A Short History of American Medical Insurance
Its a solid article that offers insight to the origins of the "problem". But I think it misses the mark, where in the constitution does it say the government has any right to operate in health assurance?
Costs will go done and results will improve.
Leonard Peikoff's 1985 Ford Hall Forum lecture, "Medicine: The Death of a Profession", printed in the Ayn Rand anthology The Voice of Reason describes the rapid decline transforming the medical profession between the statist milestone of Medicare in 1965 and the mid 80s. Today it is much worse, with statism hopelessly entrenched without a major revolution in thought to overturn it. Technical advancements despite the politics are all that has led to important medical improvements in some ways in the last 30 years.
For most patients, the amount charged has nothing to do with what the third party payer actually pays, and what the medical facility accepts as total payment.
An interesting study I keep coming back to was if the cost of a total hip replacement. The researchers called 2 hospitals in each state and 20 major institutions and asked the cost for a hip replacement for a 62 year old female relative with no insurance. They were able to get numbers out of 45% of the major institutions and 10% of the others. To get more they had to separately contact doctors which got them over 50%.
These people knew exactly what to ask for, they had the appropriate CPT codes for the charges etc. Nevertheless the institutions couldn't or wouldn't tell them.
Prices ran from $12,500 - $105,000 at the top ranked facilities and $11,100 - $125,798 at the others.
https://jamanetwork.com/journals/jama...
I even noticed that one of the "Blue" insurance companies, not sure which state, would cover this, including costs for companion and arrange follow-on care when the patient returned to the U.S.
I had an employee who was covered by insurance negotiate his co-pay down by working with the surgeon and scheduling his elective surgery at a time when the surgeon had a slack period in his schedule due to hollidays.
Regarding their solution of publicly posted prices, I wonder if they could pass a law saying contracts must have pricing info to be enforceable. It wouldn't be forcing anyone to disclose prices to the public or even to customers. But if you don't disclose to customers ahead of time, you can't win a judgment for nonpayment.
Much of the original historical context of the amazing stupidities of our methods of paying for health care are talked about. An informative read.
Really liked this idea: "One way to achieve this would be for employers to provide major medical insurance plus a health savings account to take care of routine health care. If the money in the account is not spent on health care, it would be rolled over into the employee’s 401(k) account at the end of the year, giving him an incentive to shop wisely for routine medical care."
As a Firefighter for 30+years we had regular "Emergency" calls for people who 'needed' aspirin or other cheap OTC drugs who were too lazy to go out and buy them, and got a ride to the hospital for the OTC drug and a free taxi ride home after. If they had to pay the average of a Fire Engine company ($500/call at the time) and the ambulance and the taxi in addition to their $1/1,000 aspirin, they would have sought out the 24-hour market and gotten their aspirin there... a much cheaper and 'capitalistic' way of care.
In conversations, people actually think it doesn't cost anything since the insurance companies are paying for it.
That's just those who are Big Brother wanting to become a bigger Big Brother.
Big Brother was too big way before ObamanationCare came along after power glutton statists passed a bill to big to read.
The other problem that wasn't discussed is that modern life, although vastly improved from days of old, is mostly the problem in causation of disease.
Emergency medicine and surgeries have advanced tremendously and are life saving much of the time but preventive care and disease curing is still a crap shoot, highly profitable for everyone except the patient.
On that front, the biggest gains in history were cleanliness and nutrition. Natural medicine still beats the modern system of alleviating symptoms only.
And last but certainly not least...Government has no role what so ever in your health care nor those that pretend to care for your health...The free market is the only cure for that disease.
Health Insurance is NOT Heath Care.
The easiest solution to stop the increasing costs of health care is to force people to only demand care when they need it. To do that the cost of health care must be paid by the person demanding the service. This will guarantee a lower demand and lower costs.
Ban Health Insurance Completely in all forms.
I have lived without it for 30 years.
It's unfortunate that in common language forcing people to pay for a gov't health plan is "expanding rights", while not doing that is calling "forcing people". It's backwards.
I would say that the word "insurance" is at the heart of the confusion. Current health insurance has way too many aspects that aren't insurance at all. One step in the proper direction would be for Congress to do it's constitutional job of establishing standards. Insurance should be clearly defined and that which is not insurance should not be allowed to be called insurance.
"And yes, all pricing should be published so people can compare."
I think so too. My thought is a less intrusive way to make that happen is to say the courts cannot enforce contracts that don't have pricing. Laws requiring published pricing might work and be the right approach; I really don't know, but I'm just cautious about law requiring people to do anything.
/s
But "let nature take its course" in old age? What is meant by that? Not treat an old person? And what about Alzheimer's and other senile dementia? I wouldn't mind too much if a heart attack took me suddenly in old age. But I think that too much dementia would be horrible.
I see an example just below me. The first comment was posted by by brucejc04 1 hour, 30 minutes ago. He references a comment by OldUglyCarl, which appears WAY down the page.