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Health Care is not Like Buying a Car

Rant for the Day:

I prefer buying a car by comparison shopping and then selecting the dealer who gives me the best price. But a classic dealer tactic is high-pressure negotiation in which they push the buy-now special to keep me from comparing prices and included accessories elsewhere. How frustrating to buy a car and then find your neighbor bought the same car from the same dealer the next day for $500 less. Dealer invoices don't help, because they don't show dealer incentives and rebates. Neither do they show the influence of the bank that actually owns the dealer's stock.

If you think that buying a car is complicated, consider buying healthcare.

Despite claims to the contrary, IMHO, you can't reliably comparison shop hospitals and doctors. You may put off buying a car for a week while you compare prices, but that emergency bypass is not likely to wait. Moreover, surgeons and hospitals don't have the brand-name consistency of Ford or Toyota. I've yet to see a hospital procedure that came with a sticker price.

Looking over the hospital bills for my sister-in-law, I notice that the hospitals billed insurance for more than a half-million dollars, but the private insurance "negotiated" the price down to about $80K: Obviously, a disconnect in what the services are deemed to be worth even more spectacular than car prices. After the negotiation, I don't deny that money was still made by both organizations, but I sincerely don't believe (See SCOTUS recent decision on sincere beliefs) that much of that money went to doctors and nurses.

Making huge profits on healthcare has evolved from being a dysfunctional nuisance into a diseased system. Why can't we have a sanity? Because corporations who benefit from the current system like to stir up fear and resentment like "you can't see your own doctor" or "someone undeserving might get medical care."

If you don't want to pay for another person's hospital visit because you don't approve of that person, then #1. You don't understand the way insurance works either, and #2. Shouldn't you worry that others with more influence might likewise disapprove of you?

Some physicians have come out in favor of a single payer plan. I agree. It is a sensible way to control costs, something the other schemes are incapable of doing. It doesn't encourage insurers to profit by denying me coverage, but then I'm distrustful of a profit motive for healthcare when it is virtually impossible  to comparison shop. Besides, it makes actuarial sense to require that every one is covered and everyone pays.

On the downside for politicians, a single payer system eliminates a large source of campaign funds from private insurers and other special interest, and perhaps that best explains the fiery rhetoric in Congress against any such a plan.

I don't mind if a single-payer plan is bare-bones (excuse the pun) and allows those who wish to add "premium" coverage from private insurers:that's pretty much how Medicare works now.


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