In the US – Understanding the power triangle in Healthcare –

A precursor to understanding the triangle is why the government is not listed as a leg of the triangle and that is because government regulation sets parallel to all three legs and has different effects on. Also, not included in this explanation is the patient since they are not a power entity because their input into American Medical Healthcare is only as a tool of the insurance companies, lawyers or government. This is not to be construed as all inclusive.

Leg One – Hospital Administration:
Leg Two – Insurance/Lawyers
Leg Three – Doctors

A hospital is a business and as such their goal is to make a profit; even non-profit hospitals are in the business of profit for reinvestment since the pay of its administration is based on the number of beds in the hospital. Hospital Administrations are stuck between the needs of the needs to supply the needs of the customers of insurance companies and federal government dollar recipients with the demands of the doctors for equipment, money and labor (support staff). If a Hospital Administration starts to favor the doctors they will start losing insurance and federal money due to inefficient work practices. If a Hospital Administration starts to favor the money received from the government and insurance companies then disgruntled doctors will no longer associate with the hospital.

Insurance and lawyers are listed together because they are a direct relationship in cost and care. One side of insurance deals with malpractice insurance for the doctors which is directly related law suits which are signified here by the lawyers (see below). The other side of insurance is “patient care”. The ideal situation for insurance companies, also seeking a profit, is a patient paying in for coverage and never needing medical coverage. Since the situation is impossible, in order to maximize profits and prevent abuses of the system insurance companies established rules and regulations for the payment of medical services. These rules are generally in direct conflict with the desires of Hospital Administrations and the Doctors.

Doctors are forced to follow the insurance company standards to maintain a solid customer base and at the same time pay out huge malpractice insurance rates due to law suits. While it seems the doctors are the “poor guy caught in the middle”, remember everyone in this system knows that without doctors this multi-billion dollar industry collapses so they are generally a well paid and sought after asset.

In the end you end up with a triangle of power with each leg trying to increase their profits. What ends up happening is that the each institution finds new ways to make or save money that ultimately causes the federal reimbursements to increase or the cost to insurance companies to increase or both. Those costs are passed on to the tax payers and the insurance policy holders in the way of new/higher taxes and higher insurance programs.

This system is obviously not working but before we give credence to a national healthcare plan you need to look at why it is not working and see where a national system may help or hurt.
1) Hospital Administrations are tied to the payments they receive from the government and insurance companies. This does not change with any of the national healthcare plans and in fact becomes worse since the hospitals will be solely reliant on those payments.
2) Hospital Administrations are run by people seeking profits and increase salaries and this is also not altered by national healthcare plans.
3) The doctors are highly trained assets that are sought after with money and benefits (like all employees) and are in limited supply. The only way this issue is covered in any national healthcare plan is to limit doctor income. They don’t label it as such but when you mandate $$/procedure then you are limiting income or promoting the procedure. It is only a matter of time before that procedure is cut or the payment amended if the costs get too high. You limit doctor income and you will get fewer doctors and ever worse patient care.
4) Limiting law suits has been brought up in national healthcare platforms but on a personal note: since lawyers are creating these proposals I doubt you will see any real limitations placed on legal actions.
5) Insurance companies are out for profit as well and they hold a powerful card in that they control a majority of the patients and therefore they wield undue power in medical decisions that effect patient care. There are two trains of thought on national healthcare where one allows for the insurance companies to retain control of their client base but operate under government “guidelines” and the other is that the government takes over the whole medical insurance industry. In neither case do you remove the basic problem of an entity having too much control and making decisions based on $$ instead of the value of patient care.

In all cases a national system fails even compared to our current system because not only do you have the same problems you are also saddled with increased bureaucracy and increased waste (remember this is going to be a government program). I would love to see everyone have access to medical treatment when they need it but just like zero unemployment it is a scenario that reality will not allow no matter how many programs you set up or how much money you spend.

I am against the idea of government healthcare and here are a few reasons why:

Healthcare entitlements such as Medicare, Medicaid, and SCHIP already cost our government over 600 billion dollars a year and are reported to go bankrupt with the decade.

The Kaiser Foundation projects that it would cost us at least a trillion dollars and Americans would feasibly see their taxes hit 70% of their income to pay for universal coverage.

European countries with good healthcare do not have our military, space, or infrastructure costs. Their tax burden (with government healthcare and better public schools) is roughly half of their income. We are already paying a third.

Countries with government healthcare have begun to put restrictions on citizens who might become a burden to the system.

That great northern paradise Canada is already feeling the pinch of government healthcare and currently trying to choose between charging a copay or raising more taxes.

The UK's dental service is almost nonexistant as more and more dentists opt out of government payment to make money in the private sector. Because of the shortages, almost half the citizens do not have access to a government dentist and some 20% don't visit a dentist at all.

In short, American politicians want government healthcare as a backdoor way to fix Medicaid.

For our system to even be on the same level as Canada's, we would have to choose between military and infrastructure or healthcare.

A few more things to consider:

Thanks to the Baby Boomer retirement flood, America's elderly are becoming a disproportionate amount of our society which is already straining Social Security and other government services. According to the Boston Globe, our current government's entire budget will be needed just for the retired by 2050.

(Quick question I never seem to get answered by libs: Why do we have to pay for Social Security and build our own retirement accounts?)

Our government has doubled funding for public schools in the past 30 years (even adjusted for inflation) yet they remain a hopeless quagmire. Do you really want these people recruiting the best doctors?

America remains the world's leader in medical research and innovation precisely because of our current meritocracy.

Guess how Canada keeps their healthcare budget low? They force price caps onto American suppliers and give doctors formularies of what to prescribe. Guess who is paying the largest bill for these companies to make profits....

Just a little more food for thought.