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Zonie63 -> RE: US Health Care Costs (11/22/2014 7:17:51 AM)
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ORIGINAL: DesideriScuri
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ORIGINAL: Zonie63
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ORIGINAL: DesideriScuri
1. Why does Health Care Insurance Cost so much?
I contend that insurance costs so much because cost for treatments and procedures costs so much.
I would not make that assumption. Considering how much insurance companies pay their CEOs and how much they must have spent on their big beautiful expensive office buildings, they surely must have money to burn in the insurance industry. They don't look like they're cutting to the bone.
Costs haven't gone down, even though Obamacare requires them to spend 80% of their premiums directly for care, leaving 20% to pay administrative costs. If the cost of care was slashed, don't you think the cost of insurance would also drop?
Possibly, although I have no idea how they plan to enforce that 80% requirement. With my company's insurance plan, we switched from United Healthcare to Blue Cross, although the premiums have been going up. Not just for the cost of care, but for certain optional extras, like Long-Term Disability, Accidental Death and Dismemberment, etc.
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That begs the question:
2. Why do procedures and treatments cost so much?
3. Is it inflated costing by the hospitals/providers?
I wouldn't put it past them to inflate the costs, although it may not be the hospitals as much as the equipment manufacturers and the pharmaceutical companies. The hospitals themselves may be part of the problem, but I think they're far lower on the food chain. I would also cut the hospitals a bit of slack since they're required by law to treat anyone who requires their services, no matter if they can afford to pay or not. As a result, it's the hospitals and other providers who are forced to eat those costs incurred by deadbeat patients, whereas the insurance companies, equipment manufacturers, and pharmaceutical companies don't have to contend with that. Their attitude is, "Fuck you, pay me."
So, if hospitals have to inflate the costs in other areas to make up for their losses, it may be because they're stuck between a rock and a hard place. Besides, the hospitals are the ones doing the actual work and dealing with the patients on a face-to-face basis, whereas the insurance companies are just sitting in their offices doing absolutely nothing. Kind of like what government bureaucrats do, except bureaucrats are far less expensive than insurance company executives. The equipment manufacturers and pharmaceutical companies are still creating useful products, although they're still buffered and insulated from the actual process of patient care.
So, equipment makers and pharmaceutical companies are making huge profits?
It would seem so.
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I do believe hospitals get at least some reimbursement from government for "charity care," and that there is a requirement for a certain level of charity care for a hospital to get and maintain "non-profit" status.
Some reimbursement, but not all of it. I know that border States have requested and unsuccessfully sued the Federal government for reimbursement for healthcare costs for undocumented immigrants.
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Would price controls really solve the problem, though? Where would you put those controls? That is, at what level would you place the controls? If hospitals are making "too much" profit, you could control those prices to squeeze profits out, but are hospitals making too much profit? Is the profit too high for pharmaceuticals or equipment manufacturers? At what point does the Federal Government get the authority to decide how much a private company can charge for a good?
When it gets too far out of control and/or could negatively impact the economy or the quality of life for America as a whole. The same authority that allows the Federal government to outlaw or restrict certain drugs, the same authority that allows the gov't. to prohibit people from yelling "fire" in a crowded movie theater. We already give the Federal government the authority to take actions for the public good (as you mentioned eminent domain up above, which is another example of governmental authority). We implemented price controls during WW2 because there was an urgent national need to do so. If there is a crisis in healthcare in this country, then the Federal government has to be given the authority to deal with that crisis - even if it means declaring martial law, as they've done on many occasions during times of crisis.
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I know you and I have had discussions about the Federal government before, particularly the size of government and the level of interference in the private sector. There seems to be an underlying assumption that, no matter what the Federal government chooses to do, they'll always do it badly and inefficiently. This is what feeds the viewpoint that, if the Federal government was put in charge of healthcare, it'll just turn into one big mess of bureaucracy, inefficiency, corruption, and waste.
Actually, more often than not, that is the demonstrated history...
Not necessarily. History has also shown that the private sector created the Great Depression, whereas government intervention lifted us out of that and built our economy into a powerhouse which was on top of the world during and just after WW2. Leaving the private sector to its own devices would have meant disaster for America. Even before that, the government had to intervene to break up trusts, monopolies, environmental destruction, worker abuse, labor unrest, etc.
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I will say this: Regardless of how we pay for it, whether through tax dollars or insurance premiums/co-pays, we the taxpayers/insured have every right to expect something for our money.
Are we not getting something for our money? Actually, we may not be. If I pay for insurance coverage, but never use it, I got little or nothing for my money. Same goes for every insurance type. If you don't use it, you've spent money for, pretty much nothing.
I would say that we'd need to compare with other countries regarding what we're paying and what we're getting in return. If other countries can offer better quality care to more people for less money than we're paying, then something is clearly wrong with the way we're doing things. This much is obvious and is not even debatable. This is the point where I begin to doubt the alleged "fiscal responsibility" of conservatism, since they seem to believe that it makes perfect sense to pay the price of Rolls Royce to get a used Pinto.
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