And it is when, not if. It presents an opportunity to finally fix problems with the system dating back seven decades:
There is an alternative. A much freer market in health care and health insurance can work, can deliver high quality, technically innovative care at much lower cost, and solve the pathologies of the pre-existing system.
The U.S. health-care market is dysfunctional. Obscure prices and $500 Band-Aids are legendary. The reason is simple: Health care and health insurance are strongly protected from competition. There are explicit barriers to entry, for example the laws in many states that require a “certificate of need” before one can build a new hospital. Regulatory compliance costs, approvals, nonprofit status, restrictions on foreign doctors and nurses, limits on medical residencies, and many more barriers keep prices up and competitors out. Hospitals whose main clients are uncompetitive insurers and the government cannot innovate and provide efficient cash service.
We need to permit the Southwest Airlines, LUV -0.19% Wal-Mart, WMT +0.22% Amazon.com AMZN +1.11% and Apples of the world to bring to health care the same dramatic improvements in price, quality, variety, technology and efficiency that they brought to air travel, retail and electronics. We’ll know we are there when prices are on hospital websites, cash customers get discounts, and new hospitals and insurers swamp your inbox with attractive offers and great service.
…Health insurance should be individual, portable across jobs, states and providers; lifelong and guaranteed-renewable, meaning you have the right to continue with no unexpected increase in premiums if you get sick. Insurance should protect wealth against large, unforeseen, necessary expenses, rather than be a wildly inefficient payment plan for routine expenses.
People want to buy this insurance, and companies want to sell it. It would be far cheaper, and would solve the pre-existing conditions problem. We do not have such health insurance only because it was regulated out of existence.
Time to make a clear distinction between “health care” and true insurance, and let the market work. Instead, as always, we try to fix a mess caused by regulations with more regulations. This time, I hope it was a bridge too far.
It’s bit exasperating to always say this, but it’s not about knowing a solution. It’s about the 50%+1 that don’t care. It’s not about the ‘leaders,’ it’s about the followers.
This is not a problem you can fix with solutions. Any solutions.
Walmart and Amazon famously underpay and mistreat their staff.
I don’t think i want a nurse getting 8.25/hour treating me and still trying to
get 13 more patient tickets processed that hour.
There is lots of room for efficiency and productivity and quality in
medicine without going the walmart model
Walmart and Amazon famously underpay and mistreat their staff.
Their staff voluntarily entered into hiring agreements with these employers. If the treatment is so “unfair”, then work elsewhere.
Do you want a medical tech, changing your Mother’s IVs who is getting $8.25/hour?
Do you want to continue asking stupid, straw-man questions?
That was a rhetorical question; we know you do.
The Clinic at Walmart
Independent clinics now offer a wide range of common healthcare services at select stores nationwide. These clinics combine walk-in convenience with budget-friendly prices.
Do I hear heads exploding?
By the time the unaffordable careless act implodes and is finally repealed such independent clinics without connection to insurance may be the bulk of functional medical care surviving.
There is an alternative
The alternative described is a much greater change than Obamacare. Given the enormous status quo bias in our political system, it’s hard to imagine such a change ever being passed.
many more barriers keep prices up and competitors out
The incumbent hospitals and doctors will fight tooth and nail to keep those barriers in place. It isn’t as if they exist by accident. And it’s no accident that the Republicans haven’t voted on any bills along the lines described here — they have zero interest in going to war with health care providers.
To actually happen a major reform proposal has to attract strong supporters, and/or neutralize opponents. Obamacare passed because it had something to offer doctors, hospitals, insurers, device makers, pharma companies, etc., even as it worked to limit the growth in health care spending. Threading that political needle required all sorts of compromises and kludges, which is one reason that virtually nobody is 100% happy with the result. But it’s impossible to imagine a purer, more sweeping alternative — no matter the specifics or ideology — having any chance of becoming law.
Politics is the art of the possible, and Obamacare is — just barely — possible.
had something to offer doctors, hospitals, insurers, device makers, pharma companies, etc., even as it worked to limit the growth in health care spending.
And the offer turned out to be a fabric of lies.
It’s early days yet, but already there are millions of people on Medicaid who wouldn’t have been otherwise. They represent new income for insurers and healthcare providers, and a reduction in uncompensated care. A recent poll of hospital executives showed 90+% support for Obamacare, despite all the launch problems. As I wrote, nobody is 100% happy with it, so expect lots of jockeying to nudge the law in one direction or another (e.g. the medical device people want to drop that tax, unions want to lose the Cadillac policy tax, etc.). But so far the coalition that got it passed/let it be passed is still on board, because they are getting what they were promised. There is no equivalently influential coalition that wants the sort of dramatic changes proposed above.
“It’s early days yet, but already there are millions of people on Medicaid who wouldn’t have been otherwise. They represent new income for insurers and healthcare providers, ….”
Once again you fail the basic economics test….you buy into the broken window fallacy. And that’s just the first of many objections to your silly post. Such as:
“A recent poll of hospital executives showed 90+% support for Obamacare…”
Oh please. You just state that without stating the source of the poll where we can read it makes your assertion worse than worthless…it’s worse because of your well-established history for lying even about your own sources. Like, I’m sure the hospitals that are refusing to service the exchanges are happy with them. As are the hospitals which are not *allowed* by the government to be on an exchange.
“As I wrote, nobody is 100% happy with it, …”
hahaah you came in just under the wire for the understatement of the year!