SoylentNews is people
SoylentNews
from the But-I-*like*-getting-50-different-invoices-for-one-hospital-stay dept.
There is an instinct among political pundits to confuse caution for practicality — an assumption that those who advocate for incremental change are being reasonable, while those pushing for bold reforms aren’t. This is seen most starkly in the debate around health care reform, despite the fact that the “practical” pushers of limited reform fail to address the real problems in our health care system.
We all recognize that the status quo isn’t working. We spend more per person than any other country on health care, but we aren’t getting any bang for our buck. We have lower life expectancy, higher infant mortality rates and more preventable deaths, and too many personal bankruptcies are due at least in part to medical bills.
[...]Time to get real. As an economist who has spent decades studying our health care system, I can tell you that Medicare for All advocates are the only ones who are being reasonable, because theirs is the only plan that will control health care costs while finally achieving universal coverage.
The problem with incremental plans, whether they are public options, buy-ins to Medicare or Medicaid, or pumping more money into subsidies in the Affordable Care Act's individual marketplace, is that they preserve the private health insurance system weighing down our health care. [...]they are leaving the main reason for our system’s dysfunction in place: the multipayer, for-profit financing model.
Commercial insurance companies are nothing more than middle men. They add no value to our system, but they do drive up costs with their bloated claims departments, marketing and advertising budgets and executive salaries. We pay for all of these things before a single dollar is spent on the delivery of care.
They also create extra costs for providers who need large administrative staffs to deal with billing systems, accounting for as much as $100,000 per physician.
Any plans short of Medicare for All leaves these costs in place. In other words, they leave hundreds of billions of dollars a year in savings on the table.
[...]Gerald Friedman, a health care and labor economist, is an economics professor at University of Massachusetts Amherst and the director of The Hopbrook Institute.
[Related]:
Democrats' promise of Medicare for All is remarkably misguided and unrealistic
Trump wants to drop a neutron bomb on Obamacare. Over to you, 2020 voters.
Take it from me, tweaks won't fix health care. Dems should focus on Medicare for All.
(Score: 5, Informative) by Azuma Hazuki on Tuesday April 09 2019, @01:48PM (12 children)
Bradley, the reason removing regulations and letting "the free market" solve the problem won't work is that healthcare is not a free market.
You are familiar with the term "elasticity of demand?" Demand for healthcare is remarkably inelastic; people still get sick whether an aspirin is pennies or dollars. All you're doing by letting "the free market" have control is allowing corporate entities to, very literally, hold people hostage in "your money or your life!" situations. In fact, without proper regulation, we'll be back in the days of radium toothpaste and heroin syrup for babies; it'll be "your money AND your life, sucker! Whaddaya gonna do about it?!"
And that completely ignores the knock-on effects of a sick population. Healthy people are more productive, less likely to riot, cost emergency services less, and do better work. By ensuring healthcare, the benefits to be reaped extend far beyond simple first-order effects on the balance sheet.
"Free market" principles simply do not work when demand is this inelastic, constant, and growing, and you'd need to be either blindingly stupid or outright evil not to understand that after it's been explained to you. No more of that, okay? You're better than that.
I am "that girl" your mother warned you about...
(Score: 0) by Anonymous Coward on Tuesday April 09 2019, @01:56PM
Which is why scammers perennially run amok.
(Score: 1, Disagree) by khallow on Tuesday April 09 2019, @01:57PM (4 children)
But they will buy and use less aspirin as a result, if it's more expensive. But I suppose that would imply that health care is less remarkably inelastic than you assert.
I suppose we should have "proper regulation" then. Sigh.
One could use that babble to support the present system just with more vaccinations.
And once again, someone just asserts that "X doesn't work!" without actually trying X.
(Score: 5, Insightful) by DeathMonkey on Tuesday April 09 2019, @05:03PM (1 child)
Those regulations weren't formed by the Big Bang. We tried the full Free Market and started creating regulations because it kept killing people.
What we HAVEN'T tried here is the proven solution of socialized medicine.
(Score: 1, Touché) by Anonymous Coward on Tuesday April 09 2019, @05:15PM
Nono, THIS time we have Trump who will cut through the deep state that loves regatory capture and we will all be blessed with affordabke care. Oh wait, this came from khallow who doesn't see anything wrong with massive wealth inequality?
Woops.
(Score: 4, Insightful) by Azuma Hazuki on Tuesday April 09 2019, @06:53PM
You don't know your history very well, do you? Go research the era of patent medicines and radium in the toothpaste and privately-run asylums. That is, at BEST, what your approach would return us to.
Look, I get it, you are a slave to your ideology and nothing as silly as reality or history or facts or evidence is going to get in your way. Fair enough. Just don't expect me to humor you when you start pissing in the meme pool.
I am "that girl" your mother warned you about...
(Score: 3, Insightful) by aristarchus on Tuesday April 09 2019, @08:00PM
The Obvious Rebuttal is, khallow just posted in response. Wait a minute!
(Score: 5, Insightful) by bradley13 on Tuesday April 09 2019, @02:08PM (2 children)
To an extent, I agree. If I break a bone, it's got to be fixed, and I'll obviously pay what it takes to fix it. So, yes, some demand is inelastic. However, other things are more flexible. Do I want a check-up this year? Should I go to the doctor with this pain in my shoulder?
In my perhaps naive view of the world, if there were a true selection of different clinics to visit, I would choose the one that took care of both the optional and the not-so-optional things. When I break my leg, if the clinic screws me on the price, I'll go somewhere else with the rest of my business. In order for this to work, people need to care about the direct costs of their ordinary health care, which means that they need to pay those costs directly. Not through intermediate organizations that add no value, but do add lots of overhead.
Health insurance should only be relevant for life-changing catastrophic care - and should be accordingly cheap, because most people do not have catastrophic health problems. Here, too, if there were genuine competition (ensuring competition is a proper role for government), then people could also comparison shop. Look for the health insurance that provides the level of care you want, for the price you want to pay.
This can work. For example: when I first moved abroad (from the US to Switzerland), I was completely free of US regulations, and at the time Switzerland had minimal regulation. I found and used an insurance company in England - good service, inexpensive rates, it was great. Then Switzerland joined the ranks of countries heading towards socialized medicine. Suddenly, insurance was required, had to provide exactly the government defined benefits, was not allowed to turn anyone away...sound familiar?. Oh, and regulatory capture at work: I was no longer allowed to use a foreign company. The net result? My costs instantly doubled, and have gone up substantially every year since. In inflation-adjusted terms, I'm now paying at least 3 times as much as before.
Where I am admittedly naive: It seems to me that taking care of your health is an individual responsibility. But what do you do about people who don't? Someone doesn't bother to get insurance, gets horribly sick, and...do you just let them die on the street? Cold-bloodedly, yes, it's their own fault. However, people aren't that cold-blooded, and that scenario is the basis of the desire for big-brother, socialized medicine.
Everyone is somebody else's weirdo.
(Score: 4, Interesting) by slinches on Tuesday April 09 2019, @06:11PM
While I tend to agree that letting the market work by minimizing regulation will help reduce costs in the long term, that only works when there is competition. And competition only works when customers have ready access to the information needed to make comparisons and the time to make them. Currently, the health care system pricing is so opaque that it is impossible to comparison shop, even for non-emergency care. To fix that, some regulation may be necessary to ensure that prices are listed publicly up front and ensure they are fixed independent of who is paying. Doing that would also establish a market price reference to detect when health care providers are gouging people for emergency care when the time and capability to make an informed decision on care is limited or the care provider is making the choice for the patient.
(Score: 0) by Anonymous Coward on Tuesday April 09 2019, @08:03PM
In other words, you used to be one of those free-loading unbroken leg types? Oh, the shame, bradley13! American tend to bring America with them, no matter where they go.
(Score: 0) by Anonymous Coward on Tuesday April 09 2019, @03:08PM (2 children)
Maybe a solution would be to have a system where if you go to a doctor/hospital that costs less than average, you get the difference between the real cost and the average yourself.
Yes, short term that will increase the insurance cost, but it gives a big incentive to people to chose a cheaper doctor/hospital, and in return a big incentive to doctors/hospitals to get cheaper. All the while keeping your freedom to choose a more expensive doctor/hospital when you think you get a better treatment there.
(Score: 0, Insightful) by Anonymous Coward on Tuesday April 09 2019, @08:30PM (1 child)
People will get injured/sick intentionally so that they can turn a profit.
(Score: 0) by Anonymous Coward on Wednesday April 10 2019, @11:27AM
You are too uncritical of human nature. Assholes will deliberately make their partners and kids and elderly relatives sick or injured, then take them to the really low cost shyster and pocket the profits.