A Short History of American Medical Insurance

Posted by  $  AJAshinoff 1 month, 2 weeks ago to History
29 comments | Share | Flag

Its a solid article that offers insight to the origins of the "problem". But I think it misses the mark, where in the constitution does it say the government has any right to operate in health assurance?
SOURCE URL: https://imprimis.hillsdale.edu/short-history-american-medical-insurance/


Add Comment

FORMATTING HELP

All Comments Hide marked as read Mark all as read

  • Posted by brucejc04 1 month, 1 week ago
    OldUglyCarl is absolutely correct! Health Care needs to be free to operate in the free market.
    Costs will go done and results will improve.
    Reply | Mark as read | Best of... | Permalink  
    • Posted by ewv 1 month, 1 week ago
      There is a lot more to it than just "markets". Left out of the article is the philosophical premises driving the trend. It became much worse with Johnson's "Great Society" Medicare and Medicaid imposed in law after decades of collectivist demands for socialized medicine and claims of a "right" to medical care. That was not just another event along the way, it had major effects.

      Leonard Peikoff's 1985 Ford Hall Forum lecture, "Medicine: The Death of a Profession", printed in the Ayn Rand anthology The Voice of Reason describes the rapid decline transforming the medical profession between the statist milestone of Medicare in 1965 and the mid 80s. Today it is much worse, with statism hopelessly entrenched without a major revolution in thought to overturn it. Technical advancements despite the politics are all that has led to important medical improvements in some ways in the last 30 years.
      Reply | Mark as read | Parent | Best of... | Permalink  
  • Posted by  $  WilliamShipley 1 month, 1 week ago
    It isn't just that they don't post the prices, in many cases the institutions charging for the services don't know what they are going to get paid.

    For most patients, the amount charged has nothing to do with what the third party payer actually pays, and what the medical facility accepts as total payment.

    An interesting study I keep coming back to was if the cost of a total hip replacement. The researchers called 2 hospitals in each state and 20 major institutions and asked the cost for a hip replacement for a 62 year old female relative with no insurance. They were able to get numbers out of 45% of the major institutions and 10% of the others. To get more they had to separately contact doctors which got them over 50%.

    These people knew exactly what to ask for, they had the appropriate CPT codes for the charges etc. Nevertheless the institutions couldn't or wouldn't tell them.

    Prices ran from $12,500 - $105,000 at the top ranked facilities and $11,100 - $125,798 at the others.

    https://jamanetwork.com/journals/jama...
    Reply | Mark as read | Best of... | Permalink  
    • Posted by JohnJMulhall 1 month, 1 week ago
      I have heard from a friend who pays CASH for all medical care, When he offered to pay cash for an operation a couple of thousand miles from home, and the hospital realized they didn't have to put up with all the paperwork from the Insurance companies, his final bill was less than 30% of the original bill presented. L would LOVE to have a HSA that would allow me to do that!
      Reply | Mark as read | Parent | Best of... | Permalink  
      • Posted by  $  WilliamShipley 1 month, 1 week ago
        And there is also medical tourism. There are hospitals in a number of countries that have modern facilities and U.S. trained doctors. One can often fly over with a companion -- sort of a necessity for this to happen smoothly -- and have them stay in a hotel while you have the surgery and then come back for less.

        I even noticed that one of the "Blue" insurance companies, not sure which state, would cover this, including costs for companion and arrange follow-on care when the patient returned to the U.S.
        Reply | Mark as read | Parent | Best of... | Permalink  
      • Posted by  $  WilliamShipley 1 month, 1 week ago
        Yes, since most original bills do not have any relationship to what they would get from an insurer many institutions are more than willing to negotiate a cash price since it will often yield similar revenue -- and with less overhead. I tell people it's better to negotiate before than after!

        I had an employee who was covered by insurance negotiate his co-pay down by working with the surgeon and scheduling his elective surgery at a time when the surgeon had a slack period in his schedule due to hollidays.
        Reply | Mark as read | Parent | Best of... | Permalink  
  • Posted by CircuitGuy 1 month, 2 weeks ago
    This is a great article all the way through.

    Regarding their solution of publicly posted prices, I wonder if they could pass a law saying contracts must have pricing info to be enforceable. It wouldn't be forcing anyone to disclose prices to the public or even to customers. But if you don't disclose to customers ahead of time, you can't win a judgment for nonpayment.
    Reply | Mark as read | Best of... | Permalink  
  • Posted by  $  DeangalvinFL 1 month, 2 weeks ago
    "Solid" is a great word to describe the article.
    Much of the original historical context of the amazing stupidities of our methods of paying for health care are talked about. An informative read.
    Reply | Mark as read | Best of... | Permalink  
  • Posted by  $  blarman 1 month, 1 week ago
    Learned a new word: "ineluctable".

    Really liked this idea: "One way to achieve this would be for employers to provide major medical insurance plus a health savings account to take care of routine health care. If the money in the account is not spent on health care, it would be rolled over into the employee’s 401(k) account at the end of the year, giving him an incentive to shop wisely for routine medical care."
    Reply | Mark as read | Best of... | Permalink  
  • Posted by  $  allosaur 1 month, 1 week ago
    Constitutional;y speaking, how medical insurance is run is none of Big Brother's business.
    That's just those who are Big Brother wanting to become a bigger Big Brother.
    Big Brother was too big way before ObamanationCare came along after power glutton statists passed a bill to big to read.
    Reply | Mark as read | Best of... | Permalink  
  • Posted by Abaco 1 month, 1 week ago
    The government/medical complex might end up killing more people than the government/military complex. No...that's not an exaggeration.
    Reply | Mark as read | Best of... | Permalink  
  • Posted by  $  kddr22 1 month, 1 week ago
    Doctors(most in private practice) have a different schedule for self pay patients than what is sent to insurance co. If we publish the self pay rate we have issues with the insurance and/or govt payers as they then demand the same rate
    Reply | Mark as read | Best of... | Permalink  
  • Posted by chad 1 month, 1 week ago
    History proves the more government gets involved in the free market the more skewed, costly and less available any product becomes. After Obama Care was passed my premiums went up 10 times and my deductible went up 150 times. Insurance companies in a free market will find a way to market their services and reduce their costs. When everyone is forced to participate in the system (socialized medicine) it all becomes more expensive shutting out those who can least afford the care first.
    Reply | Mark as read | Best of... | Permalink  
  • Posted by JohnJMulhall 1 month, 1 week ago
    Outstanding article!
    As a Firefighter for 30+years we had regular "Emergency" calls for people who 'needed' aspirin or other cheap OTC drugs who were too lazy to go out and buy them, and got a ride to the hospital for the OTC drug and a free taxi ride home after. If they had to pay the average of a Fire Engine company ($500/call at the time) and the ambulance and the taxi in addition to their $1/1,000 aspirin, they would have sought out the 24-hour market and gotten their aspirin there... a much cheaper and 'capitalistic' way of care.
    Reply | Mark as read | Best of... | Permalink  
    • Posted by  $  DeangalvinFL 1 month, 1 week ago
      That is still happening. It distorts the entire system.
      In conversations, people actually think it doesn't cost anything since the insurance companies are paying for it.
      Reply | Mark as read | Parent | Best of... | Permalink  
  • Posted by BCRinFremont 1 month, 1 week ago
    Medicare and Medicaid, just as Social Security before them, were designed as “insurance” against catastrophic financial costs ruining a person/family. As always, government programs are subject to the lobbying of the electorate and the pandering of the elected. What started as “insurance” becomes just more entitled “free stuff”, with no incentive to be efficient or effective.
    Reply | Mark as read | Best of... | Permalink  
  • Posted by BCRinFremont 1 month, 1 week ago
    As an aside; Individual life spans have not increased in thousands of years, at a max of 120 years, or so. What has changed is that many more people are approaching that max due to numerous reasons.
    Reply | Mark as read | Best of... | Permalink  
  • Posted by  $  Olduglycarl 1 month, 1 week ago
    True, if health care was entirely transparent and operated via free market principles things would indeed be better.

    The other problem that wasn't discussed is that modern life, although vastly improved from days of old, is mostly the problem in causation of disease.
    Emergency medicine and surgeries have advanced tremendously and are life saving much of the time but preventive care and disease curing is still a crap shoot, highly profitable for everyone except the patient.
    On that front, the biggest gains in history were cleanliness and nutrition. Natural medicine still beats the modern system of alleviating symptoms only.

    And last but certainly not least...Government has no role what so ever in your health care nor those that pretend to care for your health...The free market is the only cure for that disease.
    Reply | Mark as read | Best of... | Permalink  
  • Posted by  $  Solver 1 month, 2 weeks ago
    Didn’t you know that everyone has an absolute right for servants to keep them heathy. Even the servants have that right. The same goes for all other needs, whatever they may be.
    /s
    Reply | Mark as read | Best of... | Permalink  
  • Posted by LibertyBelle 1 month, 1 week ago
    Very interesting.
    But "let nature take its course" in old age? What is meant by that? Not treat an old person? And what about Alzheimer's and other senile dementia? I wouldn't mind too much if a heart attack took me suddenly in old age. But I think that too much dementia would be horrible.
    Reply | Mark as read | Best of... | Permalink  
  • Posted by  $  prof611 1 month, 1 week ago
    This is off-topic, I know. But the article illustrates the point I want to make. Is it possible to order the comments by time of submission? It is difficult to understand them when they're not.

    I see an example just below me. The first comment was posted by by brucejc04 1 hour, 30 minutes ago. He references a comment by OldUglyCarl, which appears WAY down the page.
    Reply | Mark as read | Best of... | Permalink  
  • Posted by freedomforall 1 month, 1 week ago
    Been saying it for 2 decades.
    Health Insurance is NOT Heath Care.
    The easiest solution to stop the increasing costs of health care is to force people to only demand care when they need it. To do that the cost of health care must be paid by the person demanding the service. This will guarantee a lower demand and lower costs.
    Ban Health Insurance Completely in all forms.
    I have lived without it for 30 years.
    Reply | Mark as read | Best of... | Permalink  
    • Posted by CircuitGuy 1 month, 1 week ago
      "The easiest solution to stop the increasing costs of health care is to force people to only demand care when they need it. "
      It's unfortunate that in common language forcing people to pay for a gov't health plan is "expanding rights", while not doing that is calling "forcing people". It's backwards.
      Reply | Mark as read | Parent | Best of... | Permalink  
      • Posted by  $  DeangalvinFL 1 month, 1 week ago
        The backwards language is very dangerous.

        I would say that the word "insurance" is at the heart of the confusion. Current health insurance has way too many aspects that aren't insurance at all. One step in the proper direction would be for Congress to do it's constitutional job of establishing standards. Insurance should be clearly defined and that which is not insurance should not be allowed to be called insurance.
        Reply | Mark as read | Parent | Best of... | Permalink  
      • Posted by  $  1 month, 1 week ago
        The easiest resolution, IMO, is in the free market. Encourage more companies to manufacture the needed drugs and materials so there isn't only one source. Hospitals are a last resort, based on referral, with urgent care centers being local triage units for non-critical things. The crap shoot of insurance companies should have no border restrictions and a person should have 20 different options, none one which are the fedgov or state gov. Indigent care should be directed to county hospitals.The only expense for healthcare coming from government should be indigent care. And yes, all pricing should be published so people can compare.
        Reply | Mark as read | Parent | Best of... | Permalink  
        • Posted by CircuitGuy 1 month, 1 week ago
          In this comment I was just noticing how we call leaving people alone "forcing people". I agree with what freedomforall said, but it's an unfortunate choice of words.

          "And yes, all pricing should be published so people can compare."
          I think so too. My thought is a less intrusive way to make that happen is to say the courts cannot enforce contracts that don't have pricing. Laws requiring published pricing might work and be the right approach; I really don't know, but I'm just cautious about law requiring people to do anything.
          Reply | Mark as read | Parent | Best of... | Permalink  
          • Posted by LibertyBelle 1 month, 1 week ago
            Problem with that is: it should of course be against the law to commit fraud; but how can you justify having the government force people not to keep secrets? Of course, if patients asked for the information all the time, maybe they could intimidate the companies into coming across with it, and if they put something out as complete when it was only partial, they could be sued for fraud.
            Reply | Mark as read | Parent | Best of... | Permalink  

FORMATTING HELP

  • Comment hidden. Undo