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Monday, January 12, 2009

The Israeli military continues to pound Hamas, and Israeli leaders believe that they may be close to achieving their goals.

Meanwhile, across Europe, Mark Steyn says the 'oldest hatred' continues.

Barack Obama has some positive things to say about Dick Cheney, according to this piece by Bill Kristol.

Michael G. Franc says middle-class taxpayers need to be prepared for a big tax increase during the Obama years.

Robert J. Samuelson, as always, has some common sense thoughts on the cost of health care. In this piece he cites a recent study which shows why Americans spend so much on health care. It's not due to paperwork or to overuse of emergency room care...

What really drives health spending, the study finds, is that Americans receive more costly medical services than do other peoples, and they pay more for them. On a population-adjusted basis, the number of CT scans in 2005 was 72 percent higher in the United States than in Germany; U.S. reimbursement rates were four times higher. Knee replacements were 90 percent more frequent than the average in other wealthy countries. In 2005, there were 750,000 knee and hip replacements, up 70 percent in five years, reports the journal Health Affairs.

We have a health-care system that reflects our national values. It's highly individualistic, entrepreneurial and suspicious of centralized supervision. In practice, Medicare and private insurers impose few effective controls on doctors' and patients' choices. That's the way most Americans want it. Patients understandably desire the most advanced surgeries, diagnostic tests and drugs. Doctors want the freedom to prescribe.

Bingo. We have the health care system we want. As patients, we want the best health care service we can get, no matter the cost, and all the better if our insurance covers most of that cost. As insurers, we want whatever will make us the most money, no matter the cost. As health care providers, we want the best health care that will help our patients, and that makes us the most money, no matter the cost. As Samuelson points out...

On paper, there are various ways to control health spending: stricter regulation of prices and the availability of care; "market mechanisms" to push consumers toward more efficient or skimpier care. All have foundered, because they cannot be used aggressively. The reason is politics. There is no major constituency for controlling spending. Because most patients don't pay medical bills directly, they have little interest in using less care or shopping for lower-priced services. Providers (doctors, hospitals, drug companies) have no interest in limiting care. What others call "health costs" are their incomes -- wages, salaries, profits.

So don't hold your breath waiting for Obama, or anyone else, to bring these costs under control.

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