Monday, September 28, 2009

Here's how to make health care affordable 

All sorts of ridiculous ideas are being thrown around, but no one is mentioning the easy and obvious fixes. What we really need to do to make health care affordable is:

1) a) Stop letting hospitals charge $2 for an aspirin; only allow them to mark up physical goods by 10% rather than 10,000%.

b) In the same vein (pun intended), allow only the same sort of markup on the actual costs of occupying a hospital bed. Even adding to the cost of the area you're occupying as a fraction of the total hospital property (on which the hospital pays mortgage, insurance, taxes and upkeep) the electricity, TV and water you use, a laundry fee for your linens and so on, it's not costing them $2000 a day to have you in a bed eating 3 terrible meals and having a nurse glance at you every 4 hours... it doesn't even cost them $200.

c) And then extend this radical idea of hospitals only earning a modest profit on the goods and services they provide to everything else; tests, surgeries, therapy, etc. Think how much lower insurance premiums could then become, making insurance far more affordable.

2) End the practice whereby hospitals pretend to be giving insurers a 95% discount by creating ridiculous false prices for things that the uninsured then actually get charged; make the maximum discount 5%, and, since the actual prices to the insurers would have to remain the same to keep their business, the false prices would have to be radically reduced, and thus the uninsured would be charged a tiny fraction of what they're charged now.

3) Just as your auto insurance doesn't cover routine maintenance, health insurance shouldn't cover routine doctor's visits; as a bonus, this would prevent the over-using of medical care that always happens when it costs little or nothing to go to the doctor, which is a serious burden on the medical system and costs a bundle. It would be FAR cheaper for you to pay out of pocket to see the doctor once or twice a year for routine physicals than to have insurance premiums high enough to cover the possibility that you'll go to the doctor for every cough and cold.

The one thing we should NOT try to cut is what doctors get paid, as this has been repeatedly shown to lead to shortages of doctors; after all, a big part of the reason to go through all the time and effort to become a doctor is to make the big $, and it turns out that there just aren't enough people willing to do it for pure humanitarian reasons. In addition, lower fees for doctors means that our best and brightest will be more likely to turn away from medicine and embrace other disciplines, where they can earn the $ they deserve. When your life is on the line, do you want the smartest people in your city to be treating you... or working at the law office down the block?

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