Thursday, October 23, 2008

Socialist America

We already know America has socialised banking, socialised education, socialised disaster relief and emergency response, and of course, the very expensive socialised foreign policy and warfare.

Don't forget that America is a textbook example of socialised medicine. The government spends 14% of GDP on healthcare. Yet Australian socialists seem to point out that all the obvious failures of the American health system are evidently because it is a 'user-pays' system.

Forget any efforts to analyse the policy regime in the U.S.....If America was really a user pays free market, then how can this happen ?

In the US, we don't have prices, and so don't have a market.

The following is a transcript of conversations I very recently had with some U.S. health care providers, written down during or immediately after each conversation:

Conversation with Stanford Hospital:

My wife needs a colonoscopy: Could you give me a price on it?

Stanford Hospital: (businesslike tone)
Twenty five hundred to thirty five hundred.

You do this all the time. Can't you give me a specific price?

Stanford Hospital: (cooler tone)

Is $3500 the all up, all included price to both myself and my insurance?

(Previous research shows that mystery surprise additional charges are usually around a thousand dollars)

Stanford Hospital: (businesslike tone)
It only includes the doctors fee, and does not include any additional services

So after I have this done, any number of people could then charge me any fee they like in addition to the thirty five hundred?

Stanford Hospital: (distinctly chilly tone)
I am afraid so.

O'Connor Hospital

My wife needs a colonoscopy: Could you give me a price on it.

O'Connor Hospital
Do you have a primary physician.

Yes, my primary physician has advised this procedure, but it seems expensive. I am looking for a price.

O'Connor Hospital (indignantly)
We don't give out prices.

Mercy General Hospital

I am looking for a price on a colonoscopy.

Mercy General Hospital hangs up without a word.

Saint Joseph's medical center of Stockton:

I am transferred to financial counselling, who
transferred me to "Estimates" The estimating lady
appreciated my problem and made sympathetic noises.

She then asks me for a CPT code. I then research what CPT codes are, and discover that a colonoscopy can result in any CPT, and any number of CPTs. I discover that no matter what CPT I give, it is unlikely to be correct or sufficient, that additional CPTs can show up any time. A CPT would only be useful if it was possible to know in advance what CPTs would result from a colonoscopy, but the CPTs are only decided after the colonoscopy, usually long after the colonoscopy.

A better example of a free market in health is Singapore, which only spends 1.3% of GDP