Ways to Reduce the Cost of Health Insurance: David Himmelstein

[eridani]

April 23, 2009 congressional testimony
Complete transcript--http://edlabor.house.gov/documents/111/pdf/testimony/20090423DavidHimmelsteinTestimony.pdf


A Canadian hospital gets paid like a fire department does in the U.S. It negotiates a global budget with the single insurance plan in its province, and gets one check each month that covers virtually all costs. They don’t have to bill for each bandaid and aspirin tablet. At my hospital, we know our budget on January 1, but we collect it piecemeal in fights with hundreds of insurers over thousands of bills each day. The result is that hundreds of people work for Mass General’s billing department, while Toronto General employs only a handful - mostly to send bills to Americans who wander across the border. Altogether, U.S. hospitals could save about $120 billion annually on bureaucracy under a single payer system.

And doctors in the U.S. waste about $95 billion each year fighting with insurance companies and filling out useless paperwork.

Unfortunately, these massive potential savings on bureaucracy can only be achieved through a single payer reform. A health reform plan that includes a public plan option might realize some savings on insurance overhead. However, as long as multiple private plans coexist with the public plan, hospitals and doctors would have to maintain their costly billing and internal cost tracking apparatus. Indeed, my colleagues and I estimate that even if half of all privately insured Americans switched to a public plan with overhead at Medicare’s level, the administrative savings would amount to only 9% of the savings under single payer.

While administrative savings from a reform that includes a Medicare-like public plan option are modest, at least they’re real. In contrast, other widely touted cost control measures are completely illusory. A raft of studies shows that prevention saves lives, but usually costs money. The recently-completed Medicare demonstration project found no cost savings from chronic disease management programs. And the claim that computers will save money is based on pure conjecture. Indeed, in a study of 3000 U.S. hospitals that my colleagues and I have recently completed, the most computerized hospitals had, if anything, slightly higher costs.

Video link at Political Videos
http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=385x305409

[SoCalDem]

1. BEST way?... 86 the insurance companies

make health care single payer

re-convert hospitals to "not-for-profit" (the fatcats have made enough money in 3 decades)

Pay drug companies to make the meds we need..at "cost"..Pay them well.. they already get federal funding to "create" the drugs.. and they too, have made bazillions of buckets of loot over the decades..

It's TIME to turn health care into the RIGHT it always should have been.. We pool our resources to deliver health care to those who need it, and we choose to pay for it, because it's a necessity.. It's just that simple..


Niche physicians can still operate at the edges for the super-rich who just have to have a new pair of "fish-lips", or size 38DDD plastic boobies, but for the rest of us, just the health care we need to keep us from croaking at 45:)

[ejpoeta]

2. but, but.... that's EEEVVIIILLL!!!

if the gubmint ran the insurance, then some bureaucrat in washington would decide which doctors you could see!! and you would have to wait on a long waiting list to get anything done!! the waiting rooms would be FULL!!

let me tell you something..... bureaucrats at the INSURANCE companies already decide which doctors you see and what they will and won't cover. but these folks get an incentive to NOT cover things. so they deny things hoping to make your life a pain so you'll give up. but i guess that's better than a government worker who has no personal incentive to deny you. is government perfect? of course not. but it sure takes the profit incentive out of things. and people don't go bankrupt if they get cancer or something else. what are the savings to us all if people don't have the fear of catastrophic illness hanging over their heads? or folks going bankrupt over an illness and possibly needing some form of public assistance after they can't work and have lost everything?