4 Mar 2013 6:51 pm
I just read a very long article by Steven Brill in a recent edition of Time Magazine called 'Bitter Pill: Why Medical Bills Are Killing Us'.After reading 11 pages of story after story of people's horror stories when it came to their health care bills, this was the writer's conclusion:Unless you are protected by Medicare, the health care market is not a market at all. Its a crapshoot. People fare differently according to circumstances they can neither control nor predict. They may have no insurance. They may have insurance, but their employer chooses their insurance plan and it may have a payout limit or not cover a drug or treatment they need. They may or may not be old enough to be on Medicare or, given the different standards of the 50 states, be poor enough to be on Medicaid. If theyre not protected by Medicare or theyre protected only partly by private insurance with high co-pays, they have little visibility into pricing, let alone control of it. They have little choice of hospitals or the services they are billed for, even if they somehow know the prices before they get billed for the services. They have no idea what their bills mean, and those who maintain the chargemasters couldnt explain them if they wanted to. How much of the bills they end up paying may depend on the generosity of the hospital or on whether they happen to get the help of a billing advocate. They have no choice of the drugs that they have to buy or the lab tests or CT scans that they have to get, and they would not know what to do if they did have a choice. They are powerless buyers in a sellers market where the only sure thing is the profit of the sellers.Indeed, the only player in the system that seems to have to balance countervailing interests the way market players in a real market usually do is Medicare. It has to answer to Congress and the taxpayers for wasting money, and it has to answer to portions of the same groups for trying to hold on to money it shouldnt. Hospitals, drug companies and other suppliers, even the insurance companies, dont have those worries.Moreover, the only players in the private sector who seem to operate efficiently are the private contractors working dare I say it? under the governments supervision.The real issue isnt whether we have a single payer or multiple payers. Its whether whoever pays has a fair chance in a fair market. Congress has given Medicare that power when it comes to dealing with hospitals and doctors, and we have seen how that works to drive down the prices Medicare pays, just as weve seen what happens when Congress handcuffs Medicare when it comes to evaluating and buying drugs, medical devices and equipment. Stripping away what is now the sellers overwhelming leverage in dealing with Medicare in those areas and with private payers in all aspects of the market would inject fairness into the market. We dont have to scrap our system and arent likely to. But we can reduce the $750 billion that we overspend on health care in the U.S. in part by acknowledging what other countries have: because the health care market deals in a life-or-death product, it cannot be left to its own devices.Put simply, the bills tell us that this is not about interfering in a free market. Its about facing the reality that our largest consumer product by far one-fifth of our economy does not operate in a free market.http://healthland.ti...are-killing-us/Quite a good argument for single payer.