Why Is Health Care In America So Fucked Up?

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^ Where's that from, Russell?

I've got a friend who works in bio-medical research at university and I'd like to send him a link as it's the sort of thing that he complains about a lot.
 
Rambo said:
Why Does A Tube Of Cold Sore Cream Cost $2,500? – Consumerist
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That's insane.

How much would a tube of Zovirax cost in a pharmacy in the US, I wonder? Is it just the hospital that's getting gouged, but they don't care because it's paid for by a patient's insurance, or is Zovirax ridiculously expensive through all channels in the US?

In Australia, it costs less than $15 for a 2g tube, so a 5g tube (as discussed in the article) would be a bit over $30, I suppose.
 
Journeyman said:
That's insane.

How much would a tube of Zovirax cost in a pharmacy in the US, I wonder? Is it just the hospital that's getting gouged, but they don't care because it's paid for by a patient's insurance, or is Zovirax ridiculously expensive through all channels in the US?

In Australia, it costs less than $15 for a 2g tube, so a 5g tube (as discussed in the article) would be a bit over $30, I suppose.
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The price would be the same at the pharmacy most likely. If not, I seriously doubt the difference would be Stark.
 
Russell Street said:
Exactly my point. The same way that insurance will drag their heels on claims, billing seems to just send out invoices like water and see who actually remits.
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Journeyman said:
^ Thank you very much!

I am both a lawyer and a pedant, so I do try to get such things right.
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As a lawyer you should've already known most hospitals fish with fraudulent "unintentional" billing. The worst is when they keep billing you after you've mailed them proof insurance paid the bill, not that they don't know it was paid already.

Journeyman said:
That's insane.

How much would a tube of Zovirax cost in a pharmacy in the US, I wonder? Is it just the hospital that's getting gouged, but they don't care because it's paid for by a patient's insurance, or is Zovirax ridiculously expensive through all channels in the US?

In Australia, it costs less than $15 for a 2g tube, so a 5g tube (as discussed in the article) would be a bit over $30, I suppose.
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'Medicine' is free of racketeering laws.
 
Please don't confuse healthcare in USA with healthcare in other normal rational countries like Australia, Netherlands, UK, Norway, Denmark, Germany etc
 
A $10,169 blood test is everything wrong with American health care - Vox

A $10,169 blood test is everything wrong with American health care
Updated by Sarah Kliff on March 10, 2015, 9:54 a.m. ET @sarahkliff sarah@vox.com



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How much is that blood test in the window? Maybe $10. Maybe $10,169. Who is to say. (David Silverman / Getty Images News)
A lipid panel is one of the most basic blood tests in modern medicine. Doctors use it to measure cholesterol levels in their patients, probably millions of times each year.

This is not a procedure where some hospitals are really great at lipid panels and some are terrible. There's just not space for quality variation: you are running blood through a machine and pressing buttons. That's it.

And that all makes it a bit baffling why, in California, a lipid panel can cost anywhere between $10 and $10,000. In either case, it is the exact same test.

"We're not talking twofold or threefold variation. It's a different level of magnitude."

"What we were trying to see is, when we get down the simplest, most basic form of medicine, how much variation is there in price?" says Renee Hsia, an associate professor at University of California, San Francisco who published the price data in a recent study.

"It shows how big the variation really is. We're not talking twofold or threefold differences, it's a completely different level of magnitude."

More than 100 hospitals — with more than 100 different prices
For this research, published in August in the British Medical Journal, Hsia and her colleagues compiled reams of data about how much more than 100 hospitals charged for basic blood work. The prices these facilities charged consumers were all over the map.

The charge for a lipid panel ranged from $10 to $10,169. Hospital prices for a basic metabolic panel (which doctors use to measure the body's metabolism) were $35 at one facility — and $7,303 at another.

For every blood test that the researchers looked at, they found pretty giant variation:

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This huge variation in the price of a really simple, incredibly basic blood test tells us a few things about the American health care system.

Blood tests aren't the only place with this variation
Hsia's previous research looked at the cost of an appendectomy in California and found similarly gigantic variation. For an appendectomy with no complications, she found that hospitals in the state would charge anywhere between $1,529 and $186,955.

One the issues with that study, she says, is that different hospitals might treat patients differently. "Some hospital might use more IV bags than others or one doctor could be ordering a lot of blood tests," she says.

appendectomies can cost anywhere from $1,529 to $186,955

The point of comparing an incredibly basic blood test, and its prices, was to distill down to a very basic test that offers no space for variation — but still has a huge range in how much hospitals will charge.

Not every patient pays the full charge rate: insurance companies, for example, typically negotiate a lower rate with the hospital. Medicare, which covers seniors, has a set fee schedule it uses. But these are the prices that an uninsured patient — who doesn't have a health plan bargaining on her behalf — could face.

"If I'm hospitalized, don't have insurance and my doctor orders three days worth of blood tests, this is what I'm getting billed for," Hsia says.

What this tells us about American health care
For one, there's not much price transparency: it's really hard to know whether one hospital is charging $10 or $10,169 because prices are rarely listed. For this particular study, Hsia literally had to hire a software engineer to collect the data and line up all the different hospitals against each other.

The $10,169 blood test tells us we're suckers: we've developed a health care system where its hospitals have pretty full authority to name their price with little protest from consumers.

Americans are getting suckered on health prices

For people with health insurance, really big price variation often isn't a concern. If their plan covers the bill, it doesn't matter to them, personally, whether they get the $10 test or the $10,000 one.

For those without coverage (or those whose coverage only covers a certain percent of the bill), price variation matters a lot. Getting a $10,000 blood test can put a patient into bankruptcy. But right now, our health care system doesn't have the mechanisms to limit those high charges — nor would the patient likely have the tools to know the cost of his or her blood test to begin with.

"There's no other industry where you see this kind of extreme variation," Hsia says. "And nobody has ever really challenged it. It shows an extreme inefficiency, and something we really need to change."
 
^ this again speaks to nobody ever seeing the price of anything before it's done. Where else do you go for anything and find out what it costs at the end? Do you order a steak and then realize it cost $5,000?
 
Rambo said:
Thruth Thruth Here's one you might like

If health care is free in Canada, why can't this woman afford surgery? - Vox
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Dental care has never been part of the medical insurance scheme here so why is anyone shocked, most of all her. She did not do her homework. In each jurisdiction there are individually adjudicated programs to fund such treatment but it is not always covered.

The system saved her life by providing her with several surgeries at no cost. Probably more than the cost of the dental treatment. Would she have wanted it the other way around?

If people want subsidized dental care too like in some Eurozone countries then they should also be willing to pay much higher taxes. Does she?

The story's facts are a bit misleading. Granted the loss of bone appears to be correct given her underlying medical problems but her teeth should not be rotting. Gastric reflux, yes the tooth enamel will dissolve but not decay. Decay only happens when there is substrate that can be metabolized down to simple sugars, lack of proper self-care and professional care, fluoride and other adjunctive chemotherapeutics. But she was obviously concentrating on her ulcerative colitis.

So to answer Vox's question, she got what she was entitled to for free.

She can have all her rotten teeth pulled out and implant retained dentures made for the $40K she currently has given to her by warm hearted people.
 
How American health care turned patients into consumers — Health — Bangor Daily News — BDN Maine

How American health care turned patients into consumers
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Dr. Philip Caper
By Dr. Philip Caper, Special to the BDN
Posted March 19, 2015, at 11:05 a.m.
A clash of cultures is rapidly developing among those of us who see the mission of the health care system to be primarily the diagnosis and healing of illness and those who see it primarily as an opportunity to create personal wealth.

The concept of health care primarily as a business is uniquely American, and it has gained ascendancy during the last few decades. While there have always been a few greedy doctors, businessmen-wealth-seekers — not doctors — now dominate the medical-industrial complex. They include for-profit insurance, medical device and pharmaceutical companies as well as for-profit and nonprofit corporate providers of health care services, such as the three large hospital systems in Maine.

Partly because of the Affordable Care Act, they also include a rapidly growing army of lawyers, consultants and policy wonks who are creating lucrative businesses helping hapless “consumers” — formerly “patients” — “navigate” their way through the grotesquely byzantine maze our health care system has become.

This shift in emphasis from patient care to money profoundly has affected the practice of medicine and resulted in the clash of cultures within health care. As increasing numbers of “providers” — formerly “doctors” — become employees of large health care corporations — formerly community hospitals — we have come under increasing pressure to diagnose profitable diseases and order profitable tests and procedures without enough regard to the benefits or harm accruing to patients. Hospital “CEOs” — formerly “administrators” — trained in the ethics and practices of business rather than health care are incentivized to configure their “product lines” — formerly “services” — to produce the largest “profits” — formerly “margins.”

Those of us in the health care “business” — formerly “profession” — have been slow to react to this hijacking of our health care calling. Patients, despite sensing something is deeply wrong, feel helpless to push back. That now seems to be changing.

For the past three years The Lown Institute, founded by Dr. Bernard Lown, renowned cardiologist and advocate for universal health care, has held conferences designed to point out the growing problem of overtreatment in medicine. Recently they also have turned their attention to the equally disturbing problem of impaired access to health care and undertreatment. They now advocate for RightCare — not too much treatment and not too little.

Arguably some of the most important effects of Obamacare have been the destabilization of our deeply dysfunctional health care system and an order-of-magnitude increase in the amount of attention given to its dysfunction by the media and the public. Elisabeth Rosenthal’s excellent New York Times series “Pay Till It Hurts” and Steven Brill’s Time magazine cover story and book titled “America’s Bitter Pill” are two of the most recent examples. These two factors have created an opportunity for real structural and cultural change.

There are many advocacy groups — Physicians for a National Health Program, HealthCare-NOW, Maine AllCare — trying to highlight these issues and to propose ways to turn this runaway train around.

While they are necessary, attempts at education and persuasion are not sufficient. Unlike past human rights movements, such as women’s suffrage and marriage equality, the fight for the right to health care for all Americans will require redirecting huge sums of money away from deeply entrenched, profit-oriented private corporations to not-for-profit programs that directly promote the public’s health and wellbeing.

The Institute of Medicine estimates that the convoluted American health care system wastes $750 billion per year in inefficiency and fraud, unnecessary administrative complexity and medical services, unjustifiably high prices and missed prevention opportunities. That waste creates a lot of jobs but does not pay for one Band-Aid or aspirin.

I attended the latest Lown conference, held last week in San Diego, to talk about the “Heal-In” held at Boston City Hospital in 1967 as an example of direct action taken by doctors, nurses and other healers to achieve a political goal without compromising patient care. The capstone of the conference was to announce the expansion of Lown’s mission, previously focused on education and discussion, to include creation of a national grassroots movement that will include direct action. Their first foray will be called RightCare Action week and is scheduled for the fall. Stay tuned.

Changing our health care system is as much about persuasion through power as it is about the power of persuasion. We as patients have power through the ballot box, and we as health care workers have power through our key roles in the “business” of health care to return and redirect its mission toward healing and away from its increasingly singular obsession with profitability.

All we have to do is summon the will and the courage to exercise that power.

Physician Philip Caper of Brooklin is a founding board member of Maine AllCare, a nonpartisan, nonprofit group committed to making health care in Maine universal, accessible and affordable for all. He can be reached at pcpcaper21@gmail.com or through his website at philcaper.net.
 
As a cash dental payer, I rather must agree with the ultimate premise of this piece, that pay-as-you-go low-cost walk-in medical care is not much worse, and in some ways better, than "premium" insurance-paid care. Mind you, I'm in a reasonably affluent metro area and my dentist drives a Maserati, so I haven't gone as far in the trenches. Also, ACA is once again proven to be the most expensive and useless garbage ever.
I Have Seen The Future Of American Medicine, And It Is ImmediaDent
Last time I went to Miller Motorsports Park, I wound up with pneumonia from a day digging at the Salt Flats. This time it wasn’t quite that bad, but when I crawled out of bed from the first night of fever, knelt on the cold wood floor, and spit bloody pieces of a tooth into my hand, I have to admit that I made a few hasty and ill-considered vows to never again visit the Beehive State. Then I examined my mouth in the mirror. I’m currently, ahem, between healthcare. Could I let this minor bit of dental rectification wait a while?

Nope — my reflection was enough to frighten children. More than it normally is, even. Time to investigate the wide world of cash-on-the-barrelhead dentistry.

Strictly speaking, I should have signed up for my “Obamacare” when the last dregs of my “COBRA” ran out last year, but after seeing that the best “Bronze option” plan I could find charged ninety-seven dollars per week and didn’t kick in until I’d spent $6500, I decided to wait until I had a new day job.

My new day job was with the same contracting company for whom I’ve done half-a-dozen gigs since 2003. They explained to me that they no longer offered healthcare for full-time employees, but that I was welcome to use their ACA exchange. So now I’m paying five grand a year for coverage that doesn’t kick in until I spend $6500 a year. This is, apparently, Mr. Obama’s miracle. Once upon a time I paid $2000 a year for coverage that kicked in once I’d spent $250. The good news is that, uh, well — every poor person I know doesn’t pay enough taxes to see the ACA penalty, and even if they did it wouldn’t change their decisions regarding healthcare because poor people have low future time orientation.

That’s why they are poor. Low future time orientation.

I have the same problem. The only reason that I am not desperately poor is because I know how to make money in a hurry. Someday I will be desperately poor. I have the mentality of a poor person. That’s why I didn’t sign up for ACA until last month, which meant that I wouldn’t receive any benefits until May, so my dental and healthcare expenses related to this Utah Ebola would be entirely paid by me. Well, they would have been anyway — but now they won’t even count towards my $6500 deductible.

Sucks to be me. I should have married that FBI agent when I had a chance. I hear the government employees don’t have to deal with the ACA, for the same reason that the Waffen SS didn’t test out the gas chambers on their officers. (Yes, I know the Waffen SS had little or nothing to do with the gas chambers.)

Where was I? Oh, yes — I was arriving at “ImmediaDent”, your cash-basis weekend dentist to the stars. My longtime companion Vodka McBigbra used to go to ImmediaDent when I was her source of dental insurance, and they always did a remarkably decent job on her teeth, so I wasn’t all that frightened of the prospect. The problem was that they had a couple hours’ worth of root canals ahead of me, so I set an appointment for the following day and promptly went to a motorcycle store so I could buy one of those bad-ass Arai helmets with the Kanagawa Oki Nami Ura on it. The girl at the motorcycle store was very pretty and I did not smile.

When I arrived for my 6pm appointment the following day, there were still a few emergencies ahead of me. Two hours later, I was still waiting. The people around me, who were also waiting, were remarkably relaxed about this, but I was not. I will pay any price and bear any burden to not wait for something. Years of semi-comfortable internment in the middle class had enabled me to forget that poor people wait. To be poor is to declare, openly, that your time is worthless. So you wait — at hospitals, in the court system, at the check-cashing store, in the welfare line, for the relatively few restaurants in your neighborhood.

As an honorary member of the working poor, my time was honorarily worthless. So I waited, and eventually I was taken to a back room. There were two Chinese dentists, one male and one female, working on a wide variety of people. The male dentist had unconsciously adopted part of his customers’ street argot.

“What hurting with you bro?” This was delivered to an enormous black man rolling around in pain on a dental couch.

“IT’S MY TOOTH, MAIN!”

“Oh, let me look… That tooth gotta come out, bro!”

“IT GOTTA WHAT?”

“It gotta come out! Talk to your family!” Then he returned to look at my poor #25 incisor. “We’ll do an F6 on this.”

“What,” I asked, “is an F6?” He looked at me as if I were a chimpanzee who had magically acquired the power of speech.

“Three surface filling.”

“No problem,” I responded. About half an hour later, an ImmediaDent representative came out and gave me the total — $338 — to the penny.

“Let me tell you about our financing options,” she began…

I handed her my Sapphire. “I refuse to finance any teeth that are not made of gold,” I replied.

“We can do that, you know. We do gold teeth.” For a brief moment I considered having the front twelve or so teeth in my mouth capped in gold. Actually, I’m still considering it.

The male dentist returned, jabbed a needle in my mouth, then ground the remaining surface of my tooth nice and smooth. Then he disappeared. I reached back and periodically administered my own suction to keep the blood off my tongue. I heard him on the phone.

“Grandma! This Doctor Chang! Your boy (said “boy” being my age) need the tooth to come out! We take a credit card!” Then he was called into another room, where a client was trying to talk him out of doing any anesthetic. The client was a trifle agitated. At this point it was about 9:05PM.

“DOC! I DON’T FUCKIN’ NEED IT AND I CAN’T PAY FOR IT ANYWAY! JUST DRILL AND I’LL BE FINE! I’M NO FUCKIN’ PUSSY AND SHIT!”

“You do nitrous!” Dr. Chang replied. “It’s almost free! You big man! Handle it with nitrous only!” This reminded me of a story that a woman told me once about a night with her friends in a dentist’s office. This story reminded me of every sketchy story I know about every woman I have ever loved. I started to feel very sorry for myself. This is my life, I told myself. A combination of romantic depression and late-night discount dentistry. I dipped a finger in my mouth and made a blood-infinity on the back of my left hand. Then the female dentist came in.

Without a word, she did the rest of the grind-and-fill herself in under ten minutes. I’m used to my white-collar dentists who take forever and use no fewer than two assistants at all times. Not this lady. She was fast and competent and utterly silent. It was like watching a brilliant painter at work. When she was done she turned to leave. Not a word had passed between us.

“When, ah, will…” I see you again? “…I be okay to eat something?”

“When it’s not numb. You can leave now, though.” Anything you say, ma’am. In another room, Doctor Chang was yelling at a patient.

“Hey Bro! You can’t leave you got one more root canal left! Gonna hurt till we fix it! Might as well stay.!”

On the way out I picked up my receipt. When I got home I looked at the filling. Top notch work. I’d waited three hours for about ten minutes’ service but that ten minutes had been flawless. Most interesting to me was the way the business operated. My old dentist, a thrillingly awkward and coltish woman of my own age who closed her practice without giving much warning or any reason whatsoever, had always wrapped our interactions in layers of expensive tissue paper. The quiet Muzak, the dual hygenists, the endless questions and details, (“Are you still taking multivitamins?”) the mystery bill to be handed to my insurance company then balance-billed to me later after their negotiations were complete. A free toothbrush after every visit. I could predict the beginning and end of our appointments to within a five-minute window.

This, on the other hand — this was performance art, the fascinating future of cash-basis medicine. Every price discussed and negotiated up front. No hidden profits, no massive insurance companies sending reams of paper from block-long concrete edifices. No dental records, even. If I keep going to ImmediaDent, it will eventually be impossible to identify me from dental records. How wonderful is that? Dental care in real time, for real money, with no fluff.

The next day, V. McB. called me to see how it had gone. “I told you they were fine,” she laughed. “And for the record, they never make me wait.”

“Nobody, darling,” I responded, “ever makes you wait.”

Come the first of May, I’ll theoretically have “Bronze Dental Coverage” as part of my ACA boondoggle. I’m sure that if I operate the system correctly, I will eventually have access to a quiet dental office with multiple hygenists and motivational posters on the wall. I wonder if I’ll go. Probably not. I think I’ll just go see Dr. Chang again, bro.
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The hospitals that overcharge patients by 1000% - Yahoo Finance

The hospitals that overcharge patients by 1000%

By Olga Khazan June 9, 2015 9:34 AM
  • Try to avoid breaking any limbs in Crestview, Florida. You might wind up in North Okaloosa Medical Center, which charges 12.6 times, or 1,260 percent, more than what it costs the hospital to treat patients.

    North Okaloosa, along with New Jersey’s Carepoint Health-Bayonne Hospital, tops the list of the U.S. hospitals with the highest markups for their services, according to a new study in Health Affairs. The studyfound that, on average, the 50 hospitals with the highest markups charged people 10 times more than what it cost them to provide the treatments in 2012.

    Where Are the 50 Hospitals With the Highest Markups?

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    Health Affairs
    On average, all U.S. hospitals charged patients (or their insurers) 3.4 times what the federal government thinks these procedures cost. “In other words, when the hospital incurs $100 of Medicare-allowable costs, the hospital charges $340,” explain the authors, Ge Bai of Washington and Lee University and Gerard F. Anderson of the Johns Hopkins Bloomberg School of Public Health. The ratio of hospital charges to costs has only increased over time: In 1984, it was just 1.35, but by 2011, it was 3.3.

    In the study, the facilities that marked up their prices the most were more likely to be for-profit (as opposed to not-for-profit), urban hospitals that are affiliated with a larger health system. Community Health Systems operates half of the 50 hospitals with the highest markups. The U.S. Justice Department has investigated the Franklin, Tennessee-based hospital chain for the way it bills Medicare and Medicaid. In February, the company and three New Mexico Hospitals agreed to pay $75 million to settle a case in which Community Health Systems was accused of making illegal donations to county governments, which were then used to obtain matching Medicaid payments.

    Overall, three-quarters of the hospitals on the highest-markup list are in the South, and 40 percent of them are in Florida.

    Only Maryland and West Virginia restrict how much hospitals can charge. The Affordable Care Act makes not-for-profit hospitals offer discounts to uninsured people, but it doesn’t set limitations on bills sent to patients treated at out-of-network or for-profit hospitals.

    What Types of Hospitals Have the Highest Markups?

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    Health Affairs
    Except for people on Medicaid and Medicare, whom hospitals can only charge a government-regulated amount, these high markups negatively affect almost everyone. They’re bad for privately insured patients who find themselves being treated at out-of-network hospitals. They’re bad for the uninsured, since people with no insurance have no one negotiating on their behalf with hospitals. And they’re bad for anyone who pays insurance premiums, since high hospital prices drive up the cost of health insurance.

    “Collectively, this system has the effect of charging the highest prices to the most vulnerable patients and those with the least market power,” the study authors write. It’s how people end up with “exceptionally high medical bills, which often leads to personal bankruptcy or the avoidance of needed medical services.”

    The authors say one way to fix this might be to require hospitals to post their markups online so patients can price-compare before they go. But that wouldn’t work for emergencies, for people who live far from all but one hospital, or for the many people for whom hospital charging codes are, very understandably, inscrutable.

    Alternatively, legislators could say that hospitals can only charge people a certain amount more than what they would charge Medicare, which usually negotiates some of the lowest rates. Or, more states could do what Maryland, Germany, and Switzerland all do and aggressively limit how much all hospitals can charge, period.

    But as the authors note, that last solution would be “subject to considerable political challenges,” which is perhaps a polite way of saying, “will make the Obamacare battle of 2010 seem like a casual game of bridge among friends.”

    In the meantime, that drunken jet-ski trip in Florida this summer might be risky for more reasons than one.

    Read The Hospitals That Overcharge Patients by 1000% on theatlantic.com
 
^^ this is the problem

Medical professionals are rip off artists, same as lawyers. Not to get into too much detail, but last year I had an opportunity to get up close with how doctors really think about their practices, I can assure you that as a profession money comes first, care comes second.
 
Robert Reich (The Choice Ahead: A Private Health-Insurance...)
The Choice Ahead: A Private Health-Insurance Monopoly or a Single Payer

Sunday, July 5, 2015


The Supreme Court’s recent blessing of Obamacare has precipitated a rush among the nation’s biggest health insurers to consolidate into two or three behemoths.

The result will be good for their shareholders and executives, but bad for the rest of us – who will pay through the nose for the health insurance we need.

We have another choice, but before I get to it let me give you some background.

Last week, Aetna announced it would spend $35 billion to buy rival Humana in a deal that will create the second-largest health insurer in the nation, with 33 million members.

The combination will claim a large share of the insurance market in many states – 88 percent in Kansas and 58 percent in Iowa, for example.

A week before Aetna’s announcement, Anthem disclosed its $47 billion offer for giant insurer Cigna. If the deal goes through, the combined firm will become the largest health insurer in America.

Meanwhile, middle-sized and small insurers are being gobbled up. Centene just announced a $6.3 billion deal to acquire Health Net. Earlier this year Anthem bought Simply Healthcare Holdings for $800 million.

Executives say these combinations will make their companies more efficient, allowing them to gain economies of scale and squeeze waste out of the system.

This is what big companies always say when they acquire rivals.

Their real purpose is to give the giant health insurers more bargaining leverage over employees, consumers, state regulators, and healthcare providers (which have also been consolidating).

The big health insurers have money to make these acquisitions because their Medicare businesses have been growing and Obamacare is bringing in hundreds of thousands of new customers. They’ve also been cutting payrolls and squeezing more work out of their employees.

This is also why their stock values have skyrocketed. A few months ago the Standard & Poor’s (S&P) 500 Managed Health Care Index hit its highest level in more than twenty years. Since 2010, the biggest for-profit insurers have outperformed the entire S&P 500.

Insurers are seeking rate hikes of 20 to 40 percent for next year because they think they already have enough economic and political clout to get them.

That’s not what they’re telling federal and state regulators, of course. They say rate increases are necessary because people enrolling in Obamacare are sicker than they expected, and they’re losing money.

Remember, this an industry with rising share values and wads of cash for mergers and acquisitions.

It also has enough dough to bestow huge pay packages on its top executives. The CEOs of the five largest for-profit health insurance companies each raked in $10 to $15 million last year.

After the mergers, the biggest insurers will have even larger profits, higher share values, and fatter pay packages for their top brass.

There’s abundant evidence that when health insurers merge, premiums rise. For example, Leemore Dafny, a professor at the Kellogg School of Management at Northwestern University, and his two co-authors, found that after Aetna merged with Prudential HealthCare in 1999, premiums rose 7 percent higher than had the merger not occurred.

The problem isn’t Obamacare. The real problem is the current patchwork of state insurance regulations, insurance commissioners, and federal regulators can’t stop the tidal wave of mergers, or limit the economic and political power of the emerging giants.

Which is why, ultimately, American will have to make a choice.

If we continue in the direction we’re headed we’ll soon have a health insurance system dominated by two or three mammoth for-profit corporations capable of squeezing employees and consumers for all they’re worth – and handing over the profits to their shareholders and executives.

The alternative is a government-run single payer system – such as is in place in almost every other advanced economy – dedicated to lower premiums and better care.

Which do you prefer?
 
Rambo, re the single payer. I like the Dutch system. They've got the best of single payer /banker model combined with competition via several insurers and equalisation plus premiums utilising tax system.
 
fxh said:
Rambo, re the single payer. I like the Dutch system. They've got the best of single payer /banker model combined with competition via several insurers and equalisation plus premiums utilising tax system.
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Also free insurance for anyone under 18 regardless of income.
 
Whatever the reasons are behind the failings of the American system (in my view the fundamental fault lies with the government and the system is engineered to fail), you do not want. a UK-style system. You really don't.
 
Algernon Crisp said:
Whatever the reasons are behind the failings of the American system (in my view the fundamental fault lies with the government and the system is engineered to fail), you do not want. a UK-style system. You really don't.
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I think the fault lies within corporations and businesses that deal in healthcare. They are the ones lobbying the government.
 
OfficePants said:
I think the fault lies within corporations and businesses that deal in healthcare. They are the ones lobbying the government.
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Absolutely, the corporations are terrible, but they are not the root of the problem. The corporations are lobbying the government - it is the government that actually wields power and determines the rules. The government possesses the guns and the power, and the government is responsible.

It's like directing anger at the bail outs towards the banks - sure they took them, but who wouldn't? The banks that took the bail outs aren't the problem, the problem is the government that gave the bail outs.

The old cliche about power is a cliche because it's true. The answer in the end is to take the power away from government. This doesn't necessarily have to mean anarchy, but a sensible way forward would be to reduce power incrementally with the goal being the greatest practically attainable degree of subsidiarity. The basic unit of governance being not the small, local authority but rather the family.

This would allow meaningful change, an evolutionary process that would give people the necessary time to adapt, and genuine long-term improvement.

The alternative is for many (and eventually will be for almost all) you get ill, you're fucked.
 
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