Bitter Pill: Why Medical Bills Are Killing Us

I'm not sure if some of that was supposed to be irony. In terms of healthcare, the government pays almost half of the cost of providing care in this country. Not only does it give massive tax breaks to employer provided health insurance plans it also directly writes the regulations that govern almost every aspect of healthcare. In a sense, the government is already running your healthcare if not outright paying for it or compensating the hospital then running the system that provides or incentivizes the structure of the health insurance plan you have.

Libertarians, who would have you believe we should be free to do just about anything, fail to recognize that without a framework that defines acceptable behaviors, the social situation will quickly degrade into a free-for-all survivalist state not unlike parts of the world where the government has collapsed completely.

You can argue that the rules are too strict or too lenient, but arguing against rules period is insanity.

Also there is not the separation between provider and payer which results in providers angling for the most expensive treatments, only forced down by a payer who regards the patient as an unwanted liability. (This has been partially subverted in the British NHS by ill advised privatization.)

There's numerous examples in this article about how Medicare pays more reasonable prices for things than anything billed out to consumers.

Insurance companies often get the same sort of deals, but they certainly don't pass on the savings.

The NHS does approve experimental and innovative treatments, and it does treat rare conditions. It also chooses whether to offer, or not offer, expensive new drugs. This, again, is democratically accountable - if it refuses a drug that is widely seen as life saving, the tabloids will pressure the politicians into turning up the heat and forcing it to change course. Also there absolutely is an incentive to specialize; the NHS pays a doctor's salary, so (provided it's willing to hire them) they do not have to pick a specialty that's profitable.

Moreover, the NHS, being free at the point of delivery, is willing to take on expensive treatment of poor people. In Britain, the idea that someone might go untreated perhaps for years for a quickly treatable illness, because going to hospital would bankrupt them, is seen as abhorrent and barbaric.

Ill health strikes randomly without regard to wealth; health of everybody benefits everybody. Therefore, everybody should pay according to what they can afford, everybody should be covered according to what they need.

Doctors here in Canada can still be sued for malpractice (and with few exceptions, doctors are NOT employees of the government; they are independent contractors), so that entire line of argument is bogus, like every single American argument I've ever heard against a true universal health-care system.

There are dozens of universal healthcare systems to study and implement against. Most are single-payer (France, the UK, Canada) but some are based on heavily regulated mandatory private insurance (Germany and Switzerland, IIRC; I could be wrong).

In every case, the government says "this is the price that you are allowed to charge for service X", which is based on cost-to-deliver plus a reasonable overhead (like the Medicare price in the U.S.).

Eliminate the for-profit healthcare crap like was described in this article and most of the American overspending on health services goes away. Not all of it, but most of it. As a side-effect, the health care system will become more efficient and could finally become an effective partner in providing health security (both for individuals and for the nation; having a functional health care system is arguably important for national security in an age where biologicals are a fear).

Anyway, the US would probably benefit from a hybrid system: government provided baseline care with option to purchase private upgrades.

Preventative medicine is the most cost-effective, which from a profit perspective is the worst possible thing. If you want your for-profit hospital's revenues to go up, what you need is lots of critically ill patients.

You don't just get a group of skilled doctors together and say, "let's make our own hospital!"

Rent-seekers + regulation agencies = regulatory capture = barriers to entry = no competition.

Insurance companies negotiate rates with hospitals/doctors/etc. Medicare _dictates_ rates which providers can either accept or reject.

The reason the Medicare cost of an Xray is ~$20 is because it was decreed to be that expensive. It has no bearing on the cost to provide the service since the hospital had no input in the reimbursement decision.

You can search and easily find reports about how doctors restrict the number of medicare patients they see because the reimbursement rates for care are too low.