
The Happy Hospitalist is a board certified internist who works in the hospital and writes regularly on several blogs, including The Happy Hospitalist.
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A reader asked for the graph relating out of pocket expenses as a function of time. Here it is. Go here for some other great graphs of health care inflation since the Medicare National Bank was opened up. Notice the direct correlation (cause and effect?) with rapidly rising costs and decreased out of pocket expenses. The only problem I see with this graph is that we are not really paying less for our care out of pocket. Every $10,000 your employer spends in premiums for you is $10,000 less you take home in salary. You are paying for it one way or another.
The only way I see fixing the problem is to take the third party out of the equation, whether it’s Medicare/Medicaid or your employer and make the 300 million Americans price with their wallets. The government spends $100 for a surgical screw. Your private insurance spends $2,000 for an MR. I can assure you, the public would not stand for it. Place the word medical on anything technology and the cost sky rockets. Why? Because the Medicare National Bank pays for everything under the sun.
Take away the MNB and make the public accurately price goods and services for what they are worth. That’s how you fix over and under supply.
Take that $10,000 your employer is spending for you and spend it yourself, with contracts of care determined between you and doctors, you and pharmacies, you and hospitals in a market based bundling system of care. What’s holding this country back isn’t too little insurance, it’s too much insurance.
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Self-pay makes sense for the small stuff. But how do I self-fund the expensive, chronic stuff that keeps me from working full time? How do I self-fund a transplant if I need one?
Health care is not a normal market item like cars or office supplies. Sometimes you get a gigantic expense that is impossible to predict, impossible to save up for, and impossible to do without. There needs to be some kind of risk pooling (even if it’s not a government program) or most people simply won’t get critical care.
Comment by Mark W Schumann — May 15, 2009 @ 12:20 pm
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