Cycloptichorn wrote:
First, I don't think it was 'bureaucratic controls' which limited my father's coverage. He had good coverage. What he didn't have was honest people at the Hospital and the Insurance company who lived up to proper accounting practices. If anything, more controls would have been helpful.
Do you believe that Federal legislation requiring health insurance for all and subsidizing a large portion of it will somehow make hospital administrators and insurance companies more honest or better accountants?
The truth is that the rate caps and standard reimbursement rates of insurance companies don't always cover the real costs of the hospitals, laboratories and practicioners who depend on them for payment. In response they search the insurer's lists of numerical codes for authorized services to seek ways of recouping their costs. There is deceit and dishonesty on both sides of this process. It is an expensive, bureaucratic and often deceitful game of authorization codes and numbers that is necessary to replace the absent forces of the free market that would otherwise regulate price and demand.
Cycloptichorn wrote:
Second, I'm not sure how we would pay for services with no limits. But I doubt it's impossible. I can tell you that I don't accept that the current situation is the only way of doing things.
I think that it would probably increase costs somewhat to have truly 'unlimited' medical care; that is, to provide each and every person with the most expensive of all surgeries is probably beyond our limits. But that doesn't mean we can't make the attempt to do so, and how much waste is there in the current system? Let me spend a day pondering it, and I will get back to you.
Cycloptichorn
Well, you've had your day - any results? The "... increase costs somewhat..." is likely to be a very large number. It is easy to do a linear numerical analysis demonstrating the great potential economies of scale attentant to centrally managed and financed systems. However human nature and all the many second order effects that go with it in the way of the results they predict.
That was the case with the failed centrally planned economies of the now unlamented Socialist world of the 20th century. The initial appearances of benefits due to mass industrialization and agriculture,and the sacrifice of generations that went with it, yielded only mass production of shoddy goods and lousy services that nobody wanted. "We pretend to work, and they pretend to pay us." became the ironic catch phrase that aptly described the system. Worse, to sustain its operation, it had to suppress human freedom of thought and action.
I will agree that this can be counter intuitive. What, after all, could be more inefficient than the duplication of services, administration, financial management and all the rest that goes with market capitalism and competition? On a rational basis a centrally managed system appears to offer huge benefits. The problem is that they require Plato's phiolospher kings to manage them. Unfortunately such creatures don't exist.
