Far too many Americans have no health insurance or are underinsured. And, meanwhile, far too large a percentage of America’s Gross National Product goes toward health care. Our health care system is inadequate— yet it costs too much, threatening the economy.
How do we cover more people yet bring the costs down? That is the problem that all of America, from the president on down, is weighing and debating.
Yet press coverage of the debate has often been lacking. The Project for Excellence in Journalism, for example, found that so far this year 55 percent of coverage of health care has been about the political battles, 16 percent about the protests, and only 8 percent about substantive issues like how the system works now, what will happen if it remains unchanged, and what proposed changes will mean for ordinary people.
To help reporters understand and analyze the debate, The Commonwealth Fund has sponsored a special supplement to the September/October issue of the Columbia Journalism Review. Below is a link to the digital version.
We hope you find it useful,
The editors
The commonwealth report looks fishy to me. I wonder why they didn't include Canada in the cost comparisons.
The 'savings' they describe under a proposed plan are based on a dubious scheme of increasing 'efficiency' in the health care system. For example:
"A better-coordinated system of care that is accessible to all would save lives and billions of dollars, according to the Scorecard. For instance, if everyone with diabetes and high blood pressure had their conditions under control at rates achieved by the top performing health plans, $1 billion to $2 billion dollars and an estimated 20,000 to 40,000 lives could be saved each year."
http://www.allbusiness.com/health-care/health-care-overview/5360001-1.html
(The actual Commonwealth Fund website is down at the moment)
I sincerely doubt that a nation of 300 million people can be 'coordinated'. Rather, you have to have a system that allows people to make their own decisions but which makes it affordable and easy to manage conditions rather than waiting for them to worsen - such as a free and accessible system as in Canada.
I would be very leery of representing the Commonwealth Fund report as fact.
#1 Posted by Stephen Downes, CJR on Mon 7 Sep 2009 at 06:33 PM
Stephen you show your bias for socialist style healthcare with one line "such as a free and accessible system as in Canada".
Learn more before you believe Canada is even in the ballpark of a good idea for healthcare.
http://www.heritage.org/research/healthcare/hl856.cfm
http://kevincolby.com/2008/06/27/the-canadian-healthcare-system-and-its-problems/
http://www.shortnews.com/start.cfm?id=80257
#2 Posted by Thomas, CJR on Tue 8 Sep 2009 at 06:49 AM
Stephen, Canada expends approx. 1/2 per-capita of what the US spends (private + public combined). I'm not saying that the Commonwealth Fund conclusion is correct, just that Canada's numbers would not change the 'big-picture' (US outspending all other countries).
#3 Posted by Ernst Kaufmann, CJR on Tue 8 Sep 2009 at 12:51 PM
> I'm not saying that the Commonwealth Fund conclusion is correct, just that Canada's numbers would not change the 'big-picture' (US outspending all other countries).
Um, what?
The post above (which I assumed is what you wrote, though it is unsigned) certainly implies that the Commonwealth Fund report can be trusted., Certainly, implicit trust is why the Commonwealth Fund paid (?) to have it inserted into CJR.
And I ahve no idea what you're saying here: 'Canada's numbers would not change the 'big-picture' (US outspending all other countries." I made no such poin, nor even suggested that it would. Nor does either the insert or articles about the Commonwealth Fund talk about anything other than per capita spending.
So I really have no idea what you're trying to say, and wonder whether you read my comment.
#4 Posted by Stephen Downes, CJR on Tue 8 Sep 2009 at 06:07 PM
The issue is inefficiencies in information sharing and and complexity of the payment system's in place....the multiple private and public entities, thousands of plans with policy nuances,
and operations management philosophy is this.....Deming is the man's name....a true revolutionary..
"Complexity Kills"
According to David Cutler et al, RAND Journal of Economics, countless Standford and University studies, etc the US spends between $600 and $850 BIL on unnecessary procedures, costs, insurance protocol, unnecessary surgeries and diagnostics, etc....that we sink our whole economy....additionally, demand inducement....by physicians and institutions creates in some cases severe health problems for people in their futures, further exacerbating the total cost over a life time (the Life time impact cost of unnecessary care).
#5 Posted by Grad Student, CJR on Sun 6 Dec 2009 at 11:48 PM
Thom, the heritage foundation is not a valuable source of information, it's a valuable source for disinformation.
Ian Austen wrote some profiels on Canada for the nytimes Economix blog which I can testify are mostly accurate:
http://economix.blogs.nytimes.com/2009/07/07/how-does-canadas-health-system-actually-work/
The whole series:
http://economix.blogs.nytimes.com/tag/canada-regulation-series/
Guys like hertiage and the Manhattan institute put out a lot of scare stories on Canadian Health Care which are not true. You have a system in Canada which is expensive, but not as much as America; which is not comprehensive (no dental, optometrist coverage varies from place to place), but there are no delays and fights with insurance over procedures that are covered; which can get overwhelmed because of cuts by governments, but can also be strengthened because of public pressure on governments.
It's not perfect, but it's much better than the system of my American friends. And the Japanese system I'm currently under is much better than the Canadian one.
And the man who mentioned Deming, you are right on. Check the New Yorker Atul Gawande article on the the high cost of health care in Texas and how the Mayo Clinic manages high quality from which lower costs are derived.
#6 Posted by Thimbles, CJR on Mon 7 Dec 2009 at 12:28 AM
Here's the new yorker article
http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande
and mcclatchy's Kaiser teamup is a good public resource:
http://www.mcclatchydc.com/kaiser/
#7 Posted by Thimbles, CJR on Mon 7 Dec 2009 at 12:35 AM