jpete wrote:From the government that gave you $400 hammers and $800 toilet seats, you expect lower costs?!?
I know where you are coming from. It's true that private business often does things more efficiently than government. But I work for a hospital, and when it comes to health insurance the private vs. government arrangement is surprisingly turned on its head. The more money that passes through an insurance company's hands, the more they can siphon off in profits. So at some level, their incentive is to keep health care inefficient and expensive. The practical and sensible reforms have come from Medicare. To cite one simple example, they now require us to report inpatient admissions where the person was previously an inpatient within the last 30 days. Why? Because if the patient is back so soon, maybe it is because we messed up the first time around, and that needs to be looked into. A second example that has been around for a number of years: the hospital is paid an average fee based on diagnosis, not on treatment rendered. Why? Think about a common procedure, appendectomy. Some will be straightforward and undramatic. Some will have complications and be harder to treat. And sometimes the hospital or doctor will screw up and give the patient an infection or damage other "parts", and it really gets expensive. But if Medicare cheerfully pays ten times as much for the screwup as for the good service, there is no financial incentive for healthcare providers to do it right -- just the opposite. Paying an average lets the hospital profit more if it is careful and efficient. Cutting corners to make more profit is forestalled by the army of malpractice lawyers waiting to pounce.