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August 10, 2009


Your intention is good, I think, but this is too simplified to be of much use. You just don't have a good enough handle on the whole thing to do a simplification of this type.

Fantastic equation my friend! hahaha...
All I can add is, it is not a "Health Care Reform" but a "Wealth Care Reform"

Nice blog, its great article informative post, thanks for sharing it. Thanks for the information!

Dan, sadly what you think is obvious is wrong. Insurers make more money when costs increase as almost all their business is on a % of total costs, so they are NOT interested in decreasing costs in the way you think. That's a smokescreen. And the "fight" between insurers and providers is almost irrelevant to wider system problems.

Why didnt you get one of the 100 people who understand health care to help you?

Great that you're doing this. Much needed with all the shouting. Should you need support about the the position of insurers, here's a Bill Moyers PBS interview with former CIGNA exec Wendell Potter


Maybe you've already seen it. Looking forward to napkin 4.

They keep throwing out 30 million without health care. That is ONLY 15% of the population. And they are probably counting short term displaced workers (out of work 30-60 days but eventually employed again) and illegal immigrants. Can't we fix this problem for those 15% without killing the entire system?

Hi Dan,

Superficially, your napkin is accurate. Unfortunately, you've missed one of the primary reasons for increasing costs of care, malpractice insurance. Tort reform is necessary to reign in much of the cost of care. The government must eliminate fraud and waste on their side; medicare/medicaid. By eliminating a percentage of overhead (malpractice premius) the providers can lower rates, with lower rates, insurance companies can lower their negotiated rates with provicers, thereby lowering end-user's premiums.

One gross oversimplifications -- actually the element for which the MOST waste occurs isn't represented here. The context of medical care: doctor's offices and hospitals (all much bigger than just the doctors and their services: billing, cleaning, scheduling...).

As well, this ignores another critical element missing from the system: economic choice. We go to our doctor not knowing what the visit will cost us or whether or not we will get results from our investment. Medical is the worst economically balanced industry there is.

Hey Dan - just a quick question...are the underlying costs of health care going up along with insurance premiums, or are just premiums going up? We are sort of abstracted from the 'actual' cost of our healthcare because we pay for it indirectly, right? Great work (as always)

Thanks for putting some work into simplifying this! I only hope that the people spewing (and being influenced by) rumors and lies will take the time to learn what the true problems are.

One note, I think a fundamental problem with insurers is that most of them are public companies, therefore responsible to their investors and motivated to constantly increase profits. THAT is the main reason they want to limit payments.

Dan, this is great! Can't wait to see the rest of the story.

I understand that you've lumped MDs, hospitals, and pharma together since they all make $$ by providing product or service to patients. However, their motivations and goals are different. I would love to see a visual explanation that dives into the relationships on the left side of your sketch.

Also, it would be interesting to sketch what the healthcare system looks like from the perspective of each stakeholder.

Per your previous post, let me know if there's any way we can help.

I really like this blog and perspective. Couldn't agree more. So far. I'll be back to watch you 'draw' some conclusions! Most of my insights on this problem are on http://ow.ly/jJJj , and you can look me up in Newsblarg.com, I'd like to hear from you.

Thanks for explanation. I will share it with lots.

To suggest that the two businesses "hate each other" seems a bit too simple.

I'm interested in knowing how you deal with the "us" in the equation. To me part of the frustration in the debate is that I neither expect nor want the Federal government to provide for my healthcare.

I'd support a system where citizens have some sort of catastrophic coverage and a way to manage their own consumption of healthcare via MSAs or some sort of personal acct. I'd also support reform that helps reign in some of the abuses and costs. However, I'd prefer not having the government involved in much more than that.

So part of the healthcare debate is also philosophical and how one would view the role of government. In our quest for individual liberty we need to make sure that our perspective isn't altered by what's immediate or pragmatic at the moment. Because one day we may find that all we hold are empty promises and have lost the pursuit of liberty that is the linchpin of our society.

As always, Dan, you help the world make sense. I remember what you recently said at the VizThink conference I attended in San Jose, "...whoever draws the best pictures gets the funding." If one side or the other would just listen to your advice, they would probably win the debate.

Dan, I am quite happy to see your latest post!
I recently moved from Canada (where health care is almost free!) to US. I am shocked to see the state of US health care. Unfortunately, none of my contacts have been able to explain the way health-care works here.
I am hoping your next few posts will help me understand the system.

I'm so excited that you're doing this Dan! I think you are doing a great service - looking forward to the next ones!

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