"The root cause of the expensive healthcare is lawyers and lawsuits over everything. "
While I don’t deny there is a certain amount of health care being practiced as CYA, the whole lawyers as the cause of malpractice insurance premiums soaring and a prime cost of healthcare has been debunked. Want proof? California had a big problem with malpractice rates soaring at a ridiculous rate every year, some doctors left practice because of it, and the standard claim it was because of the cost of lawsuits, that all these pain and suffering suits were hitting the companies hard, and California passed laws limiting things like pain and suffering and so forth…and the premiums continued to soar. We all hear about the large awards, but when analyzed the rate of such monster awards when you trace them down shows few ever stay that large, and very few even make it to a verdict.
Several financial publications (the Economist and the Wall Street journal) did analysis, and what caused those rates to soar was primarily a change in the way insurance worked, the dominant model for years was insurance companies collected enough from premiums to cover payouts, and they made their money investing the 'float, money they had but not been paid out. They changed their model in the decade after 2001, and changed to make it that they wanted premiums to give them roughly a 20% profit margin and not have to count on investments to make their profits , the markets had become too volatile, and this is true across the board both with malpractice and regular health insurance. Not surprisingly, malpractice rates
In terms of doctors leaving individual practice because of the regulatory burden of ACA, I think that is much like the claim that soaring insurance premiums were all the work of lawyers or the EPA is the cause of jobs going overseas, it is more trying to pin the blame on an easy scapegoat based on ideology then fact. As others have pointed out, doctors have been moving towards giant practices, these days often aligned with hospital groups, the same way that hospitals now are part of merged hospital networks, like Atlantic Health care in NJ, etc. A lot of it was paperwork, the hospitals could leverage their already large administrative staff to handle billing and whatnot. This trend started when doctors became part of health insurance networks, first through HMO’s then PPO’s when as part of that network they were required to file a ton of information. I am sure regulatory paperwork was part of this, but a lot of it was dealing with the health insurance companies as part of their networks, rather than as basically submitting a form for clients to get reimbursement.
The other factor is doctors are looking more and more to a regular paycheck from a provider network, rather than the fee for service based approach which in the past could be very lucrative, but thanks to being squeezed by medicare and also insurance companies, that is no longer guaranteed to be a good income model from everything I have read.
like most things in medical care, it is using the old “it was wonderful in the good old days, then “they” ruined it, whether the they is government regulations, the health insurance companies, their patients, etc”, it is looking for a simplistic answer when the answers are quite complex.
