I work in healthcare. Mostly on the finance side of things. I do not work for a health insurance carrier. I work for companies who want to provide coverage for their employees in the most efficient way possible in order to maximize "happiness" per dollar spent.
I keep on reading rants about health insurance and the desire for universal healthcare. Some general points that I've noticed concerning rising healthcare costs:
1 - health insurance carriers are evil profit motivated corporations
2 - a single payer system is better than our current healthcare system in every way
3 - access to healthcare is an inalienable right
4 - etc...
Anyway, these articles seem to have a good vs. evil dynamic to them where universal care via a single payer system will cure all the evils of the current system. I would like a better argument. The ones I've read seem to be more of a polarizing political political battle cry rather than a detailed plan of action to fix the system. I think some of you folks aren't looking at the facts. Did you know:
1 - Most people who have health coverage through large companies (500+ people) DO NOT HAVE HEALTH INSURANCE. These companies self fund their employee's health care usage. I'm not saying claims aren't denied due to profit motif, they certainly are. I'm not defending insurance companies, I ask that you consider facts as well. Please compare for profit insurance companies with the "Blues" or not for profit health insurance companies. What differences do you see?
Consider this scenario, If you're the owner of a company with 1000 employees and you self fund all medical claims from the company coffers, you'll see that about 50 of your employees will account for 75% of the cost. For a company this size, the guestimated yearly cost of providing medical care would be around 7-10 million per year (depending on how much coverage is provided for spouses and children and which area of the country you live in). What would you do? Different companies have different cultures and responses to that data (which, fyi, should be pretty accurate). Lets put another spin on this, Only 5 of those people had acute cases (i.e. got hit by a car). The other 45 have chronic cases, all of them have a combination of high blood pressure, obesity, and high cholesterol. 35 of the 45 also smoke cigarettes. They are on multiple maintanence medications. The cause of the high usage may be genetic or a series of choices. Either way, heart attacks, cancers, etc... have resulted from bad health or a twist of fate. What would you do? I think you'd be surprised at your answers and the answers of many decision makers commenting on these situations. They won't be too far off.
2. - How many new medical and RX advancements have been made in countries with a single payer system?
I had one gentlemen tell me that I was stupid since doctors & hospitals drive technological advancement, not insurance. Therefore my asking how many advancements come from countries with a single payer system lacked that distinction. I still ask you to answer my question, but to lead you to this consideration:
Medical device & pharmaceutical companies develop technological advancement...NOT doctors & hospitals who provide care. These are two different breeds of professionals. Now these tech & RX companies develop new medicines and methods, then charge doctors and hospitals to use them, who then charge the insurer.
Now what you should really be asking is this: How is the insurer responsible for the rising cost of healthcare?
I've read some articles where the author attributes health insurance as adding about 30% to the cost of health care. Please explain this to me? How is it that when companies grow to a size sufficient to self fund, when they move from a fully insured system to a self funded system...the savings DO NOT add up to 30%. Nowhere close actually. There is savings, but nowhere near 30% (if you look at a 5 year horizon, there may be a statistical outlier from year to year).
So this leads me to ask, are you concerned that a single payer system would limit the advancement of medical technology? If not, why? The data reflects that a single payer system disincentivizes the best and the brightest away from research, since the fruits of their creations will not be as favorably compensated (in theory). Anyway, please explain why single payer systems in Europe create very few new medical inventions in comparison with the U.S.? Are you saying that U.S. people are just that much more talented? If so, then I ask you to walk into an R&D deptarment at Merck and tell me the diversity of the faces you see and the accents you hear.
Are you aware that our current single payer system uses the DRG system Where do you think the DRG system originates from?
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