Every American should read this piece on health care costs, from Steven Brill, of Time Magazine. It’s 11 pages of excellent journalism that will enlighten and enrage you, as it highlights the “why” of skyrocketing health care costs in the U.S.
There is an epic battle going on between health care providers and insurers. And providers are winning as they consolidate and increase their negotiation leverage. The result? We all pay more. Absurd levels more.
Mr. Brill examines a number of actual patient medical bills and compares costs to what you would pay on Amazon or elsewhere for the same product, as well as what Medicare and insurers might pay for services – and what unfortunate patients without health insurance are forced to pay.
Below are some specific examples of ridiculousness that stood out to me:
Common items like generic Tylenol coming with a charge of $1.50 PER PILL while you can purchase a bottle of 100 for $1.49 on Amazon.- Hospitals that are “non-profit” in name only, with net annual profits of $500 million+, even after paying high level executives millions. The article gave the example of the non-profit MD Anderson (part of the University of Texas), who’s CEO, Ronald DePinho, receiving total compensation of $1,845,000 – two and a half times the salary of the chancellor of the entire university.
- MD Anderson charged $7 each for “ALCOHOL PREP PAD.” This is a little square of cotton used to apply alcohol to an injection. A box of 200 can be bought online for $1.91.
- Stamford Hospital charged 11 times its costs on lab work, on average.
- 14 administrators at New York City’s Memorial Sloan-Kettering Cancer Center are paid over $500,000 a year, including six who make over $1 million.
- With $2.586 billion in revenue, New York City’s Montefiore Medical Center (a non-profit) is more than six times as large as the New York Yankees. It’s CEO makes $4,065,000, chief financial officer makes $3,243,000, executive vice president makes $2,220,000, and head of its dental department makes $1,798,000.
- In the U.S., we spend almost 20% of GDP on health care, compared with about half that in most developed countries.
- Americans spend more on health care than the next 10 biggest spenders combined: Japan, Germany, France, China, the U.K., Italy, Canada, Brazil, Spain and Australia.
- We’re likely to spend $2.8 trillion this year on health care. That $2.8 trillion is likely to be $750 billion, or 27%, more than we would spend if we spent the same per capita as other developed countries, even after adjusting for the relatively high per capita income in the U.S. vs. those other countries.
- Every hospital has a document called a “chargemaster”, which acts as a price catalog for every service/medicine/etc. they provide. Prices for the chargemaster are not in conformity between providers and seem to be arbitrarily set and automatically increased each year.
- Under Internal Revenue Service rules, nonprofits are not prohibited from taking in more money than they spend. They just can’t distribute the overage to shareholders — because they don’t have any shareholders.
- Aware of the leverage that drug companies — especially those with unique lifesaving products — have on the market, most developed countries regulate what drugmakers can charge, limiting them to certain profit margins. In fact, the drugmakers’ securities filings repeatedly warn investors of tighter price controls that could threaten their high margins — though not in the U.S.
- The difference between the regulatory environment in the U.S. and the environment abroad is so dramatic that McKinsey & Co. researchers reported that overall prescription-drug prices in the U.S. are “50% higher for comparable products” than in other developed countries. Yet those regulated profit margins outside the U.S. remain high enough that Grifols, Baxter and other drug companies still aggressively sell their products there.
- More than $280 billion will be spent this year on prescription drugs in the U.S. If we paid what other countries did for the same products, we would save about $94 billion a year.
- Congress prohibits the Centers for Medicare and Medicaid Services (CMS) of the Department of Health and Human Services from negotiating prices with drugmakers. Medicare is forced to add 6% to the average sales price, by Congressional law. In the areas of the country where Medicare has been allowed by Congress to conduct a competitive-bidding pilot program, the process has produced savings of 40%.
- Medicare has an overall administrative and management cost of about two-thirds of 1% of the amount of the claims, or less than $3.80 per claim. According to its latest SEC filing, Aetna spent $6.9 billion on operating expenses (including claims processing, accounting, sales and executive management) in 2012. That’s about $30 for each of the 229 million claims Aetna processed, and it amounts to about 29% of the $23.7 billion Aetna pays out in claims. (GE note: Medicare can negotiate prices that are a fraction of what insurers can and their administrative costs are 10% of insurers. On top of that, there is no 20% profit payout to Medicare, and no lavish CEO salaries in the other 80%. Please tell me why we are better off with Aetna and like insurers?)
My Thoughts on Steven Brill’s “Bitter Pill” article:
Despite my appreciation for almost all 20,000 words of this article, I take one rather big exception to his conclusion. Brill’s uses the entire article to explain why costs are so high – and he compares how effective Medicare is at examining costs, negotiating lower prices, and being more efficient than private insurers. Some of his recommendations at the end of the article are spot on, but he doesn’t close the circle and make the ultimate recommendation that his months of painstaking work pointed towards – the need for single payer in the marketplace.
The author, who has conservative leanings, goes as far to say we should heavily tax profits, put caps on profits, and expand our current single-payer Medicare (by lowering the age from 65 to 60), but doesn’t go as far to say we should move over to single-payer completely. Why? Cowardice? Political angst against him? I don’t know. But as this article highlights, the numbers don’t lie. There is no politics behind numbers – the lowest cost options should win out for the American people. Brill takes you up 99% of the way up the grueling, unexplored summit, then turns around and says, “oops, forgot the flag.”
If the government (Medicare single payer) is that much more efficient and leveraged in negotiating payouts and limiting costs, I’ll sign up and pay for that insurance plan vs. my existing, any day. Unfortunately, we don’t have that option. We should all want it though, because ultimately, all of these costs are passed along to every one of us. Private insurance is nothing but an inefficient non-government tax that distributes these outrageous costs while taking an additional 20% middle-man surcharge. With private health insurer payouts gone, and more leverage, our shared costs would plummet.
A few other conclusions I drew from the article:
- 60% of hospitals in this country are labeled as an IRS tax exempt non-profit. What does this tax-saving, “non-profit” status cost them? 3% of operating revenue to patients who can’t afford to pay. Meanwhile, 1. there is no cap on profitability, and 2. there is no cap on executive pay. Maybe it’s time that changed.
- Why not set a limit for hospitals to charge uninsured X percent of what Medicare pays?
- I’ll echo one of Mr. Brill’s conclusions: “the bills tell us that this is not about interfering in a free market. It’s about facing the reality that our largest consumer product by far — one-fifth of our economy — does not operate in a free market.” Health care is often a matter of life or death. And consumers have little to no choice when they end up in a hospital emergency room.
So have a read, and I’d love to have an ensuing discussion on the following:
- What are your conclusions on the article?
- How can we change these ridiculous pricing practices? What solutions would you propose, if any?
- Do you think we are better off with the current cost payment/insurance plans we currently have, or do you think we would be much better off with at least an option to choose a highly leveraged negotiator with no profit-motive (single-payer)?
- The current health care system has picked winners: drug-makers, hospitals, and insurers. Why is it that they should be the winners while every taxpayer, insurance-premium payer, and uninsured citizen stuck with an outrageous bill they can’t afford – are chosen as the losers?
I think single payer is a horrible idea. Walmart is great at controlling costs and leveraging their buying power and in turn passing it on to the customers, so why don’t we force all American’s to buy their groceries from Walmart? Well for one because Walmart’s customer service is awful. Their shelves are rarely stocked completely, and the check out lines are always ridiculously long. Now, personally I still shop there because I like a bargain, but the experience is always terrible and if others want to spend a little extra for a better shopping experience, that is their choice.
What’s my point, if we go to single payer, you don’t allow customers that choice. I realize there are many difference’s between health care and groceries, but what I’m getting at is that as you lower costs (Walmart), the service you receive greatly diminishes. If we go to single payer, you can bet that health care quality will also greatly diminish.
Do CEO’s make a lot of money. Of course they do, but they make a lot of money (in most cases) because they are good at what they do. If you put a salary cap on hospital CEO’s, then all the good CEO’s would move to different industries and hospitals would be run by the bottom of the barrel CEO’s. It’s capitalism, it’s what America was founded on, and you’re trying to give it up.
Nick, I suggest you go read the article and respond to the questions I brought up vs. just bringing a party line to the table.
There is no free market in health care. What choice is involved in being stuck with your employer’s choice of insurer, and that insurer doesn’t have any leverage in their negotiation with hospitals?
If the medical market is not actually a free market, why not restore it to the free market that it is supposed to be? Then it would actually work. The medical industry would have to compete for your business with lower costs and better care. Why is the answer always more big government intervention??? We want to put more money and more power in the hands of the federal government? Because we can trust them right? Who are we kidding here? It’s over-legislation and over-taxation by our federal government that is the cause of a lot of these problems in the first place. Many of our congressmen, who are supposed to represent US, are looking out for their own interests first. For over 100 years now, they have perpetuated a system that breeds corruption and we have sat back and allowed it to happen. Now we have a broken system and cheating or “working” the system is the only way to get ahead. Honest men and women are left paying the price.
This is not party line rhetoric, this is FACT: If capitalism dies, America – as the Republic that the Founding Fathers intended it to be – will cease to exist. Nick’s spirit is in the right place. With the institution of social programs like “Single-Payer”, we aren’t solving any of our current problems. We are creating bigger government and creating more problems. And even worse, we are causing the “American Dream” to die a slow and painful death.
I’m all for free markets when they are truly free markets. The free market, is in fact, what ruined the free market in health care. Left to its own devices, we have what we have today.
The only shining star in controlling health care costs is Medicare/Medicaid.
So what’s your fix? Let things continue as they have until it fixes itself?
The solution in your comment seems to be this: “keep things the same”. Please read the article. Then come back, and if you still feel the same way, tell me again that govt. intervention/competition would not help lower costs, and give some solutions that would have a more tangible impact on cutting costs than introducing single payer in the market.
The goal here is to present a solution that lowers health care costs. I don’t care what it is, as long as it works.
Respectfully, you are correct in one of your points. The government programs do get a lower rate on each service rendered vs the private markets.
The problem is the fraud in the system probably removes those savings because there is no auditing. More than 90+ percent of claims that are submitted to Medicare is automatically paid out. No over site.
G.E.:
I have already read the article and this is exactly how I feel. Nowhere in my response did I once say “keep things the same.” What we have now is not a true free market. It is a free market in name only. Continued government intervention on behalf of lobbies and special interests has hindered the free market from doing it’s job. In a truly free market, it is *competition* that drives prices down. We don’t have that. Congress should not be legislating what Medicare/Medicaid is paying – or what anyone has to pay for that matter. The market – supply and demand – should dictate it. There are so many artificial controls and outside influences, however, that we have ruined the market. Therefore it isn’t working and people suffer.
Small hospitals and private practices are being bought up by large non-profit hospitals, killing competition, and no one is asking why this is happening. There is a reason. Furthermore, why is no one asking why a hospital making $500 million (for example) is non-profit? What legislation is allowing that to happen? Rather than questioning that, we just get more socialist agenda jammed down our throats. Simply put: Restore the free market. The free market works when we allow it to. That is the solution I am calling for.
GE: you are wrong in your statement …”stuck with your employer’s choice of insurer, and that insurer does not have any leverage in their negotiation with hospitals?” Of course your employer’s health insurer has leverage and negotiates rates with providers. It’s called NETWORKS. Insurers negotiate rates for everything, and pay claims based on the negotiated rates. Provider usually hate it – they are forced to accept a contract rate for services rendered. Most providers participate in several networks so they can serve Aetna, Cigna, Humana, etc. patients. When you see a $5,000 bill for an MRI and your patient responsibility is $700 – that is the impact of the negotiated rate. The stronger an insurers network in a market the stronger their negotiating leverage. Also – I’d like you to clarify on exactly what pieces of “Medicare” are implemented at lower costs than private insurers. Medicare is not medicare is not Medicare. It comes in many flavors. Part D and Medicare Advantage are underwritten marketed sold and administered through the insurers like Aetna Cigna and Humana – if the costs for providing “Medicare” services cited includes those products, then of course the government CMS costs will appear lower – it’s the insurers absorbing the costs.
If you don’t care what it is, as long as it works, then that means YOU have to work, for “it” to work. How long are you willing/able to do that? Until Medicare or Medicaid takes over? Right now, how much per month do you pay for your medical care? Are you satisfied with “it”? Is it working? What do you have to do every day to get that monthly premium?
My views have changed since I originally wrote this article. I’m firmly in the single payer camp now.
@JTM316, there are many aspects of healthcare that make it next to impossible to create a truly free and competitive market, but the aspect that’s most commonly cited is this: when you are in a medical emergency, it is simply not possible for you to shop for the most cost-efficient provider of health services. You are forced to accept the prices of the healthcare provider who is giving you life-saving emergency care.
That is a major stumbling block to the creation of a truly free market in healthcare.
Now some of the other criticisms that are plain to see in Brill’s piece do dovetail with your plea that we make a more free market:
1. Hospitals, and all healthcare providers, should be forced to publish their prices for all goods and services. No more hiding behind the chargemaster.
2. At least for healthcare that is non-emergency, this publishing of prices is the first step in forcing hospitals to compete on price.
3. Hospitals should not be allowed to force you to purchase services provided by their internal service departments (a hospital that decides to run its own MRI machine should not be able to force you to purchase all your MRIs from them. They should rather be forced to allow you to go to any outside MRI lab, get a scan done, and bring the results back to the hospital.)
4. Likewise, for the things that really stir our outrage: hospitals charging you $100 for 1 aspirin tablet, when you can buy 100 tablets for $1 from Amazon. Customers should be able to purchase these types of items from any provider and bring them in or have them delivered to the hospital for the duration of their stay.
5. Hospitals should not be allowed to double-charge: they already charge you thousands of dollars per day for a stay in their hospital, which includes the incidentals needed to provide care. They can’t pile on and then double charge you for your hospital gown, for cleaning and changing your sheets, for water, for aspirin, etc.
First the article is very well written, researched and indeed everybody should read it.
It is at times hard to read the injustice done to people seems so outrageous.
But lets try to look at one question.
Can free market truly work in the health care setting, and more pragmatically in the current us US health care system?
If you trying to buy goods or services (buying groceries, a car, or going a restaurant or to hair stylist) you have lots of options, and similarly important is that you know (or can ask the price beforehand). If you have a serious health problem that there are a few major hospitals in your area and they do not publish their “chargemaster” prices. Nor do they tell you, and in fact if you ask and they’d be willing to that they would not be even be able to do so as it comes out as tens to hundreds of line items after the procedure.
So this is a market locally monopolized by a few big providers, with no prices known or compared for the buyers. On top of this there is the fear element where you’re buying services for your health or in fact to save your live; do you dare to shop around (even if that would be possible) if you’re afraid that buying a cheaper service would not save your life? If you read the definition of classic free markets this is as far from them as possible.
To have some free market forces introduced, first there should be transparency, hospitals should make their prices known to the public in a way that is understandable, bundled and not consisting hundreds of coded line items. There should be an agreement that these prices must remain within certain limits just with any other services (like having your house built by a builder). I don’t believe this would be enough at all but would be an absolute minimum before anyone can just say (without thinking) ohh let’s just leave it to market forces they provide the best health care system.
Finally people should take the pain and read through the article before commenting.
Nick, If that were true, why are medicare patients some of the happiest and most most satisfied patients? The government option doesn’t suggest changing anything about the hospital except throwing out the complete randomness of their charges. Charging people 2 dollars for an alcohol swab that costs 2 cents is something they can get away with in the process because there is no up front bill before services. If you walked into Walmart and they said,
“Be greeted by greeter: 1$ , Basket rental 5$ , carts 15$ ”
You would walk right the hell out. So would we all. Unfortunately a car accident survivor, a heart attack victim or a cancer patient doesn’t have the option to say..screw you guys.
Just a thought. We spend nearly 3 trillion on Healthcare. 60% of the hospitals are tax exempt. Imagine how much money in tax revenue we could be making back in taxes if we said, any hospital that charges such exorbitant fees must pay a tax on its reported profit. That would be no small change.
Also, to the few posters who said…”The guvmint can’t do nuthin rite!” Well, Medicare is administered pretty well (according to the vast majority of users and their friends and families {even the tea party} doesn’t want it cut}). Some will say..It is insolvent in 20 years!! But that has more to do with unemployment than the program itself..and hell..It used to be insolvent in 2 years but some how it just keeps chugging along!
You need a Walmart Neighborhood Market; it’s a Walmart but just the food.
Go to Walmart at off hours if you don’t like the lines and never go there the first of the month.
The logic of your comparison between Walmart and Single Payer is off for several reasons:
1. Walmart is FOR PROFIT whereas Single Payer would be a real NON PROFIT unlike the hospitals described in the article. You can also blather about capitalism but I personally don’t think keeping someone alive should be about profits.
2. You talk of CEOs and how they would all run away if you capped their pay. Well, that could be good thing because maybe someone who cares more about people’s health than profits could take their place.
3. How come CEOs need super awesome pay while regular workers get just enough to survive. I bet if the employees were paid better you’d have a much better experience. As an aside, the Walton family is worth at least $100,000,000,000 so I think they could afford it.
4. If all you had was Walmarts you could still choose the best one possible, right? I assume as a business Walmart would start firing managers if they received tons of complaints and less business than comparable locations.
5. For many people, diminished healthcare is better than no healthcare at all.
6. Finally, “if others want to spend a little extra for a better shopping experience, that is their choice”, well people could still do that with Single Payer. You want a doctor with a gold plated stethoscope then bust out some cash.
Let me know if you need some more reasons.
I disagree that we have a choice where to buy for hospital services. When I had an emergency apendectomy last Sept. I couldn’t shop around, compare prices and services and pick. This is not a retail choice. It’s life and death. We go to the closest ER. And NO ONE is examining if profits are fair!
So as prices decrease so does service AND as prices increase so also will service. I can hardly wait to see how high the cost goes for those ‘ALCOHOL PREP PAD” that MD Anderson charges $7 each for. I think the last couple decades has shown us what unbalanced capitalism can do. It’s time for a major market correction and sensible regulation.
You’re absolutely right, Nick. IT’S CAPITALISM!
Very good (and detailed) article. I currently work for a major healthcare company and have seen everything you have mentioned first hand. I agree with you that alot of the cost increase is on the provider side (not insurer). We’re now on a profit cap under Obamacare. That’s not saying we don’t make a good amount of money, but the providers are where the large increases come from. I know we’re personally trying to negotiate with the providers to get lower rates and make sure they are getting paid for keeping people healthy (not for how many procedures they do).
Give any individual, including the insurance companies, the right to submit to Medicare for a small fee any inpatient or out-patient bill for review. Medicare would give their automated invoice of what what they would pay on this bill. Use Medicare’s payment to legislate that no bill for inpatient or outpatient procedures could exceed 2.2 times what Medicare would pay. This would simplify things for insurance companies and individuals and save money and heartache on unrealistic overpricing practices of hospitals and clinics for everything from emergency care to medical scanning services.
I think we need to think more. Why can you go to Mexico and get health care for a fraction-and I mean a fraction!-of the cost? People in Texas go over the border all the time for cheap dental work. They fly to Guadalajara for surgery. I think government is the problem. They have protected the medical system so they can be a monopoly. It is true that you cannot shop around when you have an emergency, but you can for many things. Even most cancer patients have time to shop. The FDA is a racket-approving dangerous drugs and forbidding natural cures. People need to consider alternative medicine more. We need to think how we can make it more competitive. People need to stand up and complain and start wheeling and dealing with hospitals. Government needs to stop protecting the medical system and get out of the way. Believe me you don’t want a socialistic system-it sucks. We need to put our heads together, look at what worked in the 1910’s when it was cheaper, figure it out. Think.
If anything the FDA needs more power, money, and independence to resist corporate pressure and to actually study so called “alternative medicines” so they can prove their efficacy. Or, more likely, prove their lack of efficacy and the fact that most are just pseudo scientific nonsense. People waste so much time and effort on unrealistic stuff the government has to step in. Just look at Steve Jobs, even he succumbed to magical thinking and it probably cost him his life.
Don’t blame the government. Blame the obscene amount health care pays for lobbying Congress. There are more health care lobbies than Big Oil! All that profit and cash gives too much power to a “non-profit” system that is behind 60% of American bankruptcies.
In response to the statement that Mr. Brill does not advocate a single payer option, that is incorrect. He does in fact say that it would be the proper solution, but then says that it is impractical because no Congressman would vote to destroy the health insurance industry, and replace with a single payer system.
“Maybe, but the prospect of overhauling our system this way, displacing all the private insurers and other infrastructure after all these decades, isn’t likely.”
I actually don’t mind any organization making a ton of money doing any of this. However, if they do, they should be considered a corporation and taxed accordingly. Since most hospitals function as non-profits, they must actually act like charitable organizations to enjoy the various privileges that go with it. Otherwise, tax them more and bar them from accepting tax-free donations.
I would propose that in order for hospitals to maintain their NPO status, they must be barred from:
*Charging non-Medicare/Medicaid patients more than say, double.
*Charging patience more than once for the same thing. The patient is expected to pay for one-time-use surgical equipment? Perfectly reasonable. However, either charge it separately as a line-item in the bill OR charge it under general surgical costs, not both.
*Charging patients the entire cost of items that are reused (like blankets). If they last an average of five times, charge patients 1/5 of what they’d charge otherwise.
*Marking up the prices of easily obtainable goods by more than say, 75%. If the market value in a particular area of a bandage is $1.00, charge the patient no more than $1.75
*Taking on debt that’s more than 5% of the revenue of the past three years. Oftentimes hospitals spend money on things that are completely unnecessary and use this to raise costs.
*Colluding with any company that sells them supplies and equipment – if charges are capped at the market values, hospitals will try to circumvent this by artificially raising the market value. Make doing this a criminal offense.
*Being sued for more than $5 million in punitive damages. This would protect them from having to pay so much in malpractice insurance and would mitigate doctors ordering unnecessary tests in the event that what goes wrong .000001% of the time actually does.
*Ordering tests that cannot be medically justified
The numbers above are all completely random. They probably seem way too high, but are significantly lower than what we pay now and would save a lot of money. I used them as a general benchmark and don’t think those specific numbers should be used.
I’m frankly shocked more people aren’t outraged by this article. Whether or not you agree with his solutions, I think everyone should be stunned by his findings. I really thought this would take the Internet by storm and force Congress to do something about it, like SOPA/PIPA last spring. Evidently, I was wrong…
The reason everything is so expensive is the insurance pool is full of moral hazard. I have a 3 person family and I basically get punished because some other family isn’t getting charged enough for their 50 kids.
My enrollment options are:
Employee Only = $38.57
Employee Plus Child = $62.46
Employee Plus Children = $76.36
Employee Plus Spouse = $86.39
Family = $180.07
I currently have Family selected since I have a wife and 1 child at a cost of $180.07.
If I was even allowed to choose Employee Plus Child and Employee Plus Spouse for a total of $148.85 there would still be a savings of $31.22 per pay period or $811.72 per year (26 X $31.22).
Furthermore, if you calculate the costs for each part of the family by option then:
Employee = $38.57
Child = $23.89 (Employee Plus Child – Employee Only)
Spouse = $47.82(Employee Plus Spouse – Employee Only)
For a total of $110.28 and a savings of $69.79 per pay period or $1814.54 per year (26 X $69.79).
Basically, I’m getting gouged/punished for only having a 3 person family and it seems very strange for me to be paying the same amount as a family with 10 kids or even a 100.
A system where the buyer (employer) purchases a service that he doesn’t use. The ultimate user (employee) is unaware of the cost of the service that was purchased is doomed for failure. Then the insurance company charges the buyer for a service that they didn’t directly use… There’s too many blind spots in costs that lead to waste.
Who can afford to insure a burning building? It’s the burning buildings that are draining our health care resources. No doctor can stop a smoker from getting readmitted again and again when they ignore medical advice and continue eating a greasy hamburger the day they get discharged from the hospital for a heart attack. No medicine can cure a building that pouring gasoline on the fire.
On a similar note, in my first day in health economics and policy class at the University of Washington, the professor wrote a question on the board: “how we could improve health care in America?” The class was filled with future-pharmacists and doctors during the entire 50 minutes the class brainstormed all sorts of ideas about preventive care, screenings, etc-etc. At the very last moment, the professor wrote on the board: “close the gap between the rich and the poor.” And he promptly left the room.
Julie, the metaphor that you use of a burning building is well taken…However it exposes a gaping hole in your thesis.
When I was young, 60% of all adults were smokers. Now it is in the 20 percentile range, so progress is being made, on that front…The problem is, what you seem to be advocating, is a complete cultural overhaul of our society, and we can’t even agree on a public option.
Just skimming the surface of all the things that make us all sick, or unhealthy; such as smoking, fried foods, pollution, drugs (both prescription, or otherwise), overeating, lack of exercise, etc., etc., it would take a good hundred years to turn that on it’s head..I’m not saying it wouldn’t be a good thing; but in the meantime, we still need to insure everyone…And when I say everyone, I mean EVERYONE, for both fiscal, and moral reasons..We know why morally, (or at least we should) and fiscally, because we pay one way or another, anyway.
Not picking on you Julie, because I read here earlier some people faulting the Gov., because, Gov. is evil and can’t ever get anything right…Getting stuff right we can debate, but it always strikes me funny how silly people sound when they say how corrupt Gov. is…Seemingly suggesting that the private sector is immune from corruption, and general malfeasance, as if big business has no connection to that corruption!..I see it as they are the main catalyst!
Aside from that, the private sector colludes, (on many levels) in price gauging, with almost free reign… Example: Big businesses pushing the little guys off the shelves at the supermarkets, as Coke and Pepsi do all the time, take over an entire aisle, leaving the little guy (RC, or whoever) to try to squeeze out a 2 or 3 foot space…. There are so many overwhelming anecdotal instances, as to be too in-depth to go into here, but most know what we know, right?.
Whatever Gov. does, (or doesn’t do in the way of ineptitude) the Private sector can match, 10 fold, in unfair trade practices, off shore tax exempt accounts, Corporate tax loop-holes, unfair wage controls, multinational corporations and protectionism, etc., which, I believe, causes an even a greater kind of ineptitude….Am I anti- business?…NO!…As long as business is practiced fairly…When it’s not?…YES!…And I think the whole healthcare system is broken and corrupt…Will Obamacare help…Only time will tell….Public option would have been nice, (at least!)
Bottom-line is, we can’t have over 1/5 of our society either un/underinsured, and expect to not continue to tread water…Something had to be done…If it needs to be tweaked, (and it will) we will tweak it, over time.
Also, it isn’t just the hospitals, insurance companies, or Government..Brill makes a point of singling out medical equipment manufacturers and suppliers, as well.
I’m a single payer guy….Someone mentioned that care would suffer…When I hear that, it tells me that that person has no grasp of the numbers, (or doesn’t want to.)
In places that have it, check out the mortality rates…Check out the general health of the society…And YES!..You can still have superior care, (Cadillac insurance, if you will) in such a place as Canada; you just have to pay for it, through supplemental insurance….Gee, just like here, except everyone is covered.
I’ve thought for a very long time that private insurance companies should not be within 1000 miles of major medical plans, and being the arbiter for who gets what care, for the simple reason that they serve only God and his son…Money and the Stockholder.
I’m not positive the place you are getting your info, however great topic.
I needs to spend some time studying more or understanding more.
Thanks for great info I was on the lookout for this information
for my mission.
What aren’t you positive about? The Time’s article is quite thorough.
One of the first things I learned in a healthcare economics class several decades ago was that competition does not work in health care. If two local hospitals each buy an MRI machine, they both raise their prices in order to compensate for the loss in volume of patients. I doubt the integrity of every politician that votes (either pro or con) on the ACA without bringing up hospital and drug costs for discussion.