Showing posts with label health care. Show all posts
Showing posts with label health care. Show all posts

Wednesday, August 19, 2009

Late Summer Economy

Summer is generally a time when capital markets languish, brokers vacation in the Hamptons, and there is little economic news. That is not the case in the Summer of 2009.
A fierce battle is being fought between the economic interests of those who have monetized health care - the pharmaceutical companies, the health insurers and health care providers like doctors and nurses - and millions of Americans who are teetering on the edge of economic insolvency because of our country's unsustainable rise in the cost of health care. The stakes are undeniably high, as are the emotions of those who argue both sides of the issue.
On one thing we can all agree. To fail to address this issue is to destroy the long term health of our economy.
In addition to that issue, however, we are also emerging from the worst recession since the Great Depression. Because financial markets ceased to function at the end of last year, an enormous amount of money was provided to commercial banks (and investment banks who changed their charters to avail themselves of this money) in order to prevent a financial disaster. This disaster was caused by securitizing and selling the risk of poorly underwritten mortgages, and the sales - and disastrous effects - were worldwide.
This problem began in the late 1990s, with the dissolution of the Glass-Steagall Act, that separated commercial and investment banking. It appears that we expect, however, that this decade long problem-in-the-making is solved immediately.
"What is taking so long?" is the predominant economic question.
We have, apparently, become a nation convinced that there are simple, quick solutions to everything.
We continue to face declines in manufacturing, rising unemployment, plummeting housing prices and a distinct lack of consumer confidence. On the bright side, inflation is almost non-existent, interest rates are at decade lows, and capital markets show unmistakable signs of predicting an end to our recession. We are working on financial reform and the excesses of the past seem, at least for the present, to have subsided.
It's a mixed bag. We will not suddenly pop out of this quagmire in a month or two. That is clear.
It is also clear that we will politicize economic issues. We will criticize the Economic Team, point to rising deficits, scream about banker's bonuses and wonder why we're not back to normal seven months from the inauguration of the new administration.
Yet, not one of these issues is directly relevant.
Rising deficits? Yes. Was there an alternative to a huge cash infusion into the economy? No.
Banker's bonuses? Yes. Are they a significant percentage of the "bailout money?" No.
What, then, should we be discussing?
  1. Financial Regulation - Plug up the holes that caused excesses without unduly burdening the financial system
  2. Long Term Employment Growth Policy - Some jobs, including much manufacturing, are gone forever. Reeducating the work force for long term employment is vital
  3. Deficit Reduction and National Debt Repayment - Once we've stabilized the economy and gotten back to work (in about a year), we need to raise taxes. Yes, we all need to pay more taxes to reduce the current deficit and repay the national debt. It is as big a security issue as reliance on foreign oil.

There you have it. It's not a pretty story, but at least we're talking about the real issues.

As always, your comments are most welcome.

Sunday, July 19, 2009

Health Care Legislation

In the current debate about health care, facts are few and opinions are many. Here are some facts that may help you form your own opinion.

What We're Spending Now

The US Department of Health and Human Services' Center for Disease Control, using data from the Organisation for Economic Co-operation and Development , notes spending on health goods and services plus health-care infrastructure as a percentage of Gross Domestic Product as follows:
  1. United States - 15.3%
  2. Switzerland - 11.3%
  3. France - 11%
  4. Germany - 10.6%
  5. Belgium - 10.3%
  6. Portugal - 10.2%
  7. Austria - 10.1%
  8. Canada - 10%
  9. Netherlands & Denmark - 9.5%
  10. Sweden - 9.2%

Source: http://www.cdc.gov/mmWR/preview/mmwrhtml/mm5813a5.htm

US health care costs have more than tripled in inflation-adjusted terms over the last 20 years to their current level of 15.3%.

What We'll Be Spending If We Do Nothing

Further, if current policies remain unchanged, that percentage will increase to 25% of GDP in 2025, and 49% in 2082.

http://www.cbo.gov/ftpdocs/89xx/doc8948/01-31-HealthTestimony.pdf

Long Live the Rich, and the Poor Die Young

Yet, according to the NY Times, government research shows “large and growing” differences between the lifespan of Americans, based on their wealth. Admitting researchers in disagreement for reasons for this growing disparity, they do agree that a part of the explanation lies in whether an individual has health insurance.

Source: http://www.nytimes.com/2008/03/23/us/23health.html?_r=1

Expand Access and Curb Costs - One Out of Two

The Administration 's main objectives stated earlier this year were:

  1. Expand access to health insurance, and
  2. Curb runaway costs for the economy has a whole.

Current House legislation being considered, however, "significantly expands the federal responsibility for health-care costs," says Douglas Elmendorf, director of the Congressional Budget Office. The Senate Finance Committe has not yet released their verion of the bill. As both versions of health care legislation advance, expanding coverage has been embraced while few compromises have been made with pharmaceutical companies where savings were to have been made.

Allegations that the CBO has not "credited" such proposals as "preventative care measures" have been asserted. Those assertions are correct. It is apparent that preventative care will result in lower long term health costs. It is inappropriate, however, to assign a dollar amount to that cost savings, as that amount would be impossible to quantify.

One more quantifiable compromise would be to reduce the federal tax subsidy that encourages employers to offer large health-insurance policies, but that proposal has been opposed by labor unions (that have these tax-advantaged plans).

Where We Are Now

Current legislation has not yet achieved the goal of cutting costs in a way that will prevent unsustainable increases in health spending. Special interests on one side - particularly labor unions - are at odds with

  • AMA (that wants increases in Medicare payments to doctors)
  • Insurance companies (that want to prevent a government-run competitor in the marketplace)

Whatever your opinion, it is time to contact your Congressional representatives. Achieving both access and cost containment is critically important in solving this problem. The link below is provided for your convenience in doing so.

http://www.visi.com/juan/congress/