Is there any hope to clean up the US health system in any foreseeable future? How did the health lobby get so much power and get away with all this abuse?
replies(4):
- Through extensive lobbying, the US passed the HMO act of 1973 which requires that all employers offer an HMO plan to employees. HMOs were created to keep costs down, but United really took this to the extreme, making it as hard to use your health insurance as possible, and creating vertical monopolies like OptumRX. United takes so long to pay providers for the work they do that they now offer payday loans to doctors offices, which is crazy.
- The US uses a fee-per-service model that priorities procedures over preventative treatment or patient education. Some other countries have moved towards reimbursement based on health outcomes.
- The Affordable Care Act banned physician owned hospitals, which were growing in popularity and had better outcomes for less fees to patients.
- Private Equity is swallowing up hospital systems, emergency departments, etc. The most common seller is another PE firm, so they try to make a quick return through heavy cuts and then flip it 5 years later.
Aetna "forces" you into using its pharmacy by refusing to authorize any prescription with more than a 30-day supply unless through its wholly-owned pharmacy-by-mail subsidiary.