One of the key points of this blog is that the health care debate has never been about health care. Never. Money isn’t the prime driver. Money is the only driver. How do the hospitals, doctors and other medical providers get paid, and how much, are the real issues.
Except for a couple of purists, no one really cares who pays the doctor or hospital as long as it isn’t you, the patient. Do you really care if your $300,000 bill from the Cleveland Clinic or University Hospital is paid by Anthem Blue Cross or the federal government? Honestly? No. All you really want to know is how much, if anything, you will owe once the dust settles. And the providers? The insurers pay more, but have a lot of paperwork. Medicare pays less, but quickly. Based on the number of medical providers that accept Medicare (darn near everyone), I’m guessing that there are no serious complaints. The hospitals may even like having two major funding sources to play against each other.
I have tried to teach my clients what I know of the game. My senior clients learn about the origins of Medicare Parts A and B, the backroom deals that gave us Part D (Rx), and why costs are out of control. Countless clients have been clued in that those obscene charges are negotiable before and after services have been rendered.
Your perception of our system changes today thanks to Time magazine. Blessed with budget, time, and amazing persistence, Steven Brill has given us Bitter Pill, Why Medical Bills Are Killing Us. Mr. Brill tracked claims and laid bare the abomination that is our system of billing for services – real or imagined. Straightforward in his prose, laborious in his detail, Mr. Brill presents a system of overpaid executives and hyper profitable not-for-profits.
The real issue isn’t whether we have a single payer or multiple payers. It’s whether whoever pays has a fair chance in a fair market. Congress has given Medicare that power when it comes to dealing with hospitals and doctors, and we have seen how that works to drive down the prices Medicare pays, just as we’ve seen what happens when Congress handcuffs Medicare when it comes to evaluating and buying drugs, medical devices and equipment. Stripping away what is now the sellers’ overwhelming leverage in dealing with Medicare in those areas and with private payers in all aspects of the market would inject fairness into the market. We don’t have to scrap our system and aren’t likely to. But we can reduce the $750 billion that we overspend on health care in the U.S. in part by acknowledging what other countries have: because the health care market deals in a life-or-death product, it cannot be left to its own devices.
Steven Brill – Bitter Pill, Why Medical Bills Are Killing Us
You won’t agree with all of Brill’s conclusions. I certainly don’t. But read his work. This should be the new starting point of our national conversation.
The loss of hospital competition in Ohio and across the country is the result of the growing costs and restrictions placed on health providers since Johnson's 'Great Society' in the mid-1960's. Most notable in that loss is the many religious charity hospitals that once served the poor and the uninsurable. Bring the free market back to the medical industry and you will see more consumer choices emerge and prices come down for everything: hospitals, doctors, nurses, midwives, faith healers, shamen, quacks and insurance premiums. You would also see a return of the much-needed charity hospitals. Yes, Obama did not make health care unaffordable in America. The federal government already controlled most of the industry by 2008. But Obama's PPACA is the opposite of a free market solution and will only make the situation worse--and trample all over our civil and property rights in the process.
and all journalists. "This was an EXCELLENT piece in Time". Which is why nobody read it. Time and its like minded media partners are about as frequently consulted on the news of today as the New York Sun of "Yes, Virginia" fame.
Could someone please summarize the key points of the article? If we know the key points then perhaps we can ask more useful questions. If we can rank order our questions then we can speculate on some helpful answers to the most important questions.
Is outlawing third party liability the answer?
Nobody read it. That Issue never moved from it's spot on the shelf until I placed the next unread issue of Time in its place.
Which further explains yours -- and many others -- stupidity.
Keep the laughs coming, funny man.
When you see something that happens is it not the truth? Does a librarian have to catalog the dust that builds up on the cover of an unread item for you to believe that it inspires no readership?
Have you taken down the Psuedo James Thomas Page you Created?
Have you taken down the Psuedo James Thomas Page you Created?
Yes, it will take a bit of effort to read the whole article. Our attention spans have shrunk. Our willingness to put forth the effort to learn all of the details has diminished. But it is only through taking the time to master the issues will we be able to have a complete discussion and have real change and progress.
Mark, if you wish to be so adamant about your opinion, please take the time to read the core material. Then explain to us how the government is the problem in the cases Brill follows. Government is a lot like food in that we don't do well with either too little or too much. We may never find the right balance, but the idea that anarchy is preferable is difficult to take seriously.
"Government is not reason; it is not eloquence. It is force. And force, like fire, is a dangerous servant and a fearful master." George Washington "That government is best which governs least." Thomas Jefferson
http://www.forbes.com/sites/scottatlas/2012/12/18/lets-be-honest-medicare-is-insolvent-and-doctors-soon-wont-accept-it/ Healthcare costs have been driven up by declining market choices; milk is much less regulated and is therefore subject to more price competition. Kidney dialysis and other major medical procedures would be the most affordable when subject to market forces. Compare the costs of these same procedures done for pets; pet owners have choices in veterinary care that they do not for their own care!
There is all of recorded history showing that they are not. Mr. Greenspan learned that, and he was "shocked".
What kind of feedback do you think Obamacare will get? I'm sure federal admins will not even solicit feedback, especially when IRS agents are called in to collect! It's central planning that is theoretical, not markets; socialism has never worked as promised, but since it sells itself on emotion all reason is thrown out.