Let’s examine the different possible economic models:

1. Free market.
Doctor
Patient

  • Doctor and patient deal with each other directly.

2. Third-party payer in free market.
Doctor
Insurer
Patient

  • Doctor and patient each make a separate private contract with an insurer to pay for services.
  • Patient is happy because it looks as if HIS costs are lower.
  • Doctor is happy because he is sure to get paid.
  • Insurer pays 97 cents out of every premium dollar directly to provider (per Blue Cross ad in early 1970s)

3. Third-party payer in regulated market.
Doctor
Federal medical regulatory bureaucracy
State insurance regulatory bureaucracy
Insurer
Patient

  • Congress and states pass laws, regulators set and enforce standards for everything.
  • Patient is happy because it looks as if HIS costs are lower. Not as low as before, but….
  • Patient is less happy because sometimes insurer or government denies coverage.
  • Doctor is happy because he is sure to get paid. Not as much as before, but…
  • Doctor and insurer are less happy because of huge increase in compliance costs.
  • Congress has to pass law requiring that insurer pays at least 80 cents out of every premium dollar directly to provider.

4. Obamacare.
Doctor
Federal “exchange” bureaucracy
State “exchange” bureaucracy
Federal “death panel” bureaucracy
Federal medical regulatory bureaucracy
Hundreds of obscure ill-defined federal oversight agencies
State insurance regulatory bureaucracy
Hundreds of obscure ill-defined state oversight agencies
IRS, DHS
Insurer
Patient

  • Tax preparers, accountants, lawyers and other useless paper pushers are happy for all the new work.
  • The poor are happy because it looks like they get free care.
  • Doctors are unhappy when a bureaucrat tells them what course of treatment he can and cannot prescribe.
  • Doctors are unhappy when a bureaucrat tells them what little they will get paid.
  • Doctors are unhappy when they are driven out of their profession.
  • Taxpayers are unhappy because they are hit with dozens of huge new taxes.
  • Insurers struggle to keep state-mandated pay-outs to providers at 75% (break-even is at 72%).
  • Patients are unhappy because they are forced to pay huge new “health insurance premium” tax.
  • Patients are unhappy when the “death panel” limits or denies them the care they need.
  • Patients are unhappy when they can’t find a doctor.

Gee, do you think THIS is the path to CHEAPER, BETTER health care? On what planet?

Of course, the skyrocketing bureaucracy or the lack of competition are never blamed for the rise in costs. No, they blame defensive medicine (which they have to do protect themselves from  trial lawyers and exorbitant malpractice insurance rates), and the “excessive” use of hi tech tools, and care “wasted” on the terminally ill. They cite CT, ultrasound and MRI as examples of hi tech excess, blithely forgetting that in a previous time not so long ago, people used to undergo “exploratory surgery” just to let the doctor see what was wrong. Which is more expensive, an imaging machine or the OR and the ICU?

See also  
The True Cost of Healthcare
National Center for Policy Analysis
Obamacare and the vanishing medical miracle | The Daily Caller

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