Back in the early 1990s during Ms. Clinton's failed effort to solve the healthcare problem to just open up the program to everyone as a simple way to expand coverage. It probably would have worked.
Hillary's plan had traction until the prospect of lost freedom was brought up. Her program could not promise it and its popularity fell immediately. Putting everyone on a Federal program would never had been sustainable. It would have sunk under bureaucratic burden.
Isn't this the primary way costs are controlled? One reason networks work is that they have negotiated pricing.
Are you kidding? Large systems negotiate higher payments for themselves because they are large. Small providers get screwed. If a large healthcare system has large market penetration then the prices soar, as they have done in the market I work in.
You are making assumptions that individuals can easily do this for themselves.
No I'm not. As it stands the average person cannot understand the coverage decisions they make even with limited choices. I see it with Medicare secondary coverage everyday. The patients are lied to and scammed. Even the options from employers are staggeringly complex. So, first, it wouldn't be any worse, but second, the insurance companies would have to simplify because they would be selling directly to us. Think IBM vs Macintosh in 1984.
I'm not sure that your statement about 'denying a test and dying' is valid.
What are you confused about. I order an MRI on a patient. His insurance company denies it. We appeal as the patient gets sicker. I talk to an MD who works for the insurer who looks at a set of guidelines and denies the scan. The patient cannot afford the scan and suffers the consequences. State medical boards claim that the insurance physician is practicing medicine on this patient and 1) must have a state license to do so and 2) is liable for his decisions. State medical boards have no teeth and federal laws do not hold them accountable. So he cannot be sued for his mistake. End of story.
You seriously think doctors are going to lower their fees?
I know they will and they already are. Direct Primary Care is a new (very old concept) in which you pay cash for primary care visits. No insurance is accepted, no Medicare is accepted. Ever. You either pay for office visits or you pay, on average, $1000 a year for unlimited primary office care. Office visit rates are around $50. That's 1/3 what I charge under the current system. Those with large deductibles pay that out of pocket. Those on managed care plans have copays that range from $20-$40. I have two former partners doing this now. Super low overhead, 24/7 access for patients. For $500 a year for young patients. The patients will still need a catastrophic plan and hopefully under Trump those will become available again.
I'm sure the AMA would go crazy.
I don't think people know what the AMA is. The AMA is almost irrelevant and has suffered low and/or declining membership for years. They are extremely liberal, advocated the ACA and actively seek a single payer system. They have little or no lobbying clout. They make no decisions whatsoever that affect physicians in any legal or binding sense. They certainly care nothing about physician compensation.
In the states where this has already been done there has been very little impact of the cost of healthcare
That can't be good, right?
