Michael, thank you for this well-researched and sobering post. I just want to clarify with regard to the White House invitation that it wasn't a general one to all Patch bloggers. I just happened to be having my annual review with my boss when the word came through that they wanted some questions, and we both thought of you immediately. (Taking advantage of my situation, I added Julio Soriano, whose question did not get picked.) In all, the White House answered questions from just seven Patch sites. Thanks for making ours one of them.

Wow, the Napa Blogger has become a shill/propagandist for the White House. Even to the point of using their talking points. Many key factors were left out of your blog that are relevant such as Medical Malpractice Insurance, the Billions of unpaid medical bills picked up by the taxpayer for Illegal immigrants using America's medical services. You also left out that of the 1600 suppliers of Health Insurance, some states limit those carriers with their state, California being one of them.

Mark, there is tons of info that I left out, yet wrote the longest article I have ever written. We are not going to solve this extremely complicated problem in one article. I am aware of all those issues and there are plenty more.

But as a Republican, my question to you is, where is the free market plan? Rick Perry advocated for raising the age of eligibility for medicare, Ron Paul incredibly says that Drs should see poor people for free, if you look at the plans as stated by all the primary contenders they are a hodge podge of more government intervention and totally unrealistic unworkable plans.

A shill? I just want some answers.

Michael, another great post. I was disappointed in the WH's answer to your question. They indicated that having premium costs go up slower is saving me money - not the way I see it.

I'm glad that you pointed out that this is a train wreck waiting to happen. I am in the same situation regarding premiums and deductibles. Another side efect of a high deductible is not having routine screenings done these days, as they end up being all out of pocket. This article from the NYTimes indicates its pretty widespread http://www.nytimes.com/2011/05/14/business/14health.html?_r=2 .
There may be a lot of cases of things that would have been cheaper to catch early but end up being expensive because they were not detected, however the individuals just simply did not have money to have the screenings done after paying their premiums.

I have pre-existing conditions, so I wouldnt dare change insurance companies even if I could find someone cheaper.

I dont have any answers, except I believe it is the responsibility of all parties - providers, insurance, pharmaceutical and patients - to reduce costs however they can. One thing I discovered just recently was that there are outside labs you can go to for lab work that are significantly less expensive than hospital labs. But I dont think that's common knowledge, so people just go to the address listed on their lab order.

I have gotten some interesting emails, I want to post part of one here from a health care policy expert:
"But I completely disagree that "Medicare is far more efficient than private markets". They DO keep overhead low because they only make the rules, and pay the claims that are submitted. But more than one-third of what Medicare pays for is: 1) medically unnecessary, 2) of such poor quality that it has to be redone, or 3) outright fraud. That's why, adjusting for health status, Miami seniors are 3 times more likely to have cardiac surgery than Minnesota seniors."

There is debate about whether Medicare is more efficient, I believe even at the incredible level of inefficiencies we have in Medicare there is no doubt cost increases have been lower over the last forty years and since the late 90's, as I said.

If you qualify it and look at the numbers differently you can make a different argument, but there is no doubt we have a very inefficient private system that is unsustainable.

I wish these "experts" were confident enough of their claims to post them here in the comment thread, instead of sending them to you via email, Michael.

Thanks! You always generate fascinating discussions on topics I might formerly have avoided.

The underlying issue in the cost of American health care is the lack of preventative care which includes obesity or excercise as a lifestyle choice. The average American today is close to obese, among the poor it's worse. Any idea who pays for that? It's not the rich among the 50 million uninsured who stand in line at the free clinics. The true effects of all that junk food pushed at the poor and middle classes will come back in dialisis treatments for the diabetic explosion that has already begun. California could always break from the union, accept immigration, revise health care and start charging admission like the feds are doing with their $200,000.00 green card program.

The real issue is having the government dictate to us what our health care should be. Simple math will show what a cluster it will become and how the "State health care agencies" will fail the people. England's NHS has a bureaucracy of 1.4 million for 51 mililon population. The US is 6 times that size, that is almost 9 million more federal employees. A quick glance over the 'pond' will show that the "State Health Care" systems create tremendous debt. As per the ACA Doctors will be punished, not get paid, if they see a patient and then that patient ends up in the hospital. The market place works when it is allowed to. Restricting the market, as is the case in CA, only drives up the cost. The real increase in medical care is Med Malpractice insurance. That was never addressed by the Democrat written bill. as an aside, 45% of all physicians have stated they will leave practice once OCare kicks in. Businesses are already dropping coverage for their employees. Additionally, with the advent of the so-called women's reproductive health mandate just levied by the White House, it is clear they do not care about violating the Constitution to get what they want. Sorry, but my freedom of speech is much more important than health care for 22 million illegal immigrants!

"Spoken like the true left!"

Mark, I only have a couple minutes this morning and will be back later to write more. I appreciate your coming back to fill us in on your views.

Not sure what to say to the above comment. Should I say "spoken like the true right?" Labelling and dismissing people like that doesn't seem very conducive to dialogue. I think we need to have a discussion about these issues or we will never resolve them. When you say things like that it makes me feel like there is no point in discussing anything because anything I might have to say has already been discounted and dismissed.

"So-called women's"? What would you prefer that we be called, Mark?"

To be fair, Louisa, I think he was referring to the law or mandate, not to women.
.

Okay Michael, I could only find my cranky pants this morning!

I prefer to call it what it actually is. Forcing Contraception on the Catholic Church is 1.) A violation of the 1st Amendment to the Constitution and, 2.) Violates the concept of the separation of Church & State. Additionally, they want it given for "Free!" Nothing is free, the cost will be spread amongst the policy holders to pick up the cost. Now I think that anti-contraception drugs as prescribed by a Doctor should be covered by insurance, ONLY if that individual so desires it! To force someone against their Religious beliefs to have this is unconscionable. It is a straight up attack on personal liberty. It has nothing to do with health care.

Dean, we already are a debtor na5tion Dean. Our President is making sure of that! Our debt is larger than our GDP and under the proposed budget trillions more in debt will be added as our economy grinds to a snails pace. We are not far behind the EU, The weight of Government spending has crushed them, as it will us. I live in California and our State is $1 trillion in debt. Are our political leaders working on a solution? NO! they are working on raising taxes to fill a tiny hole in their budget to keep on spending. they are selfish, bloated politicians who care only for money and power. Typical story.

Michael - I admire anyone trying to deal with those who believe in the "free" market of health care with facts. Facts don't matter. Faith does.

I wasn't aware that T.R. Reid was liberal. I thought he was just stating the facts.

Five Myths About Health Care in the Rest of the World
http://www.washingtonpost.com/wp-dyn/content/article/2009/08/21/AR2009082101778.html

Here is a key difference between those who have private insurance and our for profit system:

"The key difference is that foreign health insurance plans exist only to pay people's medical bills, not to make a profit. The United States is the only developed country that lets insurance companies profit from basic health coverage. "

Here is more reality:

"This fragmentation is another reason that we spend more than anybody else and still leave millions without coverage. All the other developed countries have settled on one model for health-care delivery and finance; we've blended them all into a costly, confusing bureaucratic mess.

Which, in turn, punctures the most persistent myth of all: that America has "the finest health care" in the world. We don't. In terms of results, almost all advanced countries have better national health statistics than the United States does. 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. "

And it goes on and on.

Scott, thanks for the info. One starts reading all this and it becomes pretty obvious that we should take a cue from some of the other more successful countries. What is also interesting is that consumers have as much freedom in systems like France as we do---at less than half the cost.

You are right about Reid, I have no idea of his political affiliation, better put I should have said he presents facts that tend to support a liberal point of view.