There has to be a point - somewhere - where the actual cost of medical procedures has to be questioned.
I know...administrative costs, lawyers etc.....
but seriously, when does the actual cost of medical care get questioned?
The discussion is all about insurance now.
The insurance model has pretty much failed - with plenty of help from the government (medicaid/care) and Obamacare - but seriously - there has to be, at some point, a discussion of costs charged by the entire medical industry. Insurance has allowed costs of medical care to escalate without normal restraints of the market.
Can one even ask this question in polite company on FR?
The one we currently have? Absolutely. And, I would further add that it has failed because of gubmint intervention in the marketplace. Things like not allowing health insurers to compete across state lines. There is absolutely no reason why I shouldn't be able to buy insurance from anyone who sells it. Most states limit the number of companies that can sell health insurance, some limit it to as few as 3-4 providers. This is ridiculous! Cronyism at it's worst. Another thing began shortly after WWII that hurts the cost of health insurance and that was health insurance being offered by employers as a benefit on top of wages or salaries. This removes the consumer from the equation on the front end. The company may or may not be buying the best policy that suits you and you might be really healthy, but be lumped into a pool of less than healthy insureds. The consumer is removed on the back end, too, with zero or low deductibles and co-pays that are more of a nuisance than a shared cost. There is no free market and thus absolutely no incentive to shop around for the best price on anything medically related with most insurance policies. That's the beauty of the HSA. It puts the consumer back into the equation. For incidence, I just had a little outpatient thing done. Since I've not met my deductible this year I guarantee I will be going over the bill with a fine toothed comb and will be disputing anything that does not belong. (and this is after the insurance has matched all the charges and reduced them to match their network contract)
Well you can certainly raise it in this polite company. It’s the classic issue that everyone trying to find a better way deals with. The two usual proposals are empowering the consumer or putting the government in charge.
While there’s some examples like laser eye surgery and cosmetic surgery that seem to indicate that when individuals do the paying, costs stay down, that solution assumes an informed consumer base that, in reality, doesn’t exist.
The alternate approach is government studies, edicts, etc. The individuals who make those decisions are more likely to have political or financial motives that may not coincide with the desires of the average patient, though. A correlary to the “edict from on high” approach is something like “results based medicine” in the form of a series of rules based on research in our educational institutions.
It’s a really interesting issue to me, but after about ten years of study, I have more questions than answers. I do have an ideal, though, which involves a large patient base that cares enough about its own health that it gets agressively involved in issues about costs. Sadly, I think that’s mostly a dream.