Image Source: https://online.hbs.edu/blog/post/what-is-healthcare-economics
I honestly haven’t thought too much about healthcare in my life. I am still on my parents’ insurance, and with 7 people in our family, we meet our deductible quickly and don’t have many issues with paying for our medical care. When I start working full-time after I graduate, I’ll sign up for the health insurance that is available in my benefits. So, I know that I won’t struggle with finding insurance and worrying too much about how I will afford to get my healthcare. However, that’s not the case for many people in the United States. I find it disappointing that there is such a disconnect between doctors and their patients. The third-party payer system has corrupted the personal relationship that used to exist between people and their health providers. Our entire healthcare system is based on money instead of care.
**Competition
**
I think all of Dr. Flynn’s points were very valid, but I’m having trouble finding a way that this could be implemented in the United States. I feel like the healthcare system now is based on making the most money possible. Trying to create a system that keeps prices low seems unlikely. I know that Dr. Flynn said that we should increase competition to keep prices low, but he didn’t really give options on how we can make that happen. Because of the low competition, prices get higher for all medical services. Hospitals are merging, and in most major cities there are only one or two large hospital systems. There are also many physicians working at hospitals now instead of private practices. This decreases the options that people have in where they can receive their health care. When an office is purchased by a hospital, the prices typically increase because hospitals can set the prices as they want.
Another factor in the lack of competition is the difficulties in becoming a doctor. The extremely high prices of medical school make it difficult for people to obtain their degrees. If medical school was more accessible, more doctors would be available to increase competition. If there were more doctors in the field, more of them could have private practices or offices, and people could turn to these establishments instead of hospitals.
**Power of Hospitals
**
I think hospitals are one of the biggest problems in health care. I have heard countless stories about people going in for a service, and they receive a huge bill. When they call the hospital and ask for an itemized bill, the hospital will remove some of the charges and their bill decreases. I have also heard that you can call the hospital and ask for discounts and they will remove charges, bringing down the bill. This tells me that hospitals are overcharging for no reason and that they take advantage of patients who don’t know about these “hacks”. This seems like a corrupt system in hospitals, and I think they should always send itemized bills in order to prove what they are charging for.
Telehealth
I think that the increase in telehealth on the market is good for increasing competition and keeping prices lower. This is an alternative to visiting an office or hospital and can be cheaper and more convenient for both doctors and patients. On a visit-to-visit scale, they cost less than a typical in-person appointment. They are for primary care and non-emergency visits, which are some of the services that are being moved to hospitals. I think that hospitals should be left for emergency care, but primary care services should be more evenly spread to other offices and practices. Telehealth also makes it easier to find a doctor outside of traveling distance. This allows patients to explore alternative options to what is near them. If telehealth systems focused on doctors that were not part of hospitals, there would be more business for smaller practices, and competition could be increased. I think this would be a better system, but with the power of hospitals to purchase and merge with others, this does not seem likely. I am having trouble thinking of a way to implement a system with more competition. Hospitals have become very powerful, and it is difficult for smaller businesses and practices to find their place in the market.
Conclusion
Overall, I think the biggest problems with our healthcare system is the disconnect that comes with a third-party payer system and the power that hospitals have. The third-party payer system is taking away the bond between doctors and their patients that we used to have in the United States, and that still exists in other countries. Large hospitals absorbing other hospitals and smaller practices are eliminating competition, which is essential if we want to lower prices. I think a good start to this problem is using telehealth more frequently, which has become popular since the pandemic. Besides that, I feel a little bit lost about what other techniques we can use to expand competition and decrease our reliance on the third-party payer system. I look forward to hearing about some potential solutions in class.