California Adopts Right To Die Law

[Twangbanger]

Oregon heath plan had decided the $4,000.00 a month wasn't in the budget but the $50.00 death pill was.

There's more to this story, of course:

"...A lifelong smoker, she was diagnosed with lung cancer in 2005 and quit. The state-run Oregon Health Plan generously paid for thousands of dollars worth of chemotherapy, radiation, a special bed and a wheelchair, according to Wagner. The cancer went into remission, but in May, Wagner found it had returned. Her oncologist prescribed the drug Tarceva to slow its growth, giving her another four to six months to live. But under the insurance plan, she can the only receive "palliative" or comfort care, because the drug does not meet the "five-year, 5 percent rule" -- that is, a 5 percent survival rate after five years...The median survival among patients who took erlotinib was 6.7 months compared to 4.7 months for those on placebo. At one year, 31 percent of the patients taking erlotinib were still alive compared to 22 percent of those taking the placebo....

"...The terminally ill who qualify can receive pain medication, comfort and hospice care, "no matter what the cost,"..."

"...Meanwhile Wagner has faith in her medicine, not assisted death. Now, at the request of her doctor, the pharmaceutical company Genentech is giving her Tarceva free of charge for one year..."

You're taking two independent pieces of the puzzle and sticking them together, minus all the other information, and trying to make it look sinister. I honestly don't see the scandal here. The system is offering to pay for everything, except one drug that isn't that effective...which she's getting from the pharmaceutical company anyway, for the asking (a policy which the health plan is no doubt aware of). Not paying for the drug sucks, but these kinds of cost-rationing decisions have been made long before the option of physician-assisted suicide was ever available, and would have continued to occur had it never been invented.

 

[Libertarian01]

Perhaps so. I have only two real arguments with the insurance industry: First, by decades of their carelessness, they managed to at minimum allow and apparently cause astronomical inflation in medical costs by artificially boosting demand, which served to short-circuit the free market and did much to create the problems we experience in the present. Second, through legislation which I highly doubt passed without influence from the industry, we are now required to buy their product at a significantly greater cost and much smaller return than was available immediately prior to the legislation in question being enacted. I would have no problem in a free-market agreement to see an insurance company do exactly what it agreed to do and nothing more. Then again, we have not had a free-market health insurance system in my memory and since the passage of the so-called Affordable Care Act, make no pretense whatsoever of a free-market system. If anything, outlawing insurance completely would do more to correct the problem than what was done, but someone(s) certainly paid greatly to get the results they wanted in tandem with the leftists getting more of the control for which they lust.

There is so much here ^^^ and other issues that could take volumes of books to address, not the little space we have here.

Let us first face the reality that the medical industry HAS NEVER BEEN NOR NEVER WILL BE a truly "free market" system, not when you are talking about suffering and dying. I am sorry that most people overlook this simple reality. The free market is good when you are buying a lawn mower or having a new furnace installed, but is there truly a "free market" when your child is dying and you MUST get a treatment/procedure to save them? Shopping around for non life sustaining products is fine for the free market philosophy, but when faced with lifelong suffering or death the pressure to buy becomes, in my mind, far too great to consider that is is bound within the parameters of a free market.

That said, the benefits of a free market system should be sought as much as they can be given the constraints placed by the threat of not purchasing. There are areas such as competition, open pricing and other tools of the free market that could tremendously help in ameliorating the financial burden of medical care. But in the end, facing your child or spouses death is a radically different pressure to buy than simply replacing the mower because it broke.

In regards to the insurance industry I do believe you are correct. It was simply the existence of the insurance industry that fueled the bloating of the medical industry. No other industry (medical) has a completely separate industry (insurance) committed to paying its bills. Sure, there is auto insurance that helps in accidents, but millions of people use no insurance to repair and maintain their vehicles. And yes, insurance pays for new furnaces when there was a fire or tornado damage, but HVAC people receive plenty of other work outside of that covered by insurance. In both of these analogies I am quite certain that you could measure some financial harm to those industries IF insurance stopped paying for accidents and new furnaces, but they wouldn't die, although there might be limited shrinkage.

The vast majority of the problem with health care is created by the medical industry! The costs generated by their struggle with the insurance industry is phenomenal! I once visited a client at Parkview Hospital here in Fort Wayne. She left her room to go get an Xray. So she is on floor X and taken to floor Y. She returns to her room. Guess what? The way it worked behind the scenes is that when she arrived at floor Y for her test she was admitted there, ergo an admitting cost! When she returned to her room she was READMITTED to her room, ergo an admitting cost! The medical industry found a way to soak the insurance industry for more money, since the insurance industry found a way to cut payments somewhere else! The insurance industry tries to save money and the medical industry finds a way to suck more out.

I don't believe this happens as much in small doctors offices, but it can. I know one local doctor I would take people to and they could spend ALL DAY in the office for their initial "consultation." I once drove a couple to his office and asked, "Did you bring lunch?" "Ha, ha, ha. Very funny," says they. I dropped them around 0745. I returned to pick them up, they were finally done. I picked them up at 1630 hours!!! "You weren't a kiddin," were the first words out of their mouth. Nope, I wasn't kidding. If you went to his office bring a lunch, snack and a good book. He would run every test imaginable to man. He would have you watch a few "educational" videos. In the end he would charge/soak medicare/medicaid/insurance for every imaginable charge or fee I am certain was allowed. This was all done, of course, under the guise of "thoroughness." After all, he didn't want to get sued for missing anything, let alone his ethical(?) commitment to his patients to make absolutely, 100% certain that when he was done all possible information was available to provide the best care possible. Right...

Medicaid doesn't pay enough to sustain a business - period! I work for a nonprofit and we have the cost down to about $25 to take a person one (1) way to an appointment. Medicaid pays LESS THAN HALF of that for a person who can walk (ambulatory) and almost that much for a person in a wheelchair. We survive by getting grants and donations, but how can any business survive that doesn't get what we do? The answer is - it can't. Not without sticking it to other patients in other ways.

I am not familiar with medicares payment versus the necessary income for a medical provider, so I cannot speak intelligently to their costs. However, simple logic would suggest that they might pay more but still not enough. As to private insurance they may pay enough but they are getting soaked for all the lost revenue from medicaid, medicare, AND people who receive treatment but don't have insurance at all.

The ACA does attempt to address the last group of not having insurance by trying to force them to buy insurance, thus getting them to pay in monthly and not receiving care without paying for it. I don't like it, but it is logical on one side of the equation. The other side of the equation would be - if you don't have insurance you don't get treatment as we will no longer require medical people to treat the uninsured. However, the reality there is that simply wouldn't fly either. One kid in a car accident who's parents didn't buy insurance would be allowed to die just for lacking money. Even I don't want to see that. I guess I am weak that way.

The truth is there will never be a perfect system for health care. The reality is that the Utopian system of everyone getting the best treatment for their problems is unaffordable. No country on earth could do it. So, the first thing to do is convince millions of Americans perfect isn't achievable. The next is to try to figure out what IS achievable given our resources. The third is to try(?) to compromise on what we are willing to pay for and what we are not.

Good luck with that.

Regards,

Doug

 

[Twangbanger]

...The truth is there will never be a perfect system for health care. The reality is that the Utopian system of everyone getting the best treatment for their problems is unaffordable. No country on earth could do it. So, the first thing to do is convince millions of Americans perfect isn't achievable. The next is to try to figure out what IS achievable given our resources. The third is to try(?) to compromise on what we are willing to pay for and what we are not.

Good luck with that...

Some good points made. For our part, since this is a gun forum, we need to realize that some of the most vivid examples of hypocrisy are evident on the Right side of the political spectrum. As BBIs alluded to, we tend to be all, "Get the government out of healthcare, get them out of Planned Parenthood, get them out of assisted suicide," etc. But when it comes to spending MASSIVE amounts on people within 6 months of dying, that's when you get all the religious rhetoric, the sanctity of life, the Papal lectures, the "culture of death," etc. and the basic viewpoint that "I want every possible Hail Mary Treatment attempted on _my_ relative, that's what I paid in for, by God!" and all that. And oh, by the way...that person down the hall with no options left? She just has to lay there and suffer, because "suffering is divine" and "you don't own your life" and we don't want a "culture of death," etc., etc. Funny we don't get papal lectures about offspring who want the opportunity to beat each other silly the last 3 months, competing to prove who loves her the most while she's in agony and could frankly care less whether she's there or not.

 

[GodFearinGunTotin]

Some good points made. For our part, since this is a gun forum, we need to realize that some of the most vivid examples of hypocrisy are evident on the Right side of the political spectrum. As BBIs alluded to, we tend to be all, "Get the government out of healthcare, get them out of Planned Parenthood, get them out of assisted suicide," etc. But when it comes to spending MASSIVE amounts on people within 6 months of dying, that's when you get all the religious rhetoric, the sanctity of life, the Papal lectures, the "culture of death," etc. and the basic viewpoint that "I want every possible Hail Mary Treatment attempted on _my_ relative, that's what I paid in for, by God!" and all that. And oh, by the way...that person down the hall with no options left? She just has to lay there and suffer, because "suffering is divine" and "you don't own your life" and we don't want a "culture of death," etc., etc. Funny we don't get papal lectures about offspring who want the opportunity to beat each other silly the last 3 months, competing to prove who loves her the most while she's in agony and could frankly care less whether she's there or not.

This is more than just a bit of hyperbole.

 

[Libertarian01]

Some good points made. For our part, since this is a gun forum, we need to realize that some of the most vivid examples of hypocrisy are evident on the Right side of the political spectrum. As BBIs alluded to, we tend to be all, "Get the government out of healthcare, get them out of Planned Parenthood, get them out of assisted suicide," etc. But when it comes to spending MASSIVE amounts on people within 6 months of dying, that's when you get all the religious rhetoric, the sanctity of life, the Papal lectures, the "culture of death," etc. and the basic viewpoint that "I want every possible Hail Mary Treatment attempted on _my_ relative, that's what I paid in for, by God!" and all that. And oh, by the way...that person down the hall with no options left? She just has to lay there and suffer, because "suffering is divine" and "you don't own your life" and we don't want a "culture of death," etc., etc. Funny we don't get papal lectures about offspring who want the opportunity to beat each other silly the last 3 months, competing to prove who loves her the most while she's in agony and could frankly care less whether she's there or not.

and repped!

I have also read that studies have shown we spend 50% of all health care costs on the last 6 monthes of life.

If we look at it by this measure, we are spending massive amounts of capitol to buy people a few extra monthes that in all likelihood are of extremely low quality anyway.

I once had a conversation with a cardio doctor over the dinner table. He worked with folks in nursing homes. He was saying they would put their parents through treatment that he would NEVER dream of putting his parents through. They just didn't want to get it that mom (who is now 89 and bed ridden) has had three (3) heart attacks, a stroke, and a host of other problems isn't going to gain much from heroic measures to pull her through her FOURTH (4th) heart attack - but it happens all the time! Family members demand massive treatment for their loved ones.

And that is the beauty and the bane of health care - love. We love our friends, relatives (well, most of them) and others. Our love clouds our judgement in many cases in making good end of life decisions. Thus we end up spending 50% in the last six (6) monthes. We don't know how to truly love AND let go in many instances. Not all, of course, but many. The elderly are far more willing to let go than their children or grandchildren. This is why DNR's and living wills are so critical, yet so few have them.

I hope no one misunderstands my response here. I am not advocating what should happen in every case. And I am not saying it isn't nor shouldn't be sad and a horrible loss to lose a loved one. I am only pointing out that the costs involved are tremendous and in many cases do little or nothing to lengthen or improve the quality of life for folks near the end of their line. It is a horrible loss to everyone to lose a loved one.

Regards,

Doug

 

[Mark 1911]

Some good points made. For our part, since this is a gun forum, we need to realize that some of the most vivid examples of hypocrisy are evident on the Right side of the political spectrum. As BBIs alluded to, we tend to be all, "Get the government out of healthcare, get them out of Planned Parenthood, get them out of assisted suicide," etc. But when it comes to spending MASSIVE amounts on people within 6 months of dying, that's when you get all the religious rhetoric, the sanctity of life, the Papal lectures, the "culture of death," etc. and the basic viewpoint that "I want every possible Hail Mary Treatment attempted on _my_ relative, that's what I paid in for, by God!" and all that. And oh, by the way...that person down the hall with no options left? She just has to lay there and suffer, because "suffering is divine" and "you don't own your life" and we don't want a "culture of death," etc., etc. Funny we don't get papal lectures about offspring who want the opportunity to beat each other silly the last 3 months, competing to prove who loves her the most while she's in agony and could frankly care less whether she's there or not.

This is more than just a bit of hyperbole.

I am with GFGT on this one. The Christian message to the world has always been constant. Turn away from sin, believe in the Gospel, accept the gift of salvation. This is no more relevant than when a person is dealing with his last days on earth. The message will always be rejected by some, relativized by others, dismissed, ridiculed, and by some, seriously considered and accepted although there is some effort involved, perhaps some suffering, as is the case in life with all things of value. Killing is a sin, whether that killing is the taking of someone else's life, or one's own life. That is the Christian message. All are free to their last breath to use their free will as best as they see fit. To trust that God is a loving father and we are his children is probably never such a real commitment of the will as when one is tempted to suicide. Faith always involves an element of letting go, of abandonment to God's will, of trust that he knows better than we do, even in times of pain and suffering. I admire the courage of those who persevere until the end. I hope that I have that kind of courage if I am ever confronted with those kinds of temptations.

It is up to each man to decide what he will do in that situation. But each man has a right to hear the message that God loves him even in and especially in times of suffering. And nobody's life greater epitomized that message in his final moments as Christ's. He is the greatest example of perseverance in pain and suffering that we could ever hope for.

 

[GodFearinGunTotin]

I am with GFGT on this one. The Christian message to the world has always been constant. Turn away from sin, believe in the Gospel, accept the gift of salvation. This is no more relevant than when a person is dealing with his last days on earth. The message will always be rejected by some, relativized by others, dismissed, ridiculed, and by some, seriously considered and accepted although there is some effort involved, perhaps some suffering, as is the case in life with all things of value. Killing is a sin, whether that killing is the taking of someone else's life, or one's own life. That is the Christian message. All are free to their last breath to use their free will as best as they see fit. To trust that God is a loving father and we are his children is probably never such a real commitment of the will as when one is tempted to suicide. Faith always involves an element of letting go, of abandonment to God's will, of trust that he knows better than we do, even in times of pain and suffering. I admire the courage of those who persevere until the end. I hope that I have that kind of courage if I am ever confronted with those kinds of temptations.

It is up to each man to decide what he will do in that situation. But each man has a right to hear the message that God loves him even in and especially in times of suffering. And nobody's life greater epitomized that message in his final moments as Christ's. He is the greatest example of perseverance in pain and suffering that we could ever hope for.

While I agree from a religious point of view I want to point out, even from a non-religious viewpoint, are we sure we want to establish induced death as an accepted and normal health care option? I agree that it may not be in the best interests of the person or even God's will to go to heroic lengths to artificially prolong a life that would not continue but for the machines and medical magic. But I don't want the doctors pushing early death as an option because it's on some government approved, insurance backed, list of approved treatment options. I get that some don't want to suffer or watch loved ones suffer----it's a heart wrenching thing to watch and I cannot imagine having to endure it. I assert it's not such a far fetched theory to see how this can evolve over time to be a common and a prefered treatment option --- even for those situations where death is not necessarily the only possible outcome of an illness or condition but because somebody somewhere thinks your life isn't worth living or you're going to cost too much.

No, this is not only a religious reason for me. It's not that I want to tell people how to live their lives. I don't want the government to gain a foothold in telling me when I need to die...and as we continue to expand heathcare based on government payments, do you really think this day won't come?

 

[Mark 1911]

While I agree from a religious point of view I want to point out, even from a non-religious viewpoint, are we sure we want to establish induced death as an accepted and normal health care option? I agree that it may not be in the best interests of the person or even God's will to go to heroic lengths to artificially prolong a life that would not continue but for the machines and medical magic. But I don't want the doctors pushing early death as an option because it's on some government approved, insurance backed, list of approved treatment options. I get that some don't want to suffer or watch loved ones suffer----it's a heart wrenching thing to watch and I cannot imagine having to endure it. But it's not such a far fetched theory to see how this can evolve over time to be a common and a prefered treatment option --- even for those situations where death is not necessarily the only possible outcome but even because somebody somewhere thinks your life isn't worth living.

No, this is not only a religious reason for me. It's not that I want to tell people how to live their lives. I don't want the government to gain a foothold in telling me when I need to die...and as we continue to expand heathcare based on government payments, do you really think this day won't come?

This is certainly an area of control that the government should stay out of - especially considering their current track record of ever further reaching control and intrusiveness. What the government "grants" today, it can impose tomorrow.

 

[foszoe]

Becoming the 6th state that allows terminally ill people to end their lives with the assistance of their physicians. Good on governor Brown and the state legislators for doing the humane thing. It's very unlikely we'll ever see a similar law in Indiana given who runs this state. Sad to say. We can but hope.

https://www.washingtonpost.com/news...assisted-suicide-for-terminally-ill-patients/

Why do you favor Indiana passing a law that limits the choice of suicide to only those that are terminally ill?

 

[Libertarian01]

While I agree from a religious point of view I want to point out, even from a non-religious viewpoint, are we sure we want to establish induced death as an accepted and normal health care option? I agree that it may not be in the best interests of the person or even God's will to go to heroic lengths to artificially prolong a life that would not continue but for the machines and medical magic. But I don't want the doctors pushing early death as an option because it's on some government approved, insurance backed, list of approved treatment options. I get that some don't want to suffer or watch loved ones suffer----it's a heart wrenching thing to watch and I cannot imagine having to endure it. I assert it's not such a far fetched theory to see how this can evolve over time to be a common and a prefered treatment option --- even for those situations where death is not necessarily the only possible outcome of an illness or condition but because somebody somewhere thinks your life isn't worth living or you're going to cost too much.

No, this is not only a religious reason for me. It's not that I want to tell people how to live their lives. I don't want the government to gain a foothold in telling me when I need to die...and as we continue to expand heathcare based on government payments, do you really think this day won't come?

I completely agree that I also don't want "...doctors pushing early death as an option..." but that doesn't mean I don't want doctors barred from discussing it IF a patient needs the information either. We shouldn't be "pushing" people one way or the other. If someone is at the end of their rope, they need to make a decision about holding on or letting go, not the government, not their doctor, not even their family, but them. They are the ones enduring whatever burden has been placed upon them.

The problem is that the doctors are incentivized against even discussing it because they don't get paid for that discussion. As more and more doctors are finding themselves in larger pools of other doctors those corporate pools are pushing revenue generating time, not revenue absent time.

This was the whole fallacy about "death panels." Republican Representative Charles Boustany of Louisana cosponsored a bill to have medicare pay for the doctors time to counsel patients about a living will and other end of life options. That was it. That way doctors would get reimbursed something for just talking about options. Then brainiac Sarah Palin gets involved and we voila! We transform doctors being paid to give medical information to patients into "death panels" and the bill dies pronto.

What if the removal of care will cause death in monthes? Should someone suffer without care for monthes? What if someone isn't dying at all but living in severe agony and expects a normal lifespan? Should we tell them to endure because WE are uncomfortable with their decision to meet their maker on their own terms?

I do agree with GodFearinGunTotin that there could be the possibility of a slippery slope of government involvement. Where I may(?) differ is that doesn't dissuade me from support a persons right to chose their ending, it only serves to remind me to watch the government and be ever ready to tell them to KYFHO!

Regards,

Doug

 

[jamil]

While I agree from a religious point of view I want to point out, even from a non-religious viewpoint, are we sure we want to establish induced death as an accepted and normal health care option? I agree that it may not be in the best interests of the person or even God's will to go to heroic lengths to artificially prolong a life that would not continue but for the machines and medical magic. But I don't want the doctors pushing early death as an option because it's on some government approved, insurance backed, list of approved treatment options. I get that some don't want to suffer or watch loved ones suffer----it's a heart wrenching thing to watch and I cannot imagine having to endure it. I assert it's not such a far fetched theory to see how this can evolve over time to be a common and a prefered treatment option --- even for those situations where death is not necessarily the only possible outcome of an illness or condition but because somebody somewhere thinks your life isn't worth living or you're going to cost too much.

No, this is not only a religious reason for me. It's not that I want to tell people how to live their lives. I don't want the government to gain a foothold in telling me when I need to die...and as we continue to expand heathcare based on government payments, do you really think this day won't come?

If health care were just a matter of free enterprise I would say it's a private transaction between the client and the service provider. And if a patient clearly indicates from a sound mind that it's time to go, so be it, so long as there is a legal process to ensure that there's no foul play.

But the health care industry is not free enterprise (and I disagree with Doug that it can't or shouldn't be). In the convoluted system we have, the general public will end up paying for it. I have no moral issue with people paying their health care providers to help them end their lives. But I don't want that as yet another "societal expense" heaped upon individuals. I already have to pay for OPP (other people's pregnancies), I don't want to pay for OPD.

 

[Libertarian01]

If health care were just a matter of free enterprise I would say it's a private transaction between the client and the service provider. And if a patient clearly indicates from a sound mind that it's time to go, so be it, so long as there is a legal process to ensure that there's no foul play.

But the health care industry is not free enterprise (and I disagree with Doug that it can't or shouldn't be). In the convoluted system we have, the general public will end up paying for it. I have no moral issue with people paying their health care providers to help them end their lives. But I don't want that as yet another "societal expense" heaped upon individuals. I already have to pay for OPP (other people's pregnancies), I don't want to pay for OPD.

Please do not misunderstand me. It is not that I don't want the medical industry to be free market, it is that I believe the external pressure due to medical need pushes many things outside of the free market experience as far as medical care goes.

If your child is diagnosed with leukemia and needs medical care to hope to save their life, this creates such a burden that the free market does not apply in the same way as shopping for a new lawn mower, furnace installer, or accountant. It is unrealistic to say that there can be any sort of "free market" when the alternative to purchasing a product is death. There is no other need that comes close to creating the pressure of a medical "need" than facing death or the death of a loved one. That is why I believe that - to an extent - the free market can never apply to the medical industry. That is just a reality I have come to believe.

That aside, there are aspects of the free market that I 100% DO BELIEVE can be applied to the medical industry. Mandatory price posting. That is, forcing all medical providers to publish in some way their costs for services. To my thinking this would go a HUGE way toward bringing down costs. Going in and not allowing some of the shenanigans played by the medical industry AND the insurance industry. An example would be no more nonsense of admitting to a room then readmitting after you left for a test. Stupid costly. Removing the legal requirement to treat people who are uninsured. Force the insurance companies to use one (1) claim form and one (1) unified set of codes. Force insurance to reimburse self pay IF the cost of the self pay is less than or equal to the cost through an agreed upon provider. All of these would have negative consequences as well, but I believe they could push us toward a more free market medical industry.

Regards,

Doug

 

[jamil]

Please do not misunderstand me. It is not that I don't want the medical industry to be free market, it is that I believe the external pressure due to medical need pushes many things outside of the free market experience as far as medical care goes.

If your child is diagnosed with leukemia and needs medical care to hope to save their life, this creates such a burden that the free market does not apply in the same way as shopping for a new lawn mower, furnace installer, or accountant. It is unrealistic to say that there can be any sort of "free market" when the alternative to purchasing a product is death. There is no other need that comes close to creating the pressure of a medical "need" than facing death or the death of a loved one. That is why I believe that - to an extent - the free market can never apply to the medical industry. That is just a reality I have come to believe.

That aside, there are aspects of the free market that I 100% DO BELIEVE can be applied to the medical industry. Mandatory price posting. That is, forcing all medical providers to publish in some way their costs for services. To my thinking this would go a HUGE way toward bringing down costs. Going in and not allowing some of the shenanigans played by the medical industry AND the insurance industry. An example would be no more nonsense of admitting to a room then readmitting after you left for a test. Stupid costly. Removing the legal requirement to treat people who are uninsured. Force the insurance companies to use one (1) claim form and one (1) unified set of codes. Force insurance to reimburse self pay IF the cost of the self pay is less than or equal to the cost through an agreed upon provider. All of these would have negative consequences as well, but I believe they could push us toward a more free market medical industry.

Regards,

Doug

Government force is not compatible with free market. Nevertheless, when I say "free market" I mean a market that is truly based on supply and demand and free from government or market corruption. If companies are colluding to fix prices, that's not really a market based on real supply and demand.

I don't think your concern about health care in a free market is all that necessary. Why do you think an existential need for health care creates such a burden in a free market? I was born in a Hospital and delivered by a medical doctor in a time when my parents could pay cash. Not because they were wealthy, but because back then it was actually affordable. The severity of need doesn't mean there's must be a shortage of service such that the cost needs to be prohibitive. If it is cost prohibitive, only the rich could buy it. What has made it cost prohibitive is the consumer being taken out of the cost/decision loop.

Health care providers have no real market incentives to lower the price because there are no real competitors who will provide the services for less. Consumers don't demand lower prices because 1) they don't know what the price is, and 2) even if they did, the insurance company pays for it anyway. Insurance companies have little incentive to demand lower prices because they can just keep raising the rates.

I've brought this up before too. Cosmetic surgery, after adjusting from inflation, has decreased in cost over the last 3 decades while other health care has skyrocketed. Is that because cosmetic surgery isn't one of those existential services? Or is it because consumers of cosmetic surgery have to pay every dime to have fat sucked out of their asses. Botox? You pay for it. In that industry you get to price shop because society doesn't pay for it.