I am not a great historian, but up to about the 1950's, most hospitals were funded by religous orders, the state or city, and the feds for veterans. Most physicians were general practice and while making good money, that was not always the drive to practice medicine. Insurance companies generally covered just hospital care with a "traditional plan" that paid 80% of charges.

Physician specialists started when Medicare provided greater funding for the elderly. Eventually the idea of "not-for-profit" became misnomer for most hospitals. There are very few hospitals still owned by religous orders and likely that most are owned by just a few big companies.

What it has morphed into is a great example of capitalism gone wrong.

All of the above, but it's also The People's fault.

1. We silently sat by while letting this system evolve. Probably because we thought it was good to have "free" (in the long ago past) insurance from our employers.

2. We don't expect to pay for health care. It's all provided by our employers for "free". Got a cold? Go to the doctor (free visit!) get antibiotics (free!) that don't even do anything for a cold. Kid's got a fever? Go to the doctor (free!) and get a prescription for aspirin (free!).
Or even worse, got the flu? Keep going to work all week, infect everyone else in the office, then when it gets really bad on Saturday night go to the emergency room for a REALLY expensive "free" treatment.

3. Unemployed? Too bad. No insurance for you. All your trips are the emergency room, where they are required by law to treat you. So now taxpayers or insurance premium payers pick up the tab for a $50 aspirin dispensed by a $350 per hour intern.

The entire concept of "insurance" has been corrupted. My car insurance doesn't cover oil changes or routine maintenance. People need to take some personal responsibility for routine health care (including preventive, but that's getting harder and harder in today's addicted society) and save the insurance for serious crashes.

People should also pay for their own insurance or have it provided by the government if they can't afford it. And no child in America should be without insurance. That's a moral crime against humanity.

As for who should underwrite it and processes the claims and payments to providers, I don't care. Medicare seems to do a bangup job, though, with very low overhead.

If anyone suggested that, say, the school system should be making a profit, they’d be looked at as if they were from Mars.

The GOP has been suggesting just this. They also suggest for profit prisons and about anything else they think they can rip taxpayers off on. Why do you think they are trying to privative everything?

Insurance companies pull at least 30% off the top of everything. I am an actuarial tech for an insurance company. I see what the loss ratios are. Insurance should distribute risk, but health insurance actually distributes costs with profits coming off the top. With a single payer system like Medicare covering everybody we would not have that profit draining the people. Insurance companies could then still sell supplemental insurance to cover what the single payer did not cover- like Medicare Supplement does or people could self insure that portion.

People treat insurance essentially as pre-paid medical. Thus costs have gone up because the people being treated don't care what it really costs. Just treat me; my insurance will take care of it. Insurance of all kinds was meant to protect against catastrophies or major problems.

However, the first point of non-profit medical would also lead to us having to pay to put all the doctors through school...

I agree with part of what you say but...Don't put all the blame on patients. It's not like you can even find out how much anything costs and comparison shop or whatever before you get treatment.

Mainly though, people tend to oversimplify medical care solutions and forget there is middle ground. Having a single payer does not mean socializing medicine all the way top to bottom and for that matter we subsidize medical education now to some degree. This is not a bad thing. there is no reason that the MD degree should be the province of either the rich or those willing to endure a large debt load at the very start of their professional careers.

Making the transition to single payer will cause some havoc and that's a price we have to pay. It'll be worth it on the other side.

What Steve said. Plus, non-profit does not mean no salaries. Pat Robertson is a non-profit. He seems to do OK.

As Paul Krugman and his wife Robin Wells point out, the fundamental problem is:

1) The American health care and health insurance systems are extremely inefficient because of the ad-hoc, patchwork way in which they developed

2) Technology, and the resulting expansion in what is medically possible, has increased costs exponentially

3) Because the costs of technology are filtered through the inefficient system, the amount of waste has also exploded

Well, that's the market with a heavy overlay of lobbyist written legislation enforced by the government.

It's the Market...Just not a free one.

invisible hand

Invisible, indeed.

(Unless you hang around state houses and the Capitol lobby.)

In the past several years there are two books that I have read on the subject of our perverted health care system, that are must reads on what has been happening to our health care system. The first was Marcia Angell's the Truth About the Drug Companies. The second, more comprehensive, overall, book is Maggie Mahar's, Money Driven Medicine.

Both books are eye-openers, at the very least. While Angell's book is more specific, it ties into the current inability of many patients that cannot afford medicines, and specifically how the pharmaceuticals have hoodwinked the public into believing they spend billions on research & development, as well has how they have co-opted (corrupted) the FDA, and finally their "grip" on Congress. All very important issues that apply to the overall discussion on our health care system.

Mahar's book details how the patient went from being the center of a physicians world to a consumer, where physicians went from being professionals to "vendors" and where profitability trumps science. Insurance companies have a big stake in this market-driven society, and their profits show this.

What is glaringly clear, at least to me, and apparently Michael Moore, is that market-driven medicine does not work. Now, I have not seen Sicko, but from the trailers that I did see, he is trying to bring this message to the forefront.

The machination that is bent on driving up their profit margin on your illnesses have sufficiently drowned out the Marcia Angell's and Maggie Mahar's as being irrelevant or alarmist or not knowing what they are talking about, and Sicko is destined for the same treatment, no matter the relevance of the message.

To the question posed by Whitescreek: Who's to blame for the health care mess? All those that have subverted medicine to make profits. That includes the insurance industry, the pharmaceuticals, FDA, Congress, and Wall Street.

It's true that the insurance companies have taken advantage of a broken system and, even more egregiously, done everything in their power to scuttle reform.

But as Krugman notes, the problem is really the system, and thus the solution is systemic - i.e., a single-payer system that would go along way in eliminating the gobsmacking amount of waste. Focusing on the symptoms tends to lead one into the weeds and side disputes about profits and "the market," and also tends to result in proposals that merely bite around the edges.

(i.e., if the issue is really insurance companies skimming too much off the top, then the most logical solution is regulating those companies. But that wouldn't solve the crisis, which is caused by the extreme fragmentation of the system.)

So does this mean our flag will say:

"Up the System"

or

"Down the System"

or

"Replace their System with Our System"

What we really need is a cult of personality.

This is a nice intellectual discussion but I don't believe that there are near enough people who care to cut the richest industry in this country out of a major piece of thier pie. Look how badly Hillary was abused when she tried it. Still haven't got over that one. If you control the money the insurance companies do... Well, I am not optimistic.

I'm in.

I have a theory of government that says we should have an all volunteer army and draft our government. Anybody who wants to serve in government is automatically excluded.

As Krugman points out, one of the big reasons the Clinton proposal tanked is that it complicated the issue even further. This not only confused voters, it allowed opponents to engage in a a lot of wild FUD about how the gubmint was going to dictate all medical decisions. (Ironically, the reason the measure was so complicated was because the Clintons were attempting to appease the insurance industry).

If the Democrats would just stand up for single-payer and explain how the system would not only be better, less expensive and less complicated, they could avoid that trap.

Because it's in your pocket!

And if my grandmother had propellers she's be a tugboat.

Filing that one away for future use...

What an effed-up party we have.....

I just sent some money to DRAFTGORE.com.