private insurance companies. The ones that require more paperwork and processing time
But what are those insurance companies processing? If you look at it, it’s “special deals” so the agents can get a bonus, it has nothing to do with actually saving their customers money. Hospitals inflate prices so they have room to make cuts so the insurance sales people feel like they’re winning.
The problem here isn’t with the nature of insurance, but the collusion between insurance companies and care providers. It’s a dance they play so everyone feels like they’re winning, and at the end of the day the customer is the one that loses. It’s not a competitive market, it’s a bureaucratic one where you have HR departments, insurance salespeople, and hospitals all propagating the current system because it’s lucrative for all of the middlemen.
Medical suppliers want a piece of the action too. That’s why we get things like insulin prices going up:
The high cost can be attributed in part to “evergreening,” a process in which drug companies make incremental improvements to their products that can extend the life of their patents, said Dr. Kevin Riggs, a physician at the University of Alabama at Birmingham Heersink School of Medicine. He co-wrote a study published in the New England Journal of Medicine in 2015 that described the century-long history of the drug.
They prevent competition through the patent and regulatory systems, and hospitals and insurance companies are fine with it because they just pass the costs on to the consumer. Consumers don’t really have a choice because most insurance comes from employers (who just pay employees less to compensate) or taxes (ACA subsidies). Nobody actually pays the full price, so the system continues.
The same goes on with medical devices, but volume is much lower so it’s easier to prevent real competition. Add to that the legal risk for choosing a cheaper product if anything goes wrong and you’ll find no incentive to cut costs.
Let’s assume we eliminate private insurance, you just change the private collusion to public collusion, and instead of middle managers getting paid in the public sector, you get political favors to keep prices high (e.g. campaign donations). Moving insurance from private to public just moves money from one pocket to another. The true solution here is to expose the collusion, not politicize it. If you want proof of this in action, look no further than the defense department in the US.
Pretty much every ER room in America is a huge money sink that the rest of the hospital has to economically support
Which is because of free riders. The solution to that problem is different: emergency care should be completely publicly funded. It’s so expensive because the hospital has to deal with people skipping on their bills and just move the costs to paying customers.
I think we should make ambulances and all non-elective care completely free, provided a paramedic recommends emergency care.