One hundred years ago health care in America was very simple. Hospitals were either private for profit concerns, local, state, or federal government run, or religious charity run. The physicians were graduates from the medical schools or universities. The med school graduate interned in one of the above mentioned hospitals, after which he (almost all doctors were male) either joined an established practice, opened his own, or was employed by a hospital. Health care insurance was just starting in a few states and would grove very slowly until world war two. Most people paid cash for their care and doctors often made house calls. Those who couldn’t afford the cost of medicine, including the prescription drugs, usually went to any clinic that was operated by a charity. The city and county owned hospitals might have low cost clinics and were often the provider of last result. The medical care received was proportional to income. Not exactly the best system but it worked. The rich were over charged and the poor treated free or at below cost.
The AMA back around 1910 lobbied the government to place restrictions on medical schools to allow no more than 100,000 new doctors each year. The AMA also lobbied for regulations that forbid lower skilled and thus lower paid health care workers from providing procedures such as midwife services. This was essentially a make work program for doctors. We now have nursing certification that provide more procedures that were provided by doctors. It is unlikely that we will see nurses as mid wives in the delivery room any time soon. Health care has always been a problem when it comes to competition. The amount of education needed to become a family physician is very high once we include the internship. We have different grades of nurses according to the amount of education needed to be certified at each level. Then there are the laboratory technicians, the X-Ray technicians, and all the other machinery technicians that need specialized training. Often that access to training is limited. Then we have all the various specialties that a physician can acquire and the certifications needed to practice those specialties. This raises the question of cost. We see that any university degree has become extremely high priced and the cost of college has risen over six hundred percent since 1975. Attending medical school has always been costly, even a hundred years ago, but now the price of courses has skyrocketed out of control.
One may argue that there is competition among colleges and universities and thus extend that argument to medical schools. But as we are seeing, the competition is really among the prospective students applying to these institutions of higher learning. It is not so much a matter of buying an education but whether one is worthy to buy that education. When one buys an automobile one does not have to help build it. When one buys an education one must invest a great deal of effort to complete that purchase. One of the reasons why higher education costs rise is the availability of student loans. Back in the late sixties one could apply for a student loan and receive at most two thousand dollars a year. Now we see student loans being maximized at seven thousand a semester. If the demand for higher education rises then the universities and colleges expand and raise their prices. The greater the demand the higher the prices rise. Medical schools have not significantly expanded their facilities. The competition for acceptance is exceptionally high and we see American students trying to get into medical schools in the islands of the Caribbean. Our AMA and federal government limit by regulation which countries they will accept accreditation from and which they will not. Thus, we have a problem where demand outstrips supply not because the medical community cannot expand fast enough to supply that demand but because it finds it far more profitable to keep a monopoly hold on the country.
While the health care insurance industry has been seen as a group that preys on the gullible public and making obscene profits, this is really not the case. First one needs to understand the purpose of insurance. Life insurance is a bet you make with the insurance company. You are betting that you will die before you have paid more for that coverage you bought and the insurance company is betting that you will live long enough to over pay for the coverage you have bought. The same used to be the same with medical insurance. You bet that you will need the coverage to pay for procedures and the insurance company is betting that you will be healthy enough to use a very minimum of benefits. In each case, you are assigned to a risk pool. That is, how likely are you to die or get sick? If you already have cancer then why would a health insurance company want to issue you a policy? This is why preexisting conditions is an important issue. If we heard every individual in the United States into one giant insurance policy, then those of us who are not ill and have no preexisting conditions must pay the expenses of those who may be chronically ill and have preexisting conditions. This is what Obama Care is trying to do. Thus, the ACA will become a tax as insurance companies are driven out of the health care business. It also means that the brake of medical costs will be lost. Few individuals understand that the insurance company negotiates the charges asked by the hospital and doctors. The charges are negotiated down and that is why you may have to pay the excess. To give you an idea of just how corrupt the medical system is, take a look at a private hospital in Oklahoma. That hospital does not accept insurance, instead they operate strictly on a cash basis. The cost of the procedures they offer is a fifth of the rest of the normal health care system. And if you really want lower costs than that, go to Hong Kong for that knee replacement surgery. Go to India for that heart surgery. In both cases the procedure fees and airfare will be cheaper than even that private hospital in Oklahoma.
But if you want ACA in all its glory, go for it and be happy knowing that you will pay for everything you won’t get. So go and do your home work. Pull up health care in Wikipedia and read what is essentially a true assessment of our system.