Christina Jeffrey (congressional candidate, SC-4)

We also throw people out of the hospital pretty fast, the average acute stay is 5.5 days, much shorter the Germany, Canada, Switzerland, and the UK; but longer then France or Sweden. Is that rationing from not enough hospital beds, or better care, or unnecessary admissions?

Nurses per capita: we have 10.6 nurses per 1000, more then the UK with 10/1000 or Germany with 9.9/1000, or France with 7.7/1000. By your productivity metric, then France, Germany and the UK is more productive.

You seem to have limited your definition of productivity to output relative to just direct labor. Of course, most other people define productivity as output relative to total cost. Without getting into the issue of equality of access to health care which our system fails at miserably, our costs are 50% more as a percentage of GDP then the next most expensive system in Switzerland. By that metric, we have the least productive health care system.

None of this has anything to do with rationing however. Rationing problems arise when prices are suppressed. And since they tend to be slightly more suppressed in other countries (and especially where the supply of technology is tightly controlled)the rationing problems are much greater.

The US has 2.4 physicians per thousand, growing at a rate of 1% a year. You may be correct in stating that we have more then Canada, which has 2.2/1000 but a much lower growth rate at .2% a year. If you look in the European countries that have universal health care, pretty much all them have more physicians. A few examples: Switzerland 3.9/1000 growing at 1.5%; Sweden 3.6/1000 growing 1.4%; Germany 3.5/1000 growing 1.5%; even the UK has more doctors 2.5/1000 growing at 2.5% a year.

Do people from Canada keep coming over to this country for medical care because they like the view?

In that huge monster of a bill it talks somewhere about giving extra money to primary care physicians to motivate them and help them phase into the new health care systems.

First of all many of those primary care guys will be gone because of the huge doctor shortage brought on by being forced to practice socialized medicine. Secondly, there is no provision for specialists such as neurologists, cardiologists, etc. who do a lion’s share of the business in treating people with chronic conditions like diabetes, heart disease, etc.

Maybe they will manage to get that mess of a bill passed but when things get personal and affect people’s lives, I think Americans will stand up and vote all of those congressmen who have their heads in the clouds out of office.

If prices and not accurate, the underchaged will overinsure, the overcharged will overinsure and if people can game the system they will go bare — paying no premium whatsoever — until they get sick.

Ronald Reagan said “In this present crisis, government is not the solution to our problem; government is the problem.” (First Inaugural Address). Recently, John Stossel of Fox News, stated that insurance is the problem with current health care.

Reduction in the cost of health care requires reduction in the involvement of a third party payer. There is no reason why every visit to a doctor should generate an insurance claim. No thinking person would give another person $125 to pay their $100 utility bill. That is what happens with traditional health care insurance. Contrast that with other types of insurance, in which the insured rarely if ever files a claim.

The cost of processing a claim is relatively independent of the size of the claim. High deductibles would reduce the number of small claims and reduce the amount of the insurance premium.

Many primary care physicians claim that approximately thirty percent of their patient visits do not require professional attention. This degree of overutilization occurs largely because it is being reimbursed by insurance and is reflected in higher insurance premiums. High deductibles would reduce the level of overutilization because patients would be using their own funds for fees within the deductible amount.

Fraud detection and its penalties require costly efforts at protection. Fraud is most likely to occur when there is a third party payer. Fraud is unlikely when a transaction involves only a physician and a patient. Fraud reduction also allows reduction in the amount of the insurance premium.

Overhead incurred by the physician is increased when a third party payer is involved and must be reflected in the fee schedule, another reason for high cost of insurance premiums.

When a third party payer assumes the risk of a need for health care, incentive is lacking for the insured to remain healthy and avoid the need for care, leading once more to increased insurance premiums.

Another reason for excessive cost of health care is defensive medicine, prescription of additional procedures employed to guard against frivolous malpractice claims.