Here is what I observed. I am fairly old, but humor me. Back when I became a "grown-up" in the late '70s, you could buy a health insurance policy for quite a reasonable price. Everyone, unless they were totally irresponsible, had one. It paid on an 80/20 level for emergency procedures, hospitalizations, etc., major medical dilemmas. If you had to go to the hospital and your bill was $2,000, you had to pay $400 of it. Which kept us from using it unless we had a really big deal. I believe over $2,000, was 100% covered. It did not pay for things you could budget for, which was the key. But it kept medical costs from bankrupting us. In about or around 1980, an insurance company started up that paid for EVERYTHING with just a small co-payment, still with a low premium. We could hardly believe our luck! We could go in for an office call and only pay $5! Vaccinations, well baby checkups, prescriptions, EVERYTHING was paid for by the insurance! Other insurance companies took their lead, presumably in order to compete. But here's what they didn't expect: The medical profession raised their rates astronomically; after all they knew they were getting paid no matter what. They also began ordering various tests, again knowing it would be paid by the insurance company. And why would the consumer complain? After all, we weren't paying for it, the insurance company was. At about the same time, the preventative medicine folks started a cottage industry of telling us we should go to the doctor CONSTANTLY, not just when we were sick. Again, why would we resist? We weren't paying for it. Recreational doctor visits became the norm. Soon, obviously, the insurance companies had to raise the rates. And raise them. And raise them again, until the common person could no longer afford to buy insurance. This is what I saw. I also have a solution. If the government feels it must get into healthcare, force every insurance company, in order to be licensed, to offer a low cost 80/20 policy with a low deductible. They would, I think, still make money because these policies are seldom used. I believe they would still be able to sell the big Cadillac policies, because many in the population are so used to insurance paying for everything that they believe that is how it's supposed to work. But the poor and middle amongst us could buy the 80/20 policies just for emergencies and to avoid bankruptcy if the unthinkable should happen.
This is very insightful. I hadn't thought of that before. This might not explain the majority cause of the problem but it could explain a substantial portion of it. I rarely see insightful posts here, but this is one of those.
Well that's one view. It seems you are really talking about the rise of HMO's, but that was a market innovation that paid for itself. I think the real problem began with the Emergency Medical Treatment and Active Labor Act (EMTALA). This required every hospital that accepts Medicare (virtually all hospitals) to treat everyone regardless of ability to pay.
Yep, I bet that has something to do with it too. Perhaps it should have continued to be just the county and charity hospitals that had to do that. Another problem is that people began continuously going to the emergency room for illnesses that could wait till Monday and be seen at a doctor's office. Again, it was free. Before, you may have paid $40 for an office call on Monday morning, but if you went to the emergency room, your part of the bill would be like maybe $400, so there was an incentive not to use emergency rooms unless it was truly necessary. Which is also why when my husband recently got cut and was spilling much blood on a Sunday, we had to wait for two hours behind children with sore throats.
That's because the ER had to treat the sore throats. And in places like San Diego, the ER is where all the illegals go for their basic medical care, go to the Sharp ER in Chula Vista and its packed with illegals. And the illegals don't pay, they get treated and leave, the hospital knows they wont pay but the hospital has no choice. A friend of mine had severe abdominal pains, couldn't get to the Navy hospital so he went to Sharps, spent several hours on a gurney in a hallway before being really examined, then they took him into surgery and removed his appendix (which had burst) and a couple inches of intestine. The root of the problem is the govt. Get the govt out of the health care business.
IF we ever shed ourselves of the PPACA, we m ay yet again be able to obtain 'Catastrophic' policies. Those who are fortunate enough not to have a chronic condition, and relatively decent health, used to be able to purchase them for $300 per month, with a $5,000 deductible. We will never see premiums back where they were, the insurance industry will make sure of that. Big Pharma plays a hand in that also, but I could go on for hours on that little subject. As to ER use for those who cannot pay, I would rather have them use the ER and actually receive care, then pay for an insurance policy that doesn't actually provide health CARE. Insurance is just a method of payment, no more. Best case scenario would be to increase the number of Immediate Care facilities, with a sliding scale for payment, so the ERs don't get bogged down with 'sore throat' issues. I agree 100%, get the government out of healthcare.
So, were the big HMOs the first step towards socialized healthcare? I was just reflecting that some of the results I observed, like for instance the wait for ER care, are the same results we would most likely experience with the socialist model, ten-fold.
