On 31-8-2009 18:10, Jeremy "UncleHoot" Praay wrote:
> Something that I've talked about for years is the possibility of having 
> health cooperatives as a means of getting insurance.  Because they are 
> non-profit and member-owned, YOU (collectively) would decide what (and who?) 
> the insurance should cover.  Yes, these are getting a little bit of 
> attention lately.
> 
> But.  I'm not sure this really solves the problem.  Why are healthcare costs 
> rising?  Insurance.  Maybe lawyers factor into this to some extent, but the 
> real reason is that we HAVE insurance.  When you take your car in to get new 
> brakes (assuming you don't do it yourself), they tell you "Oh, you need new 
> rotors, yada yada.  $350."  At that point, I say, "I've got a buddy that 
> will simply change my pads and it'll cost me $40 plus a 6-pack of beer." 
> Ok, you don't want that buddy doing your heart transplant, but the idea is 
> the same.  If my auto-insurance covered the $350, would I care?  Heck no! 
> Change all 4 rotors, and charge me $700.  Why should I care? 

Living in a country where more is covered by insurance then in the US, I 
can tell you this is not how it works. I must admit at first glance it 
sounds plausible, like most conspiracy theories.
Yet I simply don't want the dentist to pull my teeth if not absolutely 
necessary. Moreover preventive medicine is also insured. In fact you can 
pretty much get away with not insuring for extensive dental work because 
a checkup every 6 months or so will prevent that from happening in most 
cases.
Another factor that you did not include is the professional standard of 
doctors. In general they won't do unnecessary procedures. Those few that 
do and are found out are kicked out of the profession. Not because of 
the fraud, though that is a factor, but for unprofessional conduct.

The trick of insurance is to punish those who let unnecessary procedures 
happen. If your car insurance pays such bogus repairs as in your 
example, it has to raise the amount people have to pay for the 
insurance. That will result in people going to other companies and there 
fore a loss of money. Another thing is that regularly someone brings a 
car with the same problem to different garages and publishes what they 
charge. Most firms don't like it when they appear in a paper showing 
that they charge 10 times a much than a competitor.

If you talk about wasting money in hospitals, they should get financial 
incentives (from the government) if they reduce the number of stays in 
the hospital and if they reduce the amount of MRIs etc. etc.
In general our media are focussed on finding out if and why our health 
system fails and then the government often tries to patch that. For any 
particular problem that may take some years but people know that they 
are watched and often repair things before we even need a new law.

Unfortunately for you, such a system requires journalists and a 
government that is not influenced too much by the current players with 
money. So it is extremely difficult to change your health system if you 
do not at the same time reduce the influence of big companies on your 
broadcasting companies and your politicians. (I originally wanted to 
write "if you don't stop selling your political offices to the highest 
bidder", but you might be offended if I put it that way).

(Ok, I know it is not as ideal as I tried to sketch above, but still our 
health care system works better and is cheaper than that in the US. I.e. 
for the general people like me, not for the very rich of course)

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