Friday, March 05, 2010

A muff on the Mitt watch

It's fair to assume that whatever the post-2006 Mitt Romney says about a given issue will contradict something he's said or done on the same issue in an earlier incarnation.  Nonetheless, Steve Benen misfires somewhat in this round of Mitt Hypocrisy Watch:
"The president has been disingenuous trying to lay this at the feet of the health insurance companies," he said. "Nobody believes that health care is expensive in America because of insurance companies. Health care is expensive because we use a lot of health care treatment."
Yes, Mitt Romney wants to a) defend universally-reviled health insurance companies as they jack up everyone's premiums while reaping huge profits; and b) thinks health care would be a whole lot cheaper if we'd all stop getting treatment for our ailments.

I'm tempted to ask him, by way of a follow-up, why health care costs in the United States are vastly more expensive than any other country on the planet -- per capita -- even as people in other countries seek treatments for their ailments, but Romney would probably just pretend reality doesn't exist and change the subject.

Actually, health care is more expensive in the U.S. than in any other wealthy country partly because of administrative and marketing costs imposed by for-profit insurance companies, and partly because doctors prescribe and patients demand a lot of unnecessary treatment, but mainly because all payers in the United States pay doctors and hospitals far more per treatment than payers in other countries.

Our system is hugely wasteful -- myriad insurance companies each with their own coverage rules and payment schedules jack up providers' administrative costs and therefore the price of treatment. But at the same time, insurance companies lack the pricing power that governments in other countries arrogate to themselves (including countries like France, Germany, and Japan which use private but nonprofit insurers) and so in large part they just pass through the inflated prices that doctors and hospitals are able to charge.

The worst damage imposed by our insurance delivery system is in our failure to impose uniform coverage rules -- what is covered, what is not, how much insurers are allowed to charge. That can't be fixed without an individual mandate to widen the risk pool. And our system won't truly approach the effectiveness of that of other industrialized countries until the government assumes price control over treatment.

1 comment:

  1. Nice post Andrew. These are the dirty little secrets that no one is talking about.