[dalmations202]

Originally Posted by mcsluggo

THere is some truth to what you say there... but I would argue that health care/health insurance has NEVER approximated a normal market (ie meets the requirements in your micro-economics 1a class for a functioning "perfect competiton" market). Health care is, by its nature, perverse. Lots of things have changed over the last 50 years, and adherents to one side of the debate, or the other, often want to throw it all on the doorstep of the OTHER side... but it just simply isn't that easy.

the damning feature of healthcare is that expense for it are so lumpy--- and what makes that lumpiness even worse, is that it is by no means "evenly spread" across the population. Old people need more health expenditure, as do people that know that THEY are chronically ill. AND perhaps most importanly, adequate healtchare is viewed as a semi "basic right".

the health inflation that took place over the last 50 years wasn't just it getting more expensive to provide basic serices (although some of that took place) but much more it was what people EXPECT (and get) from the system. EVERYBODY dies, and in most situations, the last year before you die is when 90% of the spending on healthcare takes place (before anyone challenges me to cite that figure, i just made it up--- !) Most people, even those with significant financial means, are not equipped to suddenly pay such huge lumpy expenses at one sudden point, and so we have "insurance" to pay for it, and smooth the expenses... but health insurance doesn't look much like any other "insurance" we purchase: largely BECAUSE we view health coverage as a "basic right" AND because people's health care needs ARE fairly easy to predict, statistically, but in the end prices paid for insurance bear very little relation to the prices that are actually paid out for the underlying healthcare--- which we as the consumers basically never see, or are completely indifferent to because we never have to pay THAT bill.

Auto insurance companies are able to jack up the prices for young kids, particularly those that have DUIs and have been busted for drag racing. As a society we don''t think it looks appropriate to jack up the prices of insurance for grandma just because we KNOW that the mere fact that she is 85 means it can't be long before she is going to kick it and is going to cost the system a boatload. Or likewise, cuting off Tiny Tim's coverage because, duh--- he is revealed to be sickly and will need lots of care.

Healthcare just, plain and simple is NOT a normal market. THe normal price and competition mechanisms just do not function very well here. IN order for it to start to look more like a real market, there would have to more freedom for prices to actually reflect services--- but the implications from that are not concequences that i think your average joe blow would be willing to stomache if they actually took place: each granny getting a $200,000 death bed bill, or alternatively having her coverage yanked because that type of bill is coming, or kicking the tiny tims out of the system, or whatever other slightly cartoonish over-dramatic characterizations of the very real underlying problem--- prices (of insurance) are too divorced from actual costs (of actual services) to provide any of the miraculous services the market/price mechanism USUALLY plays to ensure efficiency, and we aren't prepared to actually come to grips with what a truly price based system would look like...

It isn't the same because people have to have healthcare -- else they die.
It is the same though because the more $$$$ you have - the better you get.

In education -- who score historically better private schools or public ones?
In sports -- who historically are better paid coaches or rec league coaches?
It goes on and on -- money buys better everything.

Free market says that if what I sell is in demand -- I make more. Since we know that dying and injury will happen -- then if I become a Dr. I will be in demand. If I am liable for everything, and it will take me years for education and training, then I expect to be paid handsomely. Of course in this country everyone is looking for the quick payday without putting in the effort -- look at the lottery, using natural ability/looks to get into the entertainment field, and all the lawsuits.

This country has a master and it is called the Dollar.

From the perspective of medical costs, most people don't realize that they have caused the medical costs to rise because of lawsuits, and expectations.

If you stay at a hospital, you more or less expect it to be like a fancy hotel. Good food brought. Someone to check on you. Proper medication and timeliness. The nice things that you have already. Hospitals have to hire and train many people for the around the clock stuff. They pay outrageous expenses to people who sell to medical because these people try to make their money off places that have the money. No doctor wants the liability outside of their exact specialty because someone else will sue and try to win the lawsuit lottery. That means more highly paid and trained personnel, to which comes more expense. Then come the support personnel just to support what all is being done by the clinical staff. Do you think the Administration of hospitals, etc don't want paid like most CEO's and administration? How about the record keepers, maintenance, IT, billing departments, and janitors?

Then you have to deal with the fact that just because you billed for this amount -- you may not actually get it. The government and insurance companies decide what they will pay - regardless of what is billed by the medical institution. Many people are indigent and cannot pay. This means that all medical automatically charge higher than they should, in order to make up for the ones that are not paying.

You are so correct that something needs to be done. Make it public/socialized though, and you will be like public schools -- just not producing what the others do. Make it totally private, and the monetary challenged will be dying at a much high rate.

If you want to keep costs lower on medical though, then you need to limit the lawsuit lottery, and fix the expectations. Outside of this, radical changes will only hurt one way or another way. The US has the best healthcare in the world -- and there is a reason for that.