I blame employer-provided health insurance. It leads to people thinking "hey, it's free!".
The story I've heard is that at some point (WW2-ish?) there was some sort of government-induced cap on wages, so employers couldn't compete for employees merely on a cash salary.
So, as an unintended consequence to the original government action, employers started offering health insurance as a non-cash benefit.
(Please correct me if I'm wrong, I am admittedly going on hearsay.)
It isn't really a free market though, it is a fixed market. If it was true free market it would be individual to service, that is why prices are all over the place. We just need to return to individual health care plans, paid for by employees individually (or give them cash health benefits). If your employer paid your auto insurance we'd have the same problem.
Not sure how you fix it, maybe by temporarily making it illegal to allow a company to provide health benefits through insurers to fix this. Employers should only be allowed to give you the money for an individual plan (most startups sometimes do this instead). Employers don't pay your auto insurance, home insurance or other insurance. Maybe a one time convert of employer groups to individual groups managed for risk, then, for privacy, for business, for better health care the individual has that (also probably a back up plan for those in need).
Why should employers know about your health? This is ancient thinking where you stayed with a company forever. It's also a privacy thing. I think it would also combat ageism. It will also make starting companies and competing much easier with less friction. It would also allow employees to more easily go from job to job, when you have an employer plan it is a scary predicament sometimes.
Cost can only be competitive if they are seen, they will be seen if it is moved away from employer provided.
Possibly, but you can't make that leap directly, people/industries don't move that fast. First step is move away from company provided, I am sure there would be renewed interest for it in many against it now, or some workable private and public system where prices are known, more direct.
Describe "national healthcare". I see people who like to bitch about the US throwing this term around a lot, but what do you mean by it? One single, state-organized health care provider that gets funded 100% by other taxes or a flat-fee contribution that is the same for everybody? State-set price controls? Price controls on what - costs of procedure or insurance plan? What about coverage of those plans, determined by the state?
State organized and owned healthcare. You pay for it as a taxpayer and don't have to worry about going bankrupt because of a disease that can happen to anybody. For an example, the UK's NHS.
Private healthcare is still perfectly legal and fine, as is private health insurance, if you deem the state services are not suitable for you.
Hospitals should be helping people, not ripping them off >.<
Only after we have explored every other possible solution. This is America, and no socialism is possible; unless you are a homeland security contractor.
Yes, those are all socialist. That's not a bad thing.
Any government is, at its core, socialist. Rather than everyone funding their own private army, the state socialises the cost and provides national defence.
For other parts of society, it may also make sense to have everyone pay in to provide service which is to the public good. Police, fire, postal services are canonical examples.
In most countries, health care is also socialised. As is garbage collection, libraries, and road building.
The question - for most reasonable people - is where do you draw the line? Buses are socialised - what about taxis? Doctors are socialised - what about Lawyers, or accountants?
You don't even have to make it illegal for your employer to pay your insurance premium, just take away the tax deduction and watch how fast your employer stops paying.
I suspect they still would provide it, because it would be a competitive advantage. I get better rates on health insurance through my employer than I could get on my own, presumably because the average working person is cheaper to care for than the average person. So, my company (and most companies) would still find an advantage in hiring if they offered health care. (I'm assuming above that you're talking about taking away the employee tax advantage for this insurance (the avoidance of personal income tax on it). It occurs to me at the end of my reply that you might consider treating it as a non-business expense and that the company would have to pay corporate income tax on the money they use to buy health insurance. I agree that doing that is a big hammer, but it also seems like a terrible idea. If the company has a legitimate business purpose in spending its money that way, namely to better compete for employees, then it's a legitimate business expense, IMO. Trying to enforce social change via the tax code rarely results in precisely the "clean" outcome that people lobbying for those changes intend, or purport to intend.)
Why aren't the insurance companies working to drive prices down?
I understand the theory: People buy insurance; the insurance companies 'police' medical providers and regulate (through the market) the pricing of services.
From the outside it doesn't look like that works. From the outside it looks like very many more (often unneeded) tests are conducted. And it looks like the insurance companies are not squeezing the providers of health care, but are squeezing the patients.
Most private health insurance in the US is provided by employers. Thus, the people paying for the services are not the patients but insurance companies, and the insurance companies are selected by employers not the patients.
But that says nothing about why insurance companies are not pushing prices down.
They get paid by employers, but they'd make more profit if the health care they buy is cheaper. Since I regularly hear that prices are cheaper if you negotiate with the doctors it seems that insurance companies are not doing that negotiation.
So, given that they appear to be losing out on some profit, why? Why aren't they pushing the costs down?
They are pushing costs down. That's why when you get a bill from your insurance and it says "Procedure X - $5000" followed by "Negotiated rate - $1000 accepted".
Insurance companies figure out what stuff should actually cost, then enter into contracts with providers that says "Hey I know you're still making a decent profit if I only pay you $100 instead of $150, so take $100 and you'll make it up on volume when you become one of my preferred providers."
The insurance companies are going to "negotiate" with the hospitals in which the hospital's bargaining position will be to offer fewer services, or the reduce the level of service provided. That's what it looks like from the inside. The insurers put as much money in their pockets. And the hospitals do the same. The patient gets hit with a large bill and fewer sub-par services. Everyone wins. Except the patient.
"It’s that implicit I don’t know at the heart of Montaigne’s essays — his frankness about being a foolish, flawed and biased human being — that she thinks has endeared him to centuries of readers and exasperated more plodding, systematic philosophers."
