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You know who's written a lot of good stuff today? Kevin Drum. Go read him. Also, he quotes a portion of Karen Tumulty's searing article on navigating the health care system that I also want to highlight:
A paradox of medical costs is that people who can least afford them — the uninsured — end up being charged the most. Insurance companies, with large numbers of customers, have the financial muscle to negotiate low rates from health-care providers; individuals do not. Whereas insured patients would have been charged about $900 by the hospital that performed Pat's biopsy (and pay only a small fraction of that out of their own pocket), Pat's bill was $7,756. For lab work — and there was a lot of it — he was being charged as much as six times the price an insurance company would pay.Conservatives spend a lot of time arguing that Medicare uses its massive size and bargaining power to cost shift to private insurers. When Medicare pays less, they say, the rest of us pay more. And to some degree, it's true. What you hear less about is the next step: Large private insurers then use their relative size and bargaining power to cost shift onto smaller insurers. And the smaller insurers cost shift onto the uninsured. This is not a function of Medicare. It's a function of risk pooling. Bargaining units try to get the best possible price, and bigger units get better prices than smaller ones.The obvious solution to this would be a system where everyone is in the same bargaining pool and thus there's no cost shifting at all. But someone, the people who worry most about the burden Medicare places on private insurers are the least likely to embrace a world in which consumers are part of a single, seamless bargaining unit.
