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A more elegant solution in my mind, barring price fixing, would just be price transparency. Let people see the costs and use their own judgement to pick what th
by epmaybe 10y ago
A more elegant solution in my mind, barring price fixing, would just be price transparency. Let people see the costs and use their own judgement to pick what they value more.
- UnoriginalGuy 10y agoYou could combine the two: - Price transparency for common treatment/diagnosis. - They must charge insured and uninsured the same rate, no more 70% discounts for the insured. This would, if nothing else, get the insurance company and patient on the same team (since they're both fighting for lower prices across the board, rather than just higher insurance discounts on bonkers pricing).
- phkahler 10y agoWhy should the insured get a discount at all? Or do you mean their insurance would cover 70 percent of the cost? It is a common practice to charge less to insurance companies than patients. I had a friend with a high deductible who used to have everything billed through his insurance company - because it was cheaper that way even though he paid the whole thing while below his deductible. This amounts to screwing the uninsured people who need a price break the most. It's seriously unjust.
- phkahler 10y agoThat's exactly what I'm talking about. Transparency just adds the idea of publishing the price up front. I tried to clarify - different doctors are free to charge different rates for a given service (say 15K for an appendectomy), to make them charge the same is price fixing and should not be allowed. What I advocate is that Alice, Bob, and Charlie all get charged the same price by Dr. Sam regardless of insurance coverage or any of the other deals that take place today. Dr Alfred is free to charge a completely different price than Dr Sam.
- epmaybe 10y agoSorry, but I'm not sure I understand. I was under the impression that different doctors could already charge different rates for the same procedures. Insurance companies could just refuse to reimburse after a certain percentage, though.
- phkahler 10y agoThe problem is that a given provider (doctor or hospital) charges different rate to patients for the same service (procedure). Now lets not confuse what the patient pays with what the provider receives because insurance can be involved. the thing is the insurance companies "negotiate" lower rates in addition to paying their portion of the bill. Say two people get their appendix out and the hospital bill is about 15K. One person is uninsured, so they get a bill for the full amount. The other is insured, so their insurance company gets a bill for 15K. The insurance company has an existing agreement with the hospital and says "We're only going to pay 12K" and that's what the hospital gets. Then they pass on the 30 percent of 12K to the patient and get that. This is seen as a bonus the insurance companies provide - negotiating better prices - 12K vs 15K. But what's really happening is the hospital is going to try to get 3K more from the uninsured guy. My argument (how I think it should be) is that the hospital has to demand the same payment from everyone for that procedure - you will be responsible for whatever portion your insurance company doesn't pay, which is full price for the uninsured. Now the other hospital across town is free to offer the same procedure for 13K or 8K or 25K - whatever they think they can get, but they have to charge that price to all patients. This promotes competition between providers AND insurance companies and it will result in lower prices for both.
- epmaybe 9y agoSo how granular can the price be? Say you need stents for your coronary artery disease. Do you price at the number of stents? The number of catheters used? Just a flat rate for a procedure, regardless of the complexity?