Jubbergun wrote:
While you complain that I'm treating all the players as monolithic, you have treat all providers as monolithic to make the argument that there is, or would be, no competition in the "ultimate seller's market." In large metropolitan areas, there generally exists more than one large healthcare provider--and they would be competitors. That means that they'd be capable of undercutting one another, which they might be able to do for one type of service/treatment, but probably wouldn't be able to do for all services. That would mean that while you might go to the Catholic-run system for thyroid treatments, you'd be better off going to a corporate entity for cancer treatment, or a non-profit with no religious affiliations for treatment of problems with the digestive system. Rural areas might only have one large provider, but if the prices they set aren't competitive other providers might enter their region. There is also going to competition between the smaller private-practice doctors who provide service as they compete for customers. What should end up happening is what happens in other businesses, like retail, where you'll have "bargain" providers--like Wal*Mart or Dollar General--that would provide a broad range of services most everyone will be able to afford who compete with varying grades of providers of a higher quality--everything from Target to Tiffany--that wold cater to special needs/requests or provide more specialized treatment.
What you are proposing is the same logic behind airline food. Profit goes up exclusively by cutting the quality of a product with guaranteed price and delivery, then marketing it to people who have no choice.
You're giving a tortured rationalization for dysfunctional mechanics for the sole reason of preserving the pretense of a free market and ideological sacred cows like "competition", "savings", and class distinctions.
Jubbergun wrote:
Holding all payers to the same pricing avoids the problem addressed in the article Azelma linked, which is that certain payers subsidize the services bought by other payers.
Faulty premise. It isn't a problem at all. It's how society works.
It isn't a problem that some people subsidize other people's medical care any more than it's a problem that some people subsidize other people's roads, mail service, telecom, education or whatever else may have you.
Azelma wrote:
Does this seem right to you?
The question is....why is medical care in this country so expensive in the first place?
Hospitals are blameless in the same sense universities are blameless. They are actors playing a game conceived by someone else, and they are being controlled by money flowing in from private interests determined to keep the government out.
Azelma wrote:
You say insurance companies are the sole reason? Can you explain how insurance companies cause hospitals to charge 6 times the actual cost of aspirin?
The same way banks and the education industry drive up the cost of textbooks. If schools were fully funded and brought under the control of democratic authorities, they wouldn't try to mark everything up and balance it on the backs of students.
Why do you think trustee boards choose to play the game? How do you think they get their jobs?
Same with medical administrators.
Why are corporations so determined to prevent quorum-based public campaign funding? Because they know that if that were to come to pass and candidates got their money from the state, their game would end overnight. The democracy would rein the abuses in, appoint professional directors, and that would be that.