Socialized Medicine

I hear a lot about how socialized medicine is bad, how the quality of care will drop dramatically if we get it here in the US. What these people don’t tell us, however, (maybe because they’re lying or maybe because they’re just that stupid) is that we already have socialized medicine and it works quite well. It’s called Medicare/Medicaid.

They other thing they don’t tell you is that our current system is truly messed up. It’s the most expensive in the world by far, and our health outcomes are no better than those in other developed countries. And they’re worse with respect to things like life expectancy and diseases like diabetes.

Further, we can almost never find out what a medical procedure is going to cost beforehand. Generally, insurance companies don’t let hospitals disclose the prices they’ve negotiated with them.

And even if you can get an idea of what a procedure costs, there are often surprise bills for something that just happens to be out of network – that problem has now changed with the $900 billion Covid relief bill, which bans surprise bills except for ambulances. So we can still get stung there.

It would be one thing if the most expensive procedures were the best, but that’s usually not the case. And it would be nice if “no one pays the actual charge; it’s always discounted.” Unfortunately, that’s not true either. People without insurance get stuck with the full bill – and then they lose their house and have their wages garnished when the hospital sues them.

Did you know that the federal government requires funeral homes to offer itemized pricing information to consumers before they purchase services? But in medicine, there’s no such requirement. So you get better protections as a corpse than you do when you’re alive.

It’s often not the doctors’ fault (unless they perform unnecessary procedures). Instead, it’s the insurance companies and the companies that own hospitals working in tandem to raise prices and negotiate secret discounts. Doctors often have no idea what is going on at the administrative level.

With Medicare/Medicaid, prices are set in advance and easily known. There are no (or at least fewer) games between healthcare providers and patients. There isn’t a massive bureaucracy built around denying claims. That’s why the argument that we can’t afford it is so misleading.

This problem exists also in the area of prescription drugs, where the Secretary of Health and Human Services is prohibited from negotiating drug prices under Medicare. Not only that, but pharmacies often work with GPOs (group purchasing organizations) and PBMs (pharmacy benefits managers) to hide the true cost of medications and give kickbacks to big pharma.

If we had national single payer health insurance, the great bulk of bureaucratic and advertising dollars would vanish – and the people making obscene amounts of money off the poor and middle class would have to find other ways to cheat us.

If you want to know more about our bizarre system and how we can work to make it better, I recommend you read The Price We Pay: What Broke American Health Care – and How to Fix It by Marty Makary MD.

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