"...But any structural reform of the US health care system would be immensely difficult and controversial. By definition, lowering costs for one group means taking money away from another.The other element has to do with the overhead inherent in all insurance plans: the unbelievably complicated process of balancing what a doctor orders for a patient as necessary treatment, as opposed to what is acceptable for treatment under the terms of a patient's insurance plan. Something for which I have seen from first hand experience.
"One person’s health care costs is another person’s income or profit," said Jost. "It’s a very, very hard thing to pull off.”
Slowing the growth of doctors' salaries would mean drawing the ire of doctors. Reforming drug patent law would mean taking on the pharmaceutical industry. Breaking up provider networks or imposing price controls would mean battling with the hospital industry. Introducing single-payer health care would be an existential threat for the insurance industry and the hundreds of thousands of people it employs..."
This seemingly innocuous discrepancy sets up unbelievable extra flows of effort, and information flow, as charges bounce back and forth between hospitals, nurses and doctors, and the payment clearing houses; a whole lot of extra effort and information flow as one side argues with the other on permissibility, and charge responsibility. Whole armies of people are employed, in fact, to do nothing other than chase these contested charges down so that someone, ultimately, becomes responsible for it. And let me just say, the waste inherent in that effort, in my opinion, is at least as bad as the extra we get saddled with in the excesses of profits, or the less likely excesses in wages.
In my mind what this should tell us is very basic indeed: that there are things involved with human need that simply must not be about livelihoods, or capital formation. But to truly accept and deal with that truth as a reality is to come to terms with just how inappropriate Capitalism has become as means to mediate the critical interactions of a society. And that is where our real problems lay in a nutshell.
US politicians are locked in an ideological battle over health care. But they're not really debating how to bring costs down — they're just shifting how to pay for them.