I think tackling hospital / physician costs is even harder than drug pricing. Hospitals are major employers in almost every county. For a politician to break up hospital monopolies, they would be fighting against the one of the biggest employers in their constituency.
The American Hospital Association (the biggest hospital industry lobbying group) spends about as much as Phrma (the big pharma lobbying group) according to open secrets [0][1]. But the hospital industry has much more "soft power" because they are such a huge employer.
One solution is for payers to own more of their own providers, although that is challenging to implement and can lead to its own issues and bad incentives. I think one effective angle is to help more physicians stay independent -- there is probably a way to do this without legislation and i think some companies are working on this.
But i think one thing people can do is spread awareness of this issue -- you dont see it talked about in the media that much bc no group has an incentive to do so
Medicare for All. Help try to get Bernie elected, as he’s the only candidate who actually backs the policy. Warren has back-pedaled now that she’s secured the top position as the moderate alternative.
You can only bring down costs and combat things like hospital consolidations through a single payer system and dismantling private insurance (i.e. Bernie or Jayapal’s bills), so none of the “compromises” proposed by other candidates will do anything too meaningful. If you want a good breakdown on why, I recommend Tim Faust’s new book:
A single-payer system isn't the only way to bring down costs and fight hospital consolidations. Enforcement of antitrust laws on regional hospital monopolies is another potential way. Although tipping the scales more in favor of payers, with single payer being the extreme variant of this, could work as well
The issue with any political solution is that hospitals will fight any legislation like crazy. Hospitals probably have more political power than even the drug industry, and the drug industry has obviously been able to fight price controls pretty well.
The risk I see with any political solutions is that politicians create watered-down legislation that makes voters think they are tackling the issue, but don't really have much teeth. That's the win-win for politicians -- if you pass a toothless medicare for all bill, voters will applaud you, and you won't anger potential donors from industry.
> The issue with any political solution is that hospitals will fight any legislation like crazy.
> The risk I see with any political solutions is that politicians create watered-down legislation that makes voters think they are tackling the issue, but don't really have much teeth
I agree, which is why you have to start from the strongest possible negotiating stake with a corresponding infrastructure of mass organization and support (again, Bernie and his bill).
These industries are absolutely ruthless, profit from people at their most vulnerable, and will fight tooth and nail to continue this deeply predatory behavior. If you approach them with even the slightest indication that you will bend to their will, they will eat you for lunch.
If two million trained software engineers magically arrived in the US overnight, it would certainly help the bottom lines of AMFGOOG in the short-term, but would probably drive down the long-term cost of 'I want some software built'.
Merge all the regional monopolies into one big national hospital monopoly, with all the drug buying power that brings. Then get the Trump/Clinton Care bill passed that controls insurance prices and regulates this new 'National Health Service' as the hospital monopoly might be called.
The American Hospital Association (the biggest hospital industry lobbying group) spends about as much as Phrma (the big pharma lobbying group) according to open secrets [0][1]. But the hospital industry has much more "soft power" because they are such a huge employer.
One solution is for payers to own more of their own providers, although that is challenging to implement and can lead to its own issues and bad incentives. I think one effective angle is to help more physicians stay independent -- there is probably a way to do this without legislation and i think some companies are working on this.
But i think one thing people can do is spread awareness of this issue -- you dont see it talked about in the media that much bc no group has an incentive to do so
[0] https://www.opensecrets.org/orgs/lobby.php?id=D000000116
[1] https://www.opensecrets.org/lobby/clientsum.php?id=d00000050...