# Reformers' Claims Just Don't Add Up \[health care\] **URL:** \ **Category:** Great Debates\ **Created:** [July 20, 2009, 10:40am UTC](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607 "2009-07-20T10:40:02Z")\ **Posts on this page:** 20\ **Page:** 3
**Author:** ![PunkyPoo](https://avatars.discourse-cdn.com/v4/letter/p/6bbea6/32.png) [@PunkyPoo](https://boards.straightdope.com/u/PunkyPoo)\ **Post date:** [July 20, 2009, 10:20pm UTC](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607/41 "2009-07-20T22:20:22Z")
Well I leave for a few hours and you guys have had a great conversation. But I had to work. A small comment about IBD. Obviously some of you are less familiar with it than others. The main section of their paper is about investments and is very good – try [investors.com](http://investors.com). The IBD Editorial page is VERY right leaning. Sometimes good. Sometimes way over the top. I attempt to read / listen to both the right and the left on subjects like this (all subjects for that matter). The dems in Congress and WH appear to be attempting to ram a $1.5 trillion dollar piece of legislation through Congress before recess in August. Wouldn’t want the taxpayers to have a chance to learn about the bill I guess. I’m all for helping out. And I’m not against the idea of socialized medicine. But I also don’t have much faith in our federal government to do a better job than the private sector. If we’re already hearing numbers like $1.5 trillion, it’s likely to cost significantly more. What big government program has ever come in under budget? Typically it seems like they come in about 50% over. So now we’re talking $2.25 trillion. Doesn’t that make you guys nervous? ---
**Author:** ![Squink](https://avatars.discourse-cdn.com/v4/letter/s/b5e925/32.png) [@Squink](https://boards.straightdope.com/u/Squink)\ **Post date:** [July 20, 2009, 10:31pm UTC](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607/42 "2009-07-20T22:31:39Z")
> [@PunkyPoo](#): > > Doesn’t that make you guys nervous? Nope. I figure that such scary numbers have about the same reality as the numbers which showed that the reconstruction of Iraq would pay for itself. The numbers come from the same team after all, and there’s no evidence they’ve gotten any better at “the math” in the past couple years. ---
**Author:** ![Whack-a-Mole](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/whack-a-mole/32/141_2.png) [@Whack-a-Mole](https://boards.straightdope.com/u/Whack-a-Mole)\ **Post date:** [July 20, 2009, 10:32pm UTC](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607/43 "2009-07-20T22:32:27Z")
> [@Fotheringay-Phipps](#): > > The straightforward thing for you to do would be to admit that what I said was pretty much what the various experts said or were quoted as saying in the linked articles, **and are what is directly relevant in the context of this debate**. (And, for a more complete picture, that you were uninformed on the subject.) Yes, it is true that not all preventative treatments are effective. Yes it is true that politicians like to overstate (or understate depending on their inclination) how much may be gained via preventative treatments. It is also true that preventative medicine can indeed provide substantial cost savings. The trick is separating the effective tests/treatments from the ineffective tests/treatments. For instance screening everyone in the US for Malaria is arguably a poor use of resources. A lot of cost for little to no benefit. Again, it is for the medical profession to sort these out and we need an economic incentive to find the useful treatments and downplay the not so useful ones. Right now your doctor may as well test you for anything and everything. Why not? If you are insured it’s not your dime. The incentives are all out of whack. As mentioned add in suing your doctor and the incentive is for the doctor to take a cover-their-ass approach. This does not argue against preventative treatment. Pointing to one thing and saying, “See? That doesn’t work!” is missing the bigger picture. Some things do work. Hopefully any new system would stress the importance of the effective treatments. Clearly our _current_ system is not doing this effectively so arguing for keeping it is absurd. It is clearly broken in some fundamental ways. > [@](#): > > Our findings suggest that the broad generalizations made by many presidential candidates can be misleading. These statements convey the message that substantial resources can be saved through prevention. Although some preventive measures do save money, the vast majority reviewed in the health economics literature do not. Careful analysis of the costs and benefits of specific interventions, rather than broad generalizations, is critical. Such analysis could identify not only cost-saving preventive measures but also preventive measures that deliver substantial health benefits relative to their net costs; this analysis could also identify treatments that are cost-saving or highly efficient (i.e., cost-effective). > > In addition to determining which preventive measures and treatments are most efficient, it will be necessary to identify those that are not yet fully deployed and those that could serve a large population and bring about substantial aggregate improvements in health at an acceptable cost. Findings that some cost-saving or highly efficient measures are underused would indicate that current practice is inconsistent with the efficient delivery of health care. Other services might be identified as overused, and such findings would underscore the importance of fashioning policies that provide incentives to shift practice toward more cost-effective delivery of health care. In the face of increasingly constrained resources, there is a realistic way of achieving better health results: conduct careful analysis to identify evidence-based opportunities for more efficient delivery of health care — whether prevention or treatment — and then restructure the system to create incentives that encourage the appropriate delivery of efficient interventions. > > SOURCE: [New England Journal of Medicine](http://content.nejm.org/cgi/content/full/358/7/661) ---
**Author:** ![PunkyPoo](https://avatars.discourse-cdn.com/v4/letter/p/6bbea6/32.png) [@PunkyPoo](https://boards.straightdope.com/u/PunkyPoo)\ **Post date:** [July 20, 2009, 11:00pm UTC](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607/44 "2009-07-20T23:00:33Z")
> [@Squink](#): > > Nope. > I figure that such scary numbers have about the same reality as the numbers which showed that the reconstruction of Iraq would pay for itself. > The numbers come from the same team after all, and there’s no evidence they’ve gotten any better at “the math” in the past couple years. Aaahhh the old two wrongs make a right scenario. I’ve got you. ---
**Author:** ![Squink](https://avatars.discourse-cdn.com/v4/letter/s/b5e925/32.png) [@Squink](https://boards.straightdope.com/u/Squink)\ **Post date:** [July 20, 2009, 11:07pm UTC](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607/45 "2009-07-20T23:07:04Z")
> [@PunkyPoo](#): > > Aaahhh the old two wrongs make a right scenario. I’ve got you. Nope, it’s got nothing to do with two wrongs. This is the old “these guys suck at math, and they’ve sucked at it for years, so why the hell should I believe their math this time around?” That’s _completely different_ from the old two wrongs make a right scenario. ---
**Author:** ![furt](https://avatars.discourse-cdn.com/v4/letter/f/439d5e/32.png) [@furt](https://boards.straightdope.com/u/furt)\ **Post date:** [July 20, 2009, 11:26pm UTC](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607/46 "2009-07-20T23:26:18Z")
> [@Squink](#): > > This is the old “these guys suck at math, and they’ve sucked at it for years, so why the hell should I believe their math this time around?” Ah, it’s the old “conflate two different issues by pretending that all the people who supported one are automatically the same ones supporting the other, as if neocon foreign-policy analysts and libertarian health-care policy analysts are the exact same people.” ---
**Author:** ![Squink](https://avatars.discourse-cdn.com/v4/letter/s/b5e925/32.png) [@Squink](https://boards.straightdope.com/u/Squink)\ **Post date:** [July 20, 2009, 11:38pm UTC](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607/47 "2009-07-20T23:38:40Z")
> [@furt](#): > > Ah, it’s the old “conflate two different issues by pretending that all the people who supported one are automatically the same ones supporting the other, as if neocon foreign-policy analysts and libertarian health-care policy analysts are the exact same people.” Well, I’ll admit that they’re trying _very hard_ to pretend that they’re different, or massively changed, people. Can you point out a couple Republican congress critters who _support_ the current reform plan? If not, I’ll just carry on assuming that your putative “different groups” are in reality one and the same group as went wild for an inexpensive invasion of Iraq. ---
**Author:** ![furt](https://avatars.discourse-cdn.com/v4/letter/f/439d5e/32.png) [@furt](https://boards.straightdope.com/u/furt)\ **Post date:** [July 20, 2009, 11:42pm UTC](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607/48 "2009-07-20T23:42:29Z")
> [@Squink](#): > > When reading this stuff, keep in mind that, until proven otherwise, the goal isn’t to find a system that works, it’s to [kill healthcare reform.](http://www.weeklystandard.com/weblogs/TWSFP/2009/07/kristol_kill_it_and_start_over.asp) > I’m reminded of the ‘principaled’ arguments that internet libertarians put forth a decade ago in favor of school voucher programs. The goal wasn’t to improve education, it was to destroy publicly funded education. Along with the old “smear other people’s motives on a completely different issue, and throw in a blatant misrepresentation into the mix.” From your cite: > [@](#): > > Throw the kitchen sink at the legislation now on the table, drive a stake through its heart (I apologize for the mixed metaphors), and kill it. > > Then opponents can say, of course we do want to pass sensible health reform. But to do so, we need to start over. > > So the constructive part of the message would be: Start Over. We’re not giving up on health reform. Far from it. But the only way to pass health reform is first to get rid of the misbegotten efforts now before Congress. ---
**Author:** ![Squink](https://avatars.discourse-cdn.com/v4/letter/s/b5e925/32.png) [@Squink](https://boards.straightdope.com/u/Squink)\ **Post date:** [July 20, 2009, 11:56pm UTC](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607/49 "2009-07-20T23:56:39Z")
So you can’t find a Republican congressman or two who support the dem plan? I’m not surprised. I suppose, there might be a Libertarian or two with a split agenda, but who cares? The only politically potent factions are the dems and reps. Everyone else is irrelevent. Got anything _else_ that might point to there being any air between your “two distinct groups”? If you don’t, then my point about accepting figures from people who suck at math stands. -So sorry, **furt.** ---
**Author:** ![Mr.Duality](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/mr.duality/32/4098_2.png) [@Mr.Duality](https://boards.straightdope.com/u/Mr.Duality)\ **Post date:** [July 21, 2009, 1:13am UTC](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607/50 "2009-07-21T01:13:51Z")
> [@athelas](#): > > Of course people cherry-pick the health comparisons that best suit their argument, but the commonly-cited life expectancy and infant mortality rates are badly flawed because the demography of European countries is different from the US. On the other hand if you measure health once people have a disease, for example cancer, the US does come out on top.[True](http://distributedrepublic.net/archives/2007/09/27/questions). There may be more gains here from preventative care but remember the previously cited article. You say the CIA is publishing “badly flawed” statistics in the World Factbook? You’ll have to pardon me for putting more trust in them than in you. Infant mortality rankorder: > **[Spotlighting The World Factbook as We Bid a Fond Farewell - CIA](https://www.cia.gov/stories/story/spotlighting-the-world-factbook-as-we-bid-a-fond-farewell/)** Life expectancy rankorder: > **[Spotlighting The World Factbook as We Bid a Fond Farewell - CIA](https://www.cia.gov/stories/story/spotlighting-the-world-factbook-as-we-bid-a-fond-farewell/)** What do eastern European demographics have to do with the USA’s lackluster showing on the lists linked to above? I call bullshit. ---
**Author:** ![furt](https://avatars.discourse-cdn.com/v4/letter/f/439d5e/32.png) [@furt](https://boards.straightdope.com/u/furt)\ **Post date:** [July 21, 2009, 1:28am UTC](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607/51 "2009-07-21T01:28:33Z")
> [@Squink](#): > > So you can’t find a Republican congressman or two who support the dem plan? The congresspeople are not the ones “doing the math.” That would be policy analysts, economists, think tanks, etc. > [@](#): > > The only politically potent factions are the dems and reps. Everyone else is irrelevent. Acknowledging political reality is one thing; mindlesslydiscarding arguments because they come from “the other team” is another. ---
**Author:** ![Liberal](https://avatars.discourse-cdn.com/v4/letter/l/848f3c/32.png) [@Liberal](https://boards.straightdope.com/u/Liberal)\ **Post date:** [July 21, 2009, 2:14am UTC](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607/52 "2009-07-21T02:14:32Z")
From NY Times article quoted above: > [@](#): > > In fact, studies have shown that preventive care — be it cancer screening, smoking cessation or plain old checkups — usually ends up costing money. Of course they cost money. But it costs a hell of a lot more to treat a cancer patient than it does to help someone stop smoking. I mean, the comparison isn’t even close. ---
**Author:** ![Squink](https://avatars.discourse-cdn.com/v4/letter/s/b5e925/32.png) [@Squink](https://boards.straightdope.com/u/Squink)\ **Post date:** [July 21, 2009, 2:16am UTC](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607/53 "2009-07-21T02:16:24Z")
> [@furt](#): > > The congresspeople are not the ones “doing the math.” That would be policy analysts, economists, think tanks, etc. ie the lackeys of the congresscritters. Did we not have our fill of dishonest right wing lackeys in the leadup to Iraq? Much as some would like us to believe otherwise, the advent of a new national issue, and a new national debate, does not bring with it a mantle of virginity for the think tanks, policy analysts and political commentators. Their record still is what their record was, and anyone who doesn’t take that into account in wading through the current hysterical cacophony is a fool. Had the Republicans any intention of taking an honest approach to health care reform, they would have gotten on board with the Democrats last January. That way they could have had _significant_ input and forged a relationship with a president who was reaching out to them to form a bipartisan concensus. Now (see link) they want a do-over? They want to scrap everything and start over, so we can have a ‘real’ concensus? And besides that, they want the scrapping to go on in an environment where they get to scream bloody murder about fiscal responsibility, and talk about how this’ll kill the president’s agenda? Fuck em, the ship has sailed. They weren’t on it, and America doesn’t like them anyway. ---
**Author:** ![Squink](https://avatars.discourse-cdn.com/v4/letter/s/b5e925/32.png) [@Squink](https://boards.straightdope.com/u/Squink)\ **Post date:** [July 21, 2009, 2:20am UTC](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607/54 "2009-07-21T02:20:09Z")
> [@Liberal](#): > > it costs a hell of a lot more to treat a cancer patient than it does to help someone stop smoking. The part I always found most amusing about this is how the cigarette taxes that were supposed to go to getting people to quit always ended up in stupid ad campaigns instead maybe subsidizing nicotine patches for the poor. Up until a few years ago, the patches were nearly twice the cost of cigs. ---
**Author:** ![Ca3799](https://avatars.discourse-cdn.com/v4/letter/c/9f8e36/32.png) [@Ca3799](https://boards.straightdope.com/u/Ca3799)\ **Post date:** [July 21, 2009, 2:25am UTC](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607/55 "2009-07-21T02:25:56Z")
> [@Squink](#): > > ie the lackeys of the congresscritters. > Did we not have our fill of dishonest right wing lackeys in the leadup to Iraq? > Much as some would like us to believe otherwise, the advent of a new national issue, and a new national debate, does not bring with it a mantle of virginity for the think tanks, policy analysts and political commentators. Their record still is what their record was, and anyone who doesn’t take that into account in wading through the current hysterical cacophony is a fool. > > Had the Republicans any intention of taking an honest approach to health care reform, they would have gotten on board with the Democrats last January. That way they could have had _significant_ input and forged a relationship with a president who was reaching out to them to form a bipartisan concensus. > Now (see link) they want a do-over? They want to scrap everything and start over, so we can have a ‘real’ concensus? And besides that, they want the scrapping to go on in an environment where they get to scream bloody murder about fiscal responsibility, and talk about how this’ll kill the president’s agenda? > Fuck em, the ship has sailed. They weren’t on it, and America doesn’t like them anyway. I wish I had typed this! ---
**Author:** ![Guinastasia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/guinastasia/32/5751_2.png) [@Guinastasia](https://boards.straightdope.com/u/Guinastasia)\ **Post date:** [July 21, 2009, 2:42am UTC](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607/56 "2009-07-21T02:42:26Z")
> [@athelas](#): > > [True](http://distributedrepublic.net/archives/2007/09/27/questions). There may be more gains here from preventative care but remember the previously cited article. But that’s not exactly a good thing, is it? They call it the _Emergency_ Room for a reason. ---
**Author:** ![athelas](https://avatars.discourse-cdn.com/v4/letter/a/5e9695/32.png) [@athelas](https://boards.straightdope.com/u/athelas)\ **Post date:** [July 21, 2009, 2:56am UTC](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607/57 "2009-07-21T02:56:29Z")
> [@Mr.Duality](#): > > You say the CIA is publishing “badly flawed” statistics in the World Factbook? :rolleyes:If you read my post, you’d realize that it is the _interpretation_ of the statistics by drive-by posts like yours that is flawed. ---
**Author:** ![furt](https://avatars.discourse-cdn.com/v4/letter/f/439d5e/32.png) [@furt](https://boards.straightdope.com/u/furt)\ **Post date:** [July 21, 2009, 3:15am UTC](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607/58 "2009-07-21T03:15:12Z")
> [@Squink](#): > > ie the lackeys of the congresscritters. > Did we not have our fill of dishonest right wing lackeys in the leadup to Iraq? > Much as some would like us to believe otherwise, the advent of a new national issue, and a new national debate, does not bring with it a mantle of virginity for the think tanks, policy analysts and political commentators. Their record still is what their record was, and anyone who doesn’t take that into account in wading through the current hysterical cacophony is a fool. Because, of course, left-leaning thinkers have always been right about every issue ever. :rolleyes: ---
**Author:** ![Czarcasm](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/czarcasm/32/4050_2.png) [@Czarcasm](https://boards.straightdope.com/u/Czarcasm)\ **Post date:** [July 21, 2009, 3:27am UTC](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607/59 "2009-07-21T03:27:43Z")
> [@furt](#): > > Because, of course, left-leaning thinkers have always been right about every issue ever. :rolleyes: No, and neither does it mean that the right-wing slanderers and rumormongers are suddenly saints. Or did you really think the old “Never mind what is happening here-look over _there!_” ploy was actually going to work here? ---
**Author:** ![Isamu](https://avatars.discourse-cdn.com/v4/letter/i/7c8e57/32.png) [@Isamu](https://boards.straightdope.com/u/Isamu)\ **Post date:** [July 21, 2009, 3:41am UTC](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607/60 "2009-07-21T03:41:55Z")
> [@Sateryn76](#): > > It is a service, just like any other, but with more important consequences. Why do so many people think that is exists outside the normal market of goods and services? That they shouldn’t have to pay a fair price for it? > > I have an HSA with catastrophic insurance, and I am in complete control of my medical care, including the bills. We just had $4800 worth of dental bills, and we bartered $2200 by doing computer work for the dentist. The rest we paid for with cash, and never once did I complain about the price. That is what it costs, and we treated it like any other service we received. . It depends on what you think is a reasonable cost. I had two fillings done in the last month, the work is great and you can’t see any evidence that the teeth have even been touched. Total out of pocket costs for me - around US$25. No filling out of insurance forms, no correspondence with medical staff or bartering necessary. I pay the money and walk out, never having to think about it again. Of course the dentist makes more than that US$25, because he gets paid from the pool of compulsory insurance that almost everyone pays, so he drives a mercedes. Everyone is happy. And this is one thing I don’t understand about the resistance to a UC system. It actually makes planning your life a lot easier when you don’t have to prepare for unknowable expenses. None of us know what illnesses might happen to us. [Previous page](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607.md?page=2) [Next page](https://boards.straightdope.com/t/reformers-claims-just-dont-add-up-health-care/503607.md?page=4)