Four Health System Fixes Neither Party Will Touch

Here’s an interesting article at Vox that outlines four ways the US health system could be improved, but neither political party will dare touch.  They are:

  1. Let in more immigrant doctors
  2. Curtail pharmaceutical monopolies
  3. Let non-doctors treat patients
  4. All-payer rate setting

Those first three are fairly self-explanatory, but the fourth is a little more complex. This excerpt helps explain it:

In Germany, the Netherlands, and the exotic foreign land known as Maryland they practice what’s calledall-payer rate setting. That means that instead of each insurance company negotiating separately with each hospital group on prices, a government commission sets a price that everyone pays. And it works. Maryland has curtailed cost growth without inducing any noteworthy shortages of health care facilities

Another advantage to all-payer rate setting beyond the simple ability to set low rates is that it would eliminate some of the necessity of doing everything through an insurance company middleman. Right now, one of the services your health insurer provides is a real insurance function that helps you hedge against risk. But for many people, the insurer’s most important practical role is as a negotiator. Since the insurance company has a lot of scale, it can get a good price from a doctor or a hospital. An uninsured person would have to pay at a much higher rate.

Reducing the insurance company’s role as a negotiator would let insurers focus more on the insurance function, and allow routine care to be handled in a more consumer-focused way. And by eliminating some of the advantages to sheer scale on the insurance side, it could also promote more competition in the health insurance industry.

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