I guess I'm okay with costs increasing if it means the quality of care is increasing and it's going to care providers not to shareholders. That's the implication of a non-for-profit, that all costs go back into employee salaries or equipment overhead. I'm okay with a good medical team making bank or with pricier but stellar facilities justified by results. I'm sure no system is perfect, but if we'll get the same results removing the profit motive, why not eliminate that potential conflict?
> Where we screwed up is in making "insurance" cover minor procedures that really ought to only cost tens to hundreds of dollars out of pocket, because then the insurance causes those costs to balloon up to thousands by providing a deep pocket that can fund excessive bureaucratic inefficiency. (It also doesn't help that the AMA engineered a doctor shortage so now doctors are overworked, patients are less informed and prices are higher because of supply and demand.)
This is 100% true and concurs with complaints I've heard from doctors (both bits, the broken model and artificial doctor shortage). Insurance isn't the right model for baseline healthcare. People should be willing to pay for routine care like they pay for anything else (food, TV, movies, games, etc.). It should cost $30 to get a physical because it takes a doctor 15 minutes, not $300. Insurance should kick in for absurdly expensive "disaster scenario" procedures that nobody can be expected to afford.
> I guess I'm okay with costs increasing if it means the quality of care is increasing and it's going to care providers not to shareholders.
Shareholders aren't some distinct group. One of the big "providers" of MRI machines is General Electric. Are the shareholders of that conglomerate more honorable than the shareholders of some insurance conglomerate?
Somebody is the beneficiary of any given inefficiency and they're the bad guys regardless of what kind of labels you put on things.
> I'm okay with a good medical team making bank or with pricier but stellar facilities justified by results.
The "justified by results" thing is the whole problem. What do you want to do when the system is pricey but the results are still mediocre?
> I'm sure no system is perfect, but if we'll get the same results removing the profit motive, why not eliminate that potential conflict?
If you set up the incentives in the same way (e.g. by making non-profits compete for customers) then you'll get similar results, but the existing system is bad. The problem with that is we need something better, not something the same.
And it's not impossible to end up with something worse, e.g. a non-profit with no competition that allowed healthcare costs to go up when we need them to go down because people can't afford the cost as it is.
> People should be willing to pay for routine care like they pay for anything else (food, TV, movies, games, etc.). It should cost $30 to get a physical because it takes a doctor 15 minutes, not $300. Insurance should kick in for absurdly expensive "disaster scenario" procedures that nobody can be expected to afford.
There is a case to be made that it should cover an annual physical and routine diagnostics, because early diagnosis lowers costs and you don't want people to skip their checkup to save $30 and then need a $500,000 heart transplant that could've been prevented with a $5 bottle of pills.
What it shouldn't cover is e.g. most prescription medications, because then the $5 bottle of pills goes up to $500 when the insurance is covering it, or patients request $5000 patented drugs that aren't materially better than $5 unpatented ones but the patented ones have better marketing and they stop caring about the cost when the insurance is paying.
That was how we got the "people can't afford insulin" problem IIRC. Insulin isn't patented but there was a patented form of it that was somewhat more convenient, which everybody with insurance gets. There weren't enough people without insurance to justify anyone making the generic stuff anymore, so the super expensive patented stuff was the only thing available, which the minority of people without insurance can't afford.
> Shareholders aren't some distinct group. One of the big "providers" of MRI machines is General Electric. Are the shareholders of that conglomerate more honorable than the shareholders of some insurance conglomerate?
I wonder what it would look like to mandate that suppliers must also be non-for-profit. Companies would all have to spin up non-for-profit divisions (if they don't already have one) and sell to hospitals through them. I imagine it would be massively disruptive in the short term.
Anyway I agree that healthcare should be competitive regardless of whether it's for profit or not.
My wife and I just looked into genetic testing for our child-to-be and Natera bills insurance multiple thousands but only charges people $250 or so if you pay out of pocket. The hilarious part is they bill insurance so much that it would have cost us more to have them bill insurance ($650 would have been our cut of the like 3-6k bill) than if we had done it out of pocket. Ultimately we didn't do it at all because the whole thing seemed sleazy. It's just so fucked up.
> Where we screwed up is in making "insurance" cover minor procedures that really ought to only cost tens to hundreds of dollars out of pocket, because then the insurance causes those costs to balloon up to thousands by providing a deep pocket that can fund excessive bureaucratic inefficiency. (It also doesn't help that the AMA engineered a doctor shortage so now doctors are overworked, patients are less informed and prices are higher because of supply and demand.)
This is 100% true and concurs with complaints I've heard from doctors (both bits, the broken model and artificial doctor shortage). Insurance isn't the right model for baseline healthcare. People should be willing to pay for routine care like they pay for anything else (food, TV, movies, games, etc.). It should cost $30 to get a physical because it takes a doctor 15 minutes, not $300. Insurance should kick in for absurdly expensive "disaster scenario" procedures that nobody can be expected to afford.