This is also why DOGE has accomplished absolutely nothing when it comes to government efficiency. Despite lobotomizing key US strengths in research, health, food safety, etc, federal spending is up YoY.
Healthcare expenses are eating the federal budget alive, and the religious belief that collective bargaining with the health care industry is pure marxism (despite every other developed nation doing it with good results). Rather than dealing with that head on, the approach will be to simply strip millions of health care.
Collective bargaining isn't going to do much as negotiation is always about moving the costs around, it doesn't truly reduce them. We need to be looking for ways to actually make things more efficient.
I have recently been having some dealings with a medical office that provides a clear illustration of the problem. Doc orders test A and unrelated test B. Scheduling requires me to make follow-up appointments for each test because the insurance "wont pay for" discussing two of them in one visit. Why do we have a system where the incentives are so messed up?? Note that I think this is a case of saying the quiet part out loud, not that they are unusual. One thing per visit is the norm when dealing with insurance.
It wouldn't have to be that way. Make most such follow-up visits folded into whatever they are a follow-up on (even if whatever it was was external), the visit itself isn't billable and so the doctor is free to structure things in the most efficient way--and we generally don't need "you're ok" followup visits. You can't go with a full result-based system because that will cause cherry-picking (look at what we have seen with Medicare advantage plans), but there's low hanging fruit out there.
> Collective bargaining isn't going to do much as negotiation is always about moving the costs around, it doesn't truly reduce them.
This is incorrect. If a supplier has high leverage in bargaining position they charge a huge surplus. If the group on the opposite side of the table can now collectively bargain, those prices come down, the suppliers fat profit margin is now gone and they actually have an incentive to become more efficient.
If a group can make tons of money with no work they do it. If they can no longer do that, they will look for more effort full approaches including improving efficiency.
https://www.axios.com/2024/04/19/health-insurance-companies-...
This is also why DOGE has accomplished absolutely nothing when it comes to government efficiency. Despite lobotomizing key US strengths in research, health, food safety, etc, federal spending is up YoY.
Healthcare expenses are eating the federal budget alive, and the religious belief that collective bargaining with the health care industry is pure marxism (despite every other developed nation doing it with good results). Rather than dealing with that head on, the approach will be to simply strip millions of health care.
Collective bargaining isn't going to do much as negotiation is always about moving the costs around, it doesn't truly reduce them. We need to be looking for ways to actually make things more efficient.
I have recently been having some dealings with a medical office that provides a clear illustration of the problem. Doc orders test A and unrelated test B. Scheduling requires me to make follow-up appointments for each test because the insurance "wont pay for" discussing two of them in one visit. Why do we have a system where the incentives are so messed up?? Note that I think this is a case of saying the quiet part out loud, not that they are unusual. One thing per visit is the norm when dealing with insurance.
It wouldn't have to be that way. Make most such follow-up visits folded into whatever they are a follow-up on (even if whatever it was was external), the visit itself isn't billable and so the doctor is free to structure things in the most efficient way--and we generally don't need "you're ok" followup visits. You can't go with a full result-based system because that will cause cherry-picking (look at what we have seen with Medicare advantage plans), but there's low hanging fruit out there.
> Collective bargaining isn't going to do much as negotiation is always about moving the costs around, it doesn't truly reduce them.
This is incorrect. If a supplier has high leverage in bargaining position they charge a huge surplus. If the group on the opposite side of the table can now collectively bargain, those prices come down, the suppliers fat profit margin is now gone and they actually have an incentive to become more efficient.
If a group can make tons of money with no work they do it. If they can no longer do that, they will look for more effort full approaches including improving efficiency.
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