Just something I was wondering when I saw a Pit thread on a recent ACA idea. I realized I found it hard to imagine what it would take to override industry lobbying dollars; I think it’s possible, but I just don’t know when that point is. As such, if answering, hard number estimates would be ideal.
Feel free to argue that the premise is impossible.
Well, I, finally, years after graduating college, got the Real Job offer that I guess all young adults are expected to get after they get their college degree.
The offer contained the employee portion for health insurance. It was $40 for an individual, per month, and $80 for a family. For a job that pays near 80k.
So the immense actual costs are hidden from me, and this is going to be the case for a large number of Americans. Of course, this gives the employers clear financial incentive towards age discrimination, and in my industry, people in their 50s and above happen to be heavily discriminated against.
Also, these Real Jobs are getting harder and harder to come by. More and more, even if you do have that valuable college degree, the only work you can find is part time or contract or otherwise limited. And where I work, the receptionist has a biology degree. Only reason I get to go in the back and actually do work that adds significant value is simply because my degree happens to be one of the few valuable ones. (and biology is still STEM!)
I think most Americans blame themselves when they get screwed, though. When they ‘happen’ to be laid off in their 50s because their health insurance is costing too much, they blame the economy or immigrants competing in the same field or other causes. (and employers do tend to wait for such events to happen as a pretext)
When they can’t get a job that has decent benefits, they blame themselves for not doing well enough in interviews or not having a well enough polished resume.
People will pay anything to reduce their pain and prolong the lives of their loved ones, and the Medical/Industrial Complex knows that.
In terms of cost, the medical sector is unregulated, and providers can charge fees according to their whim. The health insurance sector does not object – they love high prices, they get to take a profit from an aggregate cost that is on an astronomical trajectory.
In most countries, including much of the third world, medical costs are held in check by a single payer answerable to the public, which holds providers accountable for cost escalation.
Control of cost growth in the US healthcare system is currently running comparable to that of the rest of the developed world. Our system is more expensive because of several years in the 1980s when cost growth in Europe was much slower, but that disparity has largely been erased. And no one has ever been successful at consistently achieving actual cost reduction. The best we can hope for is to slow it down.
Employer linked healthcare came about during WWII when companies could not attract new hires with increased pay.
When companies cannot afford health insurance to attract new hires, things will change. The combination of those companies and uninsured workers lobbying against the medical-industrial complex will result in a systemic change.
We probably won’t live to see it.
In 1999 at my DIL’s medical school graduation, Marcia Angell, then the editor-in-chief of the New England J. of Medicine, gave one of the speeches. She said that it was already unsustainable and the good news was that the government would be forced to act. Little did she know that, 18 years later, more than half of congress would be anxious to go back to the situation of 1999 in order to fund tax breaks, not for the needy, but for the greedy. My DIL now practices in a community medical center in a poor, mostly Spanish speaking, town in the US that keeps its costs relatively low. But they are not going to be able to pay a half million for an exotic cure for cancer.
Congress has passed laws making it illegal for the government to negotiate down drug prices, for example. Here in Canada, the provinces have negotiated much cheaper prices on drugs that keeps all drug prices relatively low. But as long as the drug companies’ lobbyists run congress nothing will change in the US.
But that’s what I was asking: is there a point of expense and brokenness in the system that will force Washington to act, with or without the industries’ approval or not? If so, what is it? After all, health care costs just seem to go up as time passes; is there a breaking point? When costs are double what they are now? Triple? Quadruple? When 1/3 of the country is uninsured? 1/2? When how many hospitals are forced to close?
Never. The rich run the world and the rich can afford their own health-care. And they make sure the politics are in place to keep them rich.
So, never. It’s always about the money.
So what, the system just stays propped up forever, even after 75% of the country is uninsured? Heck, if there’s no limit, let’s say the entire insurance industry empties out because no one can afford premiums for anything beyond a nurse using a pair of tweezers. Then everyone needs medical care but no one can pay for it. STILL then absolutely NOTHING happens or changes?
I know people keep saying that there will be a point where the rich will just hide in their island retreats or bunkers, no longer needing the little people to spend money on them or make money for them and abandoning the smoldering wastes of civilization, but I personally just don’t see it as practical.
I don’t know. The NRA is a small lobbying group compared to the medical industry, but despite 80% of voters wanting sensible gun control, including majorities of republican gun owners, nothing gets done.
From a cynical realpolitik pov, I think as middle class whites with good educations get locked out of the health system that it will maybe lead to reform. Maybe.
Politicians and the public are willing to look the other way when poor people or non whites suffer. But when college educated white families suffer, people pay more attention. And as it stands college educated white families are having more and more trouble affording health care. Even some upper middle class white families have issues with affordability now.
But politicians will still ignore them mostly. If there is a breaking point I don’t know it.
Ten years ago.
My most recent position’s health plan was $750 a month out of my paycheck, with a $2600 individual/$5200 family deductible and high copays for the month or so when I met it. I estimated health care for my family cost us about $22,000 a year.
Why does health care cost money at all?
Then the baby boomers start needing round the clock nursing and end of life care something is going to have to give in a big way. We can’t afford to take care of that many elderly under the current healthcare system. So basically 10-12 years
Because doctors like to eat?
So do teachers and policemen.
100% literacy is considered to be in the best interest of the commonweal. 100% healthy is not.
The cost of healthcare is borne by employees. Always. No health insurance on the job? The employee pays. Company paid healthcare? That is part of the compensation and without it the employee would get a bigger paycheck. Employers and Insurance companies (the only entities in the mix who can influence costs) are just pass throughs. So, for the OP, the answer is when employees start demanding higher salaries and including healthcare in their demands. When or if that will happen I don’t know. But until it does the healthcare system isn’t broken because the money will still flow into it.
Setting aside the 75% number, this is pretty much already the situation. The health industry doesn’t give a crap if you can’t afford to pay for it. You spend everything you have, go bankrupt, can’t afford any more care; if you still need more healthcare but can’t afford more health care at that point, that’s your problem.
Health care isn’t optional, so the traditional economic model of “priced too high, nobody buys it…priced too low, providers don’t make any money” doesn’t apply.
Why does arresting criminals and sending them to prison cost money? Why does fighting fires cost money? Why does military defense cost money? Why does K-12 education cost money?
That is a pretty weak strawman argument you are making. Everyone knows health care costs money, the question is should the costs be borne by consumers or the state via taxes.
Either way, the issue in this thread isn’t so much about who should bear the costs of health care, but why our health care costs 2-3x more than other wealthy nations and is inferior, and will anything change that? I personally doubt it. Politicians are happy to ignore voters when they are afraid of losing funding.
The question is also how much of the current health care costs are spent by necessity, and how much is spent in order to fatten somebody’s wallet. (Note that the level of wallet fatness has an impact on actual health care levels when the wallets in question belong to doctors - we still need them to sign up for the job. The value of wallet fatness of insurance providers, and of the existence of private insurance providers, is more in question.)
Case in point: I went to my doctor an described a symptom for which he suspected an infection in a kidney. I assumed he would take a sample of urine, and test it with a reagent strip. No, he laughed, we don’t do that anymore. He sent me down to a lab for a urinalysis, for which my Medicate was charged $60, and for all I know, they opened a bottle and took out a reagent strip. The results (a week later) came back exactly the same as the doctor suspected, and exactly as a test strip would have shown (which I could have read myself), and I was referred to a urologist, and my Medicare charged for two more $80 consultations with my doctor. The owners of the laboratory made their sailboat payments on time.
We think nothing of increasing the price of diagnosis a hundred-fold, in order to increase the accuracy of the test fractionally, maybe by one percent. Law of diminishing returns has to come in somewhere.