But you haven't changed the cost curve at all...you have now added private profits to the cost equation and shifted the cost of senior HC totally to seniors...all you are doing is to take more cost progressiveness out of the system.
The per capita cost in the US is too high...much higher than it is in single payer based HC systems. I don't care how you apportion the unit cost, the aggregate hasn't changed and in fact may have gone up. Until we learn to do smarter, more economical care, we won't solve the problem.
What do you think caused the per capita cost in the US to be so high?
Study, after economic analysis, after study has shown that the government payment system is directly responsible for increasing cost spiral for health care. It is pretty simple: As Medicare & Medicaid underpay for services, those costs are dumped onto private insurers (and worse, self-pay patients). Fees have to be increased to maximize reimbursements. Year after year.
If you had spent the time evaluating fee schedules I have you would know what I'm talking about. The first thing I do when consulting with a medical practice is review the fee schedule to be certain every single code is charged at an appropriate multiple of Medicare fees. Because if you're only charging Medicare fees, you're losing money. But the downside of raising fees is self pays have to pay them. And it forces up the UCR amounts for private insurance -- for next year. A vicious cycle if ever there was one.
The only real solution to ever-increasing health care costs is for Medicare and Medicaid to pay the same fees as private companies. Yet, that cannot happen because government payors set fees by fiat. This, more than any other thing, will fix the cost curve.
If we are going to have the best health care in the world, the cost is always going to be higher than in other countries. More than half the world's medical innovation either occurs in, or is financed by, the United States, and that's expensive. But costs could be reasonable if only we had a rational, market-based payment system. |
