For those who want to know how to fix the medical system in the U.S. and figure out how to deal with rising costs, you can listen to this radio podcast segment (23 minutes long). This is probably the best explanation I've heard about problems that exist in the system and how to fix them. The man talking is an expert, knows about the system, and is a conservative free market supporter. We don't need to get rid of the free market. The solution is to make some changes to allow the free market to work and do what it was designed to do. Tuesday, March 21. Paul Seegert, Managing Partner of PCS Advisers Tim spoke today with Paul Seegert, Managing Partner of PCS Advisers. He joined the show today to talk about the future of Medicaid coverage. And the state of Health Care in America. Live From Seattle, 820 AM radio, with Tim Gaydos Tuesday, March 21. Paul Seegert, Managing Partner of PCS Advisers - Live from Seattle with Tim Gaydos - Omny.fm
I haven't listened to that podcast yet, but the answer isn't to make healthcare "free". Nothing is free. Someone, somewhere, is paying for it...
The following are past major laws and other policies implemented by the Federal and state governments that have interfered with the health care marketplace: In 1910, the physician oligopoly was started during the Republican administration of William Taft after the American Medical Association lobbied the states to strengthen the regulation of medical licensure and allow their state AMA offices to oversee the closure or merger of nearly half of medical schools and also the reduction of class sizes. The states have been subsidizing the education of the number of doctors recommended by the AMA. In 1925, prescription drug monopolies begun after the federal government led by Republican President Calvin Coolidge started allowing the patenting of drugs. (Drug monopolies have also been promoted by government research and development subsidies targeted to favored pharmaceutical companies.) In 1945, buyer monopolization begun after the McCarran-Ferguson Act led by the Roosevelt Administration exempted the business of medical insurance from most federal regulation, including antitrust laws. (States have also more recently contributed to the monopolization by requiring health care plans to meet standards for coverage.) In 1946, institutional provider monopolization begun after favored hospitals received federal subsidies (matching grants and loans) provided under the Hospital Survey and Construction Act passed during the Truman Administration. (States have also been exempting non-profit hospitals from antitrust laws.) In 1951, employers started to become the dominant third-party insurance buyer during the Truman Administration after the Internal Revenue Service declared group premiums tax-deductible. In 1965, nationalization was started with a government buyer monopoly after the Johnson Administration led passage of Medicare and Medicaid which provided health insurance for the elderly and poor, respectively. In 1972, institutional provider monopolization was strengthened after the Nixon Administration started restricting the supply of hospitals by requiring federal certificate-of-need for the construction of medical facilities. In 1974, buyer monopolization was strengthened during the Nixon Administration after the Employee Retirement Income Security Act exempted employee health benefit plans offered by large employers (e.g., HMOs) from state regulations and lawsuits (e.g., brought by people denied coverage). In 1984, prescription drug monopolies were strengthened during the Reagan Administration after the Drug Price Competition and Patent Term Restoration Act permitted the extension of patents beyond 20 years. (The government has also allowed pharmaceuticals companies to bribe physicians to prescribe more expensive drugs.) In 2003, prescription drug monopolies were strengthened during the Bush Administration after the Medicare Prescription Drug, Improvement, and Modernization Act provided subsidies to the elderly for drugs. In 2014, nationalization will be strengthened after the Patient Protection and Affordable Care Act of 2010 (“Obamacare”) provided mandates, subsidies and insurance exchanges, and the expansion of Medicaid. source: How Government Regulations Made Healthcare So Expensive
part of the transcript from the video: Tell us where we are at when we come to Medicaid? Well we have a bunch of people who are currently on Medicaid rolls, who don't qualify necessarily by income and the other requirements that you have to meet. And part of our whole Covid experience was that we gave extra funding to states to allow for that to occur, so long as they didn't audit the enrollment, after people enrolled. So they had to qualify initially and then they didn't audit it in an ongoing way like they normally do. And as soon as the emergency ends, then that extra funding will cease. And then different states, they're all going to end up auditing those rolls again. Medicaid is one of the biggest line items for lots of states. What else should folks know? Well I think we've hit the big high points, don't wait till the last minute. Health insurance is unfortunately confusing. You'll have a 60-day special enrollment period if you are removed from a program. Now what's happening overall in just the healthcare industry as a whole. The U.S. in the last couple of years has shown the weaknesses of where we're at. There's weaknesses all over, due to aging demographics, and other factors. All over the world, you look at the U.K. right now and their National Health Service... many employers are starting to offer private insurance because of the long waits to get care through the National Health Service itself. So it has its own challenges. Here, our biggest challenge is that we haven't had the political will to create transparency, where free market can actually perform. And we're starting to see employers, that have a plan of some decent size, making demands around that transparency and getting better results. And then you're also seeing enough frustration with just American consumers broadly, that you even have 2 out of 3 of the big insulin manufacturers have just come in the last 30 days voluntarily lowered the cost of insulin 70 percent. And it's not because they just became magically altruistic. I think many see that there's enough momentum and pressure and that it's really getting to a breaking point. Americans - this economy - shouldn't have to spend 30 percent of our GDP on healthcare. That's where we're heading if we don't do something. Even knowing that we have 14 or 15 lobbyists per member of Congress to keep it the way it is, I think the pressure is building to a point where we might actually get something done. What would you say are the 2 or 3 things that if you're calling the shots, this is what we need to do. We have to create a payment model where the American consumer has the information they need to consume well, like in all other areas. The fact that it's a complicated product to consume is no excuse. So we need to create transparency rules. There's proof that these free market principles can work. Look at elective procedures that people get all the time, and where the insurance payment model is not involved, whether its cosmetic or otherwise. We need to make that possible in the overall consumption of healthcare, so that hospitals have to compete for your business. And then we need to bring serious transparency towards the way we consume pharmaceutical drugs. The fact that we are 80 percent of global profits for big pharma. And it's because we don't require transparency. There's no way that a plan sponsor that's running a health plan shouldn't know what the drug actually costs versus what they had to pay for it, and where the money actually went. I think there's a lot of folks who don't even want to know how the sausage is made, when it comes to this industry.
I truly know the medical industry is BROKEN. I have heard and experienced so much corruption and if this is true, heard that during the years of covid and all those who died in hospitals with "cause of death on death certificates was listed as covid, that hospital got a big chunk of bucks from the crooks in govt. So many died with many other deadly diseases but covid was pushed for the MONEY.
I always thought the age for Medicare was 65, no younger. What does your comment mean? And if MORE took control of t heir health and NOT run to a doctor for every sniffle and sneeze the health care system would be healthier. I have started to take care of my own health as best I researched on how back in t he 80's,,, and backed off the toxic pharma drug world... Now at 85 soon I see my MD every year to check in for a couple refills on 2 meds I take. This year it's a telemed as I have no issues to see her about, I'm become my own doctor SO MUCH. All need to do that.
Majority of people do not understand that banning people from government controlled health insurance system and handing them to private corporations effectively establishes slavery.
I do not think you can explain what is the purpose of Medicare ban? I assume your mind is not complicated. It is a slavery If you can't buy decent health insurance on the open market but need to work instead
The US gov already pays enough in healthcare for everyone. Some goes in through Veterans Affairs, some to Department of Indian Affairs, more to over 65 care, a lot to Medicaid, and Obamacare, and there are other programs - one set up by JFK providing primary care to the homeless is doing a great job.
The problem is having so many different payers and such complex payment rules, with the payer covering some things, the secondary payer covering others, and the third payer is often the patient. Which insurance pays which item is often confusing, and I just got a bill from a year and a half ago the insurance decided not to pay. A nearby hospital has more billing administrators than it has beds, and then there are the payments officers at the insurance company end, and all their accountants. The total cost of the staff dividing up and accepting or rejecting the separate parts of the bills, and office costs and profits, doubles the healthcare costs to the point where it would be cheaper to give the care for free and let the private insurance companies go on permanent holiday.
the main problem that people are silent. For some reason nobody is demaning to remove ban on Medicare. This will not solve all the problems, but that will make government responsible for the chaos they have created in the American health care system.
To be fair, the U.S. marketplace does have an alternative to this. It's called an HMO. They are known for cheap care (or at least lower cost), but also have a reputation for having lower quality, not always approving treatments, and in some alleged cases preferring that patients die so they do not use up expensive resources. In an HMO, the hospital pretty much is the insurance company. You pay for coverage and the hospital gives it to you if you ever need it. But unfortunately, by eliminating the separate role of the insurance company, the hospital has greater incentive to avoid giving expensive care. Medical billing can be a complicated thing these days and actually eats up a lot of resources and money. There are many rules. As a general rule of thumb, medical billing can account for 5 to 10% of total medical care costs. And that does not even include the medical billing on the insurance company's end.
And then 3 years after the medical bill was paid, it got unpaid and sent to me. There is a 7 year statute of limitations on medical charges in this state, so no medical problem is really gone until the 7 years are up.
