Boom!

Some health care numbers

mrgan:

Every health care debate swings between emotional and number-based arguments. On the emotional front, those in favor of universal, government-backed health care empathize with the uninsured, while the free-market proponents warn about the nanny state and ask why they should be expected to pay for others’ bills.

That game can be played forever, and neither side is likely to convert the other. Let’s look at some numbers for a change. The Washington Post has a concise and clear story on health care around the world compared to what we live with in the US. Choice cuts:

U.S. health insurance companies have the highest administrative costs in the world; they spend roughly 20 cents of every dollar for nonmedical costs, such as paperwork, reviewing claims and marketing. France’s health insurance industry, in contrast, covers everybody and spends about 4 percent on administration. Canada’s universal insurance system, run by government bureaucrats, spends 6 percent on administration. In Taiwan, a leaner version of the Canadian model has administrative costs of 1.5 percent; one year, this figure ballooned to 2 percent, and the opposition parties savaged the government for wasting money.

The world champion at controlling medical costs is Japan, even though its aging population is a profligate consumer of medical care. On average, the Japanese go to the doctor 15 times a year, three times the U.S. rate. They have twice as many MRI scans and X-rays. Quality is high; life expectancy and recovery rates for major diseases are better than in the United States. And yet Japan spends about $3,400 per person annually on health care; the United States spends more than $7,000.

Surely there must be some price to pay for such low administrative costs?

In the United States, an MRI scan of the neck region costs about $1,500. In Japan, the identical scan costs $98. Under the pressure of cost controls, Japanese researchers found ways to perform the same diagnostic technique for one-fifteenth the American price. (And Japanese labs still make a profit.)

What happens when disaster strikes and you require very costly treatment?

In terms of finance, we force 700,000 Americans into bankruptcy each year because of medical bills. In France, the number of medical bankruptcies is zero. Britain: zero. Japan: zero. Germany: zero.

Here’s how big a problem American medical bankrupcy is, according to The American Journal of Medicine:

They concluded that 62.1 percent of the bankruptcies were medically related because the individuals either had more than $5,000 (or 10 percent of their pretax income) in medical bills, mortgaged their home to pay for medical bills, or lost significant income due to an illness. On average, medically bankrupt families had $17,943 in out-of-pocket expenses, including $26,971 for those who lacked insurance and $17,749 who had insurance at some point.

Overall, three-quarters of the people with a medically-related bankruptcy had health insurance, they say.

Just sayin’.

reblogged from mrgan

Migration From Mexico to U.S. Has Plummeted

The New York Times:

Mexican and American researchers say that the current decline, which has also been manifested in a decrease in arrests along the border, is largely a result of Mexicans’ deciding to delay illegal crossings because of the lack of jobs in the ailing American economy.

Hmm, this looks familiar.  Here’s what I said last summer in response to this article on employment laws:

I have always wondered why immigration policy debates focus on border patrol rather than the employment that creates incentives for illegal immigration.

The MTA Is Not Your Mom

Dear fellow young NYC residents,

Really?

Look, I hate paying more for things like everyone else.  I hate service changes and crowded trains and waiting on a platform. We all hate these things, but we ride anyway.

I’m sick of drunk, obnoxious kids screaming at MTA employees working on tracks at night.  I’m sick of petulant signs and Tumblr memes.  Everyone’s bitching about the MTA’s rate hikes and service changes, but has anyone bothered to read about why they’re happening?  Is this why you moved here—so you could piss and moan when something bad happens that’s beyond your control?

Like everything else, public transportation has been battered by the state of the economy.  MTA revenues are based on taxes, and tax revenues are way, way down.  Additionally, the MTA has ballooning debt from a 2000-2004 capital program.  They have a budget shortfall even after running a recent surplus—that’s how bad it is.

MTA Press Release, March 25, 2009

Elliot G. Sander, MTA Executive Director and CEO
MTA Board Meeting
March 25, 2009

[…]Despite carrying a surplus in 2007, deficits were looming due largely to the ballooning debt service from the 2000-2004 capital program. We took immediate action to become more efficient in the face of these widening gaps.

[…]

In the end, though, the collapse of our real estate tax revenue, on top of the escalating debt service costs, could not be made up by belt tightening. Only 7 percent of the MTA’s $11 billion budget is dedicated to administration, making it simply impossible to cut our way out of what amounted to a $1.2 billion deficit. [emphasis mine]

Write to a state representative (the state turned down a proposal to provide additional funding).  Write to congress (I hear they’re handing out some dough).  Whatever it is, you live in New York City—stop whining and do something.

G.M. continues to be run by ostriches

“The General Motors Corporation reported a stunning second-quarter loss of $15.5 billion on Friday because of a dramatic decline in United States sales and charges for job cuts, plant closings and the falling value of trucks and sport utility vehicles.”

April 21, 2006:

The automaker’s pickups and sport utility vehicles, like the Cadillac Escalade, are critical to its turnaround.

August 2, 2008:

G.M., like its Detroit rivals Ford and Chrysler, was surprised by the abrupt shift to smaller, more fuel-efficient cars.

Surprised cannot be the right word here. But screwed? Yes.

UPDATE:  This New Yorker piece (12/8/2008) brings it home.

The Secretary of Transportation’s report to Congress begins on a dark note. “Over the past year, the domestic auto industry has experienced sharply reduced sales and profitability, large indefinite layoffs, and increased market penetration by imports,” it states. “The shift in consumer preferences towards smaller, more fuel-efficient passenger cars and light trucks … appears to be permanent, and the industry will spend massive amounts of money to retool to produce the motor vehicles that the public now wants.” The revenue to pay for this retooling, though, will have to come from sales of just the sort of cars that the public is no longer buying—a situation, the report observes, bound to produce “financial strain.”

“To improve the overall future prospects for the domestic motor vehicle manufacturers, a quality and price competitive motor vehicle must be produced,” the report warns. “If this is not accomplished, the long term outlook for the industry is bleak.”

The Secretary’s report was delivered to Congress in 1980, a year after what may soon become known as the first Chrysler bailout. Depending on how you look at things, the report was either wrong—three years later, Chrysler returned to profitability—or prescient.