I could live without healthcare reform! How about you?

The point being that the study attributes too much blame to medical bills and by extension the insurance industry

Well, no. Medical bills are what they are. If the insurance was inadequate that stands on it's own. If your argument with the numbers is the ~3 times more likely than (whenever) I get that, but otherwise there is nothing obviously wrong with them.

You are the one that introduced the bankruptcy study statistics to support the argument that the health care system is broken and in need of reform, not me.  You don't get off that easy.

What I'm saying is that it doesn't really matter how people got there. Blame insurance, blame hospitals, blame big pharma... they all played a role. People themselves, for that matter. The bottom line the whole thing is inefficient (~30% of insurance premiums go to administration, Thailand < 2% for their whole system) and unnecessarily expensive (pharma and hospitals).

Again, 16% of GDP and ~20% of adults are *still* not covered, with examples all over the world of doing better in terms of costs and outcome.

This line of argument is stronger than the consumer bankruptcy argument to support your contention, but I can't help but wonder what the difference is in the quality of care between the US and Thailand.  

Further that with states like California having policies of not allowing exemptions to executions on judgments for medical debts, and it isn't any surprise at all that with a 44% reduction in filings, those that still file have a highly disproportionate number of large medical bills (so-called "medical bankruptcies", to use the term from the Warren study).

So what you're saying is that, in terms of absolute numbers, a great many people being crushed by medical bills aren't even making it into the calculations?

I'm pretty sure I didn't say that, because I don't understand your point.  The fact that judgment enforcement exemptions are unavailable to medical debtors in California pushes more people into bankruptcy, not less.  

Sophistry is an art form practiced by all attorneys and politicians.

It's certainly not limited to those venues.

Of course, but since Professor Warren is an attorney and a political figure, I figured those professions were relevant to the discussion.  I concede that my list is not exhaustive.  I don't know if that is relevant though.

****

According to the study, there was a percentage-wise 49.6% increase in bankruptcies defined as "medical bankruptcies" from 2001 to 2007.  Last time I took math (and it has been a while), that means that 41.51% of 2001 bankruptcies were "medical bankruptcies".  Lets look at the actual numbers.

2001 - 1,452,030*41.51%=602,737 medical bankruptcies
2007 - 822,590*62.1%=510,828 medical bankruptcies

So in real terms the number of medical bankruptcies fell about 15%.  The Disraeli quote was to illustrate the point that statistics can be massaged to say whatever it is that we want them to say.

This also ignores the fundamental question of whether we should be measuring the health of the medical insurance system by the number of consumer bankruptcies attributable to medical bills.  At the end of the day it is just another data point.

EDIT:  Looking at the abstract from the study, the 2001 % was 46.2%, or 670,838.  So apparently the real number discrepancy is even worse than my admittedly questionable math skills would suggest.

You are the one that introduced the bankruptcy study statistics to support the argument that the health care system is broken and in need of reform, not me.

Yes, I did. And while I can respect your concerns about it, all you've really articulated are suspicions. If you come up with something that actually discredits those statistics I'd be very interested in seeing them.

What I'm saying is that it doesn't really matter how people got there. Blame insurance, blame hospitals, blame big pharma... they all played a role. People themselves, for that matter. The bottom line the whole thing is inefficient (~30% of insurance premiums go to administration, Thailand < 2% for their whole system) and unnecessarily expensive (pharma and hospitals).

Again, 16% of GDP and ~20% of adults are *still* not covered, with examples all over the world of doing better in terms of costs and outcome.

This line of argument is stronger than the consumer bankruptcy argument to support your contention, but I can't help but wonder what the difference is in the quality of care between the US and Thailand.

The drag on the economy is key.

Thailand was admittedly an off the cuff example because of their uniquely low admin cost. It had actually risen from 1.5% and caused an uproar. A friend of mine traveling there needed care and was impressed. Americans also take vacations there for surgery they can't afford here. Regardless, I was talking about administrative costs, only to point out they needn't be what insurance companies incur (and thus consumers). But what Thailand (and the rest of the industrialized world) does not have to do is determine eligibility, which is a significant factor. Again, France provides care for *everyone* for 70% of of our cost (not including 20% of adults), relative to GDP, allowing for care at least as good as the US.

Ben

Yo gusto, del queso.   

You are the one that introduced the bankruptcy study statistics to support the argument that the health care system is broken and in need of reform, not me.

Yes, I did. And while I can respect your concerns about it, all you've really articulated are suspicions. If you come up with something that actually discredits those statistics I'd be very interested in seeing them.

I completely countered the consumer bankruptcy angle and pointed to numbers with citations to original sources.  If anything, the consumer bankruptcy figures show that BAPCPA is having its desired effect and medical bankruptcies are down in real numbers from 2001 to 2007.  The fact that a higher percentage of bankruptcies filed in 2007 are "medical bankruptcies" only shows that the perceived abuses of the bankruptcy law prior to BAPCPA have been curtailed.  Now, the people declaring bankruptcy are the ones that actually need the protection.  The self-serving unsupported statements in the Warren study to the contrary notwithstanding.

Warren's study simply does not support the notion that medical bills are causing more bankruptcies in 2007 than they did in 2001.  That isn't suspicion, that is fact.  And I showed my work.

I hope our exchange has informed the debate at least.  It does go to the question of whether or not it is economically expedient to have a public option for healthcare, regardless of the question of if government provided health care is a fundamental right. 

Good example with Thailand fishfarmer. Part of that low cost is because you can go into a pharmacy there and self prescribe to take care of basic needs such as a new inhaler or antibiotics etc. Not only that but you can get them for a fraction of the cost here. Try getting amoxicillin for less than 20$ here. You can actually discuss your problem with the Pharmacist there and they will help you select the proper meds for your problem.

We are way to litigious of a society for that to work here but I wish it could. I for one would be happy to sign a waiver in exchange for convenient access to basic medications.


-Eliot

Yeah having to go to the doc to get antibiotics when I used to know exactly what I had since I had it for 500 times in the past is annoying as heck.

I know the current system is borked and filled with tons of waste. However I can say the same thing for EVERY govt. thing I can think of so having govt. run healthcare does not sound like a great idea. I think a mix of reforms, some kind of incentive to get people preventive care and something other than an emergency room to help people with non-critical problems (yes even non-citizens). Add in a ton of tort reform and I think you can have the same basic system that works better than gov run healthcare.

Of course it will never happen. 

Greetings from the land of socialized medicine  

I think it likely that, if the US had the same healthcare system as the UK, I'd still be there catching rockfish with you guys. After growing up with the UK National Health Service, my experience with American health care was, in a word, terrifying. There are many thousands more words to describe it, but you've heard all the horror stories. It drove me out of the country.

You've already knocked around the stats about American healthcare being the most expensive in the world, whereas measures of health and life expecancy are inferior to most developed countries. One thing I don't think that gets mentioned enough in the international comparison is this;

Any healthcare is free in the UK. For everyone.

Any time I get sick, I go to the doctor, or the emergency room. They see me, prescribe medicine and send me on my way. I get the prescription filled for free (thats a Welsh thing, in England it costs about 10 bucks, no matter what the drug is).

whereas measures of health and life expecancy[sic] are inferior to most developed countries.

And that's another one of those lies statistics. For instance, differences in life expectency between the U.S. and other countries is heavily skewed because of 1) Juvenile violence in the U.S.  2) Traffic deaths  3) The way births and deaths are recorded in the U.S vice  Canada, the UK etc... Simply removing death by violence and accidental death from the life expectancy equation, and folks here in the U.S. live longer than in the U.K.

Want a different look at a measure of health? How about 5 year cancer survival statistics. Here's a little chart for you:


The UK (though conservative) article where I found it:

http://conservativehome.blogs.com/platform/2009/08/shane-frith-can-we-get-over-this-myth-that-the-nhs-is-the-envy-of-the-world.html

You use your lies statistics, I'll use my lies statistics...

Scott

you actually have to leave the violent deaths in the stats, as they us the healthcare ecosystem and therefore drain the bucket. You can say that life expectancy minus violent death and car crashes is on par with most developed countries. That's not a true measure of the drain on the system, or the health care quality however because you don't know if in another country those deaths would not have been deaths.

No, I think traffic deaths can be taken out, after all, we don't drive cars in Europe 

The bigger point about statistics is valid to a point; both sides can find something. Especially when you trawl political sites and blogs.

However, as unpleasant as I found that source to be, I agree entirely with the point that personal experience is also no indicator of the success of the system as a whole.

But if the stats are lies and personal experience is entirely subjective, what do we do?

I think it is all crap.  We all live in a world, were we have gotten so spoiled ass rotten, that we take for granted everything in life.  We think that we have it coming, that it is our right to have this stuff.  Socialism does not work, never has, never will.  What ever happened to going to work, working hard, paying cash, and providing for the family? Now, it is credit cards, refi the house, Suv, and gov't bailouts.  I am on a rant, but I think every able bodied American should be working and providing for their own family.  The only freebee in life should be kayak fishing after the initial cost of the purchase!

Socialism does not work, never has, never will.

Well, I guess that depends on what you mean by "socialism". Northern Boy just described how "socialized" care does work in the UK. But the idea that it's somehow free doesn't wash. It's paid through taxes. Here we socialize medicine through the ER.

I have family in Denmark, a true nanny state. They were also rated as the best place in the world to start an international business. We, as a country, are far more "socialistic" they we admit. Others countries with extensive social safety nets, such as Denmark, are far more capitalistic than we give them credit for.

Addressing the issue gets lost in the rhetoric.

I am on a rant, but I think every able bodied American should be working and providing for their own family.

Montana, are you saying that you pay for your family's healthcare out of pocket?

Ben

I know the current system is borked and filled with tons of waste. However I can say the same thing for EVERY govt. thing I can think of so having govt. run healthcare does not sound like a great idea.

With the exception of the US every developed nation moved to socialized medicine for a reason, namely, because they found that capitalism does not work efficiently in this segment of their economy. WHO rates us as 37th in heath care quality yet our heath care absorbs roughly twice the costs per person as other developed countries. Health care is “borked” here because of decades of hard-pressed legislation funded by the health care industry. They don’t want competition, regulation or anything else that may interfere with their profits. They made it “borked”. They like it "borked".

“The meme that government sucks at doing anything” bothers me. It’s one of those throw away phrases that have been repeated so often people don’t even question its validity anymore.
   
At this juncture it should be painfully clear that private interests are capable of massive devastation, waste, fraud, or inefficiency on a scale with any government program. Government is not inherently evil, and neither is private business. Neither government nor private companies are inherently better at detecting fraud, allocating capital, or generally any other task you can think of because of one simple fact: people run both, American people. And frankly I’m sick of hearing how these people suck at everything they do. It’s simply not true.

Nobody here has explained why Medicare has lower administrative costs than private insures. Nobody has explained why private insurers demanded subsidies under Medicare Advantage on the premise that their costs were higher. And nobody has explained the cost difference between our system and foreign systems that produce better care.

All I’m hearing is “Government - bad”.

I know the current system is borked and filled with tons of waste. However I can say the same thing for EVERY govt. thing I can think of so having govt. run healthcare does not sound like a great idea.

With the exception of the US every developed nation moved to socialized medicine for a reason, namely, because they found that capitalism does not work efficiently in this segment of their economy. WHO rates us as 37th in heath care quality yet our heath care absorbs roughly twice the costs per person as other developed countries. Health care is “borked” here because of decades of hard-pressed legislation funded by the health care industry. They don’t want competition, regulation or anything else that may interfere with their profits. They made it “borked”. They like it "borked".

 

I completely countered the consumer bankruptcy angle and pointed to numbers with citations to original sources.
...
Warren's study simply does not support the notion that medical bills are causing more bankruptcies in 2007 than they did in 2001.  That isn't suspicion, that is fact.  And I showed my work.

Citations to what original sources? You didn't cite anything but the study we're talking about. And your "work" was two lines of math whose base numbers I couldn't find in the study.

I can appreciate your suspicion of numbers being manipulated. And I'll be the first to admit that my eyes start to glaze over when reading this sort of thing. But, unless I'm mistaken, articles published in the American Journal of Medicine are peer reviewed. Further, a lot of people smarter than both of us would like to discredit this, if possible, but I've not heard of that happening.

Ben