Monday, March 14, 2005

MORE ON THE SALLY PIPES BOOK:

The purpose of Sally Pipes' new book, the author says, is "to provide the reader with an easy-to-understand guide" to the problems of affordability, accessibility, and quality of health care in the United States and Canada. Miracle Cure: How to Solve America's Health Care Crisis and Why Canada Isn't the Answer seeks out the best approach to solving the complex problem of health care reform while simultaneously preserving the positive attributes of each country's health care system.....

In Miracle Cure, Pipes convincingly demonstrates that although the American and Canadian systems appear to differ dramatically, "they both suffer from symptoms of the same disease--the disease of central control." In the foreword, economist Milton Friedman, a senior research fellow at the Hoover Institution, states, "What should be mutually satisfactory cooperation between patient and physician turns all too often into a bureaucratic nightmare."

Each chapter presents information the general public rarely receives from media sources. "One of the best-kept secrets," writes Pipes, "at least from the media and policymakers who continually talk of a drug cost 'crisis' for low-income seniors, is that there are already programs, both sponsored by governments and private companies, that significantly subsidize this group's purchases of prescription drugs." According to Pipes, "Nearly 20% of seniors, the poorest one in five, were receiving highly subsidized prescription drugs [through state-sponsored or private-sponsored plans for seniors]. An administrative fee of $12 purchases a month's supply of any Eli Lilly and Co. product for lower income seniors or disabled. ... The same is true for Novartis Products [and] Pfizer."

The chapters on consumer-driven health care clearly describe the potential tangible and intangible benefits of health savings accounts (HSAs) and health reimbursement arrangements (HRAs). "HSA plans combine a high-deductible insurance policy with a tax-free savings account dedicated to paying for expenses below the insurance deductible," explains Pipes. Authorized in late 2003 by the Medicare Modernization Act, these plans will soon be widely available to taxpaying citizens under age 65 and may be extended to everyone in the relatively near future, offering cost constraints motivated by preservation of personal savings and implemented by enhancement of the patient-physician relationship. In addition, they avoid the austerity seemingly implied by the term "high-deductible" health insurance.

Part Two of the book, "The Canadian Solution: Legalize Competition," notes that in Canada, the sole third-party payer is the government. "Canada is the only Western country in which private insurance for publicly insured procedures is actually outlawed," notes Pipes. The federal and provincial governments jointly administer the Canadian health care system, called "Medicare." Over time, power in the system has shifted gradually to the federal government, because it controls the funds......

In the conclusion of the book, she writes, "The greatest risk to both systems is not that they will go bankrupt. It is that they will come to see human beings as nothing but cost centers. ... We will lose more than access, affordability, and quality in health care. We will lose our humanity."

More here

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.

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