July 6th, 2012
09:29 AM ET

Fareed's take: Obamacare and cutting healthcare costs

By Fareed Zakaria

Many liberals believe that the Affordable Care Act — Obamacare — is unpopular only because most Americans don’t understand it. There is some truth to this: Studies show that the core provisions of the bill are more popular than the bill itself. But there’s also a reason, rooted in reality, why many Americans worry about Obamacare — its cost.

Most Americans have health care. What they worry about is the cost of insuring 20 million to 30 million more people. Unless the meteoric rise of health-care costs is slowed, a big expansion of coverage might well remain unpopular, no matter how it is explained, Zakaria writes in the Washington Post.


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Topics: Health • United States

soundoff (157 Responses)
  1. Tam

    Do check out Canada. Universal health care, run by the provinces (like states). Taxes pay. Almost everything is covered. You don't even see a bill for your surgery. People don't worry about losing benefits - or their homes and lives.

    July 7, 2012 at 2:31 pm | Reply
  2. just-a-guy99

    Let's dispel some myths:

    1. Tort reform will have no impact on health care costs because despite the headlines that they generate payouts for malpractice suits are such a tiny percent of our overall healthcare costs that even if you eliminated all healthcare related lawsuits you would not even notice the difference.

    2. Study after study after study show that in fact doctors do not practice "defensive medicine" to avoid lawsuits. Doctors may order extra tests but not to the degree that most people want to believe.

    3. People from Canada come to America for surgery and other medical procedures not becasue the Canadian system is inadequate but because they imposed limitations on the age of patients for certain procedures as well as for other medically valid reasons. Canadian people with money come to the US for procedures that their own healthcare system won't allow them to have.

    4. Malpractice costs are soaring not because of lawsuits but because state medical boards refuse to revoke the licenses of even the worst doctors. Malpractice costs go up to cover the damage that those bad doctors who continue to practice do.

    July 7, 2012 at 7:03 pm | Reply
    • Lea

      You seem to want to replace "myths" with your own.

      HOwever, single payor would expose pro-profit medicine dressed up as defensive medicine. Patients will refuse to waste their time with endless appointments when their taxes are on the line. Canadians come to the US for treatments that are not readily available in the much smaller (population wise) nation and their provincial insurers pay for it. Canadians are triaged for urgent surgeries and do not wait at all in urgent situations although elective surgeries do have witlists, ameliorated somewhat by internet postings of wait times at various hopsitals to enable patients to move to different hopsitals if they wish to have treatment right away or much sooner. The malpractice rate everywhere tends to be a steady rate of about 1 out of 132 surgeries, but fortunately most medically avoidable injuries are minor. Doctors lose about half of the time at trial but winnow out most claimants before trial. They might lower their defence costs considerably with a no fault mentality buttressed by re-training and regulation and where worthy cases are settled quickly through mediation at much lower amounts. Don't forget most astronomical jury awards are cut dramatically at appeal. Tort reform is lawyers' parlance for sticking it to plaintiffs. But good lawsuits make medicine safer for everyone.

      July 9, 2012 at 9:59 pm | Reply
  3. Cindy Sullivan

    Loved your report on Healthcare! We lived in Switzerland for 3 years and were required to have healthcare.

    I recently completed treatment for Inflammatory Breast Cancer, a very aggressive and little known type of BC with no lump. The cost of my 10 months of treatment was over $275,000 and I am lucky, some of my new bc friends report over $600,000 for treatment.

    Dr. VIncent Tuohy of the Cleveland Clinic has a breast cancer vaccine ready for clinical trials but in need of funding. The vaccine was 100% effective in trials on mice. What are we waiting for???? Prevention IS the cure!

    At approximately $6 BILLION spend on breast cancer per year, is it possible that this cancer is such big business, it's too big to cure?

    I would love to see a report on this.

    July 7, 2012 at 9:04 pm | Reply
  4. MM

    I just watched Fareed's Health Care Commentary on CNN and found it to be one of the most informative and broad views. Great job! Thanks for the insight and comparison across different countries. Our country's healthcare needs improvement in terms of access (cost) and quality. It is so easy to get lost in all of the political twists on things. Thanks for the clarity.

    July 7, 2012 at 9:07 pm | Reply
  5. Doug

    Fareed said that a government board HAS to be the ones to select what services will be paid for and which will not. I agree that medical care has to be rationed by some means. I think most americans would like to choose for themselves.

    If we had a robust community health care center system providing basic care, we could have a safety net. Go all private for everyone who wants more than the very basics. People could choose whether they were happy with the safety net system or valued paying for comprehensive healthcare insurance. That way, the government is not responsible for choosing who lives and dies, who gets the best care and who does not. We can take responsibility for ourselves and choose.

    July 8, 2012 at 12:13 am | Reply
    • Candice

      "We can take responsibility for ourselves and choose."
      Some people cannot "take responsibility" as they do not make enough money.
      Hence "OBAMA CARE".

      July 8, 2012 at 10:05 am | Reply
  6. Surg doc

    Fareed sounds ignorant from a physician's perspective. He compares the U.S. system with countries with populations as large as our small cities and suburbs. Outcomes in the U.S. far exceed any other country by far. He fails to mention this small fact in any of his healthcare specials. Specialist increase medical outcomes. You do not want a primary care physician treating every problem; this is what Obamacare will do. A one month rotation compared to years of concentrated study.....which physician would you want?

    July 8, 2012 at 2:52 am | Reply
    • lea crozier

      This is not a concern in other countries with medicare. Systems do save money whem family docs act as gatekeepers and also as protectors of their own patients when they send them to specialists they have confidence in who then report back and eventually send the patient back. But specialists have organized lines of referrals of properly selected patients needing the care they can provide. Self-referring patients make costly mistakes and create havoc.

      July 8, 2012 at 2:54 pm | Reply
  7. Candice

    "You do not want a primary care physician treating every problem; this is what Obamacare will do."
    Where, in Obamacare" does it state that?
    The system proposed and accepted will provide the right kind of care at the appropriate time.
    Is this not what a sick person, regardless of economics, would want and need?
    Your assertion is clearly biased or you...

    July 8, 2012 at 10:09 am | Reply
  8. Gregory

    Texas had tort reform 7 years ago and recent studies have proven it had NO impact on raising health care costs. Find another scape goat – because Texas has proven all tort reform does it increase insurers profit. It done not reduce one penny health care costs!

    July 8, 2012 at 11:55 am | Reply
  9. Fubarack

    Fareed's story was mostly recycled from every other Health Care show I have watched, nothing new there. Since we now have Obama care for the time being, it would have been nice to show the failings and lack of any cost control measures in the horrible bill.

    July 8, 2012 at 1:59 pm | Reply
  10. lea crozier

    Why not push the US along quickly with four weeksa' manadatory holldays for Americans to bring US labour standards into the modern era, which will cut unemployment by 4% and create a boom, paid for by employers, and moving healthcare to the tax base, to create fully private care with a single payor (public or private) to reduce costs by 25% right away. Next, only medical reform of massive waste is needed. And, employers can always offer cadillac health plans to execs, as they do in all other medicare nbations. Wouldn't everybody finally be working (if they could), covered, and paying less for healthcare?

    July 8, 2012 at 2:38 pm | Reply
  11. bob

    the cost will be born by citizens, straight forward and obscure: the irs cannot fine you, or charge interest on the "tax", but they can withold your tax refund until you pay the tax, this applies to citizens and businesses. since 77% of Americans get a refund averaging circa $2,500, this will hit home with people. a tax? this is outright thievery – forced induction, other than military. a dicatatorship, a fleecing of the masses, kind of like lennin's russia.

    July 8, 2012 at 2:54 pm | Reply
    • lea crozier

      What about military spending? That's thievery. Surely there 8s a way to bring it down.

      July 8, 2012 at 2:58 pm | Reply
  12. robert feit

    the irs wil withold your tax refund if you do not pay the obamacare tax. since 77% of americans get a refund averaging circa $2,500, this is a "tax" to affect the masses, MOST OF WHICH WILL BE MIDDLE AND LOWER INCOME AMERICANS. do you really think obama loves ya? wait until the rest of that 2,500 page monstrosity unfolds.

    July 8, 2012 at 2:57 pm | Reply
  13. AnilN

    You guys keep fighting over this like it was the goverment or the policy or the kind of insurance. It's really the corporate greed which is basically running the USA which is taking the people for a very very expensive ride. Meanwhile – medical tourism is increasing to Asian countries and multi-fold to India which has the latest of most medical techniques available in the US. Just google for surgery cost comparison between the US and India and you'll get the fraction at which the same surgeries performed. Besides, there are plans for building a multi-billion $ facility in the carribean bringing health-care right at the doorstep of the US. I love it when capitalism teaches gets a taste of its own medicine!

    July 8, 2012 at 3:44 pm | Reply
    • mayflower

      I think you have missed the point entirely. Corporate greed, as you like to call it, led to some of the greatest R&D the most advanced medical technology in the world. We have some of the greatest medicine around in terms of level of care as well. If you go to India or the Caribbean, you will get a cheap a** surgery. You get what you pay for, dude. Does this mean I think CEOs should make millions plus bonuses? No. But I don't think we should use our tax system to pay for "fairness" when not everyone has worked to achieve the same things. A company that created a product that helps millions of lives become safer or better deserves what they earn (notice how I said earn and not got), and those responsible for its development should be rewarded accordingly.

      Honestly, we should have tackled education reform long before we considered health care reform. Make sure everyone gets the level of education they want (because not everyone wants to go to college, and some people want a PhD), a skill set or a trade, so they can provide for themselves and be able to afford their own health care. The people who don't have health insurance and run up huge ER bills because they don't get care until they HAVE to go to the hospital are a major factor in cost. When they don't pay (because some won't even bother trying to pay back their bill) this jacks up the price for those of us who are honest and DO pay. That's not corporate greed, AnniIN. You can't blame anything for that but a lack of education and resources.

      July 8, 2012 at 10:59 pm | Reply
  14. chedar888

    The UN rated the quality of healthcare in the US is at 35. And it cost an arm and a leg to have healthcare in the US. This say a lot of things like, the cost of drugs outside of the US is cheaper this alone will tell that we spend the most per capita income in the US than any in the industrial world. It does not add up.

    July 8, 2012 at 4:04 pm | Reply
  15. Russell Haney

    I did find the show soomwhat interesting except for one glaring fact. How is it that a show hosted by a medical doctor blames everyone else but his own profession for the continuued increase in costs??????

    July 8, 2012 at 4:42 pm | Reply
  16. S Southern

    Dear Mr Zakaria, You stated on CNN tonight that "Americans freely make the choice to forgoe preventive care, thus contributing to poorer health and quality of life." You obviously have never had to choose between groceries and a dental cleaning or between your electric bill and a mammogram. When you are in the lower socioeconimic class, you do not "freely choose to forgoe preventive care!" You are mandated by dollars and cents to forgoe preventative care.

    July 8, 2012 at 9:19 pm | Reply
  17. johnny

    There is a preconceived crisis level for America's healthcare by 2050.

    If the current campaign to cure the obesity disease entrenched in American society fails, it will be a monstrous headache for the nation and Americans may have to pay for this extraordinary healthcare burden..

    2/3 of Americans are obese, fat, fatsos.

    This is astonishing, and maybe abit too late to prevent about 60 million Americans having diabetes by 2050..

    Health insurancevis useful if you are one of the 60 million diabetic sufferers.

    July 9, 2012 at 8:37 am | Reply
  18. Dave

    @Ken, what you said about Canada isn't true and I suspect that you know that. Anyone who has ever lived in Canada (like I have) would call you a out and out liar. I am terrified every time I visit the states at the costs of your hospitals and doctors if I get sick while there. I have to take out insurance if I come to the states, for what is free at home. Ken, you do not speak the truth.

    July 9, 2012 at 10:07 am | Reply
  19. mikey

    This obama crapo care is not about insurance or health care. It is about a massive transfer of wealth from the producers to the looters and takers. AARP, planned parenthood, catholic social services and other lobbyists wrote the bill to fatten their own wallets by taxing the rest of us. If it is not a tax, why is the enforcement agency the IRS. Lets add another layer of guvment to make something cheaper, right.

    July 9, 2012 at 12:01 pm | Reply
  20. Timmy Suckle

    I kissed my way up to VP at a health insurance company. Now I take over $500,000 of your health care dollars for NO VALUE ADDED to your health care. And that’s just me. Now think about how many other VPs, Directors, Managers, etc. are at my company alone. Now multiply that by thousands of others at hundreds of other health insurance companies. From 10 to 25% of your health care dollars go towards administration that adds NO VALUE to your health care. But my company’s PAC dollars will continue to fool you little people into thinking that a single payer system will be bad. Little people like you are so easy to fool. Little people also don’t realize that a single payer system is the ONLY system that would allow little people (as an entire country) to negotiate better health care prices. Little people don’t realize that the Medical Cartels already know that. And that is the reason why the Medical Cartels spend so much PAC money from the hospitals and doctors lobbying against a single payer system. Some little people say that a single payer system would cost you little people more. But if that were true, then wouldn’t the hospitals and doctors WANT that extra money? Yes they would. So why do the Medical Cartels lobby against a single payer system? It’s because the Medical Cartels know it would allow little people to negotiate better health care prices. And that’s what the Medical Cartels are afraid of. Period.
    But us big wigs at insurance companies, hospitals, and pharmacy companies don’t ever need to worry about health care no matter what it costs. We get our health care paid for one way or another by you little people. And we get the little people that work at our companies to contribute to our PACs. And us big wigs say it’s to protect the little peoples’ jobs. But in reality it would be in the little peoples’ best interest to NOT contribute to the PAC. Again, little people are so easy to be fooled. I won’t ever have to worry about losing my job with so many little people being brain washed by the Medical Cartels’ PAC money. Not only that, the Medical Cartels’ PAC money is used to elect so many republicans that will never allow a single payer system. Republicans have always fought against any meaningful health care reform. But that’s what our Medical Cartels’ PACs pay them for. Politicians can be bought so easily.
    Pretty soon the only people that will be able to afford health care is us big wigs. And that’s the way it should be. We don’t want you little people using up the resources when we need them. And once again, I thank you little people for capping my SS tax at the $106,800 level. Now I only pay 1.3% SS tax and you little people pay 6.2%. Also, thank you for extending my tax breaks. I’m using the extra money on my vacation houses.

    July 9, 2012 at 4:28 pm | Reply
  21. Denisia SB

    Fareed...Do you really believe that consumers "FREELY make the choice to eat junk food" knowing the consequences to their health? We have a powerful food industry that makes people sick...SERIOUSLY sick...just like tobacco did but way worse because not everyone smoked but everyone eats and unhealthy processed food is WAY CHEAPER than healthy food...THE FOOD INDUSTRY LOBBIES to keep it that way with no penalty to them for making people sick...On the contrary, they are heavily subsidized. The HEALTH, INSURANCE and PHARMACEUTICAL industries all financially benefit from unhealthy people. They are not incentivized to make people well. They're not evil. They're just doing their jobs...

    We need to change the current system of misplaced incentives and talk about the facts, not this fallacy of a free market that does not exist!. The fact that you or any one that has commented here, believe that our current inefficient health care system with sky rocketing costs and inferior outcomes (all this before Obama Care) is the result of transparent free market policies is simply a falsehood. We do NOT have a free market economy in health care, nor in most industries for that matter... You might want to check out the JUNE 2012 "PLoS Medicine Series on Big Food: The Food Industry Is Ripe for Scrutiny" by highly independent scientists and MD's. This is a very important topic and one that is not studied nearly enough...You cannot talk about Health Care Insurance without talking about Big Food...They are intertwined...

    July 9, 2012 at 10:30 pm | Reply
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