Nobody
According to Paul Ryan,Republican VP candidate,Medicare needs some competition in the form of private insurers to keep it from going bankrupt. I have not used Medicare yet,but I have plenty of experience with competitive insurance,and all I have seen is costs going through the roof. What do you think?
http://news.yahoo.com/paul-ryan-seniors-medicare-going-bankrupt-competition-answer-213737478.html
Some answers here suggest elimination of insurance,at least the government sponsored kind,would solve the cost problem. But many other countries have government sponsored health insurance plans with mandates and their costs are much lower than in the US. What gives? Why is the US in such a quandary about this issue? Are we really this dense,or is the problem so out of hand that it is unsolvable now?
Answer
The health care industry in the US is broken. Health care spending has risen from 5.2% of GDP in 1960 to 16% in 2007 and is still rising. Switzerland is 2nd, spending around 11% of GDP. No healthy industry behaves that way. A healthy industry that experiences high prices will draw additional suppliers, and high prices will encourage efficiency and consumer rationing. None of these things are happening in the health care industry today.
1) The US is aging. The baby boom generation and medical advances mean more older people, which means more chronic conditions that need more care. This causes demand to skyrocket, and basic economics tell us that raises prices.
2) Third party payment, wherein the average American uses insurance to pay for most of his medical costs, means that consumers have no cause to ration or search for alternatives to control costs. Every healthy industry is a balance of power between supplier and consumer that controls costs. Third party payment breaks this balance since both the supplier and consumer have incentive to over-spend. This is made even worse by the employer health care tax deduction which means it's really FOURTH party payment.
Making the employer deduction into an individual deduction instead would help this problem, but not solve it. MSAs (Medical Savings Accounts) would SIGNIFICANTLY improve the problem. Any such deal must be accompanied by short term spending to offset this as well as rules to make insurers unable to drop covered people who have been paying dutifully during good times (one of ObamaCare's few good parts).
3) Doctors, and other medical professionals, take a large investment of time and money to create. Economists would call this an inelastic supply. The American Association of Medical Colleges says we face a shortfall of more than 150,000 doctors over the next 15 years. Basic economics: supply shortages create higher prices. The average medical school graduate begins their career with more than $295,000 in debt. It is expensive and slow to make new doctors.
We can help this problem by changing immigration law to bias in favor of those with medical training and making our licensing requirements skills-based so that foreign doctors with the necessary skills, regardless of where they went to college, can come to the US and practice. This will increase supply and lower prices. We can also subsidize medical college for those who go on to practice in the US.
4) Foreign drug laws. Most foreign countries have price controls on drugs. This is why drugs are cheaper in Canada and Europe. It also is why we pay more. Because we, and we alone, are financing the R&D that has produced the amazing revolution of improved medical outcomes that has helped our society live longer as well as improving the quality of that life.
If we use simple price controls, we will be putting the genie back in the bottle. We will see a much slower rate of medical breakthroughs. It is a choice of priorities. We cannot have both...unless we can get foreign nations to pay their fair share.
5) Medicare, Medicaid, and soon ObamaCare all push prices up. ObamaCare will do it through a host of new regulatory costs and requirements. Most significantly, the rule forcing insurance companies to accept people regardless of pre-existing conditions ensures that people will not seek insurance until they are sick, which breaks the insurance business model and will result in bankruptcies.
Medicare and Medicaid stimulate demand. The government spends about HALF of all health care dollars, so any inefficiencies in these programs have MASSIVE effects. We almost certainly need a program to fill this need, but these programs are unlimited benefit programs that are riddled with waste, fraud, and abuse.
Even the states defraud these programs through a variety of schemes to bring federal dollars into the state. One famous example is doctors overcharge, and then "discover" the overcharge later and reimburse only the state, and pay a small penalty (the mob would call it a "piece of the action") to the state for their error. The doctors keep the federal overpayment, and the states tax them on the extra income and get the fee. Both profit at the expense of out of state taxpayers. When CMMS has tried to close this loophole, Congress has prevented them from doing so.
6) It would also greatly help if the states would embrace market reforms. Right now, most states have restrictive rules on the industry that raise costs such as licensing rules that prevent lesser trained, and therefore less expenseive, people perform tasks that are within their skill level. Many prohibit interstate competition which effectively creates less competition, and less competition means higher prices. There are dozens of small rules that have negative effects.
The health care industry in the US is broken. Health care spending has risen from 5.2% of GDP in 1960 to 16% in 2007 and is still rising. Switzerland is 2nd, spending around 11% of GDP. No healthy industry behaves that way. A healthy industry that experiences high prices will draw additional suppliers, and high prices will encourage efficiency and consumer rationing. None of these things are happening in the health care industry today.
1) The US is aging. The baby boom generation and medical advances mean more older people, which means more chronic conditions that need more care. This causes demand to skyrocket, and basic economics tell us that raises prices.
2) Third party payment, wherein the average American uses insurance to pay for most of his medical costs, means that consumers have no cause to ration or search for alternatives to control costs. Every healthy industry is a balance of power between supplier and consumer that controls costs. Third party payment breaks this balance since both the supplier and consumer have incentive to over-spend. This is made even worse by the employer health care tax deduction which means it's really FOURTH party payment.
Making the employer deduction into an individual deduction instead would help this problem, but not solve it. MSAs (Medical Savings Accounts) would SIGNIFICANTLY improve the problem. Any such deal must be accompanied by short term spending to offset this as well as rules to make insurers unable to drop covered people who have been paying dutifully during good times (one of ObamaCare's few good parts).
3) Doctors, and other medical professionals, take a large investment of time and money to create. Economists would call this an inelastic supply. The American Association of Medical Colleges says we face a shortfall of more than 150,000 doctors over the next 15 years. Basic economics: supply shortages create higher prices. The average medical school graduate begins their career with more than $295,000 in debt. It is expensive and slow to make new doctors.
We can help this problem by changing immigration law to bias in favor of those with medical training and making our licensing requirements skills-based so that foreign doctors with the necessary skills, regardless of where they went to college, can come to the US and practice. This will increase supply and lower prices. We can also subsidize medical college for those who go on to practice in the US.
4) Foreign drug laws. Most foreign countries have price controls on drugs. This is why drugs are cheaper in Canada and Europe. It also is why we pay more. Because we, and we alone, are financing the R&D that has produced the amazing revolution of improved medical outcomes that has helped our society live longer as well as improving the quality of that life.
If we use simple price controls, we will be putting the genie back in the bottle. We will see a much slower rate of medical breakthroughs. It is a choice of priorities. We cannot have both...unless we can get foreign nations to pay their fair share.
5) Medicare, Medicaid, and soon ObamaCare all push prices up. ObamaCare will do it through a host of new regulatory costs and requirements. Most significantly, the rule forcing insurance companies to accept people regardless of pre-existing conditions ensures that people will not seek insurance until they are sick, which breaks the insurance business model and will result in bankruptcies.
Medicare and Medicaid stimulate demand. The government spends about HALF of all health care dollars, so any inefficiencies in these programs have MASSIVE effects. We almost certainly need a program to fill this need, but these programs are unlimited benefit programs that are riddled with waste, fraud, and abuse.
Even the states defraud these programs through a variety of schemes to bring federal dollars into the state. One famous example is doctors overcharge, and then "discover" the overcharge later and reimburse only the state, and pay a small penalty (the mob would call it a "piece of the action") to the state for their error. The doctors keep the federal overpayment, and the states tax them on the extra income and get the fee. Both profit at the expense of out of state taxpayers. When CMMS has tried to close this loophole, Congress has prevented them from doing so.
6) It would also greatly help if the states would embrace market reforms. Right now, most states have restrictive rules on the industry that raise costs such as licensing rules that prevent lesser trained, and therefore less expenseive, people perform tasks that are within their skill level. Many prohibit interstate competition which effectively creates less competition, and less competition means higher prices. There are dozens of small rules that have negative effects.
do other countries care about 9/11?
Kenya
I don't know too much about other countries views on it? do they really care that much at all?
Answer
I am an Australian. We do care.
Americans were not the only ones to die in 9/11. There were hundreds of people from other countries that also died in those attacks that day.
I watched the second plane hit one of the towers live on my tv screen. I was orginally watching the news when they had a newsflash. It was in the middle of the night in Australia when the attacks happened. The news continued to cross live to New York for over 6 hours. When I went outside the following day. Not many people had heard what happened. I felt like I had just been asleep and had a nightmare. Yet I never went to sleep, I just watched the tv.
By the next day everyone was talking about the attacks.
God bless the innocent souls that died that day.
I am an Australian. We do care.
Americans were not the only ones to die in 9/11. There were hundreds of people from other countries that also died in those attacks that day.
I watched the second plane hit one of the towers live on my tv screen. I was orginally watching the news when they had a newsflash. It was in the middle of the night in Australia when the attacks happened. The news continued to cross live to New York for over 6 hours. When I went outside the following day. Not many people had heard what happened. I felt like I had just been asleep and had a nightmare. Yet I never went to sleep, I just watched the tv.
By the next day everyone was talking about the attacks.
God bless the innocent souls that died that day.
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