Comments for David Brooks on Drugs and Medicare at http://www.cepr.net , comment 1 to 16 out of 16 comments http://www.cepr.net Thu, 23 May 2013 19:19:38 +0100 FeedCreator 1.7.3 http://www.cepr.net/index.php/blogs/beat-the-press/david-brooks-on-drugs-and-medicare#comment-19474 "This is why a central authority, whether it is under a private insurance company or Medicare, must make rules about what treatments should be used." Your error here is the use of the word "should". Unfortunately i have been too involved with docs lately...but it goes with the territory. In each instant we negotiate...a doctor tells you several options...insurance will cover some things, not others...you take some time to think about it...google it...see what others have done and are thinking...then you make a decision... Example...hip surgery. There are rules when insurance will cover this. But it is not at all a "necessary" operation...merely allows one to walk easier. Plenty of people can't walk at all. There are wheel chairs. The operation is dangerous, since you are knocked out for several hours. You can clot. The recovery is several months. There is the risk of infection. These are all things to be considered by the patient who is the ultimate decider. Thus there are allowable treatments, not recommendations. Insurance companies are not doctors or patients, they do not make recommendations. Now there are interesting conditional treatments. For example, CT scans can spot cancers. If a CT or other test says you have cancer and you decide not to do chemo (oops another patient choice), your insurance will not pay for more CT scans...what's the point. - pete Wed, 10 Oct 2012 05:41:02 +0100 http://www.cepr.net/index.php/blogs/beat-the-press/david-brooks-on-drugs-and-medicare#comment-19457 the government is always more efficient than private enterprise. there is this great myth that continues to be put forth in the media, schools, corporations, churches & the military about the great hard work & ingenuity of americans as opposed to other nations. it's all malarkey & brainwashing. we have the poorest healthcare of any first world nation. it costs the most, isn't efficient, & our life expectancy is several years shorter than countries where the government runs healthcare. you can't have efficiency with many executives making bloated salaries & bonuses. when you run a for profit healthcare, or educational system it will always be very poor. brooks is a great believer in moving money from the people that have earned it to the leisure class who make their money by moving markets around & buying attorneys & accountants to perform the best three card monte money can buy. & the american people continue to fall for it electing one con artist after another, & then becoming enraged at the same result each time. - mel in oregon Tue, 09 Oct 2012 13:30:41 +0100 http://www.cepr.net/index.php/blogs/beat-the-press/david-brooks-on-drugs-and-medicare#comment-19456 Did Mr. Brooks consider the time value of money in his outline of payments Vs payouts? If so, at what rate? - Dave Tue, 09 Oct 2012 13:18:06 +0100 http://www.cepr.net/index.php/blogs/beat-the-press/david-brooks-on-drugs-and-medicare#comment-19455 Pete, What role does the SEIU play in restricting entry in the nursing profession? And what is this "excessive nurse coverage" mandate of which you speak? - Kat Tue, 09 Oct 2012 09:40:08 +0100 http://www.cepr.net/index.php/blogs/beat-the-press/david-brooks-on-drugs-and-medicare#comment-19454 My wife is a nurse with several special certifications (now retired). About 20 or 30 years ago there began an increased immigration of nurses, particularly from the Philippine Islands. At the time we all thought this was to lower costs for hospitals and doctors who had to pay nurses. I never saw any discussion of how they got visas/work permits or any study of the cost effects of this surge. Anybody know what was actually happening? Could it be done again? or is the AMA that much stronger than any other lobby. - Ethan Tue, 09 Oct 2012 09:33:22 +0100 http://www.cepr.net/index.php/blogs/beat-the-press/david-brooks-on-drugs-and-medicare#comment-19451 Brooks is advancing the view's of Special Interests. There are a number of ways we could alleviate this problem if we confined ourselves to the evidence provided by the real world. Neither Political Party has any interest in such an approach. We're just serving different masters or balancing them differently. - Donald Pretari Tue, 09 Oct 2012 07:27:58 +0100 http://www.cepr.net/index.php/blogs/beat-the-press/david-brooks-on-drugs-and-medicare#comment-19448 Having "skin in the game" does not enable a layperson to decide what medical treatments are necessary; that is something that requires specialized knowledge. Decisions are also not best made by people who make money from additional treatments. This is why a central authority, whether it is under a private insurance company or Medicare, must make rules about what treatments should be used. The expert panels who do this are necessary under any system, whether they are called "death panels" or not. - skeptonomist Tue, 09 Oct 2012 07:19:04 +0100 http://www.cepr.net/index.php/blogs/beat-the-press/david-brooks-on-drugs-and-medicare#comment-19445 Romney's Republican care is the same old failed health care system that wastes $1 trillion per year compared to every other developed country. All they want to do is to change a few deck chairs on the health care Titanic. The reality is that there are big corporations and wealthy people who make big money off of this price gouging system. Romney, Ryan, Republicans and Republicrats are being paid very well to keep the money flowing to these price gougers. Republicancare means we stay 100 years behind the times in health care instead of only 50 years under Obamacare. - FoonTheElder Tue, 09 Oct 2012 07:02:01 +0100 http://www.cepr.net/index.php/blogs/beat-the-press/david-brooks-on-drugs-and-medicare#comment-19444 Gladwyn, I thought that's what Medicare Advantage was about, except they privatized the customer interface, which as stated above, ends up driving up costs. I seem to recall the insurance companies didn't want to compete with Medicare directly (in a free market, competition should be welcomed, no?). - David Tue, 09 Oct 2012 06:58:00 +0100 http://www.cepr.net/index.php/blogs/beat-the-press/david-brooks-on-drugs-and-medicare#comment-19443 "Insurance" should be for the unexpected. Car insurance does not cover oil changes. It could, but why would we pay the little gecko 10-20% of our oil change cost to have him cover it. Same with dental. Regular cleanings, xrays and so forth are not insurable events like crowns. Yet we pay dental insurance companies a premium to cover these. Same with contraception. Why pay a 20% premium to an insurance company for something which is not risky? Just pisses some people off, and raises the costs by 20%. - pete Tue, 09 Oct 2012 06:50:58 +0100 http://www.cepr.net/index.php/blogs/beat-the-press/david-brooks-on-drugs-and-medicare#comment-19437 of course all costs rise over time....but some not much more than CPI - pete Tue, 09 Oct 2012 06:00:36 +0100 http://www.cepr.net/index.php/blogs/beat-the-press/david-brooks-on-drugs-and-medicare#comment-19436 I have no idea what the costs of cosmetic care are, but I can tell you the costs for dental care have not come down. Furthermore, in non covered cases of dental care you have the option of many providers. This is not the case with medical care. - jjmsan Tue, 09 Oct 2012 05:56:38 +0100 http://www.cepr.net/index.php/blogs/beat-the-press/david-brooks-on-drugs-and-medicare#comment-19435 Why doesnt Medicare offer private services? On our employer's health insurance form we should be able to choose between our PPO, Kaiser. or Medicare. With half the cost of private insurers Medicare would make sense for small businesses. - Gladwyn d'Souza Tue, 09 Oct 2012 05:52:38 +0100 http://www.cepr.net/index.php/blogs/beat-the-press/david-brooks-on-drugs-and-medicare#comment-19433 Easiest way to see how consumers with choice and skin in the game can affect costs is to look at non covered medical procedures. For example, cosmetic surgery, dental care, laser eye surgery, to name a few. Here the provision has become very efficient, costs have fallen relative to other health care. Even copays are effective, my son recently declined to go to the doctor because he didn't want to pay $30. On the other hand, promises to pay less for procedures have been broken time and again. Why should this be expected to change? Dean wants nurses and doctors to be paid on a global scale. Absolutely. Unfortunately the SEIU and AMA restrict entry, mandate excessive nurse coverage, and visas have been horribly restricted. Last I heard there was quite a waiting list to have British and French doctors immigrate here. The response in TX is for more physicians assistants...kind of a third best solution. Anyway there is plenty of room on the supply side (more visas and less monopolistic labor supply) and the demand side (more high deductible plans). - pete Tue, 09 Oct 2012 04:55:58 +0100 http://www.cepr.net/index.php/blogs/beat-the-press/david-brooks-on-drugs-and-medicare#comment-19432 For a good recent example of the relation between Republican statements on taxes and policy on taxes, see George W. Bush. Millions see debates, thousands are aware of facts. - foosion Tue, 09 Oct 2012 03:46:36 +0100 http://www.cepr.net/index.php/blogs/beat-the-press/david-brooks-on-drugs-and-medicare#comment-19431 During last week's debate, Romney went beyond revenue neutral to a claim that he'd cut taxes for the middle class. From transcript: 21:16:44: ROMNEY: ...And number three, I will not under any circumstances raise taxes on middle-income families. I will lower taxes on middle-income families. Of course, Romney may claim later that he's just lowering rates not taxes but that's not what he said in the debate. - Robert Salzberg Tue, 09 Oct 2012 02:58:26 +0100