most of what you write isn’t true.
The insurer is an expert — but only because they can jack up rates whenever they want.
That’s incorrect. The customer of the insurer is the corporation. The larger the corporation, the more influence they have. The corporation pays a % of employee’s premiums on their behalf. If the insurer raises rates, the corporate bottom line takes a hit.
So, quite obviously, every year, the corporations take bids from the majors as to who can provide what they want to buy at the lowest price. This keeps price pressure on the insurer, and if they they want to be more profitable than the rotten 2% and change they’re going to get in the bid process, they can do that by being more efficient, part of which is rooting out fraud.
And because of the consolidations, there is very LITTLE choice left in this country, and almost none in most states, esp the States that have the sickest, poorest populations.
News flash: A substantial majority of the insured population of the US is insured privately, someplace around 70–75%. Every state has a full complement of major insurers (UNH, Cigna, Humana, Aetna, BlueCross, etc) competing for that business through the employer of those patients.
What you’re referring to is the 15% or so who are stuck with the ACA exchanges. And yes, you’re right, their situation sucks. But everyone knew the ACA was going to kind of suck anyway from the way it was structured, after all.
Also HC is a complex product, not open for typical Capitalist solutions (try negotiating on your way to the emergency room sometime).
Less than .5% of all medical care is vended on an emergency, situation critical basis. I know it looks like more than that because of all those TV shows, but people who are being rushed to an ER for life-saving treatment is extremely rare.
So, because it’s rare, sane people don’t try and build a health care plan around something that almost never happens.
So, countries like Singapore, the Netherlands, etc., DO use capitalist solutions that encourage negotiation in order to keep prices down. What matters is that people have care; I seriously don’t know why the idea of “negotiation” causes everyone on the left side of the political equation to break out in a rash. Other countries with universal care systems do it, nothing wrong with it.
Instead, hwo about we start by negotiating all prices, the way EVERY other business in this country does?? Canade and the UK pay X for a drug, but we pay 2–4 X — nope. We’re the volume buyer, we now pay .8x.
Boom $100–200B saved right off the top.
I have no problem with negotiation. It will slow down the pace of new drug research, but sometimes you have to take the bad to get to the good.