Source: http://www.jsonline.com/story/index.aspx?id=741118

Get serious about health care reform

By DAVID NEWBY

Posted: April 20, 2008

"Consumer-driven health care" and "medical tourism." Remember those words, because this is the future of health care in this country if conservatives get their way.

Consumer-driven health insurance is high-deductible insurance with incentives to "shop" for the best health care deals we can find to save money. And now we hear that these health care "plans" soon will want us to shop for health care not in our own communities but in low-wage countries abroad for the best deals!

That's the ultimate in consumer-driven shopping for health care: Fly patients to India, Thailand or some other medical low-cost country in search of surgical procedures that cost less than they do in the United States.

Perhaps that's the logical extension of shipping the jobs of blue-collar manufacturing workers, call-center workers and lower-end computer jobs to low-wage countries. I suspect that American surgeons and other skilled medical personnel won't be too happy. But then maybe the highly skilled surgeons can do what millions of middle-class, blue-collar, service-sector and white- collar workers can't: Force our government to adopt a sensible set of rules for international trade.

But I digress. Back to our health care crisis.

While the drug industry warns us against importing cheaper drugs of supposedly uncertain quality (and the Bush administration makes it illegal), health care "reform" leaders now think "medical tourism" will solve our crisis.

Don't import the drugs - but export the patients.

Note the absurdities of trying to save significant costs by flying American patients to other countries: the rigors of long flights complicating medical conditions, exposure to diseases most Americans have no immunity to, questions regarding accurate certification of medical facilities abroad (especially in Third World countries), uncertainties in the event of complications, the lack of legal protection in the event of malpractice or medical error.

Why not just fix our own American health care system?

Serigraph Inc. CEO John Torinus regularly uses his weekly column in the Journal Sentinel Business section to promote these consumer-driven health insurance plans. On April 6, Torinus wrote that he might go to Ireland for his next hip replacement (and spend his recovery time in a pleasant Irish pub). He could do this, he says, and still save money.

First, note that Irish wages are close to those in the U.S. Second, how instructive that he would choose a country with universal health care, a system that guarantees quality health care to all its citizens at a little above half what we pay in the U.S. Could it be that Ireland has a better and less expensive health care system than we do because it has adopted health care for all? (The World Health Organization ranks Ireland's health care system the 19th best in the world; the U.S. rank is 37th.)

Contrary to Torinus' claims, there is no stampede toward consumer-driven plans in this country. According to the Kaiser Family Foundation, only 5% of workers with health insurance are in such plans. And the numbers are not rising quickly.

By promoting consumer-driven health care, Torinus is a cheerleader for a team that's not playing.

We know that we can provide decent health care for all in America, so why insist on avoiding the obvious?

Healthy Wisconsin, re-introduced in the Legislature last month, has demonstrated that we could provide quality, comprehensive health care for everyone in Wisconsin - and still pay less than we do now.

How? By eliminating unnecessary bureaucratic overhead required by our current fragmented insurance system; by bargaining with the drug companies for discounts on behalf of more than 5 million people in Wisconsin; by simplifying our medical billing system with a standard, comprehensive health care plan; and by promoting preventive care and better quality medical practices.

Let's stop coddling (and paying off) the health care/health insurance special interests and do what's right, what's efficient and what benefits everyone: provide straightforward, comprehensive, quality health care for all.

David Newby is president of Wisconsin State AFL-CIO.

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Greater numbers of primary care doctors yield more effective care and lower spending

States with higher Medicare spending often provide lower quality, less effective care to Medicare beneficiaries, according to a new study by Dartmouth College economists Katherine Baicker and Amitabh Chandra. The study, published in the current issue of Health Affairs, shows that spending more money does not necessarily translate into better care for the elderly.

States spending more money per Medicare beneficiary are likely spending those dollars on intensive, expensive care instead of more effective care, the study's authors said. High-spending states also are likely to have a greater concentration of specialists.

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Riding gains from investment portfolios and enjoying the pricing power that came from a decade of mergers, many nonprofit hospitals have seen earnings soar in recent years. The combined net income of the 50 largest nonprofit hospitals jumped nearly eight-fold to $4.27 billion between 2001 and 2006, according to a Wall Street Journal analysis of data from the American Hospital Directory. AHD, an information-service company, compiles data that hospitals report ...

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