4 ms·
Medicare reimbursements are below cost of care. If all insurance lowered to Medicare reimbursements, you will reduce supply.
by conanbatt 8y ago
Medicare reimbursements are below cost of care.
If all insurance lowered to Medicare reimbursements, you will reduce supply.
- conductr 8y agoThat’s what most providers claim. In my experience (healthcare Corp finance), it’s typically closer to breaking even on Medicare. Especially if you cut out some fluff/unnecessary spending companies like to engage in. I’ve worked with Medicare and they actually try to do a bottoms up, zero based, pricing to determine what something should cost. So when a hospital is built by some award winning architect and has fountains and statues etc. Medicare doesn’t cover that (donors often do in the hospital example, but not other lines of services). I often have to explain to C suites that Medicare should be seen as a high volume that basically helps break even thus covers your fixed costs in entirety and making commercial patients all the more profitable. That said, every branch of healthcare works different and could be upside down from this where they make a ton on Medicare but not commercial
- conanbatt 8y agoAt least from what I know, its accepted medicare is below cost. I cant attest for padding or number fudging, but at least in primary care medicare pays crap and below physician salaries.
- conanbatt 8y agoConsidering private pays almost 200% what medicare pays, I doubt it. Its more like how airlines work: they make money on first class, and coach is something that fills the plane to cover some costs. If planes were made mandatory to only have coach, they would go bankrupt.
- bborud 8y agoI was referring to private healthcare without reimbursements or insurance. And mind you: Norway has a pretty high cost of living so it isn't like this is a low cost country. Which suggests to me that prices do not reflect actual cost, but rather inflated profit margins.
- conanbatt 8y ago> Which suggests to me that prices do not reflect actual cost, but rather inflated profit margins. There are lots of healthcare companies that are public. Healthcare insurance companies are amongst the lowest earnings of any insurance, contrary to the argumentational of Bernie Sanders. Also, one of the biggest health insurance companies, blue cross, is a non-profit. Furthermore, 60% of hospitals are non-profit. And hospitals are 30% of the national healthcare spending. If we are theorizing at random on what changes could impact the cost-effectiveness of healthcare, it is the increase of profits, not the decrease, that would be a more significant change.
- bborud 8y agoSo how do you explain that getting treated at private hospitals (on your own dime) in Norway is cheaper than in the US?
- conanbatt 8y agoThat private healthcare in the us is heavily and negatively affected by regulation. US has.. - a very low doc/population count, due to the artificial constraints of medical licensing and immigration law. - a draconian FDA process for drugs and an unreasonable patent application to drugs. - An incredibly distortive public service implementation (Medicare) that provokes cost-shifting (by paying below cost), that creates heavy admin burden (fee-for-service), and that overpays specialties and punishes primary care (fix reimbursement fees in multiples for specialties, giving a very low primary care doc count) - An incredibly distortive tax credit for the wealthier to spend on healthcare (the richer you are, the more tax effective it is to get better insurance through your employer) - A free-market abolishing regulation requirement: tying healthcare provider to employer.