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Zonie63 -> RE: US Health Care Costs (11/24/2014 8:17:11 AM)
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ORIGINAL: cloudboy
The NYT has an investigative reporter, Elizabeth Rosenthal, who has been covering this issue in depth for a long time.
Here an example of her reporting: The 2.7 Trillion Dollar Medical Bill
Interesting, well-written, and informative article. Thanks for posting that.
From the article:
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A major factor behind the high costs is that the United States, unique among industrialized nations, does not generally regulate or intervene in medical pricing, aside from setting payment rates for Medicare and Medicaid, the government programs for older people and the poor. Many other countries deliver health care on a private fee-for-service basis, as does much of the American health care system, but they set rates as if health care were a public utility or negotiate fees with providers and insurers nationwide, for example.
This is what I was saying earlier about price controls, just as we do with utility companies. That's what should have been done from the very beginning.
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“In the U.S., we like to consider health care a free market,” said Dr. David Blumenthal, president of the Commonwealth Fund and a former adviser to President Obama. ”But it is a very weird market, riddled with market failures.”
Of course, it's a weird market, and it's not even a free market. If health care was actually a free market, there would be no such thing as "controlled substances" or requirements for prescriptions. That's what always floors me about the "free market" arguments regarding health care, since no one truly wishes to have a free and unfettered health care market out there.
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Consider this:
Consumers, the patients, do not see prices until after a service is provided, if they see them at all. And there is little quality data on hospitals and doctors to help determine good value, aside from surveys conducted by popular Web sites and magazines. Patients with insurance pay a tiny fraction of the bill, providing scant disincentive for spending.
Even doctors often do not know the costs of the tests and procedures they prescribe. When Dr. Michael Collins, an internist in East Hartford, Conn., called the hospital that he is affiliated with to price lab tests and a colonoscopy, he could not get an answer. “It’s impossible for me to think about cost,” he said. “If you go to the supermarket and there are no prices, how can you make intelligent decisions?”
Instead, payments are often determined in countless negotiations between a doctor, hospital or pharmacy, and an insurer, with the result often depending on their relative negotiating power. Insurers have limited incentive to bargain forcefully, since they can raise premiums to cover costs.
“It all comes down to market share, and very rarely is anyone looking out for the patient,” said Dr. Jeffrey Rice, the chief executive of Healthcare Blue Book, which tracks commercial insurance payments. “People think it’s like other purchases: that if you pay more you get a better car. But in medicine, it’s not like that.”
Perhaps another way of dealing with this issue is requiring health care providers post a price list which is easily accessible to the public. Any other product or service I might purchase in the "free market," I'd have the opportunity to examine it, comparative shop, read customer reviews, check with the Better Business Bureau, etc. I don't think it's wise consumerism to pay the price of a Rolls Royce and end up with a Pinto, but that's how it seems to work in the healthcare industry.
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