bsphil wrote:
gbaji wrote:
bsphil wrote:
So you'd rather pick up the health care costs from uninsured ER visits than force others to pay for their own health care?
False Dilemma.
So you think rising health care costs can in no way be attributed to the uninsured being treated at ERs?
No. I think that has absolutely nothing at all to do with whether or not mandating that someone purchase health insurance represents a reduction of that persons freedom.
Your problem is that you are assuming that I'm arguing in favor of the status quo as well when I'm making my freedom argument. I'm not. When I say we're going in the wrong direction, I don't just mean in the last couple years. We've been going in the wrong direction with health care for at least 40 years.
What we should be doing is going back to a situation where people did not rely on insurance to pay for regular and/or inexpensive care. No one should be using insurance to pay for a checkup, or to get a flu shot or a cut looked at. We should have private general practitioners operating their own practices and people should be able to just walk in and get health care from them directly without going through 5+ layers of middlemen. Those doctors, since they are not part of some larger plan or partnership or insurance co-op or whatever can be as selective with their rates as they want to be, allowing for true competition and keeping prices low. And since these doctors will operate in the community, they'll be more responsive to the needs and funds of their clients and ensure that no one goes without at least some medical care.
Insurance should be kept to paying for things which are expensive and rare. I've made this argument several times in the past. It makes no sense at all to use insurance to pay for anything else. All it does is increase the total cost. If you stop and think about how insurance works, you'll understand why this is (must be!) true.
By breaking those two things apart, we accomplish two results:
1. Regular and minor care is handled directly with no middle man, so it's cheaper. You don't show up at the ER for a scrape or a flu shot. You call your doctor (who might even make house calls!). Absent all those extra layers, the doctor has a vested interest in providing good care at an affordable price. He can also adjust rates based on ability to pay. Right now, a poor person walks into an ER to get care, and the ER charges full price. If they can't pay, some public assistance mechanism steps in to cover that cost (or the owners of the ER pass that full price on to the rest of their customers). The layers make the cost higher. Take them away and the doctor is only dealing with actual cost, not some assumed amount the care is valued at on an actuarial table. Thus, if he chooses to provide care for less money, no one has to make up the full cost of the care. It's much more flexible and affordable and available.
2. Insurance becomes cheaper too. The reason health insurance keeps going up is exactly because we keep insuring more and more things which shouldn't be covered with insurance. As with my example of someone who requires $300/month in medicine, they have to charge at least that much for the insurance for that person just to break even. Worse, as more people use insurance to pay for their health care instead of paying out of pocket, the disconnect between buyer and seller results in price gouging. Why not charge more for that medicine if everyone buying it is just paying a co-pay and their insurance is covering the bill? And when costs rise? The insurance company ups its rate and the employers (or the government) pay more. The people don't notice the costs going up, but it shows up in the form of flat wages or fewer jobs which provide health care as a benefit. Remove that process and everyone is just paying insurance for the rare and expensive care. It becomes far less expensive.
I'll use my standard example to illustrate this:
Imagine what would happen to car insurance rates if car insurance covered regular maintenance of your care instead of just accidents. Then think about what would happen after that. Mechanics would start increasing the cost of a tune up. Why? Because they can. It's covered by the insurance, so the person taking their car to them wont care. And when the rates go up, they wont necessarily connect the two. More to the point, if they raise their rates, people will think they provide better service. I mean, if you're going to get your car tuned up, you going to take it to the guy charging $35 or the guy charging $80? The latter guy must be better right? And if the insurance covers it, you'll pick that one. And even if you are smart enough to realize that this will cause rates to go up, other people will go to the guy charging $80, so you'll end out paying higher rates anyway. May as well get your money's worth, right? And the mechanic who doesn't charge $80 for a tuneup is going to feel stupid when his competitors are making twice what he is.
When you use insurance as a mechanism to pay for regular and affordable services, you create a ton of factors which serve only to make those things more and more expensive. You create a whole industry which serves no purpose other than to act as a middleman for all the money flowing between the customer and the seller. Worse, that industry become yet another factor which will tend to increase costs even more. Insurance should only be used for things which are both rare and expensive. That is what is wrong with our health care system (and is also what's wrong with socialized systems, they just use different terms).
When I talk about private health care in contrast to public health care, I'm not really talking about how the US does things right now. I'm speaking about how private health care should work. Right now, the US has this sort of ******* system that's halfway between the two with none of the benefits of either and most of the negatives of both. But the solution isn't to march forward into socialism. The solution is to remove the socialized aspects we have and move to a more true private health care system. Such systems do work. But you have to actually have it privatized. What we have right now is the result of government meddling so much in the medical insurance industry that it no longer resembles anything which the private market would have created on its own.