Driving Down Healthcare Costs Must Begin with Understanding Why They Got So High
You will be surprised.
The following is from the introduction to my book Dupe ‘em and Dope ‘em.
First lady, Hillary Clinton was working on a national health care plan and Washington State was determined to be the leader of the nation. Our legislators called a town hall meeting. I showed up and after a short introduction one of our legislators asked for input from the audience.
I stood up and asked a couple of questions. “First we must be clear. We are talking about reducing the cost of seeing a doctor. Is that true?”
The legislator nodded.
“What do you think would happen to the cost of a doctor visit if you went back to the legislature tomorrow and made health insurance illegal?”
The legislator appeared dumbfounded.
From the back of the room a man shouted, “It would drop in a hell of a hurry. I’ll tell you that.”
Later I found that man. He was a retired thoracic surgeon.
The story points out a couple of points. It seems obvious that if every doctor in the nation and all the pharmaceutical companies had to compete for the dollar in your pocket, costs would come down.
It also seems obvious that if you had to pay for your care out of your pocket, you would be more careful about your health care purchases. I’ve seen many people who have insurance and still cannot afford to see a doctor. Or, even more frequent are the people who think if the insurance company won’t pay, they can’t afford to take care of their health. Often, it is a simple matter of priority.
I concluded the introduction to the book with the following paragraph.
I’m going to tell you why your physician or hospital is charging so much. I’m going to tell you why your insurance company gets a discount while those without insurance are sent to collections for the whole amount. I’m going to tell you why big pharmaceutical and the insurance industry are the winners and the average American is losing. I’m going to show you the role our government is playing in the rising cost of health care.
I wrote the book in 2009. The basic problem has not improved. Today, in the eyes of a politician, a health care provider is an insurance company. Doctors are merely peon employees. The American system is based on competition. The competition is no longer between doctors. Doctors no longer have to strive to be the best at helping patients. Doctors work for corporations who stress how many procedures the doctor performs to increase the bottom line.
The idea that we can convert Medicare to an insurance company and get more and better care is silly. Both Medicare and corporate insurance companies are middlemen, driving up costs. Corporations hire people to bill, re-bill and justify patient care to Medicare and insurance companies. Medicare and insurance companies hire workers to deny care. The result is a war between providers and payers. Costs go up and patients suffer.
Future posts will go deeper into that problem.