11 ms·

Thank god nobody has actually proposed giving the healthcare industry a "blank check."

by chasing 12y ago

cookiecaper 12y ago
That's effectively what Canada et al have done. Yes, I understand the government "negotiates great rates" for the citizens, but it's effectively the same thing as a blank check. It just takes a bit of shenanigans behind the scenes to sell the bureaucrats on your latest rate hikes. If you think pricing is bad now that the big insurance companies have to "negotiate great rates" for their clients, think how it'll be when there's only one party there. Government-negotiated rates places the pricing totally outside the realm of necessity or reality and makes it a purely political matter, and politics is a messy, fickle thing built on personal favors and tit-for-tat. Not having your political activity interpreted as corruption or bribery mostly depends on not pissing off someone with more power than you. Health care costs so much because of the insurance leech. The only way to restore sanity is to restore real competition and make the consumer pay directly. Doctors will have to charge reasonable fees to the patients, suppliers and vendors will have to charge reasonable fees to the doctors, etc. It will break the cycle of exorbitant cost in health care. That may be, in some senses, a painful transition, but it's the only sustainable thing in the long term. The cycle will not be broken by saying "Wow, health care sure costs a lot of money. Let's just get the government to print some extra cash and take care of that for us." Insurance is typically a highly regulated industry because when insurance is involved, people get screwed. The incentives are misaligned; the insurance company only makes money when they don't give you what you're paying for. Insurance only works in events that are very unlikely. It's extremely likely that everyone will go to the doctor or need medical assistance. Insurance is a very, very bad model for this service.
- DanBC 12y ago
  > Government-negotiated rates places the pricing totally outside the realm of necessity or reality and makes it a purely political matter, and politics is a messy, fickle thing built on personal favors and tit-for-tat. Not having your political activity interpreted as corruption or bribery mostly depends on not pissing off someone with more power than you. You might want to read how England does it. A national organisation (NICE) gives guidance about what care pathways and treatment should look like. Local CCGs (clinical commissioning groups) decide what they're goong to pay for. Your description isn't even close to reality in England.
  - cookiecaper 12y ago
    From Wikipedia: >Groups will have, in addition to GPs, at least one registered nurse and a doctor who is a secondary care specialist. Doctors and clinicians deciding just how much they're going to get paid. Not subject to any kind of market or competitive force that may work toward an equilibrium based on supply and demand. The government has said "Here's a massive amount of money, fight among yourselves about who gets how much, good luck". Politics is very much at play here, as it is in any system where the prices are determined by committees or small groups instead of the free market. This includes the current system in the US, which is effectively controlled by a handful of paper pushers in the insurance industry, leeching billions out of our system each year without providing any value and ever-inflating the costs for the patient. There's no reason health care has to be a distorted market. Free market principles are applicable in health care as they are in any other field. While it's true that people need medicine to survive in many cases, people also need food and groceries to survive, but we haven't had to nationalize a grocery chain heretofore. There is enough competition in the space to keep prices low. There would be ample competition in the medical space if we could break the insurance cabals that currently exist. The powers that be rather like our current system, and they love it now that the ACA has made it a crime to not purchase their product. They would certainly also enjoy the "print money til the doctors are happy" system proposed by many left-leaning persons. The one thing they're most afraid of is the one thing that restores equilibrium and stops their ability to gouge, which is real competition and a true free market undistorted by unfair practices and insurance company leeches. Non-catastrophic medical insurance should be outlawed and clients should have to pay their doctors directly, forcing doctors to charge a reasonable amount of money or have no clients, forcing suppliers to charge a reasonable amount of money or have no customers, forcing medical schools to charge a reasonable amount of money or have no students. We can't just keep saying "The expensive way of doing this is easy and great, so let's just have the government pay for it." Things must be self-sufficient.
    - DanBC 12y ago
      > Doctors and clinicians deciding just how much they're going to get paid. Not subject to any kind of market or competitive force that may work toward an equilibrium based on supply and demand. How do you get to that conclusion? There is plenty of tendering happening in NHS. > The government has said "Here's a massive amount of money, fight among yourselves about who gets how much, good luck". > We can't just keep saying "The expensive way of doing this is easy and great, so let's just have the government pay for it." Things must be self-sufficient. You know that the English government pays less per capita than the US government for health care and we have better health outcomes, right?

Thank god nobody has actually proposed giving the healthcare industry a "blank check."

by chasing 12y ago

Thank god nobody has actually proposed giving the healthcare industry a "blank check."

That's effectively what Canada et al have done. Yes, I understand the government "negotiates great rates" for the citizens, but it's effectively the same thing as a blank check. It just takes a bit of shenanigans behind the scenes to sell the bureaucrats on your latest rate hikes. If you think pricing is bad now that the big insurance companies have to "negotiate great rates" for their clients, think how it'll be when there's only one party there. Government-negotiated rates places the pricing totally outside the realm of necessity or reality and makes it a purely political matter, and politics is a messy, fickle thing built on personal favors and tit-for-tat. Not having your political activity interpreted as corruption or bribery mostly depends on not pissing off someone with more power than you. Health care costs so much because of the insurance leech. The only way to restore sanity is to restore real competition and make the consumer pay directly. Doctors will have to charge reasonable fees to the patients, suppliers and vendors will have to charge reasonable fees to the doctors, etc. It will break the cycle of exorbitant cost in health care. That may be, in some senses, a painful transition, but it's the only sustainable thing in the long term. The cycle will not be broken by saying "Wow, health care sure costs a lot of money. Let's just get the government to print some extra cash and take care of that for us." Insurance is typically a highly regulated industry because when insurance is involved, people get screwed. The incentives are misaligned; the insurance company only makes money when they don't give you what you're paying for. Insurance only works in events that are very unlikely. It's extremely likely that everyone will go to the doctor or need medical assistance. Insurance is a very, very bad model for this service.

DanBC 12y ago
> Government-negotiated rates places the pricing totally outside the realm of necessity or reality and makes it a purely political matter, and politics is a messy, fickle thing built on personal favors and tit-for-tat. Not having your political activity interpreted as corruption or bribery mostly depends on not pissing off someone with more power than you. You might want to read how England does it. A national organisation (NICE) gives guidance about what care pathways and treatment should look like. Local CCGs (clinical commissioning groups) decide what they're goong to pay for. Your description isn't even close to reality in England.
- cookiecaper 12y ago
  From Wikipedia: >Groups will have, in addition to GPs, at least one registered nurse and a doctor who is a secondary care specialist. Doctors and clinicians deciding just how much they're going to get paid. Not subject to any kind of market or competitive force that may work toward an equilibrium based on supply and demand. The government has said "Here's a massive amount of money, fight among yourselves about who gets how much, good luck". Politics is very much at play here, as it is in any system where the prices are determined by committees or small groups instead of the free market. This includes the current system in the US, which is effectively controlled by a handful of paper pushers in the insurance industry, leeching billions out of our system each year without providing any value and ever-inflating the costs for the patient. There's no reason health care has to be a distorted market. Free market principles are applicable in health care as they are in any other field. While it's true that people need medicine to survive in many cases, people also need food and groceries to survive, but we haven't had to nationalize a grocery chain heretofore. There is enough competition in the space to keep prices low. There would be ample competition in the medical space if we could break the insurance cabals that currently exist. The powers that be rather like our current system, and they love it now that the ACA has made it a crime to not purchase their product. They would certainly also enjoy the "print money til the doctors are happy" system proposed by many left-leaning persons. The one thing they're most afraid of is the one thing that restores equilibrium and stops their ability to gouge, which is real competition and a true free market undistorted by unfair practices and insurance company leeches. Non-catastrophic medical insurance should be outlawed and clients should have to pay their doctors directly, forcing doctors to charge a reasonable amount of money or have no clients, forcing suppliers to charge a reasonable amount of money or have no customers, forcing medical schools to charge a reasonable amount of money or have no students. We can't just keep saying "The expensive way of doing this is easy and great, so let's just have the government pay for it." Things must be self-sufficient.
  - DanBC 12y ago
    > Doctors and clinicians deciding just how much they're going to get paid. Not subject to any kind of market or competitive force that may work toward an equilibrium based on supply and demand. How do you get to that conclusion? There is plenty of tendering happening in NHS. > The government has said "Here's a massive amount of money, fight among yourselves about who gets how much, good luck". > We can't just keep saying "The expensive way of doing this is easy and great, so let's just have the government pay for it." Things must be self-sufficient. You know that the English government pays less per capita than the US government for health care and we have better health outcomes, right?