Health Care for persons in this country illegally.

What should we do about providing health care for people in this country illegally?

On the one hand, persons here illegally may put a strain on the system (I say “may” because ironically, many illegals do pay taxes).

On the other hand, to ignore the health needs of a large group of people has public health implications- diseases may spread within that population and then affect “the rest of us”:

  • tuberculosis
  • HIV
  • flu and related conditions

Also, for the purposes of this question, please assume that “sending all illegals back home” would take years, so we still have to deal with the issue, at least temporarily.

So here is the question- please select only one answer:

Until the day when there are no illegals, should persons in this country illegally have access to the health care system?

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Fourteen Zeroes!

Part 1- the problem.

If you look at our present level of health care spending ($2.6 Trillion), and project it forward, growing at 6% annually for the next 20 years, the total exceeds $100 Trillion.

That’s 14 Zeroes:

  • Just for health care
  • Just in America
  • Just for the next 20 years (if we look at 30 years, the number is over $200 Trillion).

That number is incomprehensible.  Not only is it not sustainable, it is not even possible to finance this number.  Yet, that is the path that we are on.

The present discussion aims to “bend the cost curve” and to somehow shift the burden:

  • Blame the insurers
  • Blame the pharmaceutical companies
  • Reduce provider reimbursement
  • Limit what Medicare pays on behalf of seniors.

Whomever we choose to blame, we are clearly headed for a scenario where we all  work our entire lives just to pay for health care, and when we get old, all of our assets, if there are any left, get paid over to our huge, for-profit health system.

We must fundamentally restructure our health care system, and our expectations of living and of dying, or life will become one long health-care payment treadmill.

Part 2- the discussion.  Please answer the following questions. One answer per question:

What is the responsibility of consumers (the system calls us "patients")?

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What is the responsibility of insurers?

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What is the responsibility of the government?

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What is the responsibility of providers (doctors and hospitals)?

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What is the responsibility of suppliers (pharmaceutical companies and device manufacturers)?

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Now, please consider all of the answers you provided.

What do your answers, taken together, mean for the 14 zeroes in our future?  Something to think about…

Is “bending the health care cost curve” enough, or do we need to do more?

All over the country, people, companies and entire sectors of the economy are experiencing, or will soon experience, drastic cuts.

  • benefits of unionized employees significantly reduced
  • layoffs
  • salary freezes and reductions
  • reductions in state provided services

Yet, in the health care industry, we talk about “bending the cost curve”, which means a reduction in the rate if increase, say, from 6% annual growth to 4% annual growth.

Why is health care exempt from the drastic cuts being made almost everywhere else? (In fact, it is health care costs more than anything else that is forcing states to the brink of bankruptcy).

So is bending the cost curve enough? What do you think?

Is "bending the health care cost curve" enough, or do we need to do more?

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Should our health care system be a for-profit system?

Some have said it is the profit motive that is at the core of our health system’s problems:

  • Insurers need to provide profits to their shareholders
  • Hospitals and hospital systems need to provide profits to their shareholders
  • Physicians perform tests with their own economic interests in mind
  • Pharmaceutical companies and device manufacturers charge too much

A system that is not designed for profit might look as follows:

  • A single payer health system
  • All hospitals should be not-for-profit
  • All physicians should be employees, and their employers should be not-for profit
  • Pharmaceuticals, devices and supplies should be subject to price regulation

What do you think?  Please select only one response.

Should the profit motive be removed from our health care system?

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Introduction

We are headed for difficult times in this country.

Over the past 50-60 years, the economic pie has been growing. This has made possible a number of positive social changes, such as Medicare, Social Security, Civil Rights and Women’s Rights.  When our situation is getting better, it is easy to share a little with those who have less.

We are now entering a period where the economic pie is shrinking, or at least perceived to be shrinking. What we now see is an unwillingness to share- in fact, many want to reduce or eliminate some of the social programs that have been introduced over the past half century.

I am not arguing that this is either good or bad. I am asking “how do we get there?” How do we reduce the costs of health care in a way that is fair? Who pays? Who sacrifices?

This is what this blog is about.

Further, it is not just about what I think. Over time, this blog will make available a discussion forum and brief surveys (polls) so the readers, you, can make your opinions known, hopefully with a minimum of partisan politics.

I hope you will participate, and that you find this blog and related forums and polls to be useful, timely and engaging.

Steven Yergan, CEO, Health Tactics