Well, see, that's part of the problem--generally, even private insurance provides too much opacity when it comes to prices. The difference being that his is a trait that is inherent in socialized medicine, but not necessarily so in private insurance.
As for incentive, insurance companies have an incentive to minimize costs, so they put pressure on doctors to minimize unnecessary procedures. After all, they're paying with their own money. There's competition to incentivize them to maximize care at the lowest cost.
Apparently the insurance companies aren't doing a very good job, since we pay MORE per person than pretty much any socialized country. They can put a bit of pressure, but when it comes down to it they have limited control on the situation.
Precisely, but remember that there's more than one insurance company, and if you don't like your current coverage, you can shop around. Not so with socialized medicine. Granted, that introduces issues like pre-existing conditions, which is a corner case that the free market doesn't handle very well.
Please try to shop around insurance companies and figure out how they'd deal with the things you expect to happen. "Hey, if I get shot in the shoulder and have to go to ___ hospital for 3 days, what would it cost me with your company, and what would you cover?" Then call company B and get the same information.
You most likely won't be able to get the information, at least not in a reasonable time frame. Virtually the only way you get that information is to have it happen to you. Even if they do tell you, you've got to ask them about 10000 other potential situations, then repeat with another insurance company and compare the two. You also have to get it in writing to ensure that their policy doesn't change, and hope that the hospital billing practices don't change before it happens to you.
You have to shop around for something before you know what you're buying, and there are millions of potential situations that could come up. Shopping around is completely useless, other than comparing deductibles and max out of pocket. This tells you nothing about whether they will authorize the shoulder surgery that isn't necessary, but will provide increased mobility later in life (assuming you know that's what you'll need). Additionally, if you have coverage through your employer as many people do, you're basically stuck with them.
Perhaps the examples I included are small, but there are thousands of just such small examples. End-of-life care is a nice juicy one to explore as well.
Yes there are small examples of things. I don't think we have to figure out every politically charged fringe case before making a change. They're already in debate in our current system, it's not like we currently have them all figured out and changing would completely undo our understanding of them.
It's like we're debating whether our house should be built on the sandy lot or the clay lot, and you're bringing up what color the shudders for the windows might be.
Those cases can be decided under either system. Neither one prohibits them from being decided, and neither system can ensure that everyone is happy.
It looks like I need to rephrase this in the context of consumer choice/responsibility. This really boils down to a matter of avoiding unnecessary or discretionary treatment. If the patient has to pay (at least a percentage) for it, they'll have a greater incentive to only choose care that is worth it. If they see that getting nitrous oxide for getting a dental filling will cost them an extra $50, they'll be less likely to want to foot the bill. The current lack of transparency to the customer makes it much harder to decide what to do or not to do, and that lack of transparency would be exacerbated with socialized medicine.
Except they currently do have to pay for it, and they currently don't only choose care that is worth it. They might be less likely if pricing was easily available, but it's not, largely because of how insurance is currently set up. It'd be hard to be any less transparent than we are now.
There's a point where the customer doesn't get to choose what they do. Currently doctors are highly incentivized to provide unnecessary treatment and tests, because there's no reason not to. Insurance companies have limited control, although they do have some. The folks discussing their socialized systems above describe how that works sometimes.
Certainly portability of insurance is an issue. It's made worse by the fact that every state has its own set health insurance mandates, so every plan only works within one state. And the complexity of medical billing is another area that *really* needs an overhaul.
As long as there are many different insurers and plans that have set costs for different services, there will be complexity in medical billing. *One* solution is having a single insurer, a la socialized medicine.
Medical bankruptcy *is* an issue. But how much of that issue would be mitigated by catastrophic insurance?
The fact of the matter is that health insurance policy really comes down to the edge cases.
Catastrophic insurance would help, it's also expensive if you cover pre-existing conditions. Again, no free market incentive to cover a cancer survivor, as it's more likely they'll get it again than an average person.
I don't think us spending 2x as much as most other nations is an edge case at all.
