Unconstitutionalcare

You say that as though you need to see the movie.

 

Yeah, I'll walk to the grocery store to get my week's worth of groceries. Carry them on my back home. Yay, no gasoline!

 

Businesses do and should set prices according to the market. Or else they won't be businesses for much longer.

Do you think that gas stations should lower their prices out of ... what? ... sheer altruism?

 

Just pointing out the utter ridiculousness of "who is making you buy gasoline?"

 

Are health costs a result of the market? There are only so many insurance companies in each state. Why are there only state-based markets?

 

When prices soar, though, we buy less gas. Every time.

 

The short answer is yes.

This conversation comes up again and again on here. If you are waiting for businesses to lower their prices below market rate, you might as well be waiting for Godot. And if it angers you that they don't, you might as well be angry about oxygen or water. It's wasted energy. Wasted and misdirected.

If you think there is a market failure going on, identify it and explain why government should correct it. Example: The mandate. There is an identifiable market failure in insurance and the mandate is the fix.

 

The very existence of health insurance, by the way, is a market failure of sorts. The reason prices soar is largely due to the fact that people order up more health care than they would if they actually had to absorb the costs themselves. Things like deductibles try to curb it a little bit, but never all the way.

 

That doesn't make gas a friggin' luxury item. And gas prices don't automatically drop upon less demand; there are complex geopolitical issues that largely control that, so that's not the best example. People will still drive to work and for groceries, but may not make that cross-country drive. Of course the cumulative effect of millions of people doing that further picks at the economy and makes other sectors suffer.

And health care should not be subject to markets. It should be a government service, absolutely.

 

But it's a finite resource, like anything else. There would have to be rationing of some sort. Are you OK with that? (I am.)

 

Just to toss in a little medicine...

People present to their doctor or ER with the complaint of abdominal pain. The diagnosis of appendicitis may be made clinically and/or by imaging. CT or ultrasound are viable options. Each has its won benefits and limitations.

Once the diagnosis is made, surgery may be a treatment option, though some European studies suggest that aggressive antibiotics may be a viable alternative. That said, the diagnosis of appendicitis is usually followed by a surgical consultation. These are usually done urgently and if your appendix is inflamed off hours, then likely you are stick with the surgeon on call for your hospital. In some small towns there may only be one surgeon available...ever. If you don't like the surgeon assigned, you do have some time to request an alternate, though this may engender some animosity. It implies lack of faith in the skills and abilities of that surgeon. Unless, the patient has a "history" with the surgeon, the conflict usually arises because of poor communication between the two parties.

This is also not a time to price shop since the price of care is likely determined by the patient's insurance status as predetermined by price schedules agreed upon in advance (this is especially true with Medicare and medicaid patients). Thus the price does not reflect the cost of care but rather a complex formula that is individualized for each hospital depending upon their payer mix. If there is significant charity care provided and if ther is a high percentage of Medicaid patients whose reimbursements often do not cover cost, then teh remaining patients will be billed more aggressively to cover the overall shortfall.

Please be aware that there is an unfunded federal mandate contained in the EMTALA legislation (Emergency Medicine Treatment and Labor Act) informally known as anti-dumping, which requires a hospital to evaluate and stabilize patients to its full capability before discharge or transfer. This is a fine law that codifies the ethics of emergency care but unfortunately demands significant efforts to meet the standards. The law as written is relatively short but there are numerous accompanying regulations from the Office of the Inspector General that require mpst hospitals to have an employee specially versed in EMTALA.

 

There already is rationing, only it's by the insurance companies.

They refuse to pay for something, so the patient either goes without, tries for some charity care if possible, or ends up bankrupt and in a cardboard box.