Brett
Guest
I'll echo what others have said about how interesting and engaging this thread is. And thanks to many of you for personalizing your experiences and the truly shocking costs of healthcare in America today. I'm blessed--60 years old and never with a major health challenge for either me or my DW. I'll offer my two cents on how to get this runaway train under control:
So what's the solution? Of course, there is no easy answer and this issue is incredibly complex. But I would offer a few suggestions that would at least have a positive effect on the outrageous costs in the American system:
- This is an industry that is inherently immune to the laws of supply and demand. Good old-fashioned competition just doesn't work--and here's why: right now DW and I are shopping for a new refrigerator. Since it's a major purchase, I've checked Consumer Reports to see which are the best-rated. We've shopped online, gone on the message boards and review sites to see what others who own the brand and model we're looking at say about it, and are now checking various retailers to see what their delivery costs and service capabilities are. But when I have a medical emergency--whatever it may be--I not only have no time to do my due diligence, but time is of the essence, especially if it's a life or death kind of issue. Literally the only factor keeping my healthcare provider(s) from charging whatever they darn well please is the pre-negotiated rates for products/services by my insurer. If it was just me, the doctor/hospital/specialists/drug and medical supply companies could and most likely would hang me out to dry. Competition is out the window because my insurer directs me to which provider and hospital I'm allowed to see. The invisible hand of Adam Smith is not just invisible in the healthcare industry in America, it's non-existent.
- The tort attorneys are killing us. I'm old enough to remember when attorneys were not allowed to advertise--until a Supreme Court ruling in 1977 changed all that. Even forty years later, that ruling is controversial because it allows so-called "ambulance chasers" to pre-dispose people to sue doctors and medical companies for so much as a hangnail. One organization has estimated that the passage of federal tort reform would lower healthcare premiums by about 3.5%. It's doesn't sound like a lot, but every little bit helps.
- There is no doubt in anyone's mind that greed runs rampant in the healthcare industry. This particularly egregious example comes from an article published just today in Bloomberg BusinessWeek about a drug company--Alexion--which charges an almost unbelievable $500,000-$700,000 per year for a drug called Soliris. The drug companies will often trot out the old saw that they need this kind of pricing flexibility to offset massive R&D costs, especially for drugs that help a relatively few patients, like Soliris does. But the BusinessWeek article contends that so-called "orphan disease" drugs are in fact highly profitable for the drug companies. The article itself is pretty damning.
- Thanks to the overly-extensive lobbying strength of the AMA in Washington, bad doctors are not only able to continue to practice despite substance abuse issues, questionable training, and other things, but their patients have no way of knowing they have been disciplined. This is yet another example where the patients are hampered from being able to conduct simple due diligence. Bad doctors should be exposed and then at least let the free market determine their eligibility to continue to practice. But free market principles don't apply since these doctors are shielded by laws advocated by the AMA.
- Greg's earlier comments about the effects of a single-payer system ring true. By its very definition, healthcare gets allocated and healthcare availability decisions get made by government bureaucrats and not healthcare providers.
Not being in the medical field, I am sure some of my prescriptions (pun intended) for fixing our broken system are short-sighted. But we've got to start somewhere, because what we've got is not only unconscionable, but unsustainable in the extreme.
- Pass federal tort reform that limits jury awards.
- Repeal the ability of tort lawyers to advertise their "services" in a way that encourages frivolous and costly lawsuits that we all end up paying for. Ultimately, the only winners in the current system are the tort lawyers themselves.
- Substantially shorten the time period for drug patents, allowing generic imitators to come on to the market much sooner. The drug companies will tell us that this would completely undercut their incentives to conduct the R&D necessary to develop drugs, but I think that theory ought to be tested by allowing the free market to have a greater hand in controlling drug costs.
- Remove the veil from bad doctors and bad hospitals. Expose the bad ones, and allow the free market to laud the exceptional ones.
- Require doctors and hospitals to post their fee schedule for routine medical procedures and make these fees available online such that online consolidators such as esurance.com can immediately show consumers what those costs are. Yes, some will say that this is impossible because every patient is different and every situation is different. Fair enough. But that doesn't mean something like this could not be done to at least provide some level of price comparison to see the light of day.
- Substantially shorten the inordinately long and costly drug testing and approval process by FDA. Many will say that this process protects us, but the recent experience of the expedited process for approval of Zmapp to respond to the Ebola crisis shows it can be done--and should be done much more often and with greater dexterity.
sounds like you're putting most of blame in health care costs on lawyers and lobbyists
I'll check back in when you turn 65 and go on Medicare, it's possible you could change your mind about all those "government bureaucrats" and the single payer system!