Charles Wheelan, Ph.D. The Naked Economist

Yahoo! Finance User - Monday, March 31, 2008, 1:58PM ET  Report Abuse

• Overall: 5/5

I completely agree with this article! I am a former Republican, now registered Independent, who is fed up with the Republican party's lack of "getting it" in domestic issues. I hold a BA in economics and am also an MD working at a major academic center that cares for many insured and indigent patients. The people who think that the free market should work for health care are either rich, or have no real medical problems! This is a serious issue for our country and the Republicans better get on board. McCain's current plan for health care is rediculously inadequate, and he may lose my vote over it. The next candidate needs to honestly address the needs of the entire country's citizens, not just the few!

BruceW - Tuesday, March 18, 2008, 7:54AM ET  Report Abuse

• Overall: 4/5

First halfway decent article Dr Wheelan has written. Interesting, that he observed and termed what he refers to as the GOP's current "empathy deficit," Overall a glimmer of hope if he can remain this objective instead of his usual rants concerning his personal peeves.

Robert S - Monday, March 17, 2008, 3:17PM ET  Report Abuse

• Overall: 4/5

Universal Health Care is a disgrace to American capilaism and should not be implemented.

Yahoo! Finance User - Monday, March 17, 2008, 12:12PM ET  Report Abuse

• Overall: 1/5

I am a big fan of Charles, but he is totally wrong on this topic. He should follow his principles and give the true health care rx-no government intervention. Let the free markets work and reduce costly government mandates and regulations. Health insurance is for major unexpected costs and should not be used for routine or minor health problems. Does your car insurance pay for gasoline and oil changes? If government exists healthcare the costs will plummet.

Joe S - Thursday, March 13, 2008, 12:02PM ET  Report Abuse

• Overall: 1/5

I'm pretty sure I'd hate any plan you proposed. Sadly, if you somehow got the ear of next president and got your plan passed through Congress, I would be impelled to pay for it. Even more sad for both you and me, political compulsion isn't so tame as to even work toward your best intended goals. Whatever platitudes are offered, politics will only work toward the benefits of the privileged elite while giving only the appearance of helping common people. If you want to bill yourself as an economist, I'd like to see you tackle more the deeper questions of how socialism can work. Have you really never considered the function of entrepreneurship, production and profit? Does it not disturb you that it is industries (such as health care) lacking those market functions that function the worst? Do you have no conscience to shill for the further socialization of these industries? Or is it really a lack of intellect?

DmitriR - Thursday, March 13, 2008, 10:32AM ET  Report Abuse

• Overall: 5/5

Great article! I hope GOP will listen to it! I cannot complain about my income, but I was laid off three times during last high-tech downturn. And my major concern was a lack of medical insurance, not a lack of regular paychecks! As of businesses, they MUST clearly tell GOP that the current medialc insurance cost cannot be offset by low taxes!

DennisAOK - Wednesday, March 12, 2008, 5:17PM ET  Report Abuse

• Overall: 4/5

FYI, Gary B., HMO's were championed by the Democrats back in the 1970's as a foil to the "greedy" American Medical Association. I would only add that we Americans have come to rely on our employers for too much. Retirememt plans is another example. I would much rather be able to put money into my own IRA rather the limited number of more expensive choices provided by my employer's 401k.

Yahoo! Finance User - Wednesday, March 12, 2008, 3:46PM ET  Report Abuse

• Overall: 5/5

The incentives for providers of health care currently are skewed towards using as many resources as possible. As a physician, I get paid much more for removing a skin cancer than I do for spending an hour with a patient teaching him how to manage his diabetes or heart failure. I do better spending 5 minutes each with 10 patients with colds (that would get better without treatment) than spending 50 minutes with a complicated, profoundly ill patient in whom my care can really make a difference. Hospitals receive much more return on investment to build a radiation oncology center ($100000 for treatment of one pt with prostate cancer) than for building a "wellness center" aimed at prevention. Medicare pays big money to vendors per electric scooter sold rather than paying providers that do a good job preventing people from needing scooters. Convincing people they need brand name drugs instead of cheaper equally efficacious generics using whatever deceitful means necesary (eg:passing off Robert Jarvik as an expert on coronary artery disease to sell Lipitor) is much more profitable (and successful) than arguing the reverse to a patient who really can't afford and doesn"t need the brand name drug. This is all perpetuated by greed...and greed is inherent in the US health system. There is little money to be made by individuals through prevention but much to be saved by society. Lets face it, most republicans don't care about the good of the many unless conditions get so bad that they threaten the good of the few. As this article aptly shows, that time is now. Wake up! Malpractice, while it contibutes to the problem is a convenient excuse. It is a minor player in skyrocketing costs. Greed on the part of providers is at least a small part of the problem, especially from proceduralists (and the vast majority of recent med students choose procedural specialties because that's where the decent money is) but this could be easily mitigated by skewing the valuation of services back to prevention. Universal health care systems generally do this. This is why an average primary care physician in the UK makes more than the average one in US (the worthless dollar and rising pound also have an effect). True, there are few doctors making huge salaries in England but I havent heard about a shortage of neurosurgeons or cardiovascular surgeons there. I suspect they have more people going into those specialties for the "right" reasons. Unfortunately, despite all the rhetoric and a few smart Republicans that have seen the light, I fear significant reform is a long way off. There are just too many vultures with huge financial stakes in this that will fight tooth and nail to stop any meaningful change, despite the damage it will do to the physical and economic health of our country.

Yahoo! Finance User - Wednesday, March 12, 2008, 1:51PM ET  Report Abuse

• Overall: 5/5

The best I have read of late. Think about the numbers. Right now 1/3 of the people have health insurance through their employers in the private sector. All the rest of the cost is already picked up by the government because the rest of the people are on SS or work for Federal, state or local government in one form or another. The rest of the people we pay for because they can't pay so, why not have universal health care. I have personal been involved with using Canada's system twice while in Ontario fishing. Both times the service was out standing and the cost very low. When my sister broke her ankle while we were up fishing one year the total cost for emergency room, setting the ankle, casting, crutches, and medication was $386 & we were in and out of the hospital in less than 3 hours. You can not even walk into an emergency room in the USA for $386. It is time for universal health care and lest anyone think it won't work here take a look at Medicare. Works fine just cost a LOT less than my employer based policy that keeps me from starting my own business because I have Diabetes and can not get insurance on my own. Now all we have to have is someone in Washington willing to listen and fight for what is right instead of taking the hand outs from the lobbyist to look the other way.

michael - Wednesday, March 12, 2008, 11:39AM ET  Report Abuse

• Overall: 1/5

THERE IS NOTHING ANYONE CAN DO UNTIL WE ADDRESS THE REASON FOR THE COST OF HEALTH CARE'S PROBLEM. ATTORNEY'S AND GOVEREMENT REGULATIONS DRIVE COST UP AND THE OFFICIALS DO NOT SEEM TO UNDERSTAND THE CONNECTION. CAN YOU THINK OF OUR HEALTH CARE CONTROLED BY FEMA OR ANY GOVEREMENT CONTROL. THINK OF THE WASTE, AND HOW THEY WOULD NEED TO CONTINUE TO RAISE TAXES TO KEEP UP WITH THE WASTE. CANADA HAS TO LIMIT THOSE WHO NEED CARE IN SOME CASES TO CONTROL COST. THERE NEEDS TO BE A BETTER PLAN THAN JUST NATIONAL HEALTH CARE AS IT IS PRESENTED. THANK YOU.

Gary B - Wednesday, March 12, 2008, 10:02AM ET  Report Abuse

• Overall: 3/5

Republicans are in bed with the HMOs and special interests. I once worked for a medical insurance company (one of the big ones). Let's just say that I'm happily employed elsewhere. The whole system is corrupted by rampant greed. Time to take a match to the whole system...

Yahoo! Finance User - Wednesday, March 12, 2008, 8:27AM ET  Report Abuse

• Overall: 2/5

A good point that Republicans should push healthcare reform. But they should address the biggest financial issue facing the country - the future cost of healthcare as the Baby Boomer generation hits us in a few years. In another 10 years this country will be on a very steep slope of increasing healthcare costs that it will not be able to recover from. $51 trillion is the NPV of these legacy issues that confront us - a huge portion of our GDP. This must be addressed now - but politicians do not want to openly discuss it as the corrective measures needed are severe and too politically risky. They will wait until it becomes a crisis situation and they will blame the other party for the demise. See David Walker's quarterly GAC budget updates. They are very sobering and concerning.

Yahoo! Finance User - Tuesday, March 11, 2008, 9:39PM ET  Report Abuse

• Overall: 2/5

Interesting how everyone wants healthcare paid for, but no one is concerned with the implications of irresponsible eating habits, poor physical fitness, alcohol and drug abuse, and funding of healthcare for people here illegally. If a program targeting catastrophic care for those citizens here legally who require it was funded out of the billions of dollars from "sin" taxes, versus having those monies siphoned off for ridiculous spending projects, the very items that create such a cost burden for employers and employees alike would be significantly reduced and it is time to tell able bodied Americans that if they want health care, they need to work for it...even if they would rather be watching Jerry Springer or some other useless program.

Yahoo! Finance User - Tuesday, March 11, 2008, 5:00PM ET  Report Abuse

• Overall: 2/5

I don't think the government has any business determining what an effective health care system should be. Employer-paid health care was the result of the FDR Administration's way of giving people an effective pay raise without giving them cash. Come up with effective tort and tax reform, and require people to fund their own insurance premiums - companies will want the business.

Jazzbo - Tuesday, March 11, 2008, 4:58PM ET  Report Abuse

• Overall: 3/5

Before you criticize insurance companies, learn how insurance and economics works. Try developing some critical thinking and analytical skills cut thru the rhetoric... In HI., health coverage is mandated by law. Companies must cover workers working more than 20 hours/week for 4 weeks. The employee pays 1.5% of wages as their cost. There are minimal exemptions. People rail about the cost of care and blame the insurance industry. Yet, the BC BS plan in the state is non-profit, covers half the mkt and admin costs are only 7% of costs..THE REST GOES TO PROVIDERS! Yet, these guys all claim that they are underpaid! They have a loony doctor/politician, Josh Green, who is going after the insurer because he wants more $$ paid to the docs AND he claims this doesnt come from the employers...explain that one! Who else pays for the cost of care in the state...its simple economics. The same applies on the Mnld. However, people cant or dont want to understand that. Its easier to blame the big bad insurance company! He criticizes the company execs for being paid pretty good salaries...in a very difficult business yet they are paid below comparable C level jobs in the state for similarly sized companies! Green NEVER talks about what the Drs make AND he never talks about the huge issue of malpractice insurance costs....way overstated due to the overly liberal political and judicial climate in the state. Again, similar in other states. He never talks about the cost shift from the state and feds? Dont get me wrong....Drs graduating from schoool owe money and they need to live decent lives BUT most of the ones I have dealt with have attitudes they are owed! Drs got used to insurance companies just paying as they raised their rates. Hospitals rushed out to buy new technology. Pharma co's advertised so consumers would want the latest drug. That was all a reaction to the attempts by insurers to get control of costs via HMOs and PPOs. Didnt really work for long. Employers just ate the increases. Insurors just paid the bill. 25-30 years ago employers started to fight back, pushing against the constant increases in dr charges, hospital charges, etc. They forced insurors to act. Govt saw an oppty and stepped in and cut reimbursements thinking it would put pressure on drs and reduce the costs.Providers simply charged private industry more! This increased cost to business has led to job losses, poor raises, overseas migration of factories, and lower taxes to govt. Consumers/workers, who feel they have a right to health care, dont know or care what it costs! They dont pay for most of it! Insurance costs alot because of utilization, pure and simple. Go to the dr all the time, pay no attention to his advice, someone else pays the cost. Technology and drugs brought to bear on diseases is wonderful AND expensive...someone has to pay! Care for chronic conditions is ongoing who pays? Employers pay. Its not like the insurance companies sit there flush with free money so go after them? Its employer money! (For profit insurors may be the exception as they charge a profit.) Reality is most of the expense is with the docs/providers as they ARE UTILIZATION/the factory, SO rightfully focus there. Recognize govt doesnt pay its share too although thats probably a lost cause. BTW, Drs are just being pulled into the middle class...i.e. its no longer a clear means to become rich! . However, most drs have nice cars and houses yet complain? The insurance industry has tried to create products to make consumers more aware of costs...so called Consumer Direct health care...it shifts more costs to employees. Guess what they get pissed off. Educate consumers about costs and to ask drs what things cost and most wont do it...for fear of offending the dr! Why not? Most dont care unless its their money! Reality is it is their money because money paid for benefits comes out of salaries and new jobs.

craycapt - Tuesday, March 11, 2008, 4:10PM ET  Report Abuse

• Overall: 5/5

In 50 years Americans, and maybe even Republicans, will wonder what life was like without healthcare for everyone. Imagine getting a major illness and not having to worry about selling your house or cashing in your retirement to pay for overpriced hospital care. It's easy to pick apart and fault other countries government run health systems but what we have is disgrace. How many Republicans refuse Social Security? It was enacted by Democrats!

David PC - Tuesday, March 11, 2008, 3:33PM ET  Report Abuse

• Overall: 5/5

Is this article and its rating being posted on McCain's site? It certainly should be!

timj - Tuesday, March 11, 2008, 3:20PM ET  Report Abuse

• Overall: 4/5

It's interesting how everyone blames the doctor's or the health insurers for the skyrocketing costs. The average MD doesn't make that much income, given their level of education, as compared to other professionals. There are exceptions, depending on specialty, but for the most part Doctors aren't getting rich off of the system. Neither are health insurers. To me the real culprits are the hospitals and the pharmaceutical companies. For example, its not unusual for the average coronary bypass proceedure to cost over $100,000 in total expenses (and the majority of that goes to the hospitals). How can people really think health insurers are the ones getting rich? Is it any wonder they have to negotiate to try to control their expenses? I believe the median household income in this country is less than $50,000. Think about that...the average household would have to work 2 plus years (with no taxes taken out) to afford to pay for bypass surgery, which takes several hours followed by a few days of hospitalization (and obviously rehab consults thereafter). Yet health insurers get blamed for having to raise premiums. The drain on the US economy related to health care costs is tremendous. Then look at the pharmaceutical companies and what they charge for their non-generic drugs. They blame the cost of research, but seem to spend much more on advertising and lobbying than they do on research. The US health care system seems to fund most of their research as the same drugs are sold in other countries at a fraction of the cost our citizens and health insurers have to pay. They also have one of the strongest political lobbies in the country (necessary so the government will let them continue to rape the public.) I'm a Republican, but one problem I have with the party is that our leaders seem to be especially closely tied to the pharmaceutical industry. Many Democrats are too, you can't point the finger at one party and ignore the other's role. However, this is why you can forget ever having meaningful health care reform in this country. The pharmaceutical lobby, especially, is much too strong. By the way, I'm in no way affiliated with the health insurance industry. Just an interested observer of a broken down health care system.

richard - Tuesday, March 11, 2008, 3:17PM ET  Report Abuse

• Overall: 4/5

Lets get serious, the comments on this article show the incredible lack of actual data , or wrong data, referred to by the author. They also demonstrate the silly ideological bent of most persons making a comment. The problems of the health care industry are exactly as described. The exception is the influence of the insurance industry that takes 60% of the top of each dollar paid (Most insurance companies in the U.S. run about a 60% gross profit for health care insurance). The problems of documentation, etc. described have been shown to add significant unnecessary additional cost. Tort litigation simply doesn't amount to any significant portion of health care resources - this is an ideological argument with no factual support. This is especially true since the tort limitations placed in effect a few years ago. What is happening to the doctors and nurses, in terms of education costs, is a real problem. However, it should be dealt with as a separate issue under education, not the cost of health care. Health care including insurance for a 50 something now runs about $20,000 per year. That is more than most people spend on their mortgage. This cannot continue for long. Get serious and start finding solutions and forget your ideological positions.

Yahoo! Finance User - Tuesday, March 11, 2008, 3:13PM ET  Report Abuse

• Overall: 5/5

Time for Americans to proclaim war with the healthcare system. The healthcare industry has successfullly played a key role in driving other industries out of the US. Controlling healthcare costs should be the key topic in this election.

Yahoo! Finance User - Tuesday, March 11, 2008, 2:01PM ET  Report Abuse

• Overall: 1/5

Get something straight - Healthcare is a business. The majority of the young doctors that are getting into healthcare are there to make money. The idealism and romantic notions about helping people and saving lives is for the most part gone. I've been a doctor for 32 years and have watched it change dramatically during that period. Nobody should be surprised since it's consistent with the egocentric changes that have occurred in all of america. They will not support any effort to diminish their income. Considering many of the young residents I teach are in debt for several hundred thousand dollars, have families, are in their 30's, and haven't earned a dime yet - frankly, I can't say I blame them. The interest just keeps piling on. No one is giving them a break, why should they fell compelled to work for less than they deserve.

Yahoo! Finance User - Tuesday, March 11, 2008, 12:27PM ET  Report Abuse

• Overall: 5/5

Thank you for a cutting-through-all-the-crap article. The amount of ignorance on display in these comments is staggering. Also the amount of callous disregard for fellow citizens who are less fortunate than some of you self-satisfied and closed minded individuals. If you ever experience a misfortune - through no fault of your own - that reduces you to insolvency (and this happens every day in America), then perhaps you will have your eyes opened. All of the railing against getting the government involved in national health care is pretty ironic, considering that it has been the ability of powerful special interst groups to manipulate our government policies on the healthcare industry that have gotten us into such a mess. You don't mind govenment involvement as long as you can control it for your own purposes. The real fix is to get healthcare out from under the control of lobbyists, otherwise nothing can change under either party. The truth is - HEALTHCARE SHOULD NEVER HAVE BEEN SET UP AS A FOR PROFIT INDUSTRY. As long as it is, then the interests of the stock holders will ALWAYS trump the interests of the patients.

Yahoo! Finance User - Tuesday, March 11, 2008, 9:41AM ET  Report Abuse

• Overall: 1/5

Typical ill-informed "news" from the left. http://money.cnn.com/2008/03/10/news/economy/tully_healthcare.fortune/index.htm?postversion=2008031105 Here's another article explaining why McCain's plan is the best. Everyone has different feelings on what's important in healthcare reform, but no one with an education agrees that socialism is the answer. Not one point of McCain's plan is listed in this article. It's easy to argue from the left when you don't have to do any research on the oppsing argument. That's why a country filled with American Idol fans will be charmed into socialist ideas in November.

b.m - Monday, March 10, 2008, 11:33PM ET  Report Abuse

• Overall: 4/5

No way can you trust corporations to go unchecked when it comes to health care. Look at the likes of Enron and the recent mortgage crisis. When profit becomes the chief motivation then costs get cut at the expense of the consumer. I don't want to trust my health to some uncaring corporate board that is only concerned with how much profit they're going to get from some life saving procedure that I need. Even worse, I can see a doctor offering the cheapest solution instead of the best solution.

Yahoo! Finance User - Monday, March 10, 2008, 10:45PM ET  Report Abuse

• Overall: 5/5

That doctors are making big bucks here is a fallacy. I see more patients, work longer hours and make less money than I did in the past 2 years. The current administration favors large corps. so much that they get to make money hand over fist and everyone else loses. It violates antitrust laws for docs to negotiate collectively so we are forced to bargain with these companies as individuals and therefore have no leverage. Here in PA they tell us what they will pay us, take it or leave it. Malpractice is not the culprit here, it is the fact that we live in a state with only 2 major health insurers (BC/BS and Aetna) and they basically collude with each other to set fees. Taking in lots of money in premiums; paying out very little. Sounds like a good business model to me, too bad it isn't good for peoples health!

Yahoo! Finance User - Monday, March 10, 2008, 6:18PM ET  Report Abuse

• Overall: 1/5

Wake up people! Socializing or making health care "universal" will not fix it. The problem is not that it is currently run "for profit", but that lawyers and regulations are strangling it! We all know about the excessive liability awards that continue to happen. How about also considering the need to free health care companies to offer more options, and to stop requiring certain coverages as part of plans?? A young person can't go get a "basic" plan that just covers major items right now in order to get a low-premium plan - our legal system requires that plans include X, Y & Z. It's idiotic the level of regulation that is imposed on this industry. You want lower health care costs? Try freeing the companies as much as possible and letting capitalism truly work!

Andrew - Monday, March 10, 2008, 6:01PM ET  Report Abuse

• Overall: 1/5

I don't mean to put words in his mouth, but the author should simply come out and say he wants national healthcare. Don't say the system is unfair and companies shouldn't be burdened with the responsibility (implying the government should take up the obligation). I agree that there are inefficiencies in the current system that need large reform, but when has the government walked into a situation with more regulation (and the possibility of completely taking it over) and made it more efficient? I would say the opposite is true...government control means less efficiency. Yes, Medicare and Medicaid have low administrative costs (

Yahoo! Finance User - Monday, March 10, 2008, 5:22PM ET  Report Abuse

• Overall: 2/5

This is naive. The Republicans won't change health care because the present system is highly profitable for doctors, insurors and drug companies, all of whom pay the GOP big bucks. They want NO change. No change will happen. As to the middle class guy's retirement funds at risk, the doctors attitude is, screw him for being such a loser. It's our money now.

Yahoo! Finance User - Monday, March 10, 2008, 5:22PM ET  Report Abuse

• Overall: 2/5

Get over the "preventive care" ideal. Who's responsibilty is it to "focus" on preventive care? The patients. Doctors can't force patients into their offices for annual check ups. The reason so much money is thrown towards people who are damn near death is because that's how long most people wait to seek care. Yes costs would decrease (in theory) if more preventive medicine was provided. But that cannot happen until patience (especailly the insured) choose to seek preventive care. The system is not what's broken. Americans receive some of the best care in the world. How about taking some personal responsibility and stop blaming the Government, Health insurance companies and health care providers for the rising costs. You live in a FREE and CAPALIST country. Learn to love it and take control. Everyone has the opporunity in this country to make money. It is your choice whether you seize the opportunity. Then you wouldn't have to worry about the cost of healthcare.

Yahoo! Finance User - Monday, March 10, 2008, 4:55PM ET  Report Abuse

• Overall: 3/5

Finally, some reepublicans are getting it (but I'm afraid that most aren't)! Bill Clinton had a sign on the wall when he was in office that read: "It's the economy, stupid!." National health care will, in my opinion, help the economy in the long run. The comment about Toyota not having to worry about providing health care is something that I've been harping about for years. It's not a republican or a democrat thing. It's about business. If American business didn't have to worry about health care and the associated costs, just think how much more competitive we could be. So. . .instead of an amount taken out of my paycheck for health care, it will be a medical tax instead. What difference does it make to me! I had my own business way back in the 70's but had to close shop because I couldn't get health care because of a pre-existing condition. I couldn't even get a health insurance carrier to insure my wife and she was in good health. Heck, I'm a republican, but I will NOT be voting republican in the next election!