The Instigator
Pro (for)
0 Points
The Contender
Con (against)
7 Points

The real problem is Doctors Fees, not Insurance !

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Voting Style: Open Point System: 7 Point
Started: 9/20/2013 Category: Health
Updated: 5 years ago Status: Post Voting Period
Viewed: 1,500 times Debate No: 37952
Debate Rounds (3)
Comments (8)
Votes (1)




Everyone blames the insurance companies for such high rates, but the real culprit is Doctor fees and Hospital charges. Next time you go to a Doctor, Specialist or Hospital, just look at the actual bill. They charge you $400 for 10mins of their time. And you don't even get to argue with them on the bill, you can't negotiate. On top of that, they never tell you the cost upfront, they tell you after the doctor has seen you.

Why is nobody talking about the exorbitant fees? Who decides how much they can charge?

Look at the list highest paying jobs, top 10 would be all doctors and medical specialists. The same doctor visit in other countries would cost a fraction so why in US the cost is so high?


Hi. I accept the debate and will argue that, while the cost of medical fees are exhorbitantly high, it is because of insurance that causes such a high rate.

Premise 1: Extreme overhead to process claims and reimbursements by health care agents (both providers and insurers)

The estimate of administrative costs in 2007 was $156 billion, with projections to reach $315 billion by 2018.(1) Also, due to the increasing complexity of the medical billing and insurance environment, the American Medical Association, in 2011, estimates "health insurers have an average claims-processing error rate of 19.3%, an extra $1.5 billion in unnecessary costs.(2) Costs are passed to us.

Premise 2: Public insurance raises costs by underpaying health care providers

Public insurance programs such as Medicaid reimburse so little that 1/3 of doctors won't take new Medicaid patients in 2011.(3) On average, Medicaid pays physicians 56% the amount private insurers pay.(4) Costs are passed to the rest of us.

Premise 3: Less Health Care Providers (supply/demand)

U.S. medical schools have not provided for the loss of 33 percent of the nation’s physician work force.(5) In October 2012, the Association of American Medical Colleges published a report titled "Recent Studies and Reports on Physician Shortages in the US."(6) Just about every state will continue physician shortages and increases in not only health care costs but doctor salary as well. It is simple supply and demand economics.

Debate Round No. 1


You are actually making my arguments !! Since you provided reasons for exorbitant fees, you have admitted that Doctors' fees are very high. We can go into reasons why they are high, but bottom line is that everyone agrees they are too much.

Premise 1 : Yes the administrative costs are high but so are administrative costs of doing all other kind of business. Same with auto insurance or mortgage, loans etc.

Premise 2 : Yes Medicaid reimbursement is problematic but thats a government problem. Why should hard working Americans pay Doctors for Government incompetency? Is it the fault of a person with a job who goes to the hospital for some checkup?

Premise 3 : I said that myself that we need more doctors because right now it feels like they have a monopoly and can charge as much as they like without worrying about competition.

I am surprised why we don't hear people who have been to hospitals and doctors and were charged hundreds of dollars for 10mins.

TIME magazine made the same argument (they are the only ones to say it publicly, besides me) -



I believe the debate topic is "The problem is doctors fees, not insurance." I'm arguing that fees are high due to insurance, not doctors, thus the problem is insurance, not doctors, taking a Con to the topic.

Premise 1: It is currently estimated that 31% of health care spending is towards administrative costs.(1) It is estimated that 85% of excess administrative overhead can be attributed to the complex insurance system.(2) Basically, if we eliminated insurance companies, and relieved health care providers of the burden of insurance management, it could reduce medical costs by over 26% or about $2000 savings per capita/year.

Premise 2: The money has to come from somewhere. The vast majority of hospitals and health centers are non-profit(3), meaning they cannot seek profit from services. So when they need to recoup the government insurance that underpays, it has to come from somewhere. This is not about fault, but Econ 101.

Premise 3: Sorry this was unclear. I ran out of words. What I was trying to do was tie the shortage of doctors to the increasing hostile and complex environment of the medical field. Those who remain are fighting further bureaucratization.(4) It's not always by choice either as insurers choose winners and losers.(5)

The high cost of health care is not due to DOCTOR's fees but higher ADMINISTRATIVE costs, making up for GOVERNMENT programs, and a HOSTILE ENVIRONMENT that discourages joining the medical field. INSURANCE companies is the primary factor for my three premises.

Debate Round No. 2


I agree there are Administrative Fees (like every other business out there) but to put the blame solely on that is turning a blid eye to the real issue. It applies to Law firms, Financial firms or any other business that interacts with other entities. Can you describe a little about Admin fees, why are they so high?

Administration is not only necessary but critical too, to maintain the quality of service and faster processing. That's why a doctor is able to see so many patients in one day. If you go to a Physicians office or a Specialist, normally there is one admin office for 3-4 doctors so that way they cut their admin expenses smartly. It can be reduced further but to highlight that as your main point is deceptive.

Your argument suggests that if there were no Insurance Companies the Doctors would be charging $50 for a 10min checkup (unlike $300) and everyone will go home happy. I don't think so. The doctors would still be charging pretty much the same and a lot of their time and patient's time would be spend in arguing over the fees and charges. Insurance companies protects patients and docors from all the bickering and bargaining.

Also if you look at your Insurance Company Claim, you will see that the doctor charged $400, but the Insurance company adjusted to a lower amount, lets say $300 and then they pay most of it. So the Insurance companies are 'fighting' with the Doctors over the fees and trying to reduce those. If they didn't exist an 80yr old granma would have to do that !!

Insurance companies also makes it fair for everyone, if youve been paying into the system you will get the benefits. You can't just 'use' hospitals and doctors without paying nothing.


"Can you describe a little about Admin fees, why are they so high?"
I feel like I adequately did that in Rounds 1 and 2.

"Administration is not only necessary but critical too..."
I didn't talk about admin fees as a whole. See Round 2 where I cite estimated 85% of admin costs are due to complex insurance system.

"Your argument suggests that if there were no Insurance Companies the Doctors would be charging $50..."
26% savings equals approx $2000 per capita annually. That's $8000 for a family of 4, which is pretty significant.

"Insurance companies protects patients and doctors from all the bickering and bargaining."
I'd rather do it myself and save $2000 than pay an insurance company to do it for me.

"the Insurance companies are 'fighting' with the Doctors over the fees and trying to reduce those."
As would anyone. However, because they are an intermediary, it always drives up costs. You are paying someone else to provide a service. Any good middleman will ensure they get their cut.

"Insurance companies also makes it fair for everyone."
I disagree with this statement. The most fair system is we each pay for what we consume. Thus, if I go to hospital, I pay for my own hospital expenses. If I'm a young, healthy person in my twenties, why should I pay for health insurance when I ever see a doctor?(1)

I want to first thank Andy for creating this topic and engaging me in a fun debate. However, in my opinion, Pro did not effectively argue why doctors are the reason for high medical costs. As with all complex systems, one cannot ever really pin the entire blame on one group but I have presented several reasons why I believe insurance companies represent a large chunk of medical costs incurred by medical providers and, thus, passed down to consumers. Also, 2k characters is too short. I ran out of room often and apologize if my arguments did not seem fully developed. Vote Con!

Debate Round No. 3
8 comments have been posted on this debate. Showing 1 through 8 records.
Posted by slin2678 5 years ago
Also comments on competition driving costs down.
Posted by slin2678 5 years ago
Interesting article on medical care before insurance companies.
especially the fees charged
according to $1 in 1848 would equal $29.41 today. So $0.40 in 1848 to get a leg amputated, which I would consider a major surgery, would be equal to approx $11.76 today.
Posted by Andy99 5 years ago
So you are saying, in a world where there were no Insurance companies, someone who just broke his arm can go to a hospital, get treated, maybe stay overnite and pay a few hundred dollars after negotiating and go home happily !!!!

I wish there were Doctors on this forum who responded to clear out the matter.

Or we will find out as soon as Obamacare is in full effect.
Posted by slin2678 5 years ago
Absolutely, I believe fees will go down if we didn't have insurance. The insurance market has created an artificial bubble where only a few large insurance companies have true negotiating power with medical providers. It is in the insurance company's best interest to keep costs high so people will HAVE to buy insurance. It's not a true free market infrastructure. If you were a doctor, or any business, wouldn't you accept a lessor amount if it's cash in hand? Happens all the time. Stores have sales because prices are artificially inflated. If there were no insurance companies, then the competition will be between medical providers, not insurance providers. Right now, it's between insurance providers because they can dictate who you can seek medical care from.
Posted by Andy99 5 years ago
Thanks for debating, I kept the word limit short as to keep it concise and interesting.

I guess we agree on a lot of points including the concept of 'saving', but that works in a utopia, not in the practical world. What if a whole bunch of people don't 'save', what happens to them? They will still have to be given healthcare right? Who's gonna pay for it?

You did not answer a couple of my 'what-if' points. Lets say, we get rid of all Insurance companies, are you sure Doctor fees would go down drastically? If you are really sure, then let's see how much they go down when ObamaCare begins !! And then we'll talk on this topic after we visit a doctor and see the fee change.
Posted by slin2678 5 years ago
Whoo. Finished my first debate. Thanks again Andy for starting this.

Seriously though, 2k characters is too short. I had to pare down in all three rounds to fit the character limit, which might've caused a seemingly disjointed argument.

For the point on insurance being more fair, I wanted to add this:
Before the whole insurance thing, our parents and grandparents did something call "saving." It created this source of cash for a "rainy day." If an emergency happened, then that is their insurance. Nowadays, instead of saving money each month, we pay premiums on car insurance, health insurance, 401k, life insurance, and Social Security/Medicaid and other taxes that's supposed to eventually come back around and benefit us. How much would you have in the bank if you took all that and put it away each month. I'm sure it's a lot, even if you deduct the money you would've spent on auto repair and hospital visits. Instead of personal responsibility to save, insurance is a system created to "save" for us. But they wouldn't be in business if they weren't making money which means most of us way overpay for that service.
Posted by The_Master_Riddler 5 years ago
I would debate this but I totally agree. I once broke my arm and they charged us 1200 dollars just to put a cast on. They left us in the lobby for 3 hours and it only took 30 minutes to put on the cast.
Posted by henryajevans 5 years ago
The problem is doctors' fees, in the sense that they exist
1 votes has been placed for this debate.
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Total points awarded:07 
Reasons for voting decision: Con could've argued this a little better. But against this opponent he knocked it out of the park.