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It's a good goal, but this is a very complex system. For example, if published prices were brought down to slightly-above-insurance rates, fewer people would b
by ethbro 8y ago
It's a good goal, but this is a very complex system.
For example, if published prices were brought down to slightly-above-insurance rates, fewer people would buy insurance.
Consequently, insurers would have less bargaining power, further erroding their price advantage (and financial solvency).
As an end result, absent regulatory mandate, non-high deductible plans would cease to be market viable.
Providers, insurers, and patients are in a zero-sum competition for the same dollars.
The ultimate question is -- do we want the US medical system to look like the US air travel system?
On the whole, it seems like it would be better than what we've got. But I think we could do better (specifically: smooth boom/bust cycles, increase healthy competition)
- pavel_lishin 8y ago> For example, if published prices were brought down to slightly-above-insurance rates, fewer people would buy insurance. Would they? I don't buy insurance so my doctor visits are only $20 - I buy insurance so that if something catastrophic happens to me, I'm not on the hook for hundreds of thousands of dollars. Even if the cost of (e.g., brain surgery, emergency appendectomy, resetting shattered bones) was the same as what insurance pays, I still wouldn't be able to afford it.
- ethbro 8y agoI would hazard to say that both of us aren't in the demographic where $20 matters. But for a lot of people, $20 vs $250 is the difference between going to a doctor and not. Separate from that there's the catastrophic vs no coverage argument. If you're struggling to make rent at the end of the month, it's probably a smarter personal bet not to buy insurance. But patients without at least catastrophic are corrosive to our medical system, and what the ACA mandate was targeting. Personally, I think the ACA mandate for a catastrophic policy, with preventative care included, and direct cash subsidies to people at the poverty line (to cover routine care) is the best solution. I'd expect the ACA designers considered this, and only broadened the mandate requirements as a horse trade to insurers for assuming the risk of offering marketplace plans.
- dmoy 8y agoYea this is exactly why I only ever get high deductible insurance.