It doesn't. I fact our whole approach is totally upside down. We put more money, time and energy into treatment than prevention.

Any possible cure takes for ever to get approved, if at all. Think how much money the health industry would loose if an actually cure for say cancer or heart disease where to be found.

As my own doctor has observed hospitals are suppose to help people to heal but are set up to do the opposite.

And we pour millions of dollars into patients who are just barely clinging to life, most of the time suffering outrageously. In stead of allowing them to die with dignity and some degree of comfort.

C

Especially when the military cuts can pay for some of the cost.

I was quite annoyed by the TPM article with headline proclaiming that the CBO had found savings of billions... over ten years. We should be seeing savings of trillions over ten years if health care cost reform is for real.

The cost to go to supposedly more efficient and useful means of medical record keeping is supposed to be in the initial setup, buying computers and software and loading stuff into them. I think it's bull. I don't believe the savings are all that big in general. And then no more handwritten charts everything has to be entered into a database so there will be ongoing costs which might eat up most or all of the alleged savings over current methods. And just how often do you need old x-rays STAT? Rather it's an attempt to erode privacy and doctor-patient privilege (once the data is online the NSA will have a back door and so will others). Of course once someone else pays for your health care, you don't deserve total privacy anyway, and if tax dollars pay for it, why shouldn't your medical records be public?

Okay, I'm not entirely against improving how records are generated and kept, and sometimes speedy access to records is a good thing.

I can give you a couple of examples that have been well documented, but I am guessing that if you go to the web sites of your local hospitals and clinics you will see the majority of them have CT Scanners and MRI machines, which are over $1M/each. So they try and use them so they can bill and recoup the cost - but are they necessary.

In critical care units, the nursing staff can do blood glucoses at one hour intervals...are they necessary?

An individual sees a "newly diagnosed disease" on TV...and they may have it...so off to their physician who may or maynot be able to diagnose the illness, but the patient demands the drug, which requires monitoring...more cost...and because the treatment doesn't cure, but does eliminate the symptoms, so now you are on a medication for life.

Which works better for preventing blood clots, PLAVIX or Aspirin...which is marketed?

When you have consumers demanding things with insufficient knowledge and physicians give in to their demands or lose the patient...which action is most likely to happen?

How many real studies are necessary to prove gall stones vs how many studies are given? How many surgeries are performed unnecessarily?

You want to see costs for no reason...there you go! The change may be because we know so much and the medical community has so many ways to diagnose and treat...they use them all regardless of cost. And the patient is happy because they think they are getting the BEST care.

In order to save money, there needs to be a change, not just by physicians, hospitals, clinics, but also Patients...and that will take time - and Americans are not patient people, we want immediate solutions to all our medical ailments and drugs to solve many problems. Go to the AHRQ website and see how many people by age are on medications - it is astounding.

At risk of being obtuse, there are two "costs" here:

1. Cost of operation, which as e.g. the CBO and pretty much any sane entity with any understanding of mathematics tell you will be less than the current system.

2. Cost of transitioning to the new system, including the organisational and logistic restructuring and, in many cases, outright creation thereof -- this means anything from administrative structure to claims handling process to personnel to districting to provider liasoning to contract negotiation to medical record consolidation. In addition, responsible calculations would take into account e.g. the costs of the current insurance corporations' employees having to find new jobs etc. This is where the "extra" cost is.

It will cost more, and it will never be a direct money maker for the country (increased output through improved living standards is too complex for most "conservatives" to understand), but that is OK. It is the right thing to do.

We've all had to drop our cars off at the mechanix's shop for repairs and the bill for services is based on the flat rate.

Flat Rate or Actual Time
If the actual time it takes to repair the vehicle is LESS or MORE than the estimated flat rate time, the customer still pays the flat rate amount. More experienced auto technicians and techs with time saving tools can most of the time beat the flat rate time (AKA book time). The technician, if paid by flat rate has an incentive to do the job fast and correctly. If he makes a mistake and has to do the job again (commonly called a comeback) he does it the second time for free! Also keep in mind that a flat rate technician does not get paid time and a half for over-time, or for standing around waiting for work or parts.

Now exchange technician with doctor, nurses, staff, hospital and the problem is solved. Getting paid by flat rate hasn't deterred people from starting auto mechanix shops to service people's needs. In fact, many make a pretty good living repairing people's cars because they can do it for less than the major auto dealers with better results and customer satisfaction.

I think there's a basic misdirection at work here. The program will "cost $1.5 trillion over 10 years" we hear, but that's not in addition to whatever else we'd spend in 10 years under the current system, it replaces it.

This is a classic case of liberals getting lost and confused in their own multiple arguments.

The core issue that prompted the debate was the fact that we have up to 50 million people without health insurance. That gave birth to proposals for mandated universal coverage.

Given that we are a nation divided, this in turn created a backlash against turning to socialist models to solve any problem.

That's when the classic liberal tactic unfolded in front of all of us.

First, the stopped stressing universal coverage and focused on the overhaul instead, intending to bring the universal mandate under the guise of the overall reform.

Second, they had to convince the public that the system was failing. So they latched onto any report that would help paint a picture of epic failure. OECD, as always, obligingly provided statistics. Dozens of TPM bloggers were laboring on posts showing our system sucks. Infant mortality! Spending per capita! Terrible quality of healhcare.

Third, liberals simply couldn't resist firing shots at their favorite scapegoats. Insurance industry - oligopoly! Capitalist bloodsuckers!

In the process, the original intent of universal coverage was completely overwhelmed by the hysterics of fixing our "failed system" and "teaching insurance companies a lesson".

And when the cost of the "reform" became known, the liberals got hit on the ass by the very argument they thought would help THEM.

It's been a while since Obama noticed any "green shoots of recovery" on the economy last time. Given his slipping numbers on handling the economy, it's no wonder the cost of the reform would freak out a lot of people.

And now that more and more people are going to ask Desi's question, liberals are left trying to square a circle, but the genie is out of the bottle.

Since the liberals made cost the central argument for "reform", they are now blocked from bringing back the original call to arms on universal coverage mandate.

The moral of the story: they wanted to bring change but ended up replaying the same failed tactics.

It's over. No reasonable person should buy an argument that we have to pay more to pay less.

Where is the waste? This article will help.

http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande?currentPage=all

The only reason "it" will cost "more" is because we are taking the dumbest possible approach which is tha we are bowing and scraping to the paisitic insurance and pharmaceutical interests and keeping our rotten, far too expensive and underperforming system in place while also establishing an alternative "public option" that will almost surely be designed to fail if it even is included in the final legislation under discussion. Then, when the public option is structured so badly it cannot possibly work properly the very same parasites choking our families our businesses and the economy will point to it and exclaim: "See! We told you! Government run healthcare won't work!"

The solution is simple, obvious and straightforward. We need to abandon the current system and estalish a single payer system. Personally, I am for the simplest and most straightforward approach which is to support Rep. Conyers' Medicare for All bill.

Destor nails it! I've been asking this question for years!