Re: Numbers (Long)
From: art fougner, md (evsono@pipeline.com)
Mon Mar 7 11:45:33 2005
Robert
these are questions that need answers ... quickly. unfortunately,
little save posturing is coming from either side of the Congressional
aisles.
art
At Mon, 7 Mar 2005, RModugno@aol.com wrote:
>
>Drs. Michael A. Glueck & Robert J. Cihak
>
>Numb3rs and Medicine: What Are the Real Medical Costs?
>
>http://www.NewsAndOpinion.com | "Numbers," as every investor knows when
>considering a stock, must be questioned. By themselves, they tell you litt e.
>Here's how to think about the numbers presented in a recent L.A. Times sto y —
>an exercise in "Yes, but what would the numbers be if ...?"
>The February 9, 2005 edition of the L.A. Times has a story on U.S.
>health-care costs derived from a new study by researchers at Boston Univers ty School
>of Public Health. Major points include:
> * Rising health-care costs are absorbing nearly one-fourth of all
>economic growth. The statistics cited to support this fact are that spendi g for
>health care this year will be $1.7 trillion, which is up $621 billion from
>2000. That $621 billion increase represents 24 percent of the total GDP gr wth
>between 2000 and 2005.
>By contrast, increased spending for military defense during that same peri d
>accounted for only 10 percent of GDP growth. The growth in medical spendin
>during this period was three times the growth rate in educational spending
> * U.S. health-care spending per person in the U.S. is double that in
>Canada, France, Germany, Italy and Britain. The study researchers argue th t
>the $1.7 trillion annual cost of health care in the U.S. would be adequate to
>provide coverage for everyone if proper controls on medical costs were in
>place.
> * Doctors receive or control 87 percent of all health-care spending.
>This is broken down as 21 percent in doctors' fees and 66 percent in docto s'
>orders for drugs, diagnostic tests, hospitalization and other prescribed
>services such as physical therapy. The L.A. Times story offers no explanat on for
>what the remaining 13 percent of medical costs are. Presumably, a large pa t
>of it is administrative costs.
> * The researchers conclude that the only way to manage health-care
>costs is to force everyone into a socialized medicine scheme.
>
>"Yes, BUT WHAT WOULD THE NUMBERS BE IF ...?"
>The story fails to reach the level of detail required to understand what's
>really going on. For instance:
>
> * If doctor fees represent 21 percent of total costs ($357 billion
>annually), what percentage of those fees represent the cost of purchasing
>medical malpractice insurance, and is that insurance cost rising faster or slower
>than the aggregate rate of growth in medical costs?
>What percentage of total medical costs result from the practice of defensi e
>medicine, which incurs unnecessary medical costs for the sole purpose of
>reducing vulnerability to unjustified or frivolous malpractice claims?
> * Is it the assumption of the researchers that a socialized medicine
>solution in the U.S. would somehow magically eliminate all medical malpract ce
>suits?
> * What percentage of total medical costs are prescription drugs, and
>are those costs rising faster or slower than the aggregate rate of growth n
>medical costs?
> * What percentage of total medical costs is incurred for acute hospit l
> care, and are those costs rising faster or slower than the aggregate rate f
> growth in medical costs?
> * What percentage of total medical costs is incurred in nursing home
>care, and are those costs rising faster or slower than the aggregate rate f
>growth in medical costs?
> * Is the rate of growth in Medicare costs rising faster or slower tha
>the rate of increase in the number of covered persons after factoring out he
>new prescription drug benefit?
> * Medicare is a form of socialized medicine, somewhat comparable to
>that which exists in Canada, France, Germany, Italy and Britain. However,
>Medicare, unlike those European plans, does not cover all medical costs.
>Also, U.S. retirees pay a monthly Medicare Part B premium of $54.00 (about
>$650/year, deducted out of their Social Security checks. Consequently, the
>government-paid Medicare cost per retiree should be substantially less than the
>cost per retiree in those European nations.
>But if the annual Medicare-paid portion of medical coverage (less the
>$54/month premium) per retiree is comparable to or higher than the governm nt-paid
>cost in those European nations, doesn't that eviscerate the argument that
>socialized medicine approach for everyone would result in substantially
>reduced medical costs?
> * The Bush plan for controlling medical costs proposes that many
>consumers should become managers of their own health care by a combination of
>tax-sheltered health savings accounts and high-deductible catastrophic heal h
>insurance. But the Boston University study argues that the sickest individu ls
>are not competent to make their own decisions about medical treatment, and
>thus the Bush plan won't work.
>The L.A. Times story does not offer any kind of objective proof that a
>socialized medicine solution, where medical decisions are influenced or di tated
>by a mindless bureaucracy, would produce superior overall outcomes.
>
> (https://www.kerenyehoshuavyisroel.com/keren/jwr/donate.cfm)
>
>Of the alleged 45 million Americans without health insurance, what
>percentage of them are:
> * Those who get assistance from Medicaid and other federal/state/loca
>government medical aid programs?
> * Those who rely on free clinics?
> * Those who are wealthy enough to pay for their medical needs without
>relying upon insurance?
> * Those (particularly young employed single people) who believe they' e
> bulletproof and reject employer-offered medical insurance plans as
>unnecessary, even though they can afford it?
> * Those who rely upon hospital emergency rooms/trauma centers for the r
> medical care, and then skip out on their medical bills?
> * The estimated 10-20 million people who are in this country illegall .
>
>In Parting
>The argument for socialized state care assumes that the present mess is the
>only alternative. These single-solution enthusiasts are trying to limit our
>choices. President Bush versus socialized medicine versus present disarray s
>not the whole universe. "Numbers" can help solve the problem, but only if w
>calculate and interpret them correctly after asking the right questions.
>Just ask the professors and students at Cal Tech who consult on the new CBS
>Friday night hit "Numb3rs."
>Editor's Note: Michael Arnold Glueck, M.D., wrote this week's commentary a d
>thanks Dan Emory for contributing to the analysis.
>
>Michael Arnold Glueck, M.D., is a multiple award winning writer who commen s
>on medical-legal issues. Robert J. Cihak, M.D., is a Discovery Institute
>Senior Fellow and a past president of the Association of American Physicia s and
>Surgeons. Both contributors are Harvard trained diagnostic radiologists.
>**********************************
>Robert Modugno MD MBA FACOG=20
>**********************************
>Marietta, GA
>_www.novaobgyn.yourmd.com_ (http://www.novaobgyn.yourmd.com)
> (http://www.jewishworldreview.com/0305/medicine.men1.asp#top)
--
art fougner, md
"If you don't know where you are going, you will wind up somewhere else."
Lawrence Peter Berra
