http://www.theatlantic.com/doc/200909/health-care
Before I even begin, there's one major point: Employer paid health insurance is a big, big problem, and the bill in front of congress right now is set to entrench that system for a long, long time. Penalizing businesses for not providing health care? That's not going to fix our system, that's going to truly and completely destroy it.
Here's the Cliff Notes as I see them:
- Employer provided health care is a major problem. Because our providers are "paying" for our health care, we don't see the real costs and therefore abuse the system. I put "paying" in quotes because the fact is that you, as an employee, are actually paying the cost and you just don't know it. Why do you think wages have stagnated over the past decade? Because of evil and greedy employers? Wrong! Because they are shelling out 20%-30% more money for your health care. That's wages that you don't make.
- Employer provided health care is a major problem. Did I mention that already? Well it's one of the biggest problems so it deserves to be the top two items. This time I'm going to point out that because employers provide health care, insurers have no incentive to go after individual policies. Why waste your time trying to lower prices so that Joe Taxpayer can afford them when Company X, with a lot more capital and a government subsidized tax writeoff, is out there. You sign up Company X, you get a whole bunch of people into your system. You spend the effort signing up Joe Taxpayer, you get one person.
- Joe Taxpayer isn't the one paying the bills at the hospital, the insurance company or government is. This means hospitals have about a dozen different pay schedules depending on who's paying. Try calling up your local hospital and ask them how much a simple physical is going to cost. Some of them will probably tell you, "We'll tell you after you come in and get the physical." I'm not kidding, that's probably what most of them will tell you.
- This entire debate is about the wrong subject. We're debating insurance costs and not health care costs. Health insurance isn't the real problem. Health care costs are.
- Doctor's and hospitals aren't evil, but they have to make a living. This means that they frequently order more profitable procedures. Remember, in most cases, you are not the customer - your insurance company (or Medicare) is the customer and that's who they are out to please and who they are out to bill.
- The government is really bad at running most businesses. There's no incentive for employees to be efficient (just go to your local post office to experience this).
Well stated. That article is FABULOUS.
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