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the price of healthcare
Cost Control First, Access Second
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  • Andrew Allison

    Americans have already come to believe that intellectual and political elites no longer see the prosperity of the American middle class as Job One. The nonsensical belief that first-class healthcare can be provided to everybody is just one manifestation of this. It’s equally nonsensical to think that any meaningful impact can be made on costs without radical restructuring which will be fought tooth-and-nail by the medical-pharma establishment.

  • FriendlyGoat

    Yes, we need to control health care costs. That has been the subject of plenty of articles better and more informative than this one since 1975. Some of them actually spoke of substance, but alas, not this one.

    • Andrew Allison

      It was worse that that; the headline was ass-backwards. Affordable (by the taxpayer, not the insured) access first, cost second. The two largest cost components are the private insurance industry (which costs 10x as much to administer as Medicare) and the huge number of unnecessary procedures which it funds. The knee-jerk opponents of Medicare-for-all can’t (won’t?) acknowledge that the fraud in the private insurance market is far, far greater than that in Medicare.

      • FriendlyGoat

        As I recall, you and I are in agreement about some sort of single-payer arrangement that the current Congress will not ever enact, right?

        • Andrew Allison

          Never say never, but as long as Congress, notably those who voted for ACA (aka the insurance and healthcare industries welfare act), remain bought-and-paid-for special interests I fear that you are correct. The evidence is incontrovertible that a developed nation (which the USA is clearly not) provides a minimal level of health care for all its citizens.

      • Dale Fayda

        As you may recall, I recently responded to this with a link stating that according to GAO waste & fraud in Medicare alone in 2014 was estimated at $60 BILLION. Combine that with Medicaid and the VA and it’s around $100 BILLION a year – that’s a low-ball estimate, no doubt. Over a decade, that roughly a TRILLION dollars WASTED by the government. Not how much these half-assed programs cost, mind you, but just the pure waste!

        Whatever the waste & fraud in private insurance is (and I have no doubt it’s very high), it pales in comparison to the sheer insanity of what the government throws away and calls “compassion”. Also, whatever the insurance companies lose hasn’t been confiscated from me by force, unlike the taxes government tosses down the bottomless rat-home that is Medicare. If I don’t want to buy health insurance, I don’t have to. Oh, wait… Now I do, thanks to the “gubmint” telling all of us how to live and die.

        You want lower healthcare costs – get the government OUT of the healthcare business and watch every insurance company in the country bend over backwards in coming up with affordable plans for every imaginable demographic. Private enterprise creates price competition and abundance; government creates rationing and casual oppression.

        • Andrew Allison

          I stand by my statements concerning knee-jerking and fraud waste and abuse.

          • Dale Fayda

            Competition in every field of human endeavor brings about efficiency in delivery of those related services. Healthcare is no exception. There is no point parsing the completely deleterious role government interference has played in ALL aspects of healthcare delivery, its pricing structure, its availability and overall quality. Why you continue to ascribe greater “efficiency” to government in doing anything, despite monumental evidence to the contrary, I have no idea. I just clearly reminded you of the galactic INEFFICIENCY of government-run single-payer healthcare programs. If you can present evidence that private sector insurance waste is even higher, I’d like to see it.

          • Suzyqpie

            We see reports regularly on waste, fraud, and abuse in SS, Medicare, IRS, Medicare.
            Software would solve a lot of the WFA. Perhaps, the software is never installed because the bureacrat with the authority to install it has a financial benefit in its absence. I speculate that a large portion of the WFA is insiders in the bureaucracy.
            Who better to rip off the system than insiders with knowledge of the systems weakness.

  • Anthony

    “In the long run, affordability is access and attacking the factors that inflate the cost of health care in the U.S. will do more good….” Yes, yes, yes.

    However, health care, as most attentive Americans know, will not reform itself. Health care providers are making a bundle of money, and have no incentive to give it up per capitalist’s interest. Indeed, talking/writing about spiraling costs and ACA affects may play well in some places but health care provision, for Americans at all income levels and stages of care, remains caught up in both economic and political forces (interests). Realistically expecting our current massive, very well-financed, high revenue, high margin, “high growth”, high-cost health care infrastructure to take steps to reduce costs and prices is at best wishful thinking without National demand followed by organized concerted effort. Health care (in spite of ACA) is a robust and growing sector of immense size, scope, and scale. It feeds many interests (and benefits from both legislative inaction and voter quiescence).

  • Jacksonian_Libertarian

    Obamacare was always going to be the wrong solution. It took a limited monopoly market which had separated most consumers from the choice and costs of their health insurance, with Medicare/Medicaid and Employer paid for Health Insurance. And limited it even further with fewer Insurance Companies, forced participation, and built in profit guarantees for Insurance Companies. Monopolies, even Limited Monopolies all suffer from the same disease, the lack of the “Feedback of Competition”. It is the “Feedback of Competition” that provides both the Information (What are our competitors doing, and how can be beat them?) and the Motivation (If we can’t sell our products, our company will go bankrupt and we will lose our jobs.) which forces continuous improvements in Quality, Service, and Price, in free markets.
    Henry Ford had a saying “Work expands to fill the time available to perform it.”, in the case of Health Insurance, the Quality and Service decline and the Price rises until the Public can no longer tolerate the miserable care and outrageous prices. Obamacare was rammed down America’s throat by the Democrats without a single Republican vote. And the Democrats will pay for this abuse with a massive loss in power. We see this at the State level where Democrats have lost over 1,000 seats in State Governments. And we are beginning to see this at the Federal Level with the Republicans in control of the Senate and House and seems likely the Presidency as well in 2016.

    • Andrew Allison

      Other than your misattribution of a C. Northcote Parkinson dictum, you are spot on!

  • solstice

    Through its meddling, the federal government has done to health care what it did to higher education: it has driven up costs to outrageous, unaffordable levels, created perverse incentives, and greatly distorted the market. Young Americans are the most detrimentally affected by federal government policies in these sectors, yet they tend to vote for politicians who perpetuate them. This situation is akin to illiterate, sub-Saharan Africans who earn less than a dollar a day and who still donate a third of their income to their local witch doctors/pastors.

    • f1b0nacc1

      How refreshing, we are entirely in agreement!
      It is not surprising to see that those areas of the economy where the government has the most (and deepest) involvement, such as education and healthcare, are experiencing massive inefficiencies, high costs, and stagnation, where those where the government has had little involvement have experienced innovation, efficiency, and growth.
      As for young Americans and their misguided voting patterns…this is a surprise? Most of them are the products of the current educational system, which churns out obedient statists with a commendable efficiency. Of course the problem is older than that…remember the old dictum that ‘those who at 20 are not liberals have no heart, those are still liberal at 40 have no brain’…

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