August 14, 2009

Before Voting on a 1,000-Page Bill, Shouldn't We Understand the Problem We're Trying to Fix?

Carroll Andrew Morse

In his defense of a Canadian-style single payer system for health insurance appearing in today's Projo, Dr. Michael M. Rachlis either makes a case that President Barack Obama is badly misguided in his belief that government has to get more heavily involved with medical decision-making as a part of healthcare reform, or else he calls his own basic assumptions into question…

On costs, Canada spends 10 percent of its economy on health care; the U.S. spends 16 percent. The extra 6 percent of GDP amounts to more than $800 billion per year. The spending gap between the two nations is almost entirely because of higher overhead. Canadians don’t need thousands of actuaries to set premiums or thousands of lawyers to deny care. Even the U.S. Medicare program has 80 percent to 90 percent lower administrative costs than private Medicare Advantage policies. And providers and suppliers can’t charge as much when they have to deal with a single payer….

Because most of the difference in spending is for nonpatient care, Canadians actually get more of most services. We see the doctor more often and take more drugs.…

If the problem of runaway costs is driven mostly by administration and overhead -- as Dr. Rachlis plainly asserts -- then by what rationale have government-commissioned effectiveness panels that will "bend the cost curve" by determining treatments to be denied (i.e., we've decided we'll pay for the red pill, but not for the blue pill) become so central to the President's discussion of healthcare reform?

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"(i.e., we've decided we'll pay for the red pill, but not for the blue pill"

Wait, this insurance won't cover the little blue pill? There goes my Viagra stock!

Posted by: Patrick at August 14, 2009 2:53 PM

"On costs, Canada spends 10 percent of its economy on health care; the U.S. spends 16 percent."

Does that include:

1.) all of the advances in medicine that have come out of the US system?

2.) all of the seven and eight figure malpractice awards that have arisen of a reluctance to implement tort reform?

[Patrick, if you don't start taking this more seriously, I'm going to report you to the White House Snitch Line.]

Posted by: Monique at August 14, 2009 5:30 PM

I seriously question the authenticity and accuracy of Dr. Rachlis's factual claims.

Posted by: BobN at August 14, 2009 6:45 PM

My Canadian friends and relatives are
happy with their health-care system.

My parents were both Canadians

Posted by: Herm at August 14, 2009 8:45 PM

What kind of cheap trick are you trying to pull here? The quote from Dr. Rachlis says one thing and you present a bogus straw man- red pill vs. blue pill- argument completely unrelated, except by paranoid fantasy as an argument. You threw in the red pill vs blue pill argument and then cited it as a reason to kill or delay the health care program.

I try not to let paranoia drive my decisions and I certainly do not wish to see my government ruled by paranoids.


Posted by: OldTimeLefty at August 14, 2009 9:58 PM

The point is that whatever the U.S. government spends on medical care it misses 48,000,000 people. this is of no apparent concern to you and yours.

Posted by: OldTimeLefty at August 14, 2009 10:01 PM


Thanks for pitching in. But the President does not favor either a Canadian or a British health care system.

The current talking point is to vilify insurance companies. Feel free to circulate among like-mindeds.

Rahm E

Posted by: Monique at August 14, 2009 11:07 PM


There’s nothing happening in the main post that’s not explained in the main post.

Dr. Rachlis claims that "most of the difference" between American and Canadian healthcare costs is administrative in nature, not directly related to patient care. If his numbers are legit, then why do we need a new government program for effectiveness research -- which has been a major focus of President Obama’s description of his healthcare plan -- in order to substantially cut costs?

And whether Rachlis knows what he’s talking about or not, exactly what is a new program for "effectiveness" research giving us that existing medical research doesn’t, if it’s not telling us we can have the red pill but not the blue pill (which is President’s Obama’s example, by the way)?

Posted by: Andrew at August 15, 2009 12:12 AM

"Feel free to circulate among like-mindeds"
Thanx Monique
(sorry i forgot that AR is for
right-wing "like-mindeds" only)


Posted by: Herm at August 15, 2009 9:56 AM

Sr. Morse,
You are driven by paranoia. You have nothing to sell but paranoia itself.

Posted by: OldTimeLefty at August 15, 2009 8:59 PM

If you Removed the chubby guys ad at
the top of the page,and posted this in

\"Feel free to circulate among like-mindeds\" Monique

only right-wingnuts would comment here!

Posted by: Proxy Guy at August 15, 2009 9:46 PM

By all means, Proxy Guy, feel free to circulate Anchor Rising among "un"like-mindeds.

That's kind of the point, actually ...

Posted by: Monique at August 16, 2009 9:25 AM
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