US Healthcare leadership—an oxymoron (part 3)
by Miki SaxonThe next response is from Al Negrin, a retired CEO whose career ran the gamut from giant multinationals to startups.
“First of all, to provide a social safety net of the type most European and Scandinavian countries do, it is necessary to increase taxes on both businesses and individuals. This of course is a disincentive for both aggressive managements and aggressive employees. Why work hard to further your company’s prospects or your own prospects when any gains are largely taken away in taxes?
That’s why European companies are large, stable and slow moving, and European employees are satisfied to live a middle class existence without fighting to achieve higher paid positions and prefer to balance work and family by taking 5 weeks vacation every year. Election after election has shown this social position is favored by the electorate all throughout Europe (except in the UK).
The United States has achieved the pre-eminent world economy by taking a contrary social position. I don’t see that we want to give up aggressive business and personal challenge by converting to an all-embracing social safety net. That said, however, the Constitution provides that the government shall be empowered to “promote the general welfare.” Having tens of millions of citizens without access to appropriate health care is not “providing for the general welfare.” Thus I favor some sort of universal health care, without however extending it so far as to impede personal or ” business incentivization.”
Do you think that some form of universal healthcare
is possible in the US?
Your comments—priceless
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February 14th, 2008 at 6:22 am
It is possible — but only if the negative propaganda surrounding universal healthcare is debunked. And it wouldn’t mean more taxes — if we balanced it with cuts in pork barrel spending, subsidies to profitable companies and military support of other countries.
February 14th, 2008 at 9:59 am
Miranda, You are right on about funding, but universal healthcare is up against powerful entrenched interests, such as insurers and the AMA, and they’re the folks who fund the politicians. That’s why I consider it unlikely that things will change any time soon.
February 15th, 2008 at 7:34 pm
Obstacles to Healthcare in the United States
While the development of healthcare technology and pharmaceuticals provides longer life expectancies for Americans, there are a number of structural impediments to providing efficient healthcare.
Health insurance companies have created bureaucratic nightmares for efficient and cost-effective distribution of healthcare services and administration while optimizing profits.
The industry consistently says it provides the most efficient and cost effective business processes to provide healthcare to millions of Americans. If that is the case, then:
(1) Why do Medicare Advantage providers require a 12% or higher surcharge to provide Medicare Part C coverage than the amount spent by Medicare to provide Medicare Parts A and B coverage?
(2) Medicare beneficiaries in south Florida are offered the choice of Medicare Part A and B which allows the use of any physician or medical facility in the country that accepts Medicare payment.
In contrast, Medicare Advantage offers more than 60 separate healthcare plans that may provide lower monthly Medicare payments, but restrict beneficiaries to specific physicians, medical services providers, and hospitals, and have a relatively complicated set of co-pays.
Medicare Advantage beneficiaries have to check carefully to determine coverage when outside their service area, which may be as small as a county.
It appears that the administration of 60-plus plans must require significantly higher administration, marketing, and overhead costs to service the 10-15% of South Floridians who use these plans in lieu of Medicare Parts A and B.
(2) In a two-year period, the United HealthGroup, Inc. offered their CEO stock options worth 800-Million Dollars followed by an additional $600 Million Dollars in stock options and retirement perks the following year.
The $600 Million Dollar offer was retracted the following year after investigations started by the US Attorney’s office and a civil penalty/fine of $7 Million Dollars. Is this an appropriate of the healthcare premium dollars paid by beneficiaries?
Commentary – As a retiree of a major US Corporation that allocated approximately $3,000/retiree to provide health and dental services, I watched the cost of a benefits-rich nationwide HMO healthcare plan for a husband and wife with $5 Doctor and Rx co-pays, no co-pays or limits on lab, Rx, and hospital services go from $1920 Dollars/year in 1998 to more than $13,000/year by 2006 with 35% co-pays and limits on Rx coverage and 20% co-pays on everything else.
That did not include the $3000/retiree that was still being allocated. I understand that the costs of providing medical care have exceeded the annual rate of inflation. I think that the health insurance costs increases of 677% over an 8-year period for an employer with a very sharp pencil and ability to command competitive prices far exceeded the actual increases in fees received by healthcare providers.
It would appear that marketing, administration; overhead costs, executive benefits and perks, and HMOs being traded back and forth at increased prices on every takeover probably represented a major portion of the 677% increase in premiums paid.
February 15th, 2008 at 8:52 pm
Alan, In addition to the incredible waste in the system that you delineate so well, I think that you nailed the other problem with Medicare in your comment at Project Mgnt 411. “Social Security has paid in $1.844 Trillion Dollars more than has been paid out by Social Security. The excess has been BORROWED AND SPENT by the Federal Government to cover ongoing non-Social Security expenditures since 1986.”
It seems that greed, stupidity and politics-as-usual doom fixing the mess. But no surprise there, but I sure hope I’m wrong!
February 18th, 2008 at 10:22 am
Miki, regarding your comment that “It seems that greed, stupidity and politics-as-usual doom fixing the mess. But no surprise there, but I sure hope I’m wrong!” There is always hope.
However, in addition to hope, it depends on an informed electorate and media demanding that our elected representatives, Democrat and Republican, stop telling the voters that $2 + $2 of revenues = $6 and that $2 = $2 of expenses = $1.
February 18th, 2008 at 10:27 am
Miki, let’s try that again.
Miki, regarding your comment that “It seems that greed, stupidity and politics-as-usual doom fixing the mess. But no surprise there, but I sure hope I’m wrong!” There is always hope.
However, in addition to hope, it depends on an informed electorate and media demanding that our elected representatives, Democrat and Republican, stop telling the voters that $2 + $2 of revenues = $6 and that $2 + 2 of expenses = $1.
In addition, we should demand that ALL earmarks be ended, including those buried in the Administration budget as well as those buried in the Congressional legislation.
February 18th, 2008 at 12:35 pm
Alan, Well said, but people rail against earmarks and pork all the time—unless they happen to be the beneficiary.
I guess I am getting cynical in my old age, but “informed electorate” seems like another oxymoron.