Ezra explains why this is a reasonable request:
There’s no reason the CBO shouldn’t be asked to run the numbers on H.R. 676 (the leading single-payer bill). Single payer is, after all, the most common set-up for the health systems of industrialized nations. It’s not some wild fantasy that doesn’t deserve to be modeled. And sure, on some level, you can probably predict the outcome: Impressive cost savings leavened by concerns that innovation — both in medical technology and in health coverage — would retard and consumers would ache for choice. Having examined the evidence, Baucus and others would be within rights to prioritize choice or flexibility or another value that militates against single payer. But not before.
I don’t know what the procedure is to get the CBO to start a legislative cost projection, but I suspect that calling or emailing your Representatives would get to ball moving, as well as contacting CBO directly.
Capuano, Michael E., Massachusetts, 8th
Delahunt, William, Massachusetts, 10th
Frank, Barney, Massachusetts, 4th
Lynch, Stephen F., Massachusetts, 9th
McGovern, James, Massachusetts, 3rd
Markey, Ed, Massachusetts, 7th
Neal, Richard E., Massachusetts, 2nd
Olver, John, Massachusetts, 1st
Tierney, John, Massachusetts, 6th
Tsongas, Niki, Massachusetts, 5th
Hodes, Paul W., New Hampshire, 2nd
Shea-Porter, Carol, New Hampshire, 1st
Kennedy, Patrick, Rhode Island, 1st
Langevin, Jim, Rhode Island, 2nd
Courtney, Joe, Connecticut, 2nd
DeLauro, Rosa L., Connecticut, 3rd
Larson, John B., Connecticut, 1st
Murphy, Christopher S., Connecticut, 5th
Himes, Jim, Connecticut, 4th
I’m in complete agreement on single payer.
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p>The Massachusetts Nurses Association has been doing important advocacy on this for some time. One of their active rank-and-file members, Sandy Eaton, testified at a congressional hearing this week in DC about the shortcomings of the Massachusetts Chapter 58 model.
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p>Your suggestion about the CBO running the numbers is a good one, and something we should all be pushing for.
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p>–Leo
I’m still not 100% sold on single payer because I’d like to see the impact on transition. I think it’s probably the most cost efficient, but if a case can be made that the ‘startup’ costs to transition to it are prohibitive (compared to other options that may be less desirable as an end product but are easier and less painful to get to), I’d be open to hearing about it. Also someone needs to model what the impact will be to the overall economy when the efficiencies of single payer necessarily reduce the insurance workforce overall. This is a large sector of the economy we’re talking about.
No question. Transitioning to single-payer wouldn’t be simple.
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p>Others know far more about this than I, but we certainly could transition to single-payer over time–say, over 10 years–by incrementally expanding Medicare to eventually cover everyone.
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p>–Leo
What are you going to do—suspend or revoke the licenses to practice medicine for any MD not seeing ten patients an hour?
I do, however, believe that “universal” works both ways. Not only will every patient have access to health care, but every provider would be required to accept patients in the public system.
Please—–. Anything that could even remotely jeapordize
reelection is immediately jettisonned or done covertly in the middle of the night, in darkness, in whispers.
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p>Secondly–as I have asked repeatedly—and no one will answer the question: Who will provide the services?
How will the cost for 13 million illegal aliens be factored in? Where will you build the additional hospitals and clinics—who will staff them? You better put the horse before the cart. And last but not least—what is the exit strategy when and if the entire medical system collapses. I put my money on collapse—you better have an alternative plan or a plane ticket that will get you out of the country fast.
I’m not convinnced lack of facilities is a problem; it’s a matter of coverage and affordability.
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p>http://news.yahoo.com/s/ap/200…
President Obama is right to say that health care costs can and must be reduced. This is appplicable to the Commonwealth. As the Veterans Health Administration hospital system has shown since its late 1990’s overhaul, better medical care can be delivered at a lower cost most importantly through coordination of treatment; electronic record-keeping, which has allowed the gathering of information on results of treatments and prevented drug and other errors during hospitalizations; a commitment to first of all serving the patient; by removing perverse incentives that produce unnecessary tests and by promoting quality of care and individual patient followup and preventative care rather than quantity of procedures; by buying of prescription drugs in bulk; and by investing in primary care physicians and nurses rather than in specialists.
As Dr. Jack Wennberg and his associates at Dartmouth have shown, in many studies, there is much inappropriate over-treatment of patients, without better pateient outcomes and often with greater perils for patients. There is, in many geographic areas, as Shannon Brownlee has shown in Overtreated and Atul Gawande demonstrates in “The Cost Conundrum,” in the latest issue of the New Yorker, a pattern and culture of delivering the care that is in the best interests, under the current payment system, of doctors and medical facilities, rather than the interests of patients.
President Obama and Peter Orszag are well aware of the cost conundrums. Granted, it will take time for the implementation of uniform electronic record-keeping, a shift to emphasis on efficacy of treatment, and systems of patient-centered coordination of care. President Obama is, here, as in other areas, is thinking strategically, while almost everyone else is planning tactics.
The country–and Massachusetts– can not afford the continuation of our dysfunctional, fragmented, quantity-driven health care system. What Massachusetts and the US need are to build a new coordinated health care system with collaborative doctors focusing on prevention and quality of care, while discouraging, as Gawande puts it, “overtreatment, undertreatment, and sheer profiteering.”