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Posted at 12:00 AM ET, 11/29/2010

Fan dance

By Tom Toles

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Say ahhh
How come so little of the debate is about why our health care costs, like, TWICE what it does in other industrialized countries, without better outcomes? Huh? Why is that? Lotsa talk about the big debt looming, not so much about how health-care costs are the driver. MUCH grumbling about COVERING PEOPLE who don't deserve to be covered and deserve to get sick and die or drive up costs even further by not getting pre-crisis care and ending up in emergency rooms where they cost even MORE before they die as they so thoroughly deserve, but that's about the level of focus on this particular public policy issue.

Much head-shaking and consternation about how your run-of-the-mill GOVERNMENT employee is so outrageously overpaid, to say nothing about if s/he happens to be a teacher. No END of teeth-gnashing about that. But health providers here spending DOUBLE what they do everywhere else with no better outcomes to show for it? Well, the crickets are busy discussing it, anyway. --Tom Toles
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By Tom Toles  | November 29, 2010; 12:00 AM ET
Categories:  Environment & global warming  
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Comments

You hit the nail directly on the head. Arguing about who is or isn't covered is just obfuscation. Why does health care cost at least twice as much in the US as any other place? Follow the money!

Posted by: Tengle1 | November 30, 2010 5:16 PM | Report abuse

It isn't all about tort reform, but it IS (again) about insurance cost/profit.

Why is it that, the rates charged by insurance companies for malpractice are so much higher that what can be justified by claims paid? Like with private health insurance, BECAUSE THEY CAN.

Most health care professionals are fine with single-payer. Again, it is the insurance companies that have the vested interest.

Insurance is the place to be. No question.

Posted by: jonroesler | November 29, 2010 4:43 PM | Report abuse

Of what value will it be to gain wealth and power when our children and grandchildren will suffer and curse our decisions. Problems can only be solved if we recognize their existence.

Al Gore admitted this past week he made an error about biofuels, which proves you can't be wrong all of the time. Al Gore said it was foolish (fuelish) to use corn for ethanol.

Food prices have skyrocketed all over the world, and with the Fed printing money as fast as it can, it will cause even greater inflation and even higher food prices.

Corn is being subsidized by farm subsidy tax dollars, both for ethanol and High Fructose Corn Syrup, which go to ADM and other huge agricultural businesses.

Posted by: alance | November 29, 2010 4:00 PM | Report abuse

Simple Fact:
Too little/too late.

Exponential growth of the human population is PAST the "point of no return", as the saying goes.

No matter WHAT some of us attempt to do to stave off environmental disasters and very bloody conflict . . . . it is too late.

Sad that certain world leaders have consistently failed to recognize the danger of the population bomb, and have indeed, facilitated it (read Vatican Dark Age biological ignorance).

Glad I'll be dead before long (I'm 82) so I won't see my few grand-kids suffer.

Posted by: lufrank1 | November 29, 2010 3:55 PM | Report abuse

Obama and the Democratics Congress had what was perhaps the best and last opportunity to provide real health care reform with cost containment, but blew it by not even attempting to include a public option plan. Claims that further improvements could be added at a later date incrementally was just pie-in-the-sky projection. The corporations won, and we continue to pay higher premiums for less coverage.

Posted by: alexnyc8 | November 29, 2010 3:25 PM | Report abuse

While I agree our health system is messed up we need to look at the root cause and have intellectual honesty.

Middle class and upper class people who have health care paid for by their employers are in fact living linger than our European and Canadian counterparts under socialized medicine; those hurt by our system are the uninsured and poor who die far to early.

For instance the life expectancy of a white male in the DC area is 83.1 years while Japan ranks #1 for a country with men living to an average of 79. This shows my local health care is superior to that of Japan's national system. Also studies prove weight is less of a factor than wealth.

So what we need is a solution that keeps up the quality of our system, reduces cost, and covers all.

Tort reform is a big help in all the other systems out there, it could shave 2% of the GDP spending on health care according to the CBO. Connected to tort reform is the real money hog in th4e system, over testing. Doctors over test for 2 reasons: 1) The pay per test system medicare created, they docs and hospitals are being shorted money by the system so they order useless tests and operations to get more money to care for those on medicare. 2) Without tort reform doctors fear legal action if they miss anything so they order test after test to cover their butts.

Posted by: flonzy1 | November 29, 2010 3:18 PM | Report abuse

Preventitive medicine is being ignored and we are being inundated with diabetes and obesity. More than half of Americans will have diabetes or be prediabetic by 2020 at a cost to the U.S. health care system of $3.35 trillion if current trends go on unabated.

High Fructose Corn Syrup is in nearly everything we eat or drink. Soft drinks are poison, including the ones with Aspartame.

We need to outlaw these dangerous substances causing diabetes, heart disease and cancer.

Posted by: alance | November 29, 2010 3:12 PM | Report abuse

The FACT of global warming is irrefudible (to use an invented word that Sarah Palin might understand).

There are two relevant questions:

1) Can humans do anything to stop global warming? and

2) If the answer to 1) is "no", can humans, at least, prepare for global warming?

The answer to both questions is a resounding "no." In fact, the average human has an intellect not very different from the intellect of a sheep.

Posted by: jjedif | November 29, 2010 3:10 PM | Report abuse

~~~The bertzel death panel! Maybe...we stop treating everyone's diseases and injuries to reduce population. Just throwing that out there. Of course, we still end up paying too much for little or no health care. Well, I'd be dead. But you know what I mean.
Posted by: ptgrunner~~~

Lol, ptgrunner, you make me laugh.

Seriously tho, if you think about it,with all the advances in science..why has a cure for cancer been soooo slooowww in the making?
All the money is spent on the newest, best technology involving equipment used for treatment... yet no cure.
When a possible cure is close at hand for any debilitating/death sentence type of disease and worth exploring we have people crying that the positive means to that end would be immoral.
I certainly am not suggesting we stop treating injuries and diseases. I do question why some diseases are still incurable.
Bottom line is money, money, money and profit, profit, profit....no, it should not be that way.
When Drs. are told to see x number of patients per day and must herd their patients thru like cattle, well, you get the picture. Cost up service down.
And again...we can't all live forever now, at least not on this little speck of a planet!

Why would anyone invent a lightbulb that never burned out? What would the profit be in that?

Posted by: bertzel | November 29, 2010 3:05 PM | Report abuse

The problems our Earth face will not go away through denial, avoidance or subterfuge. We face multiple herculean issues that are global in their magnitude. Of what value will it be to gain wealth and power when our children and grandchildren will suffer and curse our decisions. Problems can only be solved if we recognize their existence and work together to correct what we can and mitigate what we cannot solve.

Posted by: MyVoice3 | November 29, 2010 2:24 PM | Report abuse

TWICE what it does in other industrialized countries, assuming we are still industrialized. The only way to achieve this is euro-style healthcare. The best chance for this happening was lost by Obama and Pelosi. The socialist label tends to make this impossible, now. Obama kicked the progressives under the bus and healthcare will be 20 percent GDP forever.

The global warmers are all getting their fat cans down to Cancun in sunny Mexico to try and give us more climate-scare. Obama wants to print billions to giveaway to other nations to prevent something that doesn't exist and commit our nation to poverty with inflation and foreclosure.

Posted by: alance | November 29, 2010 2:21 PM | Report abuse

If we had a cure for say…cancer…our population levels would be ridiculously high…just throwin’ that out there.
Posted by: bertzel | November 29, 2010 10:35 AM
-----------------------------------------------
The bertzel death panel! Maybe...we stop treating everyone's diseases and injuries to reduce population. Just throwing that out there. Of course, we still end up paying too much for little or no health care. Well, I'd be dead. But you know what I mean.

Posted by: ptgrunner | November 29, 2010 2:02 PM | Report abuse

"It's a version of 'inverted' socialism, is what we really have here." by jonroesler

Yes there is a name for it. We're not allowed to say it because it's another of those things that we all know but agree to never discuss. Better to let the USA fade away than to have an honest discussion, I guess.

Listen to the modern day developer of this type of inverted-socialist government:

"Fascism should rightly be called Corporatism, as it is the merger of corporate and government power." - Benito Mussolini

You can't get any clearer than that.


Posted by: queraro1 | November 29, 2010 1:12 PM | Report abuse

Something else funny:
In a genuinely competitive health market, additional providers (supply) being present should tend to drive prices down because per capita demand would be lower and providers would need to reduce prices in order to attract business, right? But not in the U.S.

The reality is that, time after time, the more suppliers of a particular part of the health market exist in a locale, the HIGHER prices tend to be. More providers means fewer patients, and fewer patients means providers must and do charge MORE per patient in order to maintain their income at a given level.

The laws of supply and demand work fine in a free market, but that is NOT what we have operating here. It is also not Socialism, at least not a form of socialism run for the benefit of the public. I'm not sure there's a label, yet, for the way we Americans socialize risks while privatizing profit... at our own expense and to our own detriment.

It's a version of 'inverted' socialism, is what we really have here.

Posted by: jonroesler | November 29, 2010 12:43 PM | Report abuse

Kinda seems like health care is found in the nebulous area between the private and public sectors. The public can't really touch the costs because government provides protection of the profits of existing providers, yet private competition can't really touch the costs because there is no incentive to reduce them. As long as we are willing to pay exhorbitant costs to socialize the risk of providing health care while ensuring profits for private companies, private companies will be willing to accept our help.

The current "private" insurance system is basically forced Socialism (the only choice is to go without) with guaranteed profits to the ones who got there first, and we've just got to suck it up and deal with it. Right? Our public servants in Congress aren't going to change it in any hurry.

Besides... Lok at the WAY health care is delivered in other industrialized countries. Their hospitals have wards, while ours have private rooms (and we must protect privacy, mustn't we?). Their hospitals and doctors use dated (though perfectly adequate) equipment, while ours have nothing but the latest and greatest.

Apparently, enough of us are satisfied by the status quo not to want to force our public servants (i.e. Congress) to go "too far." Hell, we're already complaining that they've done precisely that.

We'll figure it out eventually, or we won't.

Posted by: jonroesler | November 29, 2010 11:49 AM | Report abuse

Since Congress is owned by the Health "Care" Insurers, they don't want you to know the real costs. As long as their profits rise, they would rather kill off the ill and elderly. More money for them (and the members of Congress they own).

Posted by: pjohn2 | November 29, 2010 11:02 AM | Report abuse

PrairieDog wrote: "So, a question for private sector employees. Do you think you deserve a raise for working hard? Especially after not having any sort of raise...not even cost of living...for a couple years? Well then, why don't I deserve such a raise too? I work just as hard as you do. But instead you seem to think my salary needs to be cut more, and my benefits too. And no more spending on any tools I may need to do my job the best I can."
------------------------------------------
It is difficult deserve an additional raise prairiedog when raises are already built into the grade/step system.

And besides, you enter into the fed job knowing that you are trading away moolah for job security.

You want both? Sorry hoss. It is your choice to work for the feds (or the state or the locals).

Besides, i have worked alongside feds for over 27 years and it is SO easy to pick out a fed versus a contractor. Here are some easy signs to look for:
1. the contractor works weekends and evenings when required whereas the fed takes off regularly (it helps that the fed has significantly more leave than a contractor)
2. the contractor's screen has excel on it while the fed's screen has today's suduko
3. the fed is sick several times a month while the contractor is sick once or twice a year

on average i would think it takes about four or five feds to do the work of one contractor, which is why contracting is booming. People who make the decisions may not want to say it but that is the driving force. If a particular contractor turns out to be a bad egg, it is easy to can him. if it's a fed, forget about it.

Posted by: bryanmcoleman | November 29, 2010 11:01 AM | Report abuse

How about measures like this: once you are diagnosed with a certain disease or condition what is your life expectancy from that point?

To my knowledge, the USA has, by far, the best measures for the above type outcomes. That is why people come here from all over the world when their life is on the line.

There are problems with our health care system. Ironically, outcomes is not one of them.

Posted by: scott3 | November 29, 2010 9:30 AM | Report abuse

Where does this knowledge come from?

I realize we do have some of the best doctors and hospitals and people who can afford it from all over the world do come here for treatment, but I don't think that, for the average American this "diagnosed/life expectancy" ratio is likely any higher than in other developed countries.

Also, does this include people who are not diagnosed with some disease or condition until they visit an ER? Even if those people's lives are saved and they live a long life afterwards, did it cost more because they didn't treat the symptoms earlier due to lack of ability to pay for preventive care? How many strokes or heart attacks, and the subsequent expensive ER visits, could have been avoided by a doctor telling a patient "Hey, your blood pressure is high. Here's a pill, and watch what you eat"?

Posted by: jhnnywalkr | November 29, 2010 10:46 AM | Report abuse

~~~So, a question for private sector employees. Do you think you deserve a raise for working hard? Especially after not having any sort of raise...not even cost of living...for a couple years? Well then, why don't I deserve such a raise too? I work just as hard as you do. But instead you seem to think my salary needs to be cut more, and my benefits too. And no more spending on any tools I may need to do my job the best I can.~~~

Private sector workers are not getting raises either. Their jobs are being elimanted or cut back too....so what is your point dog?
by the way, how are your bennies?
Government workers were always 'taken care of'...just sayin'.

Posted by: bertzel | November 29, 2010 10:45 AM | Report abuse

I’ll take your bait Capn0ok…
What do you mean by Inconvenience? We are already changing the way we live, sure it is evolving slowly, yet evolving none the less. We are moving towards alternative resources and that trend will continue. It is the only logical step to follow.

As for your environmental disaster; are you suggesting worldwide or local? Worldwide disaster would have major implications which we would have to adapt to and living like the Amish (I’m assuming you refer to lack of electricity and use of cars for transportation…even tho they do rely on others for car transport and I believe some even use generators) would most likely be the way of ‘survival’ for a time…for the majority of the survivors…I’m sure the few, the proud and the select, will be living a bit differently.

As for religion…

~~~How come so little of the debate is about why our health care costs, like, TWICE what it does in other industrialized countries, without better outcomes? TOLES~~~~

I’m guessing that Money and Profit has quite a bit to do with that.

Also, by not finding a cure for something like…cancer…the money still flows And the populace continues to ‘die off’.

If we had a cure for say…cancer…our population levels would be ridiculously high…just throwin’ that out there.

Posted by: bertzel | November 29, 2010 10:35 AM | Report abuse

Hey TT, thanks for the good toon today, and the great comment. Ditto on what people have said here about health care. The right-wing echo chamber succeeded in keeping Dems from talking about that bill's benefits and what it's already done, in addition to what it will do. Not perfect by any means, but the Dems ran from it like it was poison. Which baffles my mind since the majority of Americans like most of the provisions in the bill.

Thanks also for the comments about government employees. I'm a state gov worker, with two degrees and about 12 years experience in my current field. I gross a whopping $42,000 a year, and thanks to budget cuts and other things, am making less now than I was two years ago. No one I know is getting rich doing this kind of work. Yes some salaries at the highest level may be in the six figure area, but there's none of that for people in my neighborhood.

So, a question for private sector employees. Do you think you deserve a raise for working hard? Especially after not having any sort of raise...not even cost of living...for a couple years? Well then, why don't I deserve such a raise too? I work just as hard as you do. But instead you seem to think my salary needs to be cut more, and my benefits too. And no more spending on any tools I may need to do my job the best I can.

So to all those "shrink government to the point where it can be drowned in a bathtub" types, I say thanks for your warm and loving Christian thoughts towards me and my family.

Posted by: PrairieDog60 | November 29, 2010 10:10 AM | Report abuse

fostersm1,

How about measures like this: once you are diagnosed with a certain disease or condition what is your life expectancy from that point?

To my knowledge, the USA has, by far, the best measures for the above type outcomes. That is why people come here from all over the world when their life is on the line.

There are problems with our health care system. Ironically, outcomes is not one of them.

Posted by: scott3 | November 29, 2010 9:30 AM | Report abuse

Even if they are at least partially responsible, and could do something about it, humans will never inconvenience themselves in any way to preserve the environment that sustains them. Nothing will change until and unless an environmental disaster thins their numbers. If a disaster does happen, people will ascribe it to divine retribution for failure to adhere to ritual with sufficient strictness, or inadequate hostility towards those they perceive as the enemies of their religion. Don’t believe me. Look at the history of Easter Island.
Of course, there is the possibility that fossil fuels will be exhausted before any disastrous “tipping point” is reached. In this case, the resources will be inadequate to maintain current population levels. In which case, everybody left should have been paying attention to the way the Amish live.

Posted by: Capn0ok | November 29, 2010 8:52 AM | Report abuse

Mr. Toles:

Hope you have a good week. Nice drawing today.

Posted by: GaryEMasters | November 29, 2010 8:47 AM | Report abuse

The warmers will probably be using fans down in Cancun at the start of the big UN Man Made Global Warming Convention (AKA Socialists Redistribution of World Wealth Shakedown) today well at least it will be warmer there than the arctic conditions in Copenhagen last year.

Posted by: billybeer6 | November 29, 2010 6:08 AM | Report abuse

I agree with all who have so far posted about this country's inefficient health system. (I won't even dignify it by call it a health care system--care is not even a close second). We have some other drivers of cost which deserve mention.

First, with a nod to Murrow, the fault, dear Brutus, is not in our stars but in ourselves. We are of the fixed delusion newer is better. Even limiting ourselves to one disease, prostate cancer, we can tick off several expensive approaches of unproven benefit: Provenge, proton beam therapy, PSA testing. We jump at the next new thing with a mind boggling avidity.

Next, there is no common understanding of what information should be collected by a provider about a patient before care is rendered. We treat the squeaky wheels and forget the patient. When is the last time the doctor asked you what you want? Ignorance is expensive.

I will not pile on about insurance companies although the deserve our rancor. Malpractice insurance and defensive medicine add to the mix as well.

We can do better and we deserve better. Write your congressman (unless he's in the pocket of the health care lobby--oh, wait, they all are--never mind...)

Posted by: DougMUSN | November 29, 2010 5:51 AM | Report abuse


I have posted this already here before You guys should stop complaining because, one the health care we have now isnt as good as it was supposed to be. also the law has just been signed so give it some time. so if u want to say u have the right to choose tell that to ur congress men or state official. If you do not have insurance and need one You can find full medical coverage at the lowest price check http://ow.ly/3akSX .If you have health insurance and do not care about cost just be happy about it and believe me you are not going to loose anything!

Posted by: williepayne | November 29, 2010 12:26 AM | Report abuse

Thank you Mr. Toles for bringing up health care reform. The media has done a terrible job overall of educating the public about healthcare reform - like the fact you mentioned: every other industrialized nation spends about half as much as we do, cover everyone and have as good or better medical outcomes as we do (WHO, The Commonwealth Fund). These are facts, not spin. Perhaps some of your colleagues at the WP will start doing some reporting on this crisis and not let up to go on to the next "fad". As T.R. Reid said in his book, Healing of America, - no other nation lets it fellow citizens suffer and die from lack of health care but we tolerate it here in the U.S. Sadly, we all would be spending far less and get better medical care if we had a national health insurance program. Single payer would be the most efficient but at this point I would settle for a German or Swiss model. The for-profit health plans have to get out of our healthcare system. They do nothing but take our money and get in the way of our healthcare. I know - I'm a doctor and a patient so I get it coming and going. Health plans don't deliver the care and they don't raise money independent of our premiums to help pay for care. They are unnecessary, destructive middlemen. They need to stick with auto, life, home insurance and get out of health insurance. The media has dropped the ball on this issue time and time again. They get facts wrong and they don't check out their sources to make sure they aren't paid operatives for the health insurance industry. It's as if they want to stay ignorant too so they don't bother to do their job of keeping the public informed of accurate information so they can be educated voters. You, on the other hand, are in the mold of Edward R. Murrow and Walter Cronkite - presenting facts even if they are unpopular. Keep it up and try to get some of your colleagues to step up to the plate on this issue. Our health system is imploding and soon it won't matter if you do have health insurance because the system is being weakened daily by the abuses of the for-profit health plans that will always put profit ahead of people. Thank you for speaking out.

Posted by: chrzcatt | November 28, 2010 11:33 PM | Report abuse

thank you, mr. toles, for a reasonable (though overly capitalized) synopsis of the missing debate on health care provision in this country.

someday, someone will speak intelligently on the absence of "socialised medicine" in the health care bill and that there is no government takeover of health care, as the shrillest naysayers continue to espouse. collectively, we have ignored a basic question: is basic health care a right or a privilege.

to fostersm1, apparently any form of elective cosmetic surgery would fill the bill for those who think that corporate, for-profit, health care can't be measured by traditional success outcomes.

Posted by: mary_ellen | November 28, 2010 9:59 PM | Report abuse

All my teachers were clearly in it for the money. They all drove Porsches and took home huge bonuses.

Those overpaid gov't civil engineers, too! It's a widely spread liberal myth that civil engineers are low paid! In engineering school all my friends want to become civil and transportation engineers for the money! They're leaving financial engineering and its wall street salaries in droves for gov't civil engineering positions!!!

All joking aside, the belief that gov't employees are overpaid is patently absurd. Nobody goes into gov't work for the money. Unless it's to become lobbyists later....

Posted by: will12 | November 28, 2010 9:22 PM | Report abuse

I have mentioned the discrepancy in health care costs versus outcomes in a couple of other forums, but someone always manages to mumble something about infant mortality rates, life expectancies, and maternal outcomes not being the "best" indicators of a country's health care achievements. I don't know what else would be--number of successful face lifts?

Posted by: fostersm1 | November 28, 2010 8:56 PM | Report abuse

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