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Lastly, we need to lower overall costs. Running everything through an insurance company seems to be adding an additional layer of profit to further enrich the insurance companies, one of the most powerful lobbies in the country. Is the motivation behind this one sort of making sense now?

Forcing all Employers to Provide Health Insurance

First, it (again still) puts no downward pressure on health care costs. (Does this sound vaguely familiar?) Second, it does nothing for those who are not employed or who are self-employed.

"If you can’t convince them, confuse them."

Third, if you subscribe to the "creates new jobs" philosophy, it will actually only increase the cost of labor. I can assure you there will be fewer jobs, lower service levels, and higher prices for other goods and services. Aye, there's the rub: the costs of health care will be borne by every product or service we consume in this country.

"Many citizens engage in behaviors that are directly destructive to their health such as poor diet, lack of exercise, smoking, drugging, drinking alcohol in excessive, etc. These behaviors drive medical costs like no other."

Finally, it will make all products made in the U.S. even less competitive than those manufactured elsewhere. Ever wonder why the manufacturing jobs keep going overseas ? Consider the labor cost difference between the U.S. and China. Then consider those foreign-made goods, that were put on a boat that sailed almost 4,000 miles and are still cheaper than making them on our soil. The primary cost drivers for U.S. manufactured goods are labor costs, U.S. government regulatory costs and other government-imposed restrictions (But that's another topic relating to inefficient and badly managed government for another article.)

Pool Large Numbers of People and Negotiate Lower Rates

This puts very little pressure on health care prices. It doesn't affect the operational efficiency or the treatment/prescribing decision-making process. What if you aren't in one of the larger pools of insured? In this scenario, it wouldn't pay to be a big fish in a small pond. This proposal solves no problem; its strategy, as an old business law instructor of mine said, if you can’t convince them, confuse them.

Causes: Players With Incentives and Resultant Conflicts of interest Players: Media Untruthfulness in Ads

Have you ever noticed that every commercial ends with how their product or service will solve your problem? Weight loss → Call Jenny. Headache? → pain reliever. Heart burn? → Antacid. I don't really expect to see commercials anytime soon that say, "Want to lose weight? Get counseling, exercise, make good food choices, and eat reasonable quantities. Have a headache? Drink Water. Go to a quiet place, lie down and relax. Heart burn? Stop eating the foods that cause you discomfort. Try something simple first. If the problem persists, see you health care provider.”

Player: Citizen/Patient Behavior

Many citizens engage in behaviors that are directly destructive to their health such as poor diet, lack of exercise, smoking, drugging, drinking alcohol in excessive, etc. These behaviors drive medical costs like no other. Providers can only do so much; the rest is up to the patient. By the way, many of these behaviors are caused by physiological dysfunctions and the patient would probably benefit immensely from psychotherapy. My father had an old joke: Q: How many psychologists does it take to change a light bulb? A: As many as seven, but the light bulb has to want to be changed.

"The earlier you detect a problem the less unpleasant the treatment, the less expensive and the greater the probability for a complete and successful cure."

Unfortunately, many citizens do not get regular check ups. The earlier you detect a problem the less unpleasant the treatment, the less expensive and the greater the probability for a complete and successful cure. The education about breast cancer in this country has saved countless lives, pain, suffering and (of course) money. Similar education about other diseases (like prostate or colon cancer) would reap similar benefits.

I've heard the argument, "I can’t afford regular checkups..." Depending upon where you get treated, an annual check up is probably a few hundred dollars. If you can't set aside less than a dollar a day to take care of your most prized possession (your health), why would you expect someone to care more for you than you do for yourself? I do believe some people really can't afford it; however, I think many can but won't. Lack of annual checkups or only seeking health care at the onset of symptoms also leads to avoidable and expensive trips to the emergency room (ER). High costs are also driven by early triage treatments and the fact that emergency rooms can't turn away people in need.

"How many patients don't follow the advice of a health care professional and wonder why their health doesn't improve or worse, continues to deteriorate?"

Iatrophobia (fear of doctors) is another barrier to cost limiting efforts. Many are afraid to seek medical treatment. This fear is almost always overcome by pain and then they end up in the ER.

I once overheard someone complaining, "I took the time to get a check up, paid, and the doctor told me there’s nothing wrong with me. What a waste of time and money." I didn't quite see it the same way...

"Some patients are downright bullies. After watching the commercials, these patients tell/insist/demand their practitioner prescribe a particular medication."

How many patients don't follow the advice of a health care professional and wonder why their health doesn't improve or worse, continues to deteriorate? Even mainstream AMA doctors are beginning to prescribe vitamins more frequently. Oh well, you can lead a horse to the treatment plan but you can't make him sign the consent form.

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