Health Care, Insurance Companies, Antitrust Laws, and Obamacare

My dad, Jack Goldstein MD, wrote a decent article on healthcare, antitrust laws, and insurance companies, which you can read here. I thought I should share it and add some background information. He also wrote a petition on moveon.org about the same issues.

For background, US antitrust laws are federal and state laws, which regulate corporations to promote fair competition in the marketplace. They can prevent monopolies from forming and benefit consumers. However, antitrust laws as they are currently written affect physicians much differently. They essentially make certain types of cooperation within the medical community nearly impossible by criminalizing discussion between physicians on how much money they make. Of course, there is much more to cooperation than just discussing pricing, but this is significant because this lack of transparency surrounding doctor’s wages allows insurance companies to pay certain doctors different amounts for doing the same procedures. This defeats the entire purpose of antitrust law. In a similar sense, insurance companies also dictate the paths of patients by deciding how much to cover and what not to cover at all. One part of the article I disagree with is his mention of Sweden’s healthcare. They do have excellent healthcare, and health care costs are actually lower there too.  Healthcare costs to cover everyone in Sweden amount to about 9% of their GDP.Total_health_expenditure_per_capita,_US_Dollars_PPP_(alt)

While the Affordable Healthcare Act has covered more individuals, and it has likely helped some, it doesn’t insure everyone, and it doesn’t establish healthcare as a right, which is most important. The Act mandates everyone must have health insurance or face a financial penalty, which is a crony capitalist gift to the insurance industry and an unfair burden on those who don’t qualify for free Medicaid / Medicaid but can’t afford private medical insurance.  Health insurance itself is an issue as it doesn’t guarantee healthcare. It only guarantees the right to file claims, wait an unreasonable amount of time, suffer complications from our worsening conditions and eventually have our claims denied most likely.

Owners of large, for-profit hospitals and insurance companies only care about profits, for the most part, and this is the major reason healthcare is a disaster in America. Large insurance companies (of all kinds) don’t want to pay when someone files a legitimate claim. They along with the owners of large for-profit hospitals also don’t want to pay doctors for doing hard work, so doctors often struggle to provide good, timely care and many patients struggle to get it. Some noble doctors provide free care out of compassion but doing so can be financially untenable for doctors and many people still die in this system that leaves many out.

I think the reason we have had such difficulty getting to a single payer system in America is that the US government doesn’t want to use our tax money to pay for it, even though most Americans support it. And major American medical insurance companies don’t want it because it would put them out of business. America’s healthcare is expensive and in bad shape because of greed, not among the majority of doctors, (although there are certainly some) but among owners of large for-profit insurance companies, big pharmaceutical companies, large hospitals, and corrupt politicians who collude with them and ensure they are fairly unregulated. But there are solutions and rewriting antitrust laws in America would be a realistic, achievable reform, as we work towards a single-payer system that provides everyone with healthcare. So long as we have governments that tax (extort) us, tax money ought to go to social services like healthcare and not punitive services like prison, war, and policing. But healthcare could be established as a right without any government by collectivizing hospitals and trading hospital services for other goods and services.

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