@r8
The commercial insurance model is fatally wounded. CMS and overly charitable healthcare handouts have ki-led it.
CMS dictates the amount they pay for services. These amounts are ALWAYS much lower than the standard market rates.
The government allows far too many people to be on medicaid which forces them to continuously attempt price controls. In most cases, a medicaid patient will use the highest cost services (ER) for the most minor issues which drives costs up even more.
This is primarily why hospitals which rely on medicaid are failing. Rural hospitals and inner city safety net hospitals are failing at huge rates.
CMS regulations exact a huge administrative cost burden onto providers which the provider has to account for in other areas of pricing.
Unlike student debt, healthcare debt can be defaulted on. The biggest driver in healthcare cost is medical debt defaults.
Illegal immigration is a HUGE driver of this. By many estimates, 1/2 of all medical defaults since 20000 have been from illegal immigrants. The federal government and many states force providers to care for this group, but there is simply no way to collect these payments once the patient is out of the parking lot.
That leaves the good ol’ reliable American employer-provided health plan to pick up the slack, but there’s a problem. Employers are tapped out and would often rather send jobs overseas than continue paying for benefit cost increases that seem to be never ending.
Recap:
Medicaid patients and other disadvantaged patients utilize about 60% of healthcare services. Often the most expensive ER visits for minor treatments.
CMS forces artificially low prices onto providers while simultaneously increasing these provers’ administrative costs.
Legislation guarantees access to medical services to everyone.
Illegals and others who don’t care about their credit ratings very often default on medical debt.
Providers are forced to squeeze commercial insurance for profits, but there’s no juice left.
This model is not sustainable.
Since our federal debt is $40T+, Medicare for all would probably be even worse.
Free market “pay-as-you-go” for minor issues and wellness visits, catastrophic-only insurance coverage, allowing providers to decline services based on inability to pay, and less government regulation is the only way out.