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This highlights a fundamental difference in how governments regulate healthcare. In most countries, regulation is designed to protect the public interest while giving manufacturers and pharmaceuticals a fair profit. In the USA, driven by corporate lobbying, regulation is designed to protect corporate interest at the expense (literally) of the public.
As it relates to healthcare, the American Hospital Association, Big Pharma, medical equipment manufacturer lobbies and politically appointed state insurance commissions that create and enforce 50 sets of unique laws and regulate insurers combine for the most costly healthcare in the world.
I doubt very much that they are losing money, at any point in the process. But when confronted with the exorbitant costs that Americans pay, one of the refrains is that the money goes to research and development of new and better drugs. Which Americans pay for, and consumers globally enjoy. Subsidy. It makes one wonder, how did Pasteur and the Curies manage?
And more pointedly, before the model became so focused on profit, research and development seemed to have been more about developing CURES and less about developing TREATMENTS that let you live with the disease.
A lot of drug research is 'for profit' and is bankrolled by risk capital rather than by the major Pharma companies.
So you get a company like Dendreon which was formed to develop a prostate cancer drug which is called Provenge. They develop the drug and get the approvals, etc. The risk capital is rewarded when the value of the shares goes up (if it goes up).
The company is then usually acquired by a major Pharma and the founders get bought out and make a lot of money. Big Pharma acquires the patent and then can sell the drug at a large profit for the life of the patent. Big Pharma are no longer taking the risks. Those risks are in the risk capital. Investors are not necessarily Americans. They can come from all over the world.
Originally, pharmacological research was done in the Universities. That transitioned over to Big Pharma from the 1960s onwards. The transition to risk capital has been from the 1990s onwards.
Both COBRA and ACA provide for that. How old is this suggestion?
COBRA is likely the least used mandated benefit, because it is exclusive of the employer subsidy at a time when the former employee is least likely to be able to afford it.
Wow, give seniors a fixed amount to find and buy insurance on their own? That's a death panel approach. Kick granny to the curb and it's her fault if she can't get affordable insurance in her '80s or they cut her off when she gets too expensive?
Medicare was created because private insurers refused to insure the elderly.
Now over in Switzerland, everyone is mandated to buy a prescribed baseline of insurance, including seniors. The concept of employer subsidized group health insurance does not exist. The Swiss are risk adverse by culture and 99% of the people comply with the law. 40% receive a government subsidy.
The big difference is that in Switzerland most hospitals are owned and operated by government. The Swiss negotiate the price of prescription meds. The Swiss healthcare system ranks in the top 5 on a global basis while the U.S. is #34, wedged between third world nations.
If all seniors are in the market with a certain dollar amount, the insurers will be incentivized to compete for business. I wouldn't expect you to get this because I'm sure you've never set foot in a business class but if the insurance companies pool of paid premium is high, they're offset won't really mean a lot. Competition creates favorable conditions for the CONSUMER...not the provider.
In markets with competitive healthcare systems, hospitals and MDS compete for Medicare business, their bread and butter.
With regards to point 3...I think they are talking about PA's and NP's primarily. Naturopaths are trained medical professionals, just not in conventional medicine. And I get the point you're trying to make but obviously people with their head gashed open from a car accident aren't looking for an accupunctrist or a naturopath. However, these practicioners are great for chronic pain which is billions upon billions of dollars annually for sufferers. These practicioners often charge OOP as opposed to through claims which inject a market mechanism...thats why their treatment is inexpensive. My neighbor's wife is a Naturopathic Physician and she has a large client base and makes a good amount of money all through alternative treatments that are quite popular. Eastern based medicine and dietary plans have existed for thousands of years and it's popularity has survived for a reason.
With regards to points 4 and 5. It may have been rejected in that Romney/Ryan lost the election but it has proven to be a great cost saver without damaging treatment availability. Look at the period during Gary Johnson's governorship of New Mexico. Read the reviews on Medicaid block grants in NM and their successes.
Oh, no they're not talking mostly about NPs and PAs. Here's a quote: midwives, naturopaths, chiropractors, and other non-physician medical professionals Now there are nurse midwives, and there are direct entry midwives; the former are basically NPs, the latter are not, and can have any education level. In regards to naturopaths, read this: A Close Look at Naturopthy
Here's some information about chiropractic. Traditionally, chiropractors have believed that all health problems can be traced to the spine, and have opposed immunizations, as well as other interventions. Chiropractic controversy and criticism - Wikipedia, the free encyclopedia
Some insurances currently pay for chiropractic care.
What other non-physician "medical" professionals are they referring to?
If all seniors are in the market with a certain dollar amount, the insurers will be incentivized to compete for business. I wouldn't expect you to get this because I'm sure you've never set foot in a business class but if the insurance companies pool of paid premium is high, they're offset won't really mean a lot. Competition creates favorable conditions for the CONSUMER...not the provider.
Quote:
Originally Posted by middle-aged mom
Medicare was created because private insurers refused to insure the elderly.
Those fixes don't seem to address the basic problem, at least to me. There is little competition so the medical industry charges as much as they want to charge.
I would "flood the zone" with doctors by ordering states to open more medical schools or expand existing medical schools. We should easily produce 40,000 doctors a year and that will introduce more competition. The states can eliminate many of the Liberal Arts programs and just produce doctors.
MD shortages are a regional thing. In some areas, MDs find it substantially more lucrative to open pain ( pill) clinics, rent motel rooms to dispense Suboxone to opiate/opioid addicts and sell the latest greatest weight loss systems. Physician Assistants and Nurse Practitioners have all but replaced primary care physicians and are the primary front line at cancer treatment facilities without diminishing the quality of care.
When the market is flooded with MDs, their compensation takes a toll. How many of the best and brightest are going to be willing to invest a small fortune into a 4 year medical school and say 5 year residency to make substantially less money. Heck, go to Wall Street and have better hours.
I have been stunned by how little high quality MDs are paid in my PPO- $15 for an annual pap smear and annual breast exam. The serious costs are hospitals and cancer treatment
Just from my personal interest, I would like to see a Britian-modeled service. I worked in the UK for about three years after college and I thought the healthcare system was pretty exceptional. Sure it had it's downfalls, but I felt that it was satisfactory in all the realms that mattered.
Just from my personal interest, I would like to see a Britian-modeled service. I worked in the UK for about three years after college and I thought the healthcare system was pretty exceptional. Sure it had it's downfalls, but I felt that it was satisfactory in all the realms that mattered.
What the British system does is to offer a base level of public health which is generally pretty good and which is great value for money. The other thing it offers is choice. There is a parallel private system which is kept 'honest' by the existence of the public one. Private medicine in the UK has to be better than the NHS as well as being affordable or people will simply not use it.
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