Healthcare is the US is so dysfunctional it would take a week of shows to cover it properly.
1) Where are the *care* dollars spent? No one ever considers where the money goes. Before you can bring down cost, you have to know where you are spending the money. A household trying to cut back looks at how much they spend on the mortgage, dinners out, car payments, etc. Cutting 50% on $100/month in dinners out while your mortgage is $3000/month is not going to help your financial situation. Are most care dollars being spent on Herculean neonatal intervention, end of life, obese middle-agers? Some one knows, but it's never discussed in public discourse/debates such as these.
2) Many people, especially law makers, confuse health insurance with healthcare. The health insurers have inserted themselves into the system as middlemen skimming a percentage healthcare dollars. How much does it cost to have insurance companies with their high executive salaries and legions of claims processors? How much does it cost to have doctors offices and hospitals with their admin staffs to comply with the insurance billing requirements? Again no one knows. At best we get a dubious statistic like the insurance companies spend 9x% of every premium dollar on claims. Well if that includes salaries, IT and infrastructure, and lobbying, I am not impressed.
3) How much does Medicare & Medicaide cost-shifting add to the insured folks that are trying to play by the rules? Everyone agrees it exists, but again, no one wants to do the hard work to put a number to it.
4) How much does the broken malpractice and torts system cost us.
5) Doctors have huge overhead from school loans to foregone compensation for their many years of school to malpractice insurance to ridiculous billing overhead and rejected claims. They are the only profession which cannot charge for the *time* of their expertise, only for procedures. How does this bias to do procedures effect the healthcare delivery and drive up costs from unnecessary procedures?
6) Prescription drugs and drug companies have been a two edge sword. Drugs can save costs (and lives) tremendously in some cases, but seem to drive up costs overall from dubious look-a-like new drugs that replace perfectly good and cheap old drugs.
posted 3 years, 3 months ago
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