Luddly Neddite
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- Sep 14, 2011
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The Myth of Health Care's Free Market - Newsweek
We're doing it wrong...
For weeks, politicians and writers in the opinion pages of The Wall Street Journal and other critical outlets have declared Obamacare a failure with plenty of victims. Those are silly assertions because the law only took effect this week, on the first day of 2014.
These critics are all outrage with no detailed alternatives, except the mantra that competition will magically bring down health-care costs. The libertarians at the Cato Institute argue "we need market competition more than ever. Not the mealymouthed substitutes bandied about by most health policy wonks. We need something that none of us has ever seen - real competition in a free health-care market."
No. We need something easier, simpler, and already proven to cut costs...
... More than four decades ago the Supreme Court defined a fair market as the "price at which the property would change hands between a willing buyer and a willing seller, neither being under any compulsion to buy or to sell and both having reasonable knowledge of relevant facts." How many of us have "reasonable knowledge" of medical procedures, costs, or even the difference between a neurologist and a nephrologist?
Is an accident victim writhing in pain, life's blood flowing out of his body, free of compulsion?...
... We don't have a free market for health-care services. If we did, we would see a narrow range of prices for the same service. After all, a Ford F-150 pickup with the same options costs about the same in Washington, West Virginia, or Wyoming. Not so hospital and medical costs, a fact brought home in the 2012 Pricing Report of the International Federation of Health Plans, a trade association for health insurance companies.
While the average U.S. hospital stay is just under $4,300 per day, one in four patients are charged $1,514 or less and one in 20 pay $12,537 or more.
The total cost for an appendectomy ranges from $8,156 for a fourth of these procedures to more than $29,426 for the most expensive 5 percent. The average cost is $13,851....
... In France the average daily cost of a hospital stay is $853; in the U.S., it's $4,287.
An MRI costs on average $335 in Britain and $363 in France, but $1,121 in the U.S.
Routine and normal childbirth costs, on average: $2,641 in Britain and $3,541 in France but in the U.S. averages $9,775. Caesarean section delivery runs $4,435 in Britain, $6,441 in France; $15,041 in the U.S.
This pattern holds for all 21 procedures examined in the report...
... Our universal single-payer health-care plan for older Americans, Medicare, has lower costs and lower overhead than the system serving those under age 65. If everyone in the U.S. was on Medicare, the savings would move the federal budget from deficit to surplus.
We're doing it wrong...