The price gouging here comes from owning the only hospital that serves a particular area, not from any sort of evil government insurance mandate. Your choices are:
a) pay high prices at the door of the hospital
b) pay high insurance prices (to the same entity that owns the hospital)
I would be interested in a map that details distance to a major hospital vs price and also whether 95% of customers would be better served by air ambulance to the major hospital vs the local one.
One example is the hospital in El Granada just outside of Half Moon Bay. This hospital serves the local community yet it is only 30-45 mins over the hill to get to Stanford or Burlingame by car and less by helicopter. Considering that, the hospital is under utilized. Even further south in Pescardero you would go up to Stanford via La Honda typically. That is at the limit of the golden hour though. So here you have an example of a hospital that doesn't really need to exist except for widow maker events where you need to be seen as fast as possible (within the golden hour). So one question is, can you have smaller hospitals with lower revenues to serve this market. Even in rural hospitals if you need specialist care you will be transported out or otherwise wait several hours.
Could you argue that, with UPMC owning the hospital and also offering the best insurance plan for the area, the mandate increases the number of people buying their plan who otherwise would not?
> evil government insurance mandate
Don't try to gin us up. Honestly, I'd prefer single-payer. The stop-gap insurance mandate is far from optimal, which is why a lot of us don't like it - not because we think it's "evil."
I'm not super knowledgable about healthcare but my gut feeling says that this problem was around before government mandated insurance. I would think it would mitigate it a little but then also create the problem of uninsured people so I don't really follow how it makes the system better.
About 10 years ago I was able to buy individual family health insurance coverage for a reasonable cost. It excluded a couple of key things, such as maternity coverage, which I didn't need anyway, and certain pre-existing conditions which I didn't have, so I was OK with that.
You can't buy a plan like that now, because of mandated coverage of things that not everyone needs.
Costs of insurance where rising steadily and faster before the ACA. Since the ACA has started to take effect, the speed with which the cost of insurance rises has slowed.
While this plan you had ten years ago may have worked for you, many more people were paying out for low-cost plans that covered little, if anything. Mandated coverage isn't the perfect fit for everyone but, in my opinion, it is an improvement.
The ACA market place is supposed to reduce those costs.. The competition for patients by the insurance carriers who then negotiate rates with hospitals etc... Having more customers is not a prelude to higher prices. So your argument is bogus.
> The ACA market place is supposed to reduce those costs
Except it didn't and I question whether it was even supposed to. Costs were known to go up, they just mandated discounts for some types of consumers. There is no provider negotiation because the laws targeted the demand side and forced requirements upon them (consumers and insurers) and left the supply side unchecked (providers).
> Having more customers is not a prelude to higher prices.
Having more customers using your insurance is going to raise prices. The argument is not bogus.
Costs increased slower under Obama then the previous administration.
"..the average premium for single coverage through employers has gone up 28 percent “under Obama” That’s right again, but much lower than the growth of individual premiums during Bush’s first six years. That increase was 72 percent."
In that case wouldn't the alternative be having no insurance at all? How would that help?
Edit: I'm taking "government mandated third party payer" to mean something like the ACA mandate. If you meant a government mandated monopoly, then yes that's a terrible idea
The economics associated with modern healthcare demand consolidation, which basically means local cartels or monopolies for hospitals and health networks.
