if you take the same argument that "making everyone get health care" will lower service for everyone, then are you against the fact that you have to have car insurance in order to drive? if the only people who really wanted car insurance were the ones who saved for it and bought it, do you think they would all get better services and rates?
and i've about had it up to here with this "malpractice insurance is driving up medical costs" argument. no offense to you, reggie, but malpractice insurance is just another piece of the huge, complicated, interwoven pie. i don't really believe that the reason my doctor charges my insurance company $190 for a checkup and blood work is because he has to pay a lot of malpractice insurance or his student loans. granted, it's tough for doctors starting out, but once they hit their stride, the what they recoup from their investment is huge compared to other jobs. plus, if you're a doctor the only reason you have to come up with all the malpractice insurance yourself is if you have a private practice. otherwise it's the responsibility of whatever clinic or hospital you work for. malpractice insurance itself i think is another huge scam. the chances of one of the millions of doctors finding themselves solely at fault for a multi-million dollar settlement are astronomical, but, like all good insurance agents do, they make you feel terrified to not be covered.
when you look at all the aspects that drive your medical bills upward, from administration, equipment, rent, taxes, outsourced labor (i.e. lab results or analysis), and wages, you find that there's a lot more ways to chisel down the cost. this stupid talking point that i hear all the time that uninsured people who use ERs are the reason everyone else has to pay more is bullshit. health insurance companies aren't interested in that. they want to always be able to pay the lowest price, period. so even people with health insurance through their work find themselves being kicked out of hospitals perhaps earlier than they should be because they've met some criteria their insurer has made up themselves and will refuse to pay out any claims once the patient has done so.
to me, the entire health insurance system, not necessarily the doctors and hospitals, is the big dinosaur. it made sense, probably, when costs were low and you didn't necessarily need insurance just to go to the doctor, but only for major things. nowadays, though, anyone who wants to take their kid to the pediatrician can't just afford to do that out of pocket, so they need to rely partially or fully on their health insurance provider. and the interest of the health insurance provider is to pay out as little as it can get away with because all of the money is tied up in investments. think about it. if an insurer had to actually pay out 100% of even minor claims for all its clients on the same day, it would be like a fucking run on a bank.
but, of course, you can't just wipe the slate clean and then say, "okay, that whole big mess with all its waste of paperwork, manhours, bickering, and lies is gone: so now you doctors have to reduce your rates." it's just unrealistic. so i think obama's trying to go in the right direction with making rule changes, just like with the credit card companies. but insurers are always going to be playing with house money, and they'll always be able to adjust the little scales for their best possible income.
the whole legislation should have been structured from the start to focus energies on different aspects of the entire fiasco with separate bills, not just one huge tome that will confuse everyone. unfortunately i believe, as I recently read in Esquire, that the real reason Obama is pushing so hard for it this year is because next year starts the election cycle, and any vulnerable senator or rep, whether they're republican or democrat, will hesitate even more to put their name to a bill that could easily rile up their constituents. Obama knows that next year there will be half-hearted support at best, and a complete wash at the worst. ultimately the republicans will win because all they have to say is "no" without putting up any good ideas of their own.
oh, and also all the big pharmaceutical and insurance lobbies have spent $800 million so far THIS YEAR on congress.
