Originally Posted by
sonatine
a lot of countries have affordable health care, its 100% a thing. coincidentally they dont have huge insurance/mediscam lobbies.
This is mostly correct, but believe it or not, the absurdly high cost of American healthcare is NOT the fault of insurance companies. Sure, insurance companies have their issues, and they are profiting handsomely for the most part, but they aren't the problem. They are just along for the ride.
Due to the insane expenditures on healthcare in this country ($3.6 trillion per year last I checked), the "Big 8" health insurance companies' collective profits of about $35 billion accounted for just 1% of all healthcare expenditures in the US.
Simply put, take insurance companies out of the equation, and we save 1% on our healthcare costs. Not the solution we're looking for, obviously.
The problem is that the entire cost structure of healthcare in the US is broken, and every single healthcare providers -- from hospitals down to single-doctor offices -- employs billing experts to squeeze the most out of every single office visit, test, and procedure.
It's a complicated, opaque, non-free-market system where the patient has zero visibility into what he's buying until after he's bought it, and insurance is usually forced to foot the lion's share of that bill. Then insurance passes the increasingly staggering costs onto the patients via higher premiums. Rinse and repeat.
It's a "billing code" driven system. The more codes which can be applied for one visit, the better. Often multiple codes are possible for a service provided, and the billing expert makes sure to bill the most expensive one, which is totally legal. Then lobbyists sometimes get absurdly expensive codes slipped into Medicare reimbursement schedules, which also drive private insurance rates, and doctors take advantage of this until that loophole is closed. A big one recently is/was the "nuclear stress test" in cardiology -- something which is crazy expensive, usually unnecessary, and actually harmful to the patient.
Other countries don't have this nonsense. Their billing systems are simpler, and the charges are much more sane.
So why don't we just switch to socialized medicine to do away with this problem?
Because none of the single payer proposals include an overhaul of this billing code system. It stays in place, with the only change being who pays. You may hear that the government will get "Medicare rates" and save money, but that's nonsense. Medicare rates are the problem in the first place.
You might hear that socialized medicine in the US will save a ton of money due to cutting out insurance profits (see above why that is BS), or that easy access to preventative care will save money later. We already have free preventative care on Obamacare, and that has not decreased overall costs. While preventative care has its place, it's naive to believe that it saves much money in the long run, and in fact sometimes incurs extra costs because it leads to "discovering" non-problems and engaging in unnecessary treatments.
The entire billing/cost structure must be overhauled to get the US system in line with other first-world countries cost-wise. Neither party has stated a plan to do this, because lobbyists within the very powerful healthcare industry would scream bloody murder. It would result in hugely decreased profits, and they know it.
To use an analogy, say a pipe is broken in your house and leaking water all over the floor. The broken pipe is the broken medical billing system, and the water is the wasted money.
Democrats are showing up with towels and saying that if we keep wiping up the floor and making the rich buy us more towels, everything will get better, while not at all paying attention to where all the water is coming from.
Republicans are laughing at the foolish Democrats spending all that needless money on towels, but they're also not attempting to stop the flow of water, and they just shrug their shoulders and assume that as long as the water doesn't drown us, there's no point to do very much to attempt to stop it.
Both approaches are very wrong.