Originally Posted by
Dan Druff
LOL at Universal Health Care cutting down US healthcare costs.
No.
The main cost of US healthcare comes from tests and procedures. The left likes to push the myth that cutting out the insurance middleman will produce huge savings, but that's a drop in the bucket compared to what is actually paid to medical providers, hospitals, and test facilities.
What aboug Big Pharma? That's some of the problem, but not the main part of it. The pharmaceutical cost can be brought under control far more easily than the cost of the rest of US healthcare. Simply introduce the ability to order pharmaceuticals from other first world countries, and the prices in the US will plummet.
Healthcare in the US is so expensive for various reasons:
1) The pricing model is opaque. The patient has no idea what services he's buying (or what they cost) until after he has them, and receives a bill. Furthermore, in the cases where insurance pays all or most of the bill, the patient doesn't care about the cost anyway.
2) There are no free market forces at work. Doctors and facilities are for what they do, not how well they do it. There is little financial incentive for a doctor to do a good job, but big financial incentives to see large numbers of patients and creatively bill for as many expensive things as possible.
3) The pricing model is driven by Medicare. That's the benchmark insurance companies use to set "allowed rates", which dictates how much they will pay (and how much in-network patients will be responsible for). Unfortunately, thanks to lobbying and corruption, some Medicare rates are artificially inflated, and that drives the health care industry to push for those test/procedures to be done. A good example is the Nuclear Stress Test in cardiology, which is usually unnecessary (and not good for the patient), but usually prescribed instead of the regular Echo Stress Test, because the Nuclear one costs so much more.
What will socialized medicine do?
It will simply shift the bill to the government, with all the same existing problems. But even worse, with all tests/procedures being "free", utilization will go way up, and the net cost will be more.
Neither party has approached this healthcare fiasco properly. If something reasonable is not put in place soon, then yes, socialized medicine will be in our future -- at least until that is a spectacular failure and it's rolled back.
How come socialized medicine works in other countries? First off, there's lots of debate as to how well it actually works, but I will concede that cost-wise, other first world countries spend far less per capita on their socialized healthcare systems.
But that's simply because they don't have all of these horrible price structures in place like the US does, and these wouldn't be dismantled if and when socialized medicine comes to the US. Comparing the US cost to, say, England or Australia, is a apples-to-oranges comparison.
Right now, what we need is a complete restructuring of the way medical services are sold.
The following would roughly accomplish this (and I've said it before, btw):
1) Completely reform the billing system, removing a lot of the hidden charges which turn into "gotchas" for patients. For example, if you go to the doctor for a checkup or examination due to a health concern, the doctor can only bill for the examination, and not for equipment he uses to examine you, or because you mentioned other problems while at the office. Most importantly, a written estimate must be provided to the patient prior to treatment/examination, which will indicate his out-of-pocket cost, and the patient must sign it. This, of course, would be waived in the case of extreme emergency.
2) Do away with the "preferred provider" model with health insurance. Instead, make health insurance pay for any doctor and any facility, but with a (relatively low) cap on the amount paid for each billable item. Doctors can charge what they want (but must disclose it to the patient before treatment), and the free market will take care of the rest. For example, let's say you want a checkup. Your insurance will pay $60 for it. You can go to a top doctor who might charge $200 for it (meaning you'll pay $140 out of pocket), or you can go to a lower-tier doctor who just charges the $60, thus making the visit "free".
3) Based upon income, the government can provide relief for health insurance premiums or certain out-of-pocket expenses. So the guy making $14,000 per year will still be able to get treated even if he is living from hand to mouth.
4) Sicker people will pay higher premiums than healthy people, with a subsidy from the government at a certain point if those premiums cannot be afforded. Nobody will be denied insurance based upon health condition.
5) End group insurance. The entire group insurance model is antiquated, and hails from a time when people tended to work for one company for most of their life, and the company would almost act as a parental figure. That's how company-provided healthcare was born. However, today's economy is far different, and now the burden of providing healthcare has fallen into the laps of today's corporations. It is highly inefficient, unfairly favors the older people, and is a huge profit center for insurance companies. (For example, if you're a healthy 35-year-old, you'd be SHOCKED what your company is paying for your healthcare coverage -- money which could otherwise be used for your salary!) Replace the group insurance with the company simply paying the employees' individual insurance premiums.
Implement the above, and we will save a ton of money, while not denying anyone care. You'll be shocked how quickly the costs come down once the free market takes hold.
Reply With Quote
