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Unbroken's avatar

Is the healthcare industry, in America, as we know it today, a cartel?

Asked by Unbroken (10185 points ) December 11th, 2013

Would you agree that the healthcare industry is a private cartel?

And is the government trying to legislate it into a public cartel?

Basically we have alot of credible sources claiming we have a cartel history books and policy indicate deregulation is the answer. And instead we are heading toward down the path of public cartels. An example of a public cartel is OPEC.

So is this where we want to be headed? Whether one is democrat or republican I don’t think any nonmembers recipient of cartels like or want that kind of answer, so why aren’t we talking about this?

Why are we so divided? Why are we playing partisan politics?

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18 Answers

DWW25921's avatar

Would you agree that the healthcare industry is a private cartel? YES! sorry for yelling

And is the government trying to legislate it into a public cartel? Well duh

So is this where we want to be headed? No, but we’re starting this new healthcare system with a firm foundation of corruption… What could possibly go wrong?

so why aren’t we talking about this? Because it is the law and at this point beating your head into the wall would be less painful.

Why are we so divided? Why are we playing partisan politics? Because of misguided loyalties perhaps?

Michael_Huntington's avatar

That’s an insult to cartels

KNOWITALL's avatar

Yes. We are held financially hostage by high costs of healthcare. I still believe it is nonpayers & big pharma greed.

zenvelo's avatar

The problem with the economics of health care is that there is no way for a consumer to cost compare when they are sick. Since the consumer is held hostage, the usual economics forces can’t be at work.

So the best way to solve it is to declare health care a right, and that there are no more for-profit hospitals.

The health care system does come close to a cartel because the networks tend to be monopolistic in their area. A Physicians Group will align itself with a hospital. Usually, that hospital restricts access to only one or two Physicians Group. Thus, the customers are a captive audience.

SavoirFaire's avatar

Of course not. Cartels kill far fewer people, always get the job done quickly, and let their victims die with dignity. The health care industry, meanwhile, kills people they’re supposed to be saving, drags the process out as along as possible, and makes you beg every step of the way. ~

But yes: according to the technical definition of “cartel,” the health care industry certainly does seem to qualify. Moreover, those participating it don’t even seem to notice. I remember a most illuminating statement made by one of the doctors I served while working in a hospital. He looked at me one day and started complaining about how little money he made. “I thought by now I’d be one of those rich doctors you always hear about.”

The previous year, he had purchased his own private island.

drhat77's avatar

The health care industry kind of has people by the balls so it’s always hard to think rationally when you are a patient. And because US is schizophrenic about it (Is it a business? Is it a right?), we’re half-assing it the entire time. ACA does not address these issues, and they run too deep to be changed with even this monumental legislation.
I don’t think in general the healthcare industry is trying to “get you”. There is probably the same amount of corruption any pooled amount of money typically brings. I think most cases the situation is that health care is trying to please too many masters and ends up pleasing none.

rojo's avatar

@drhat77 is it the health care industry or the insurance companies? Or, perhaps both working in cahoots?

Espiritus_Corvus's avatar

@rojo Right you are. How many Hospitals have you seen with the name Kaiser-Permanente or Humana (HCA) on the side of them? These are insurance companies. And they own hospitals. Conflict of interest, much? Where’s the outrage? Where are our lawmakers on this? Crickets. Stockholders don’t legislate against successful money-making schemes, no matter how unethical.

There is only one way to make a profit off sick people, and that is to promise them services for money up front, then withhold those services when they need them. It’s a lot easier to pull this off if you can control DRG policy—hospital discharge criteria—by owning the hospitals you insist on sending your clients to.

Unbroken's avatar

@DWW25921 So apathy?

@Michael_Huntington Hrm. What does that mean?

@KNOWITALL I won’t argue about big pharma greed. But cartels are motivated by greed. Question though because I don’t know. Who are these non payers? Everyone I know pays through the nose even if they can’t afford it. If not they have creditors and they eventually get paid. Sooo that leaves illegals who don’t have to worry about credit history? The homeless… How many of those people are too scared of systems like that to even go.. and of those that go how many don’t get kicked out on their ear as soon as they are stable enough not to die?

How much money annually does this cost the health care system in a year, how much does the health care system net in a year?

Does any one have these figures, even if just broken down by a particular institution.

@zenvelo Yep, Banner health a legal non profit owns this healthcare in town, and they own a large chunk of ever expanding land as well. I get surveys after an outpatient procedure or an er visit… Asking if I would recommend them… I say no and tell them why. And it isn’t just because of the staff infections so many have gotten there, or the fact a maintenance guy stroked out and died while at work there. Or because I have to explain to many doctor’s what my condition is or they have to google it… They just have crappy service all around.

I get most of my major medical our of town. But how do they do it, ppo’s they tell people they will pay less if they go to this particular list of providers. The patient is just relieved to catch a break, and then they refuse travel expenses if a person can get be treated with in a area. The only people who need this are really sick. Which means they are really broke, the rest of the population is too busy to notice.

@SavoirFaire Wow, just wow. But I would say most of the docs I met are not that rich or callous and do care about the patient, though they are ignorant and too busy to get to attached.

@drhat77 true there are too many groups feeding off the pool, so many that when they are swarming you can’t tell where one ends and another begins.

@rojo Or the FDA or the colleges teaching the doctor’s and doing studies or the pharmaceuticals trying to research and push pills or the lawyers and malpractice insurance companies. Or 3m invacare or other companies that supply medical equipment… Are they in cahoots do they have to be? They just have to get along well enough to drink from the pool I think…

@Espiritus_Corvus I was born in Humana as a matter of fact, they are an insurance company too?

drhat77's avatar

I find that when insurance companies also deliver care, like Kaiser, they are more into pushing preventive services, like weight loss and mammograms, etc. it is better for their bottom line over the long run to keep their pool as healthy as possible. Its when these interests are split is when the insurance companies try to push costs off on the hospitals and doctors offices, and then these care providers deny services.

Unbroken's avatar

@drhat77 Interesting, I was looking up what would be considered preventive care apparently some things considered preventive are coming into question.
In doing so I stumbled on the distinction between preventive and diagnostic care.

Preventive = Deductible does not apply When you have no symptoms, noreason tothink you aren’thealthy,andyou geta serviceortest listed in the Preventive Health Care Guidelines, it’s a “preventive service.” If your doctororders a preventive service more often than these guidelines suggest, it’s still a preventive service.
Diagnostic = Deductible applies When you have some risk factors or symptoms, your doctormayorderone ofthe tests listed inthe Preventive Health Care Guidelines as a “diagnostic service” to diagnose what’s wrong. It’s the same service, but it’s not preventive care.

Wait.. here is the list and they don’t mention diagnostic v preventive.

drhat77's avatar

The prevention issue was just an example. They seem to be incentivized to keep patients healthy because that prevents higher costs decades down the line. When I was in Kaiser, they sent me a letter the minute my BMI was higher than 30, with weight loss classes and ideas and a threat to raise my premiums if I didn’t rein it in in 6 months. Sounds a little cold but by nipping obesity in the bud they prevent higher costs later. When insurance and providers are split up I think they can play the game of pushing those downstream costs off to someone else later, so it doesn’t make fiscal sense for either party to address obesity immediately.

KNOWITALL's avatar

@Unbroken Everyone I know blows off paying their medical bills, it’s actually a HUGE pet peeve of mine. You owe it, you pay it, period. Yes it’s high but you got the care so buckle down and do it. I’m not a stats gal, I just know from personal experience and loan officers who say “don’t worry, everyone has medical bills, just pay everything else off.”

Unbroken's avatar

@drhat77 I had never considered it from that perspective. I am résistent to that form of babysitting. The equivalent for that is car insurance and being pulled over or paying higher premiums because I don’t wear seat belts frequently. That sort of oversight into my personal choices I feel is a violation.

@KNOWITALL I have found quite the opposite anecdotally, personally and my associations. I tried googling and am now asking fluther for actual data.

drhat77's avatar

It’s actually more fair, since THEY will have to pay for the consequences of my being obese in the form of heart attacks and knee replacements, so they should charge me up front if I choose to be obese

Unbroken's avatar

I do understand the principal behind it. I just don’t like it, it’s like viewing myself as a commodity.

drhat77's avatar

Don’t view yourself as a commodity. Just think of it as proper alignment of goals: if you stay healthy, they have to spend less money on you, so they make money. So just like you want to stay healthy, they also want you to stay healthy.

SavoirFaire's avatar

@Unbroken Most of the doctors I met cared about the patients as well, even Dr. Private Island. The problem, as you mention, is that many of them were ignorant of how the system worked for those on the other end. They fail to understand that truly caring for the patients means not subjecting them to the system that has been built by the health care industry—a system in which doctors are nearly all complicit.

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