Nobody likes to say this out loud, but because the US healthcare system is largely based on “fee for service” billing, it is true by definition that the sicker the patients are, the more profit the providers make. So incentives for actually making people
healthier have to be imposed in indirect ways.
There are some pockets of “per capita” payment, where the provider gets a fixed amount per person and is thus encouraged to reduce treatment costs, which indirectly should encourage preventative care, but also encourages just refusing to treat people.
We could remove these weird constraints by making health care a government service rather than a highly contorted pseudo-market, but that would not be the American way. It has to at least look like a market, even if it’s an ineffective, inefficient, opaque, corrupt one.
There are some pockets of “per capita” payment, where the provider gets a fixed amount per person and is thus encouraged to reduce treatment costs, which indirectly should encourage preventative care, but also encourages just refusing to treat people.
We could remove these weird constraints by making health care a government service rather than a highly contorted pseudo-market, but that would not be the American way. It has to at least look like a market, even if it’s an ineffective, inefficient, opaque, corrupt one.