The OPINION based here is that cost controls must be established for healthcare services provided to sick individuals in order to prevent potential financial ruin for individuals diagnosed with illness.
The absence of effective cost controls in the healthcare reform dialogue creates an overly complex, ineffective dance between insurers and consumers and governments regarding how to achieve the goal of healthcare accessibility for Americans through affordability.
Current dialogue about controlling costs is pinned on consumers who are left to weigh their potential health needs in a strange kind of crystal-ball analysis that has left many consumers gambling against paying for any insurance at all to those who latch onto embracing preventive care in an equally weird anticipation that with preventive care their healthcare needs will be minimized because after all, they’re getting checked out all the time.
Those left out of current cost-control logic are those with a diagnosed health problem who need medical attention and are likely to be unable to afford it.
Remarkably after all is said and done the result of bickering among politicians, (who have the benefit of higher incomes than many of those for whom they’re lawmaking as well as the benefit of their civil servant insurance coverage which is far better than most insurance those outside of civil service have access to in terms of costs of premiums as well as extent of coverage) individuals facing the crisis of illness are in just as bad a position as they were before all the blustering.
Financial stress and financial ruin is caused by amounts of medical debt assigned to the sick that would make any but the richest among us gasp at the sheer dollar amount. Yet, discussion of controlling medical costs, the amount charged by healthcare providers for the performance of their jobs is an untouchable target.
Today’s healthcare costs have to be controlled, the cost of the services and medications required to address illness. Everything else is an unworkable attempt to distract from the fact that insurers don’t want to pay for the prices being charged for healthcare and consumers cannot afford to pay for the prices being charged for healthcare.
There can be no healthcare reform with a continued game of chasing affordability as healthcare providers pursue unfettered increases in healthcare costs charged to individuals and insurers. All that can be accomplished from this chase is that thresholds get raised as insurers and consumers somehow try to figure out how to pay more and providers continue increasing costs.
It is stunning to read the bulk of argumentation, research and justification by government, insurers and healthcare providers who significantly omit the real issue in healthcare which is how sick people can get treated without going broke. The distraction caused by these three stakeholders as they persuade, buy and justify the reason they each should have more say and power and money is obscene when compared with the devastation caused to individuals from the cost of trying to get treatment for illness.
The free market argument needs to be put to rest not because it’s a bad idea but because there is no free market economy in our biggest industries that spend billions lobbying, advocating and pushing for governmental legislation that makes them richer. Like the banks, medical lobbying and advocacy and participation in government is a fact of life whose beneficiaries use “free market” as a means of distracting and exploiting those who don’t consider how hypocritical it is to argue free market as governmental tools are used to create favorable market conditions for their business.
The costs of medical school are no longer a justification for giving healthcare providers a pass on the prices being charged for medical care. Statistics about the quantity of educational debt being carried by recent college graduates indicates that many people are graduating with debt whether they attend medical school or some other degree program.
Using current fee schedules established by the Federal government for Medicare payments, there should be established rates for physicians and other healthcare services that cannot exceed a specific percentage over the amounts determined by the Medicare standards.
This IS government interference in the free market much as the legislation lobbied for by the AMA and others IS governmental interference but this governmental interference addresses a broader-base of the citizenry than the specialized laws passed to protect specific industries.
Such an approach would address the problems from widespread determination of fees regarding the provision of medical services that seems to amount to and qualify as price-fixing in any understanding of that term.
The next dialogues about ending lifetime limits on health insurance coverage will bring the problem of (which will apply to insurance companies for “essential health benefits “not yet completely defined for section 42 USC 18022) uncontrollable costs to a head again because the removal of the lifetime cap will be at different levels ranging from 60 percent coverage at the “Bronze” level to 90 percent coverage at the “Platinum” level.
While a win for consumers vis a vis insurance companies, without price controls individuals in need of medical care will still face financial ruin because they will remain responsible for 40 percent of costs at the Bronze level and 10 percent of costs at the Platinum level and with no limits on what can be charged, for healthcare providers the sky’s the limit.
