Originally posted as a comment in Finland for Thought.
A system of health care paid by insurance (of whatever form) and provided by private hospitals looks attractive on the surface but isn’t really a good system.
Look at the economic dynamic of the system. The insurance (if comprehensive) will essentially pay for any operation that the physician at the scene deems necessary. Is it in the physician’s interest to use that tab as efficiently as possible? No, in fact, it is the opposite: it is in their best interest to find as many reasons to bill as much as they can. This is a road to disaster.
Of course, you can balance this system by introducing insurance investigators who examine bills and determine if they are legit. To do the job properly, they need to be qualified physicians, and they need to have access to all the data that the physician at the scene had. Essentially, these investigators would be doing the job all over again, except never seeing the patient.
Result: the money you save from preventing fraudulent billing is spent in maintaining a paraller physician workforce. Why not let the “investigators” be the healers, and cut the private hospital out of it altogether? These physicians would have budgetary responsibility on what they spend, and thus they only do what they need to do.
Oops. Looks like we just transformed the “market-based” health care system into a state-operated, “socialized” system.