People always look to costs and say how we will root out waste abuse and corruption.
My wife is a psychiatrist, and a journal article recently showed how "defensive medicine", ie docs being afraid of being sued, was responsible for up to $ 850 BILLION a year. The total of all of the docs' premiums for malpractice insurance is about $20 billion. Not a good return on investment.
Out of the 20 billion, the docs' lawyers are paid, as well as the patients claims. If a patient wins a suit, their lawyer gets a contingency fee of 30-40% plus expenses. So the patients get only 10-15 billion and extra tests and hospitalizations and end of life care costs 850 billion.
How to save: In England, a patient CAN'T sue, because the docs are "given" to help patients, by national health, and are therefore protected by sovereign immunity. The most egregious cases get NO compensation. This would not fly in the US, so I would propose a health court, no fault, workers comp system, let the trial lawyers participate and get their fee, because negligence would still have to be proven, get the experts hired by the court, so it's more like science rather than debate and exaggeration, and costs could go down.
#2, JP Morgan, Berkshire Hathaway, and Amazon want to do no profit health self insurance. The administration in the white house have used the concept of "associations".
Now, the ACA, has "limited" ins co overhead and profit to no more than 20%.
Sounds great! right?
BUT, 20% OF A 500 PREMIUM WAS 1000, JUST TO PUSH PAPER AROUND AND PAY BILLS. nOW PREMIUMS ARE UP TO 20,000, AND 20% IS 4000 JUST TO PUsh paper around. Their incentives are to increase costs and premiums because they get 20 %,
Setting up non profit self insurance associations or coops or mutual cos would save a lot of the overhead.
Doing Both of these things would save 40-50%.
These thing are doable in the states, and are doable, rather than a federal 1 payer system.
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