Thursday, April 28, 2005

What is a moderate to do?

The Unofficial Paul Krugman Web Page: "Claims that liberal bias keeps conservatives off college faculties almost always focus on the humanities and social sciences, where judgments about what constitutes good scholarship can seem subjective to an outsider. But studies that find registered Republicans in the minority at elite universities show that Republicans are almost as rare in hard sciences like physics and in engineering departments as in softer fields. Why?
One answer is self-selection - the same sort of self-selection that leads Republicans to outnumber Democrats four to one in the military. The sort of person who prefers an academic career to the private sector is likely to be somewhat more liberal than average, even in engineering.
But there's also, crucially, a values issue. In the 1970's, even Democrats like Daniel Patrick Moynihan conceded that the Republican Party was the 'party of ideas.' Today, even Republicans like Representative Chris Shays concede that it has become the 'party of theocracy.'
Consider the statements of Dennis Baxley, a Florida legislator who has sponsored a bill that - like similar bills introduced in almost a dozen states - would give students who think that their conservative views aren't respected the right to sue their professors. Mr. Baxley says that he is taking on 'leftists' struggling against 'mainstream society,' professors who act as 'dictators' and turn the classroom into a 'totalitarian niche.' His prime example of academic totalitarianism? When professors say that evolution is a fact.
In its April Fools' Day issue, Scientific American published a spoof editorial in which it apologized for endorsing the theory of evolution just because it's 'the unifying concept for all of biology and one of the greatest scientific ideas of all time,' saying that 'as editors, we had no business being persuaded by mountains "

Wednesday, April 27, 2005

Caught in a Devil's Bargain

"A 2003 study published in Health Affairs ... comparing a number of measures of health services across the advanced world. What the authors found was that the United States scores high on high-tech services - we have lots of M.R.I.'s - but on more prosaic measures, like the number of doctors' visits and number of days spent in hospitals, America is only average, or even below average. There's also direct evidence that identical procedures cost far more in the U.S. than in other advanced countries.

The authors concluded that Americans spend far more on health care than their counterparts abroad - but they don't actually receive more care. The title of their article? "It's the Prices, Stupid."

Why is the price of U.S. health care so high? One answer is doctors' salaries: although average wages in France and the United States are similar, American doctors are paid much more than their French counterparts. Another answer is that America's health care system drives a poor bargain with the pharmaceutical industry.

Above all, a large part of America's health care spending goes into paperwork. A 2003 study in The New England Journal of Medicine estimated that administrative costs took 31 cents out of every dollar the United States spent on health care, compared with only 17 cents in Canada."



" The United States spends far more on health care than other advanced countries. Yet we don't appear to receive more medical services. And we have lower life-expectancy and higher infant-mortality rates than countries that spend less than half as much per person. How do we do it?

An important part of the answer is that much of our health care spending is devoted to passing the buck: trying to get someone else to pay the bills.

According to the World Health Organization, in the United States administrative expenses eat up about 15 percent of the money paid in premiums to private health insurance companies, but only 4 percent of the budgets of public insurance programs, which consist mainly of Medicare and Medicaid. The numbers for both public and private insurance are similar in other countries - but because we rely much more heavily than anyone else on private insurance, our total administrative costs are much higher.

According to the health organization, the higher costs of private insurers are "mainly due to the extensive bureaucracy required to assess risk, rate premiums, design benefit packages and review, pay or refuse claims." Public insurance plans have far less bureaucracy because they don't try to screen out high-risk clients or charge them higher fees.

And the costs directly incurred by insurers are only half the story. Doctors "must hire office personnel just to deal with the insurance companies," Dr. Atul Gawande, a practicing physician, wrote in The New Yorker. "A well-run office can get the insurer's rejection rate down from 30 percent to, say, 15 percent. That's how a doctor makes money. ... It's a war with insurance, every step of the way."

--Paul Krugman http://www.pkarchive.org/

...Universal health insurance, anyone?