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No, I'm sure it'll have rules intended to control costs and reduce unneeded care, but our regulatory history suggests the rules won't work as advertised. And th
by glenra 14y ago
No, I'm sure it'll have rules intended to control costs and reduce unneeded care, but our regulatory history suggests the rules won't work as advertised. And that doesn't seem speculative at all - it's a dead certainty. Because the problem we have is NOT that individuals pay for health care, it's that health care is ludicrously expensive and ineffective and over-regulated and not subject to significant market competition on price or quality. Merely changing who writes the checks won't fix the other stuff which is the core of the problem.
In every other field, new technology makes production of goods cheaper. Even in medicine, if you look at the parts where people pay without insurance - LASIK, plastic surgery, dentistry, veterinary medicine - costs get cheaper over time. The parts of medicine that tend to get ever more expensive are the parts that involve third-party payment.
The book _Priceless_ has some decent suggestions for mechanisms that might help improve matters even given the existing (terrible) constraints we face.
- crusso 14y ago> The parts of medicine that tend to get ever more expensive are the parts that involve third-party payment. Medicine has a problem with third party payments that are invisible to consumers, coupled with insurance premiums invisibly negotiated by employers, coupled with ridiculous regulations that have created an enormous amount of dislocation of the economic incentives that would tend to drive prices down. In short, government got involved. What's our national solution? More government involvement. See any similarities between health insurance, retirement planning (Social Security), "free" healthcare (Medicare & Medicaid), student loan programs and the cost of college education, or maybe in the home loans that caused the housing disaster? Disaster after disaster is caused by applying heavy-handed Federal Government "solutions" to problems better solved by individuals, free markets, or at worst local and state governments.
- infinite8s 14y agoSo then do you agree with the following statement: "Individuals who do not have health care or can not pay for it should be denied treatment". That's what happens when you leave it up to free markets.
- crusso 14y agoSince there's already Medicaid for the poor and no hospitals deny care now... your statement would appear to be incorrect. I don't mind funding a worst-case-scenario safety net for the most vulnerable in the society. I don't mind some serious legislation aimed at fixing the real problems with healthcare in this country. The law passed by the Democrats in 2009 was a useless counterproductive disaster.
- niels_olson 14y agoI work at an urgent care. We routinely turn away people who are uninsured or have Medi-Cal (California medicaid) AND are unwilling to an upfront fee for the evaluation. So we see the uninsured but only if they pay. I see no difference in the chief complaints, but the uninsured generally wait quite a bit longer, and therefore often need not 5 times as much care, but 100 times as much.
- niels_olson 14y agoOne term, one book. Term: risk pool -- http://en.wikipedia.org/wiki/Risk_pool http://en.wikipedia.org/wiki/Risk_pool Book: The Social Transformation of American Medicine -- http://www.amazon.com/The-Social-Transformation-American-Medicine/dp/0465079350 http://www.amazon.com/The-Social-Transformation-American-Med...