Having healthcare provided by the employer is a terrible idea, because healthcare needs have nothing to do with what labor provides. Of course, Obamacare won't fix the problem as it doesn't do anything substantive about costs. Just allowing Medicare to negotiate drug prices when purchasing would save ~$50B a year. My guess is that Obamacare is a poison pill to force a public option, basically buying Medicare coverage out-of-pocket. It won't be what you want if you can afford better, but it will be far better than being uninsured now (which means you pay far more than insurance companies do for the same service). I have a decent job at a healthcare provider, and my costs have just gone up and up for the last decade at a rate that defies logic. It's not like Obamacare is going to ruin something good. The whole system is fucked and getting worse. I think Obamacare is basically making sure that we are all fucked together, and hoping then we will be forced to actually fix the real problem, which is the insane costs.
I always suspected the provision that ensures insurance companies spend 80% of premiums on medical care was a cyanide pill slipped into the bill without the companies knowing. This will destroy them in the long-run and eventually force us onto some kind of nationally-run system more appropriate for a developed country.
I'm not sure, to fit that metric, increasing what they pay out for services has the same effect as reducing administrative costs. The effect could be that service prices just go up all around. Unless the public has another option to jump ship to, which in that case it might have the effect you suggest anyway.
Indeed, I realize now I wasn't very clear. I figured doing this would greatly hurt the industry since it effectively places a cap on salaries, bonuses, benefits (unless I'm not misunderstanding the situation). Or as you said, will raise costs at an even more astronomical rate forcing the electorate to give up on the quixotic "private sector will find a way to provide healthcare" idea.
turns out publicly provided healthcare means less regulation.
I think JV means administrative costs. Medicare and Medicaid administrative costs are far lower than private insurers. But the US system is pretty much proof positive that private healthcare costs more than public, when comparing the same service. Of course, quality of service is another issue. It seems private does better on the high-end care, and public does better on the low-end care. Which makes sense, when you are billing for profit, the high-profit margin care is where you are going to focus your energies. Low-end care is generalized and repetitive, which is just perfect for a public service that can buy in bulk, and seeks parity on costs and expenses. It makes me wonder if you couldn't have plans that created a hybrid of public care for outpatient medicine, and private care for inpatient care where competition and quality makes a difference. General care is dealt with in a very inefficient manner by private insurers, and there's not much money in it.
I would be shocked if Medicare/caid expenses are lower across the system. They may be lower on the government side, but that probably means that they've just shoved the costs on someone else. Warning, anecdote masquerading as data:
My family doctor now gives me a 50% discount on our BCBS rates on office visits because we pay cash at time of service. We essentially pay less than the gov't does for the same service. He's a small business, so I'm going to assume he understands his overhead picture. Back to my main point. You assert that the government can provide healthcare more cheaply. Please point out something else they provide more cheaply. crickets -XC
denmark, germany and france have lower healthcare cost percapita and better outcomes (based on life expectancy) then the US. in fact we have the worst bang for our buck of any industrialized nation.
Denmark - 5.5M people, single gene pool
Germany - 81M people
France - 65M USA - 311M I can't find the cite right now, but I know that in the last 10 years we've more than doubled public/private spend on medical research, that's a 7%/year increase. And in 2000 I think the US was spending more on medical research than the next 15 countries combined. So, I would, as usual, suggest two things. One - what works for small countries and companies does not always (or even often) work for large ones. Two - There is significant "free ridership" in the global healthcare market. Finally, ask yourself one simple question: if you get really really really sick with something serious you get on your G5 and fly to..... where? _XC PS - Not saying we are perfect, but baby/bathwater and all that.
It seems the me much of the private spend in centered in replacing drugs that treat chronic illness before they reach public domain. (not exactly a public good). solution to the "large country problem" -> federalism. 311 / 50 = 6.2 million well within reach. solution to the "heterogeneity problem" -> white folks need to stop pretending that being white is a genetically meaningful thing. (Seriously is there genetically meaningful way to include Italians, Greeks, Poles and the Irish in one group and exclude Mexicans, Jews and North Africans from that group? ) for your last question Canada is the answer and I would drive.
unless it could be cured pharmacologically in which case I would head south.
I'm not sure if there is something, but the rest of the developed world pays less for the same care when compared to our private care. Healthcare is a very unique service. The need for an individual is unknown, and profit, by definition, means that parity between costs and outlays is not the goal. Also, since doctors, not patients, choose the care, and as patients don't have the knowledge to choose the care, shopping around just doesn't work so well. But don't think that I am just criticizing private healthcare. Our system is a hydra of dysfunctionality, which includes price-fixing, monopolies, collusion, misguided regluation, and bureaucracy. Also, I don’t think there’s much logic for employers paying for it in this day and age. It worked when Generous Motors could pay grandpa enough to take care of grandma and their five kids, and when healthcare costs were somewhat limited by what they could do. These days, not so much. Also, we are subsidizing the pharmaceutical costs of much of the world. I bet a private police force might be cheaper, but I don't want one. I just want what works best. My guess is that a private/public hybrid could do better than what we have. But, that's not saying much.Back to my main point. You assert that the government can provide healthcare more cheaply.
Please point out something else they provide more cheaply.
Regulation means government telling private businesses what to do. Right? that is way libertarians say that it is evil? government regulation is meaningless when it is applied to governments if anything it would be called policy. there is a downside to this Chernobyl comes to mind.