They used the Physician fix because it always finally gets approved. A cynic would say that they go through the entire drama of the Physician fix to generate campaign funds from doctors.
There is certainly a lot of waste in our health care system, we spend more than any other modern economy on health care, twice as much as the average and three times more than the lowest. All with generally average outcomes. This is a terribly inefficient system.
And it is not hard to understand why our healthcare system is so inefficient. If you rank the modern economies by the percentage of the health care system that is in the hands of for profit entities it corresponds almost exactly to the order of the list of the most expensive health care countries.
The healthcare system is one of the parts of the economy that doesn't lend itself to the for profit model. It is best and most efficiently handled by professionalism.
It is quite doable. that we could save quite a bit in our annual costs for health care if we went to single payer, Medicare for all. But one trillion dollars a year is overstating the possible savings. We spend about three trillion dollars a year on health care. Saving one trillion dollars a year would require the complete squeezing out of the for profit businesses involved in the healthcare sector, an impossible goal realistically.
I'm saying the oppposite about the physician fix. Every year they promise to cut the payments to doctors but never do. The promise of cutting payments to doctors was included in the costs even though congress never cuts them.
I think we could easily find that we actually use too much health care in the US and finding ways to ration it will save us money and better care, but we pay our health care officials much more than other countries, so to get costs down we are going to have to pay doctors and nurses a lot less than we actually do. Good luck with that.
We don't use too much health care in the US. The Japanese visit doctors almost three times as often as Americans and have a per capita cost of health care less than half of the US.
The Physician fix or Doc Fix applies to Medicare, not ObamaCare. Congress boosted the payments to doctors over what is allowed by the legislation establishing Medicare. But they would only put a one year term on the legislation boosting the payments. In other words, if they didn't pass the legislation the payments would drop. Minor point.
I am assuming that you meant that when the Democrats were trying to cost justify ObamaCare that they assumed that Congress wouldn't pass the Doc Fix legislation. It is the only way that what you said makes any sense. I don't know that it is true, I have to rely on you. But if this is the case, it certainly isn't the most blatant fabrication that was ever used for justifying legislation.
And I have to point out that none of the predictions that conservatives made, and still make, about the economic problems that ObamaCare would cause are anywhere close to reality. It hasn't caused premiums to balloon, it hasn't been a job killer, it hasn't added to the deficit, it hasn't resulted in death panels deciding who would get health care. Compared to you and yours abysmal failure to predict outcomes the Doc Fix failed prediction seems rather tame.
The reason that health care in the US is so expensive is because of the large amount of for profit businesses in the health care system. You only have to go back to 1970 to see a time when the per capita health care cost in the US was about average for major economies. Since then our costs have exploded to more than twice the average. Why?
In 1970 the health care system was in the hands of charities and government. People's access to health care was through the large community rate based, non-profit insurance companies, Blue Cross-Blue Shield. Blue Cross-Blue Shield was large enough that they could control the rates paid to doctors and hospitals, none of whom would have hardly any patients if they refused to accept Blue Cross-Blue Shield.
Hospitals were owned by charities or government, usually local government.
Then things started to change. Hospitals were increasingly run by for profit companies who quickly learned how to game the system. Before regulations stopped it, hospitals were over built the charities and local governments who owed them went bankrupt when they couldn't fill the beds. They finally sold them to private, for profit companies for pennies on the dollar.
Then in the 1990's the Republican majority in Congress and the Blue Dog Democrat Bill Clinton turned most of the Blue Cross-Blue Shield companies into for profit companies at a time when the for profit insurance companies had only a 5% share of the market for at risk health care insurance. At this point medical costs started to balloon, no longer was one insurer large enough to able to dictate rates. For profit insurance companies can't be expected to try to control medical care costs, as long as they can raise premiums, profits rise along with the medical costs.
Yes, we pay doctors more, but we have fewer doctors than other countries, 2.4 doctors per thousand people in the US compared to 3.1 doctors per thousand in the other countries. A 23% difference.
Tell me, does your superior economics to mine, that is confused by all of the factors that go into the economy, that has no reliable way to measure the economy, does it say that it is better and more efficient to use the private enterprise system to deliver health care?
That it is probably one or more of those unknown factors in the economy that has more than doubled medical costs since the private sector has taken over more than 50% of the business, that we don't know for sure that the costs have doubled because you have no way to measure the total costs? That you have no way to measure the size of the economy exactly?
