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My understanding is the insured patients are subsidizing all the others covered by medicare, medicaid or those uninsured.
by pkaye 7y ago
My understanding is the insured patients are subsidizing all the others covered by medicare, medicaid or those uninsured.
- devoply 7y agoWhy? Why are insurance companies not demanding cash price and reducing premiums? There should be lawsuits against hospitals, this seems like something which is generally considered highly illegal at this sort of scale... charging different customers different prices -- especially when the ones paying more are more than capable of taking hospitals to court.
- dantheman 7y agoThe 80/20 Rule could be one reason -- the more they spend on health care, the more they can spend on other things. https://www.healthcare.gov/health-care-law-protections/rate-review/ https://www.healthcare.gov/health-care-law-protections/rate-...
- devoply 7y agoSounds like the government needs to sue both insurance companies and hospitals for collusion to stop this.
- kaibee 7y agoIt's extremely unlikely that there's actual collusion. But actors acting in their selfish best interest can definitely look like collusion.
- pkaye 7y agoI believe this rule came out of the ACA (Obamacare) however all the problems have existed well before that.
- rpmisms 7y agoI'm a generally anti-legislation kind of person, but as long as breaking up big tech is a hot topic, why not pass a bill requiring cash prices for any not-for-profit insurance providers and co-pay networks? There's a lot of interesting competition happening in those spaces, and making not-for-profit insurance a better deal seems like a great way to get capitalism grinding at the issue of overpriced healthcare.
- DaiPlusPlus 7y agoThat doesn’t work for emergency care - where the patient really doesn’t have the time to go window-shopping while having a cardiac arrest. And while greater transparency is good - not everyone in the public is able - or willing - to understand a medical price-sheet and might opt for a cheaper but medically-inappropriate procedure with similar-sounding-name to the procedure they actually need.
- PorterDuff 7y agoI would prefer a system where they charge everyone the same amount. It wouldn't surprise me if the insurance companies would be in favor of that, the whole price negotiation overhead goes out the window.
- youeseh 7y agoHospitals could also be charging insurance companies more, but not for subsidizing cash patients but for greater profit.
- vonmoltke 7y agoFor-profit hospitals, maybe, but what about the non-profit ones?
- moate 7y ago"non-profit" doesn't mean "doesn't make money" its just rules on how you have to spend that money. There's nothing saying a non-profit can't raise prices of service and then expand the hospital to buy a new wing, or better equipment or hire more doctors. They need the money to provide their services.
- vonmoltke 7y agoI understand that, but there is a limited amount of that which can be done before it becomes spending for spending's sake, which is pointless. Also "expand the hospital to buy a new wing, or better equipment or hire more doctors" sounds like exactly what they should be doing, because it means they can service more people at a higher standard of care (which is the reason they exist in the first place).
- pkaye 7y agoI found this interesting article on the situation. They say 1/3 are profitable, 1/3 are break even and 1/3 are losing money. And a lot of those losing money are in rural areas. And "In general, hospitals lose money on Medicare and Medicaid patients, but make up for that by charging private-sector insurers more." https://www.nbcnews.com/business/business-news/hospitals-made-21b-wall-street-last-year-are-patients-seeing-n845176 https://www.nbcnews.com/business/business-news/hospitals-mad...
- Relys 7y agoExactly! Nobody seems to realize that we already have a shitty (for-profit) form of socialized health care.
- ceejayoz 7y agoYup. We've taken the worst aspects of both sorts of system and combined them into a Kafkaesque nightmare.
- pnutjam 7y agoBut god forbid we make that official with some sort of oversight and functional standard system.
- paulddraper 7y agoGod knows there is a ton of oversight. (As anyone who starts an insurance company can attest to.)
- pnutjam 7y agoOversight into how much we overpay to cover underpayments, like single payer.
- omegaworks 7y ago[citation needed] This is a common talking point that smells like an oversimplification.
- moate 7y agoI can't speak to Medicare/Medicade but the general idea is this: Doctors and the things they use/services they provide have a cost associated with them. Insurance works by spreading risk. Guy who breaks his wrist essentially takes money from the pool that wasn't used by the guy who hasn't been to a hospital in 6 years. So far everything is fine. When you have people who exist outside that system of resource reallocation, the doctors have to find ways to ensure they're still getting enough money to cover their costs. One way they can do this is by suing patients who don't pay, but that takes time and more money and doesn't always work. Another option, would be that they then raise their rate to the insurance companies because they know that the insurance companies can afford it since they have such large pools of money. The insurance companies then raise the rates for everyone buying into the resource reallocation pool, and eventually everything spirals out into our current non-system. Is it more complicated than this: yes, but that's the elevator pitch on it.
- omegaworks 7y ago> they know that the insurance companies can afford it since they have such large pools of money This is exactly why Medicare for All is touted as a solution. It would create the largest pool. It would also reduce the significant overhead presently involved with billing N different insurance companies. Why isn't the conversation about those costs imposed by the current system?