View from inside

From someone in "it", here is what I think......

Reasons why "healthcare" is soo expensive:
-Torts. Lawsuits and malpractice insurance require higher costs.
-Three tiered payment system. You get, and whatever coverer you have, get charged a different amount for anything if you are paying cash, paying with MediCare/MediCal, or good private insurance.
-Uninsured. You have no insurance, so you never go to the doctor. Things get out of hand and you go to the emergency room. By law they have to treat you. You get stuff done that costs lots of money and you walk away. The hospital eats those costs and/or charges everyone else to make up for it.

So what do to? Kinda the opposite of what the problems are, in simple terms.



-Tort reform. Limit how much people can sue their doctors for. You are not going to win 7 figures in a settlement any more. Ever.
-Increase MediCare reimbursements, not lower them. Those of you on one of these state or federal plans, how happy are you with it? You're happy to have it 'cause it's better than nothing, but you are a second class citizen for sure. What good is it to have this type of coverage if no one wants to see you? If the provider gets paid more, they will see you more.
  The argument constantly being made that if people are seen more, this equals more preventive care and less cost in the long run.
-Require everyone to have some level of insurance. AKA what people think of in simple terms as "Obamacare".

Now why these ideas suck. From the view of someone on the inside.

Tort reform is a pretty good idea. If the person delivering your baby doesn't have a $200,000 dollar a year malpractice insurance bill to pay (This is a real California number, not something made up) then the hope is that they will lower their cost to you. Or that if the insurance company doesn't have to pay a huge settlement, then they won't have to charge the obstetrician 200 grand for his policy a year.

When has this hope of this altrusitic action ever really played out? Rarely. Both the physician and the insurer are going to try to pocket as much of the 'savings' as possible. If their costs go down, then your profits go up. The savings are not going to be passed onto the consumer.

MediCare, MediCal and their variants. Oh wow, this is a 1,000 page essay to deal with this problem. The money to pay for these programs come from our taxes. For the payments to increase we need to be taxed more. We meaning everyone, not just the so called "rich". No doctor I know likes seeing these patients because for the amount of effort you expend on them, the pay off is lower than any other kind of patient. Want to motivate providers? Pay them more.

Make everyone have insurance, or better yet give it to them. Insurance for all! This will cause the cost of health care to quadruple. Yes, a four fold increase is my prediction. Mark my word. Everyone having insurance is going to make everything cost a lot more. Why? Because now more people are using it. And the people without insurance, who are complaining about it, are people who are sick. And the type of sick they are costs lots of money normally.

If you take everyone and make them have insurance, lots of them are going to use it. Frequently. (look up studies about opening enrollment on medicare. normally 50% more people enroll than expected with resultant costs increasing 200%) There are not enough doctors, specialists, hospitals, x-ray machines, everything for the number of people that will be coming into the system.

Oh, and by the way, what the doctors and hospital make off of it is going to be less. For more trouble and more people. That is no incentive. Let's face it, if you want to motivate people it takes money. If you want the best healthcare, it costs the most money and the person doing it wants to make the most. Disabuse yourself of the old notion of the loving country doctor who will do it for a chicken and the joy of serving his fellow man.

Nothing proposed now is going to let the insurance companies or the doctors make more money. Any plan that doesn't recognize the need for people to make money is a sham, poorly thought out and not going to work. In fact it will make things worse. For everyone.