What you say is true, but for a man who is poor not due to is own actions. State provided health care is better than no HC at all.
I take $100s of dollars in medication each and every month. I cna’t burden my parish with that huge bill. One presciption alone is more than $200 a month and I take several.
It’s a poor, largely Latino parish in a small town.
Not meaning to speak for Nate, but here’s my 2 cents:
First of all, chances are you are not receiving State provided health care. Chances are you are going to a private physician who either accepts payments directly from the State as reimbursement for his bills or accepts State-funded insurance. There is a major difference between State provided health care and State provided health insurance.
And this is where my issue with the system comes in: third party paid healthcare. Because of third party paid health care, most of us are not even aware of a doctor visit actually costs. We are concerned with the amount of our co-pay, which stays the same regardless of the actual cost of the provider. Most of us are not concerned with the cost of prescriptions. We care about the prescription co-pay and whether a pharmaceutical is covered by our insurance or not.
Of course, there are exceptions: the (not so) Great State of Texas (your words) only pays for three prescriptions a month for you. The remainder are out of pocket. So you get stuck with the bill for the remaining medication. Most Americans are not in your situation. Most of us concern ourselves with the cost of the copay.
The impact of this is that costs do not have natural free-market control. Because most of us don’t care. If you have one doctor who charges $100 for a visit and another doctor who charges $125 for a visit, it means nothing to you: you pay a $20 copay in either case. So you don’t pay attention to it. Granted, the insurance company who reimburses the doctor will only reimburse $80, but that’s not your problem. Unless you are paying for the visit out of your own pocket.
Likewise with prescriptions: you don’t really care if the drug costs $60 for a one-month supply or $600 for a one-month supply, you’re going to pay $10 for a generic and $20 for a prescription. And anything else is between the insurance company and the pharmacy. Unless you happen to be stuck paying out of pocket (and that is the minority).
You may not know this but insurers (including government insurers) pay based upon a concept of a “reasonable price” for the specific procedure in your market area. What they do is they keep a running database of provider charges for given procedure codes. When the running average on those charges goes up sufficiently, provider reimbursements go up. That’s why, if you (or anybody) ever takes a look at an EOB (Explanation of Benefits), you’ll see that the “amount charged” always, always, always exceeds the amount approved for payment. Doctors, as an industry, know this and are working to inch up the amount the insurance companies (including government funded insurance) will approve for reimbursement.
In a free market system, on the other hand, you will likely care whether the doctor charges $125 or $100 for a visit and go to the more affordable one. And with as many individual providers as there are out there, the market, itself, would keep prices under control. But that’s not our system, is it?
The same with pharmaceuticals (but I won’t belabor the point).
The system doesn’t really work all that well, because, while most Americans are covered by health insurance, that health insurance is extraordinarily expensive (average cost for a family to be insured by employer-provided health insurance is about $11,000 per year). For a low wage earner, that is a huge part of the cost for employing a person. (In my company, which has mostly middle or high wage earners, the fringe rate is about 35%)
And the problem is that those people, in the minority, who have no health insurance, either government provided or employer provided, get stuck: either with astronomical insurance bills or, potentially, astronomical costs by a system that is based upon how to game the system, rather than how to provide value.
The socialists out there say the solution is to have government control the costs. Well, here’s the dirty little secret of all of this. This problem was caused by government provided health insurance, a/k/a Medicare. That’s the dirty little secret that they don’t tell you. Diagnostic Reference Groups (DRGs) and Procedure Codes were initially implemented by Medicare back in the 70s as a method of controlling costs. Those methods were then picked up by commercial health insurance companies. While they did so for a little while, the doctors, the hospitals, and the pharmaceutical companies figured out how to start gaming the system in order to improve their reimbursements.
And, over the past 30 years, we can see where that’s gotten us.
A government funded system, while it likely will be able to help the problem of excessive costs in the short term, will have disastrous consequences in the long term. The problem is that the entire system needs to be restored to having natural free market controls…that is the only way that, in the long term, that the problem can be kept under control.