat said:

President Obama actively courted Republicans to get on board, especially Maine's Olympia Snowe. Snarky asshole bloggers were pissed about his outreach. The bill was debated in the Senate Finance Committee before it passed from there to the Senate floor. That was after three House committees and the Senate health committee had vetted it, with Republicans able to debate it the whole time. This was followed by weeks of more debate and amendment votes. So if any dumbfuck conservative tries to ejaculate stupidly about how Democrats rushed through the ACA, shove that list from Congress up their idiot asses.

Vinny corrects you a little bit and you get even more pissed off

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1 minute ago, Mainecat said:

Cause its not true.

Ok Ok...fair enough. The Dems took a shot at it and now the Repubs are going to try to. Neither side will ever be happy with what the other passes. Lots of people feel like the ACA was pushed thru, pass something anything type of deal, crafted behind closed doors and passed by many who never read nor understood the bill. 2300 pages of legal speak

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16 hours ago, JEFF said:

Vince, you as a business owner can't tell me you actually think most of those are good ideas? 

Slope we all know would sign right up. 

Any smart business owner should be pushing for this full steam. Take the burden of health care administration right off of their books and put it right on the individual. Anyone who thinks our current system is the best is just not capable of independent critical thought. And brainwashed by the corrupt media. 

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13 hours ago, Carlos Danger said:

The Dems had a chance to do all of the things listed but chose to have closed door meetings with the big wigs from Insurance, for profit hospitals, big pharm and just about anyone who was to profit off of the medical field.

not completely true. a handful of dems (blue dogs) stopped some good things from happening with OC. however, it would have only taken a few repukes on board to counter them and get shit passed. but, not a damn repuke was on board.

 

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3 minutes ago, Snoslinger said:

not completely true. a handful of dems (blue dogs) stopped some good things from happening with OC. however, it would have only taken a few repukes on board to counter them and get shit passed. but, not a damn repuke was on board.

 

Yea cause the Dems we're really trying to reach across the isle.:stoned:  you knew the Dems we're playing games and looking for cover when they made Obamacare a 2200 page bill that no human could read before voting on it.

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Just now, Carlos Danger said:

Yea cause the Dems we're really trying to reach across the isle.:stoned:  you knew the Dems we're playing games and looking for cover when they made Obamacare a 2200 page bill that no human could read before voting on it.

they certainly would have if the repukes had expressed interest and good intentions. don't compare that to today's dems, either. they'd be willing to work with the repukes, if they just took their absurd demands out of the picture. imo we either need to fix what's wrong with obamacare and stop trump from throwing gasoline on it to try and kill it quicker, or go to UHC. I'd prefer the latter.

 

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4 minutes ago, Snoslinger said:

they certainly would have if the repukes had expressed interest and good intentions. don't compare that to today's dems, either. they'd be willing to work with the repukes, if they just took their absurd demands out of the picture. imo we either need to fix what's wrong with obamacare and stop trump from throwing gasoline on it to try and kill it quicker, or go to UHC. I'd prefer the latter.

 

Obama went on a scorched Earth policy from day one when it came to relations with the Repubs and for that matter he had poor relations with Congress in general.  Here is the thing Obama took all of the political hits (losing house, Senate and multiple state house races) and still did not push forward a single payer system which is what he wanted in the first place. Instead you got a plan that will fall of it's own weight regardless of what the Repubs do or do not. I am not upset one bit that Repubs who did not like the new plan gave it a thumbs down, better that than just Polish on the turd that is the current Obamacare law.

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Having had a kidney transplant two months and 8 days ago, I honestly don't even like to think about what my life would be like if I lived south of the border.  Especially with my fiancée having a baby a little less than 5 months ago.

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