Insight, analysis & opinion from Joe Paduda

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You can’t handle the truth about healthcare

Which is this:

We want access to the best doctors and hospitals, low insurance premiums that cover every treatment and drug, doctors making shipload of money, we don’t want any rural hospitals shutting their doors, and we don’t want anyone to pay higher taxes.

Oh, and we want to stuff our faces, ignore doctors’ orders to exercise, smoke, not take care of ourselves and then expect someone else to pay the bills for our diabetes, hypertension, cardiovascular disease and cancer.

There’s a reason politicians aren’t being honest with us – we want to have our cake, eat it too, and not get fat.

But there’s plenty of blame to go around; a huge barrier is the power of the healthcare industry – real healthcare reform means doctors, pharma, device manufacturers, most healthcare investors and the rest of us will make a LOT less money.

Did I mention doctors will make a lot less money?

Yes, Medicare for All would allow all of us to see whatever doctor or we want, and deductibles and copays will be a LOT lower.

But the money has to come from somewhere – which means a tax increase, and lower payments to healthcare providers.

Pretty much everyone in the healthcare industry will earn less, likely a good deal less.

How much less depends on how much we raise from taxes.

Please don’t tell me private insurers have the solution – they don’t.  If they did, we wouldn’t be in the mess we are.

As I’ve reported here, the average family with one member in poor health “pays” about $23,500 for healthcare thru direct payments, insurance premiums, what their employer pays for insurance, and taxes for Medicare, Medicaid, and other government healthcare programs.

The good news is about $5,000 of that would be stripped out; that’s my best guess at how much administrative expense would be eliminated if healthcare providers and payers didn’t have tens of thousands of people on payroll fighting each other.

Oh, those tens of thousands of people will lose their jobs.

What does this mean for you?

Fixing healthcare is going to hurt you and me. A lot. There are NO solutions that get around this.

Anyone who tells you different is lying.


12 thoughts on “You can’t handle the truth about healthcare”

  1. Amen Joe, couldn’t agree more. Getting tired of politicians saying how their healthcare plan will increase benefits and cut costs. As you say, you can’t have your cake and eat it too.

  2. You are spot on but I would add that there would be one potential major benefit if a true single payer system could be created – it would potentially greatly reduce the potential of outright fraud and abuse – which is rampant. But if not properly designed, the fraud and billing abuse might get worse. All polls and surveys show that Americans, more than any other country, want choice – almost unlimited choice – but choice comes at a cost in health care where the necessary elements for capitalistic competition are not present.

  3. On point. Thank you for stating what is not currently being stated by politicians.

  4. Politicians wouldn’t say it if we wouldn’t buy it. “We have met the enemy and he is us.”

  5. I am often at odds with your comments in your column, but I continue to read. I believe that understanding opposing views can only help to create dialogue and advance discussion. I appreciate the time and effort you put into developing your perspective and often find it provocative. However, this time I am in nearly completely congruent agreement with you. I wish your words had a platform that granted much higher circulation, visibility, and impact to the American voter….

  6. Maybe a Corporate tax for the Manufactures who make us fat put the sugar in the foods, cigarettes Manufactures, Cannabis industry. should be lose lose all round we need to grow up

  7. Joe: in agreement here. All we can do as individuals is the best we can. Work on prevention of illnesses and protection of our tax dollars for ourselves and immediate family. Educate others and be the missionaries of healthy lifestyle.

  8. I like your straightforward points, but I disagree with one item. I do not think that filing claims and fighting to get paid uses up $5000 of every $23,000 in the system. There are numerous firms that will handle all billing and receivables for a clinic for 5% of billings.
    Also, Medicare has plenty of paperwork and audits and claim denials of its own.
    Finally —
    in both the original Kaiser system and the VA system, no one fights to get paid etc, However these systems are not noticeably cheaper than all the others.

    1. Hello Bob
      Thanks for the note.
      While there may well be service providers or companies that can administer healthcare more cost -effectively, reality is commercial insurers, non-medical expenses are in the 15% range. In addition some costs that are categorized as “medical” are likely more administrative in nature.
      Add the costs incurred by healthcare providers in dealing with billing and UR – big hospitals often have hundreds of people in their billing departments alone – and it’s clear to me that admin soaks up st least a fifth of total healthcare expenditures.

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Joe Paduda is the principal of Health Strategy Associates



A national consulting firm specializing in managed care for workers’ compensation, group health and auto, and health care cost containment. We serve insurers, employers and health care providers.



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