Quote:
Originally Posted by detbuch
How about letting insurance policies actually be sold by businesses which compete on an open market. Let customers buy what plans they can afford. Let health care providers compete on an open market in which there is no guaranteed top dollar reimbursement for every procedure given to every patient. Prices could be far more reasonable if huge sums of money provided either by insurance companies or government were not automatically guaranteed to be available for any procedure and for every patient regardless of that patient's ability to pay.
This would also create a true competition in the medical supply system. With less money available to health care providers to buy equipment and supplies, businesses which want to compete in that market would have to lower the prices of their products.
Those who choose not to buy insurance can pay out of pocket. Prices would be more affordable because of the above. And for those who are truly needy, there can be government assistance, preferably by individual states.
For rare and vastly expensive care, catastrophic insurance policies can be purchased. Or, if states wished, there could be a small tax to cover such contingencies for their citizens.
As it has become, with mandated regulations and restrictions, we don't really have "insurance" in a private business sense. Especially with the ACA or with the desired government paid universal health care. Huge sums of money automatically available to health care providers guarantee huge prices for their services. The same, BTW, can be said for higher education. Every new investment by government in the education industry always results in higher tuition.
The free market has been becoming less and less free, and the regulated market has become more and more expensive. And when the Federal government finally steps in to fix the problem which mainly it has created, then total regulation will create total mediocrity. And the impression to those not paying attention will be that all is finally fair.
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I'll be honest, I didn't read the whole thing... not because I don't care about the point, but because I fundamentally disagree that this problem with rising healthcare costs in this country falling solely on the insurance industry.
This is when things get really really murky, because other problems in our society come into play:
We have an existing system where the health services we all get from hospitals, doctors and clinics are really expensive. A big part of this is because these businesses keep charging more and more for their time and resources (I think part of that is because those providing the service have hundreds of thousands of $$ in student loans.) This is then compounded by a payer system which has historically rubber stamped almost anything that comes by, but in reality while we try to fix the payer side of things, we should also expect to see price correction from the providers as well. I don't think an insurance market with the ability to operate across state lines fixes any of that.
This whole issue aside, it still doesn't fix the problem that (from an actuarial standpoint) its not in the interest of any insurance company to willfully cover aging and sick populations. Each of those enrollees consumes more from the general fund than they contribute, which is what is crippling the ACA as we speak.
If we go to a more deregulated model with no Medicare, I can't help but see more insurance companies dropping the sick and aging because its bad business... thats why Medicare is such an important part of our society. The alternative is that local and federal taxpayers end up paying for the emergency room care given to folks who have no insurance... and that is exponentially more expensive to cover than a properly configured preventative health plan is...
Bottom line is that this is an extremely complex issue and I personally believe not enough honest conversations about the underlying causes have been had. Hopefully that changes when the current administration and congress realize they can't fix it either.