Obamacare Will Bring Britain's Health-Care Problems To U.S.

For years I have been writing about the failures of the United Kingdom’s National Health Service as a warning for what the Affordable Care Act will do to health care here in the U.S.

London’s Daily Mail has chronicled the problems with the NHS, which include declining quality of care and availability of services coupled with increased costs. This is what is in store for us, if Congress does not repeal Obamacare.

According to the Daily Mail, “NHS hospitals are recruiting Spanish and Portuguese nurses in record numbers while British applicants are being refused because places on training courses have been slashed to cut costs.” More than 5,000 student nurse places, it writes, “have been axed since the General Election.” The reason? Foreign nurses cost less. Incredibly, they won’t be checked to see if they can speak English. The potential for confusion over medication and treatment because of language differences could be significant.

Another Daily Mail story is about Stewart Fleming, a man with severe stomach pains who waited six hours in a hospital cubicle because, said Andrew Horne, chief executive of Medway NHS Foundation Trust, “that evening was very busy; the hospital was full.” The 37-year-old father of two died.

The Daily Mirror reports that at Stafford Hospital in Staffordshire, 1,200 patients died over a four-year period. No one has been held accountable, but the person in charge of the health authority for part of that time, Sir David Nicholson, was promoted and for two years headed the entire NHS at a substantially higher salary.

In a cruel irony, Donald Berwick, the former U.S. Medicare administrator, who has said, “The decision is not whether or not we will ration care — the decision is whether we will ration with our eyes open,” now heads a committee tasked with preventing the NHS from causing harm to patients. That’s easy: get rid of the NHS.

A 2010 column by the Daily Telegraph’s Janet Daley ran with the headline, “Copying the NHS is the last thing the U.S. should do.” She called instead for a “combination of state provision and private contribution” for health care.

The NHS should have been a lesson for the United States. After promising that Obamacare would not raise insurance costs, we are now seeing the reality. Daniel P. Kessler, a Stanford University professor of law and business, recently noted in The Wall Street Journal, “Despite what you read, premiums in Oregon and California are going up, especially for the young.” Other states, should they participate (and many say they won’t ) will inevitably have the same experience.

The Internal Revenue Service, which will enforce Obamacare’s individual and employer mandates, announced in February, according to CNSNews.com, that the “cheapest health-insurance plan available in 2016 for a family will cost $20,000.”

CNBC, citing a survey released by InsuranceQuotes.com, a company that allows people to compare insurance rates, recently reported that 64 percent of uninsured adults say they haven’t decided if they will buy insurance by the Jan. 1, 2014, deadline.

What happens here if people begin to experience long waits for treatment, higher costs, fewer doctors and nurses whose English is poor? Will they rebel or passively accept an unworkable system?

Two friends who live in a retirement community in Washington recently told me of a change in their nursing staff. The majority are now from West Africa. This change, they say, has made many residents uncomfortable and uncertain whether the nurses are competent enough to provide the quality of care they have come to expect.

During the Depression and the rise of fascism in Europe, Sinclair Lewis wrote the novel It Can’t Happen Here. It was his warning about how fragile democracy is and how easily it can be replaced by dictatorship. Obamacare has the potential for becoming a type of dictatorship.

The negative consequences from the NHS can happen here, and they are on the way, unless Republicans win enough congressional seats next year and then vote to replace Obamacare.

Cal Thomas writes for Tribune Media Services.

tmseditors@tribune.com

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Aging Populations Pose Global Entitlement Problems

 Highlight transcript below to create clipTranscript:  Print  |  Email Go  Click text to jump within videoWed 20 Mar 13 | 06:43 AM ET Marko Mrsnik, S&P analyst, reveals the results of a new study that shows over the long-term, current policies for aging care are not sustainable.

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Three Problems Contributing To Americans’ Sky High Medical Bills — And Three Ways To Fix Them

This week’s issue of Time Magazine takes a deep dive into Americans’ medical bills and the roots of the U.S. health care industry’s rampant inflation — costs that force one in four American seniors into bankruptcy and over one in three Americans to forgo care.

The investigative piece highlights the exorbitant costs of the most commonplace procedures and medications, and how insurance coverage often falls through for Americans who encounter unaffordable out-of-pocket costs due to the rising price of health care technology and services. Furthermore, it is often impossible for patients to ascertain why they are being charged what they are for care — a pricing opacity that is truly unique to the service-centered health care industry. Here are the three biggest takeaways from the Time exposé on the unsustainable foundations of American health care costs — and some ideas for shifting the U.S. medical landscape towards a more equitable system:

The indefensible costs of medical testing, technology, and drugs. Much of the report focuses on the costs of receiving basic care and testing, such as diabetes tests, drawing blood samples, or even taking plain old Tylenol — which one hospital in the report marked up to $1.50 per pill, approximately 100 times its general market price, for a cancer patient. Hospitals are largely able to get away with this because they are, as the article puts it, “sellers in what is the ultimate seller’s market,” so device manufacturers, pharmaceutical companies, and hospital chains — even technically “nonprofit” ones — are free to run up the tabs on Americans’ care. Use market competition and price negotiations to lower costs. In its Senior Protection Plan, the Center for American Progress (CAP) advocates tying relatively low Medicare drug rebates to more generous Medicaid drug rebates, and enforcing competitive bidding for all health care products in both the public and private sectors, as well as intrastate price negotiations in the private medical sector that constrains annual spending to a predesignated cap. All told, such reforms would reduce American health care spending by at least $180 billion.People usually don’t know why they get charged what they do for care. It’s a common mantra among health care reform advocates — America doesn’t have a health care system, it has a sick care system. Services are charged after the fact, often in the form a hefty, inscrutable bill that tells patients very little about why they are being asked to pay tens of thousands of dollars in order to receive care that can mean the difference between life and death. This opacity allows providers to get away with jacking up the price of services even as medical technology makes huge strides — which should theoretically lower costs. One GAO report states that “the lack of price transparency and the substantial variation in amounts hospitals pay for some IMD [implantable medical devices] raise questions about whether hospitals are achieving the best prices possible.”Make hospitals issue easily understandable receipts for all health care services.This is a relatively simple fix that would help facilitate further cost reductions by rooting price negotiations in easily-available, verifiable, and uniform data. As the CAP health policy team’s Topher Spiro states in an email to ThinkProgress, “We propose full price transparency—so it wouldn’t take a seven month investigation by a reporter to find out what prices are being charged.” The best possible outcome would be for hospitals and insurers to provide a comprehensive list of services to all patients and beneficiaries that let Americans know exactly how much a particular disease treatment or procedure will cost them.Americans get care at expensive hospital chains that don’t necessarily provide the best service. As Time’s article points out, national and multi-national hospital chains rule the American medical industry — but that doesn’t mean they provide the cheapest, highest quality, or most efficient care. For instance, at the Texas giant MD Anderson, hospital administrators charged Sean Recchi over ten times as much for a chest x-ray as they would have been reimbursed by Medicare, which is required by law to approximate the price of services rendered. Why? Because Sean Recchi had subpar private insurance, and MD Anderson could get away with it.Encourage patients to visit high-performing hospitals with insurance incentives. Americans might believe that such hospitals are their only recourse — but that doesn’t have to be true. One approach to encouraging providers to provide more efficient, quality, and affordable care would be the creation of tiered insurance plans that reward patients — through lower premiums and deductibles — who use low-cost, high-quality hospitals for their care instead of the highest-cost brand name hospitals.

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Clinton: America’s Debt Problems ‘Can’t Be Solved’ With Austerity

Former president Bill Clinton urged House Democrats to avoid the push for immediate austerity at a party retreat in Virginia today, pointing to Europe’s failed deficit-cutting experiment that has led to further economic malaise instead of prosperity.

The American economy, bolstered by a major stimulus bill in 2009, has slowly recovered from the Great Recession, but unemployment remains high and growth slower than it should be. The U.S. has already cut more than $2.5 trillion from future deficits, but with the automatic spending cuts brought about by the 2011 debt ceiling deal fast approaching, Clinton pushed Democrats to avoid calls for “conventional austerity measures”:

The debt problem can’t be solved right now by conventional austerity measures, and that’s why Paul Krugman is right when he keeps talking about all these — everybody that’s tried austerity in a time of no growth has wound up cutting revenues even more than they cut spending because you just get into the downward spiral and drag the country back into recession.

Watch:

European countries that have attempted to spur growth by rapidly reducing their deficits have failed to accomplish either goal and have instead driven their economies back into recession. The United Kingdom’s deficit has hardly gotten smaller despite its austerity efforts and the country is on the verge of a triple-dip recession. Greece and Spain both have unemployment rates above 25 percent. Even Germany, Europe’s largest economy, is on the brink of another recession. The Eurozone as a whole slipped back into recession in November and its unemployment rate is at record highs.

Still, politicians in the United States have failed to heed Europe’s warnings, pursuing deficit reduction instead of job growth. Republicans blocked the American Jobs Act, which economists estimated would have spurred growth and created more than a million jobs, and have instead pursued damaging budget cuts that would have the opposite effect even amid evidence that the original American push for stimulus worked better than the European approach.

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