The medicare underpayments are why so many doctors will not accept medicare patients and why private insurance "supplementing" medicare is essential (both of which Elizabeth Warren and the rest of the "medicare for all" socialists demand be prohibited as part of their plan to eliminate and nationalize private insurance and medical care).

Check your major premise. Health care is not a "right". No reference to health care can be found in the Constitution. The closest we can get is in the Declaration of Independence
preamble....."unalienable right to life, liberty, and the pursuit of happiness".

I tend to agree with term2 and DrZ. The sweet spot for changing healthcare is slightly offset from your question: Posting prices allows a lower granularity of consumer choice - little decisions made by individual people to meet their own needs. With obscure pricing, you are 'buying' a black box of medicine. If you know what each part costs, you at least have the ability to select what you want and where you want to go. Without the prices, you do not have that information as a tool to use.

Jan

I have three examples of how to have low prices and good outcomes:
1) The Surgery Center in Oklahoma City posts all of its prices for surgical procedures online. The only kind of insurance it accepts is that of a self insured corporation, cutting the government and insurance companies out of the process

2) Direct Primary Care, where the patient is a subscriber, paying a monthly fee directly to the physician for basic care. The fee covers non-surgical outpatient treatment, vaccinations, physicals, and related tests. Often the physicians will offer prescriptions at their cost, which is often less than the copay under insurance programs. Fees run from $50-250 per month, depending on the location and services offered.

3) Reimbursable catastrophic insurance coverage, to cover hospital and surgical costs paid by the patient. Hospitals and surgeons will frequently offer special lower cost to the patient for saving them the burden of dealing with insurance companies.

My wife needed a hiatal hernia operation. I called the doc, $1800. I called the hospital, $10-$20,000, Found a surgical center in Billings, whole thing, $4800.

The obvious fallacy here is that healthcare is a right, but we all know that. Any simple, objective analysis can demonstrate this simply by taking any sick person and asking who must be compelled to give up their time, expertise, and resources in order to support that "right." This is also demonstrated in the hypothetical four situations, but I'll throw in a twist.

Capitalist society:
1. Outcome is going to be largely based on resources (equipment, medicine, facilities) which are expensive. I think it is reasonable to assert that level of care is going to be largely analogous to resource allocation. As resource allocation is largely going to respond to typical market forces of supply/demand.
2. Costs will be analogous to resource usage but with a premium for physician expertise.
3. Resource availability will largely adhere to capitalist principles - primarily scarcity and cost of exploitation. Intellectual property laws (patents, etc.) may also factor in.

Socialist society:
1. Outcome is going to be based on artificially constrained and undervalued resources.
2. Costs will be and abstracted from those who utilize the service, resulting in higher overall costs and burden-shifting.
3. Resources - especially expertise - will divert elsewhere, further constraining a critical supply.
4. Demand will increase due to lack of market feedback regarding cost of service.

Of these two scenarios, only the first has a chance of being stable. The second must necessarily snowball out of control due to the inherent feedback mechanisms.

govt health care is slavery and not a right...your premise is false...end of discussion...

hospitals are businesses and try to get as much as they can. They also are forced to get NOTHING when they pay for homeless and indigent care. They also have to negotiate that $12k number down substantially when insurance companies or medicare or medicaid are involved.

I would not want to run a hospital and try to keep it afloat.

When I go to my PCP who charges $206 for a visit, he actually gets less than $26 from medicare- regardless of what he bills.

Why not let the free market decide how things work out? Providers and patients can pick and choose what they want. Medical care is definitely NOT a right, since its a service that someone has to pay for if the patient himself doesnt pay for it.

You would have to see an itemized bill for the procedure and all the ancillary work and expenses involved to see where the $12k went. That's how I discovered the hospital aspirin cost $150 in my narration above.

Right you are, FFA! OMG the old neurons really messed up that one! I'll try to be more careful next time. Thanks!

At least I recalled the ambulance chaser part right, LOL!

If healthcare is a right and I need a heart transplant, whose heart do I have a right to?

John Edwards was (and is again) an ambulance chaser attorney who won lots of insurance money in NC, not GA. I'm sure there are examples in GA, too, though.

Yes and yes.
It is worse than in your first post.
It may be assumed that your children are capable and hard working (let them deny it).

A lot will be expected from them, then it will be demanded.
Then they will look round and see those less capable,
and certainly less hard working living well, but consuming what others produce.
They will look round again and decide to shrug, it may be too late,
the power structure has been set, the swamp entrenched.
It won't last for ever but unlike in AS, history tells us it can take decades for collapse.

"When life vs death is part of the equation, can market forces be adequate to balance supply and demand? " The problem in that scenario is nothing is adequate. Eternal life and good health is currently outside the realm of man.

"When the negative feedback connection of service and payment for service is broken demand for that service increases without limit. Insurance reduces the feedback to near zero." It's not only demand, but the price of the service goes out of control as well. Here's some real life examples:

1) Decades ago my employer, who was a major employer in my area, did not offer dental insurance and a standard clean and polish was about $22. Then my employer, rather than giving us all a raise that the IRS would cut into, gave us a "free" dental plan. The plan would pay up to $22 for a clean and polish. Sure enough, within a year a clean and polish cost $44, of which $22 was from the insurance company and $22 from a patient copay. Several years later, the insurance covered up to $44 and sure enough a clean and polish bumped up to $80. The same applied to other dental procedures.

2) Right down the street from the hospital where my father-in-law had to stay for a few days is a Dollar Tree where you can buy a small bottle of aspirin (or other NSAID) for a buck. The hospital had strict rules against anyone bringing their own medication so the Dollar Tree as an inexpensive NSAID source was out. However, the hospital administered an aspirin tablet each day and billed the insurance company $150 for the pill. No copay required.

3) The legal system maintains an enormous cash flow from suing the hell out of the health care system. Don't worry, insurance companies carry the load. Remember the famous $500 haircut for John Edwards? He made his fortune sucking the fat moo cow of the health insurance industry in the state of Georgia. The blue collar worker in Atlanta paid his/her $500 monthly insurance premium, but Johnny boy got his hair cut before the worker got an aspirin. Did you notice the big elephant missing in Obamacare was tort reform?

You are so correct, FFA! The entire feedback mechanism is broken. How to fix it seems to be above my pay grade, but I know "it ain't right" in a lot of ways.

Agreed. Socialists would have us irrationally believe that government programs can revoke human nature.
Grass-root Socialists feel that government can fix any problem regardless of how irrational the solution. Socialists in power know better but they are sociopathically addicted to power.
But I asked the question in search of a workable solution.
I don't have one, but I know that forcing the young and able to pay a fortune for insurance that they do not need (and thereby increasing the costs of medical care) is the wrong answer. It only works to enrich those who provide medical services beyond their value, while taking funding away from other more immediate issues including research to solve the medical problem of aging itself. If everyone is given a blank check to keep their loved ones alive for a few more years the demand for that service will exceed supply and foolish waste of resources must occur.

Freedomforall. “When life vs death is part of the equation, can market forces be adequate to balance supply and demand?” This is the question of our time. Socialism’s answer has failed every time. Free market capitalism works, but is not based on emotion or defined Rights and will lose the vote on this issue....and the camel of social justice sticks his nose under the tent...and around and around we go....

John Galt’s presentation at the 20th Century Motor Company goes into many more precise reasons and scenarios that occur long before the needs outweigh the means.

When the negative feedback connection of service and payment for service is broken demand for that service increases without limit.
Insurance reduces the feedback to near zero. Must health insurance coverage be limited by law? When life vs death is part of the equation, can market forces be adequate to balance supply and demand?

When my millennial children and their like propose the Marxist mantra, “From each according to their means. To each according to their needs”, I always respond, “The needs are infinite. The means are not.”

Mccannon01. The “given” of healthcare as a right is a conscious attempt to direct (skew?) the requested analysis. As I also stated, the given may not change outcomes anyway. Your supply and demand observation is on the right path!

One of the problems with healthcare provision no one discusses is, for the most part, everyone wants 100% good health and live forever. This places an infinite demand on a very limited resource.

"Let it be given that healthcare is a Right." False given that skews and falsifies any discussion. Health care is not a right nor can it ever be. It is a privilege that has to be created by man. It isn't "endowed" by anything.

Nicely expressed, AMeador1.

"I saw a news item today about requiring hospitals to disclose prices"
My understanding is this was a campaign promise from President Trump. Someone in the administration has a brain and kept the promise. Hospitals buried it in hard-to-read tables. The gov't, I think due to another initiative from the Trump administration, made them make it more clear. These are very good steps.
https://www.galtsgulchonline.com/post...

Here are my guesses about how a gov't plan would compared in the short run:
Compared to Medicare: similar prices and similar outcomes
Compared to a free market "non-system": way higher prices and worse outcomes, except for people who have treatable conditions they can't afford to pay for
Compared to HMOs: similar costs, similar outcomes
Compared to PPOs: lower costs, slightly worse outcomes

In the long-run, the gov't plan would have worse outcomes compared to all of these due to less incentive to develop expensive innovations for early adopters. I'm sure Senator Warren has got a plan for that, but no central plan can substitute for large numbers of suppliers and consumers making little decisions for themselves.

I say most of the plans have similar outcomes not b/c the gov't would do a good job managing people's healthcare, but because people are smart. People will wisely work the system to get the things that they can from it and go around the system for everything else. The system would save the lives of some who wouldn't have their act together under freer systems and might take the lives of people who can't find away around the system. But many people find their way around the gov't, as they do in buying recreational drugs, sex, and undocumented labor.