23 October 2009

Health Care Reform is Easy

Health Care Reform could be really easy. Did you know that every health care provider is free to charge anyone whatever they can get away with? The result is that every insurance company negotiates with every provider organization (hospital, medical group, etc.) over what price they are going to pay for what procedures and services. A big insurer can command low prices, so the costs get shifted to the smaller insurers. The result is that some insurers will pay $1500 for an appendectomy at a given hospital, while others pay $13,000. No wonder you can't find out what your hospital bill will be in advance. Nobody knows until all the insurance codes get put in, and the database lookups are done.

Now, people have to be hired and paid to do all that negotiating and to enter in all those insurance codes. Here is an opportunity for reform. Make cost-shifting illegal nationwide (not just in Maryland). Each healthcare provider (including pharmaceutical companies) organization can charge whatever they want for any given service, product, or procedure - but make them charge the same to everybody. And force all insurers to use the same codes for the same things.

A lot of people would lose their jobs, but healthcare costs would come down.

Without doing these things a "public option" would just bring the Government in as another big insurer, commanding low prices, and the costs would get shifted to everyone else. It would actually make the cost of healthcare go UP for most people.

But, noooooooooooo. We have to enact a public option to "compete" with private insurance companies, because competition drives prices down. Not so in this market. The healthcare market is neither free nor regulated. A public option would have the opposite effect to what is intended. At least until the private insurers are cost-shifted out of the market in just a few years and we get the Government as single payor. Then only the really rich or well-connected will be able to afford the best healthcare. The rest of us will get Government rationing.

That is to say, we need healthcare reform. But the bills under consideration don't fix healthcare. They just make the problem different, and for the most part, worse.

Why do we keep re-electing swine who dedicate all their thought and energy to political posturing and none to actually doing the right things?


Undergroundpewster said...

Americans are not used to bargaining for the best deal. We hate to go to the one place we do haggle and that is the car dealer. It comes as a surprise to people with no health insurance when they learn that they can negotiate with doctors and hospitals. Once you have insurance, you lose all personal bargaining power.

motheramelia said...

It would be nice if cost shifting were illegal everywhere, but I haven't heard that that's part of the projected legislation.