tag:blogger.com,1999:blog-7476621888383604834.post4703076715176798106..comments2024-02-15T03:26:38.897-05:00Comments on Health Care Organizational Ethics: Crunch Time in Massachusetts for Cost Containment and ACOsJim Sabinhttp://www.blogger.com/profile/03087828142188534542noreply@blogger.comBlogger6125tag:blogger.com,1999:blog-7476621888383604834.post-12553361792756497272011-02-23T21:29:26.675-05:002011-02-23T21:29:26.675-05:00Dear Commercial Insurance -
Your website is that ...Dear Commercial Insurance -<br /><br />Your website is that of a U.S. insurance broker, but apparently you're living in Sweden. If so, you get to see a much more equitable health system than we have in the U.S. The fact that Sweden has less diversity than the U.S., strong social solidarity values, and a population (9.5 million or so) that is the size of a single state in the U.S., gives it a real head start for developing a sane approach to health care!<br /><br />Best<br /><br />JimJim Sabinhttps://www.blogger.com/profile/03087828142188534542noreply@blogger.comtag:blogger.com,1999:blog-7476621888383604834.post-91927323493282169292011-02-22T11:52:47.155-05:002011-02-22T11:52:47.155-05:00great post and comments,i am currently living in s...great post and comments,i am currently living in sweden and i have to say that we- the US in general haev a lot more to study regarding health care insurance. like you said it's getting better at some parts but will take some time until we will be fully covered without losing all our saving.commercial insurancehttp://www.boltinsurance.comnoreply@blogger.comtag:blogger.com,1999:blog-7476621888383604834.post-22880355652148219642011-01-07T16:20:41.335-05:002011-01-07T16:20:41.335-05:00Hi Dennis -
Thank you for your follow up comments...Hi Dennis -<br /><br />Thank you for your follow up comments. I'm sorry for the delay in responding.<br /><br />You are right that the increased level of health insurance we've brought about in Massachusetts has required tax support. But we still have a mixed system, with the majority of the insured population receiving its health insurance through employers. In countries like Canada and the UK, employer-based insurance plays a very much smaller role. By "a mixture of public and private institutions" I meant our national hodge podge that relies on so many different forms of health insurance - employer based, Medicaid, Medicare, VA, safety net clinics and hospitals, and more.<br /><br />I'm happy to hear that you, like me, are a satisfied HMO member! I personally loved conducting my clinical work in the setting of a prepaid group practice. <br /><br />Best<br /><br />JimJim Sabinhttps://www.blogger.com/profile/03087828142188534542noreply@blogger.comtag:blogger.com,1999:blog-7476621888383604834.post-51389420891983007032011-01-06T10:17:20.766-05:002011-01-06T10:17:20.766-05:00Jim -
My point about taxes was that you said
&qu...Jim -<br /><br />My point about taxes was that you said<br /><br />"Massachusetts has demonstrated that a population can be (almost) fully insured without resorting to the... forms of tax(-)financed methods that Canada, the UK, an(d) most of the industrialized world have..." <br /><br />No we haven't. The increase from 90% to 95% insured (U.S. Census Bureau) or 94% to 96% insured (state) or 96% to 98% insured (Urban Institute)--take your pick; none are statistically significant -- is totally "tax- financed" just as in the UK and the Canadian provinces.<br /><br />Thanks<br /><br />Dennis<br /><br />(I took out the adjectives "unAmerican" and "socialist" because I assume you were just having fun with some conservative friend. <br /><br />And -- like you -- I have also been part of an HMO for 25 years and am very satisfied. The problem is that government policy is forcing me out it. And forcing me onto the Connector, which is the only "public institution" I can think of when you talk about "a mixture of public and private institutions." What other public institution did you mean?)Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-7476621888383604834.post-81326800979114246282011-01-06T08:02:13.847-05:002011-01-06T08:02:13.847-05:00Hi Dennis -
Thank you for your comment!
I'm ...Hi Dennis -<br /><br />Thank you for your comment!<br /><br />I'm not sure I understand your point about how we account for taxes. But I agree that "insurance premium increase are hidden taxes," in that if we believe that ensuring access to a decent level of health care is an obligation for a civilized society, choosing to provide it in large part through commercial insurance is analagous to providing it through an explicit tax.<br /><br />It's too early to see what the Cameron government proposals will mean in the UK. But since the Thatcher "reforms" the UK has actually retreated from her strong market ambitions. And surveys in other industrialized countries consistently show higher public satisfaction with their health system than we do, as well as equal or superior overall results.<br /><br />I don't agree that the Connector is the source of runaway costs in Massachusetts. We were solidly on that path before the Massachusetts reform plan. But you're certainly right that nothing so far has helped with the cost problem. If the state isn't able to get a grip on costs, we'll either go in the direction you recommend, putting more of the financial responsibility directly on "consumers," or in the direction Vermont is exploring, of a state-based single payer system.<br /><br />Best<br /><br />JimJim Sabinhttps://www.blogger.com/profile/03087828142188534542noreply@blogger.comtag:blogger.com,1999:blog-7476621888383604834.post-39144898220861145922011-01-05T20:39:40.406-05:002011-01-05T20:39:40.406-05:00You say:
"Massachusetts has demonstrated tha...You say:<br /><br />"Massachusetts has demonstrated that a population can be (almost) fully insured without resorting to the "un American," "socialist" forms of tax financed methods that Canada, the UK, an most of the industrialized world have applied effectively. But it hasn't shown that our mixture of private and public institutions can function without cancerous destruction of the economy." <br /><br /><br />How do you figure the first part of your conclusion? The huge Massachusetts state budget shortfall and problems at the munincipal level come from taxes. We just don't account for ours the same way they do in the UK and the Canadian provinces. And the insurance premium increases are hidden taxes. So what does "appled effectively" mean? The UK is already changing its system under the new government to be more like ours used to be and Canada will likely move back after its current funding law expires (next year I think). <br /><br />As for the second sentence, it is only the new failed public institutions in Massachusetts -- such as the Connector -- that has caused the problem. Go back to a free market.<br /><br />-- Dennis ByronAnonymousnoreply@blogger.com