Occasional thoughts, sermons, parables, and rants from a Constitutional Republican who is sick of Progressivism in America.
13 May 2009
The Solution to High Healthcare Costs
Competition.
"But," you say, "there is competition already! We are free to choose whatever provider we want to see." Are you, really?
If you are not self-employed, it is likely that your health insurance is provided as a benefit of your employment. It is likely that your policy has a list of providers contracted to provide services at an agreed price. The phrase "usual and customary" really means "the price that the insurance company agrees to pay and the providers agree to accept." In other words, all the providers available to you effectively charge the same price. There is no competition there.
To bring true competition back to the health care marketplace, I propose as a first step that we do away with employer-provided health insurance. Insurers can still offer group plans, including some like the so-called "affinity" plans for social clubs, university alumni, and the like. People can choose to join one of those, or buy an individual policy as some insurers are offering now. The differentiators would be in what is covered and the limits.
To improve those options, I propose that we strongly discourage, if not prohibit, the price-fixing that is now called "usual and customary charges." In fact, I think price-fixing is illegal, and that is precisely what this practice constitutes. People could then shop around for providers they like that charge affordable prices. I realize that many people, especially younger people, make so few visits to the doctor as to make this difficult to do. Sure, one could ask prices over the phone, but that's only part of the story. Talking to friends and coworkers could help, or even referral services.
Please comment on this. And I hope you'll send all your ideas (they must be better than this) to your Congress-critters.
Labels:
healthcare,
insurance,
scam
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I promised to comment. My Dad's a doc, and so is my brother. They are fervently against the insurance companies telling them how to practice medicine and then making them flip cart wheels to get paid a measly fee. The insurance companies are not doing a service to the patients, nor to the health care providers... thus they must be doing only one thing... making money for themselves. Dad says "self provided health care savings plan" is the best route to go. Personally, I was in a position years ago when my husband needed hospitalization for months and rehab after. If we'd not had full coverage we would have been bankrupt! The answer? I don't know. I do know it's not working now. Good to bring the discussion up! Let's get some folks in here to give their ideas for solutions!
ReplyDeleteWarmly, Arleen Anderson
The Usual and Customary Rate (UCR) charts are an abomination. Yes, they reflect the limitations that the insurance Company sets, but they are also used to combat Price gouging by the provider. This can range from overpriced/unncessary dental work to overpriced glasses, etc. Both these area have potential for unscrupulous gouging. I know, I work in benefits.
ReplyDeleteI know, and I agree, that the insurance industry has been a major factor in the insane escalation in Healthcare costs, and that's reflected in the UCR tables.
I'm fine with getting rid of the UCRs, but that alone wont solve the problem. Reform how the insurance industry is run and there will be no need for the UCR debacle you decribe. Eliminate the cause, not a symptom.
@Vinylmike