[Grovenet] Chance to be involved in your future -

Sat Mar 3 22:55:25 PST 2007

Like I said, I don't agree with the lies in your article.
Yes, there are problems with the current system being tied to employers.
No I don't side with an organization that scares elderly folks as a 
tactic to gain donations from them.

Ron D'Eau Claire wrote:
> Oh, so you do agree with the position the AARP is taking in the initiative I
> provided the link to read. As you quoted: "While the system that prevailed
> during this "golden era" came to be regarded as the norm by (if not the
> birthright of) American physicians and their patients, from a broader
> perspective that system is clearly an unsustainable aberrancy. At some point
> the mounting costs of "no limit" health care had to generate its own
> backlash. * 
> **The system had to implode.*
>
> Strange, I would never have thought that from your original comments. 
>
> I was just making folks here aware of the initiative for those who are
> interested. 
>
> Ron D'Eau Claire 
>
>
> -----Original Message-----
> From: grovenet-bounces at rdrop.com [mailto:grovenet-bounces at rdrop.com] On
> Behalf Of Steven
> Sent: Saturday, March 03, 2007 9:22 PM
> To: Forest Grove local interests list
> Subject: Re: [Grovenet] Chance to be involved in your future -
>
>
>
>
> *The "economic" golden era*
>
> Any health care economist worth his or her salt will tell you that from 
> an economic standpoint, an ideal health care system is one in which 
> patients pay directly for their medical care. In such a system, patients 
> freely choose their own physicians, and together with their physicians 
> make all medical decisions, mindful that any costs incurred thereby are 
> theirs to pay. Cost controls are therefore automatic. During the 1920s 
> and for the next few decades, this "ideal" system existed in the United 
> States. Inasmuch as doctors at the time had very little to offer in 
> terms of expensive (or effective) therapies, and since patients' 
> expectations were (appropriately) low, this system worked extremely well 
> from an economic point of view.
>
> *The "medical" golden era*
>
> This economic equilibrium began to falter in the 1930s, and the 
> disequilibrium rapidly accelerated in the years following World War II. 
> The first kink in the armor of direct contracting between physicians and 
> their patients occurred during the Great Depression, when hospitals 
> began to suffer from patients' inability to pay their bills. Over the 
> initial objections of physicians, financially stressed hospitals 
> prevailed on state legislatures to legalize the insurance schemes that 
> became known as Blue Cross. In order to assuage the moral indignation of 
> physicians, however, the Blues were created as non-profit, 
> provider-oriented insurance organizations.
>
> "Provider-oriented" meant two things. First, Blue Cross (and later, Blue 
> Shield) did not try to tell physicians how to practice medicine. 
> Physicians were free to practice as they saw fit, and the Blues would 
> simply pay the bills on a fee-for-service basis. Second, the boards of 
> trustees of local Blue Cross and Blue Shield organizations were loaded 
> with prominent local physicians and hospital administrators.
>
> Not only did such a system preserve the direct physician-patient 
> relationship, it also paid the bills more reliably than did patients 
> themselves. The system worked to so well that soon physicians became 
> willing to countenance the formation of private health insurance 
> companies, as long as those companies followed the same general 
> guidelines set by the Blues.
>
> Health insurance proved to be so popular that, during the wage and price 
> controls of World War II, companies began offering it to their employees 
> in lieu of higher wages. After the war, American labor unions began to 
> demand that employers provide health insurance as a benefit of 
> employment. The government liked this idea, too, and in order to 
> encourage it, tax laws were changed to make the provision of this 
> benefit extremely attractive to employers.
>
> *It is important to note that this new tax policy created a fundamental 
> change in how health care was paid for. In effect, it shifted a huge 
> chunk of the fiscal burden for health insurance from consumers and 
> employers to the government, where it remains to this day. *Within a few 
> years, the majority of American workers had employer-provided health 
> care insurance, heavily subsidized by the federal government.
>
> Then in the 1960s, the federal government became directly involved in 
> paying for American health care on a large scale with the institution of 
> Medicare, and then Medicaid. Since that moment, the proportion of health 
> care spending directly attributable to the government has steadily grown 
> - from 24% of all dollars spent on health care in the 1960s, to 40% by 
> 1990. *Today, when you include tax subsidies for health insurance, fully 
> 51% of America's health care spending is accounted for by the 
> government, and paid for by taxpayers.*
>
> Since politicians can tax the people only so much, a lot of this 
> spending has been piling up in the form of the national debt, awaiting 
> our children and grandchildren.
>
> But *for physicians and their patients in the second half of the 20^th 
> century, the resultant system seemed nearly perfect*. While patients 
> retained complete freedom of choice regarding which doctors and 
> hospitals they used, and while the physician-patient relationship 
> remained largely free of outside influence, somebody else was paying the 
> bills. There arose an almost complete dissociation between providing 
> (and consuming) health care, and paying for it.
>
> *This economic arrangement did at least two things that would ultimately 
> spell its own doom.** * *First*, it allowed the American health care 
> myth to flourish - the notion that the best possible care should be 
> provided to everybody, and that where health care is concerned, there 
> are no limits. It created expectations that ultimately could not be met.
>
> *Second*, this system fostered the development of the medical-industrial 
> complex. Since any medical advance that seemed useful would be paid for, 
> powerful corporations arose dedicated to meeting the bottomless demand 
> for medical advances. The pharmaceutical companies, hospital suppliers, 
> and medical device companies began turning out a steady stream of 
> improved and expensive technology. Ironically (given that this whole 
> system had evolved largely due to physicians' attempts to shield 
> themselves from corporate influence), these corporations used their 
> considerable marketing clout to influence the decisions, the practice 
> patterns, and even the demographic distribution (such as patterns of 
> specialization) of the medical profession.
>
> The* bottomless expectations of patients and physicians,* coupled with 
> the never-ending meeting (and flaming) of those expectations by 
> industry, created a rapidly spinning positive feedback loop. The more 
> health care the doctors and patients got, the more they wanted. The more 
> they wanted, the more the medical-industrial complex was happy to 
> provide. It was inevitable that those paying the ever-mounting health 
> care costs (i.e., employers and the government) would eventually reach 
> the breaking point. While the system that prevailed during this "golden 
> era" came to be regarded as the norm by (if not the birthright of) 
> American physicians and their patients, from a broader perspective that 
> system is clearly an unsustainable aberrancy. At some point the mounting 
> costs of "no limit" health care had to generate its own backlash. * 
> **The system had to implode.*
>
>
>
> Ron D'Eau Claire wrote:
>   
>> Nothing provides you with more security than your closed mind, Steven. 
>> You are saved the effort of thinking and caring.
>>
>> You have lots of company.
>>
>> Ron D'Eau Claire
>>
>>
>>   
>>   
>>     
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