Bloomberg just doesn’t quit; this time their entire editorial staff chimed in with a pack-of-crap.
Truth is, congressional inertia is the single-biggest impediment to controlling health-care costs, which, in turn, are the biggest driver of federal budget deficits. An existing Medicare commission repeatedly offers cost-saving ideas, and Congress repeatedly ignores them.
But tucked away in the Affordable Care Act is a promising remedy, the Independent Payment Advisory Board. It resembles the existing Medicare commission, except its proposals for changing the delivery of health-care services can’t be waved off so easily. Unfortunately, Republicans and even some influential Democrats are gunning for the board; the House voted last week to abolish it. So much for countless hours of rhetoric about trillion-dollar deficits.
The need for something akin to the IPAB will become even more clear in 2014, when millions more Americans obtain health insurance (unless, of course, the Supreme Court strikes down the individual mandate). Economics 101 teaches us that sudden increases in demand for doctor visits and procedures such as MRIs and outpatient surgery will cause prices to jump, too.
Economics 101 teaches us that when too much money chases too few goods (and services) the price of the goods and services rise precipitously. This is called inflation and it is driven by the “cheap money, unlimited goods and services” paradigm.
And chase it has — from ~$53 billion in Federal health spending in 1980 to approximately $820 billion last year, an approximate 9.2% compounded annual growth rate.
At this rate spending doubles in somewhat less than eight years time.
The claim that we can “bend” the cost curve with various machinations is false. The fact is that decoupling care from cost to the person getting the care has directly caused an unteneble situation that cannot be maintained.
EMTALA was largely responsible for this in the first instance. Prior to EMTALA if you had an emergency and no money or insurance you could visit (and would be transported to if necessary) a charity hospital or ward. There you would receive care donated by doctors others, mostly funded by religious organizations and philanthropists. There was no guarantee of “first class” care and indeed what you would receive likely would be something less than the person who paid for the “full ride” of medical technology available to the general public. There was in fact a risk you’d get nothing and you might die.
But this was a risk you knowingly took. You decided not to or simply couldn’t pay for health “insurance”, choosing to spend your money somewhere else or to not effort hard enough to pay for insured care if there was a bad outcome.
EMTALA was an attempt to guarantee equality of result. But in doing so it set up the worst sort of cost-shifting, because now you didn’t have to face the risk of a 50 mile ambulance ride while having a heart attack — the closest hospital with the ability to treat you was obligated to do so, even if you couldn’t pay.
This in turn led to the situation we have now where monstrous proportions of the “care” provided in these hospitals is in fact uncompensated. That in turn led to you being forced to pay for that uncompensated care despite the fact that you did nothing wrong and never consented to pay someone else’s bill when you had an emergency, because someone had to pay or the hospital would go bust — and the only person with money was you.
In a just society this would be called what it is: Theft, and the responsible parties would be arrested, indicted, prosecuted and imprisoned, with an added factor of coercion enhancing the sentence (forcing you to pay when in duress as a consequence of a health emergency of your own.)
But this is not a just society. It is in fact a society that is far more repressive with a political system far less worthy of support than that which faced the nascent United States in 1775. And so-called “journalists” and politicians alike repeatedly lie both about how find ourselves in this situation and what the so-called proposed “solutions” will do, all without recourse.
The fact is that despite wanting a pony, there is no pony for everyone.
We can either face the truth or go bankrupt as both a nation and a people.