4 ms·

The insurance company could do their freaking job and crunch the numbers to figure out what the average price is going to be at the providers their customers go

by imgabe 7y ago

The insurance company could do their freaking job and crunch the numbers to figure out what the average price is going to be at the providers their customers go to and set their premiums accordingly so they can cover what they expect to pay. Some of their customers will go to a doctor where a procedure costs $200, some where it costs $50, some where it costs $100. If the prices were published patients could actually make a choice based on that information.

jefftk 7y ago
If the patient chose to see someone who charged $200 vs $50 would the patient pay a different amount?
- imgabe 7y ago
  Perhaps the insurance would choose an amount to reimburse and the patient could pay the difference if they want to go somewhere more expensive. Isn't that the way most other insurances work? If my homeowner's insurance pays me to repair my house, they don't make me go to an "in-network" contractor. And if that contractor has an "out-of-network" subcontractor I don't suddenly get charged 10x more. If the patient could choose any doctor because they aren't limited to in-network only and the doctors couldn't charge different prices for insurance vs. cash, and if patients actually knew what the prices were beforehand there would be actual competition and downward pressure on prices.
  - vl 7y ago
    > If the patient could choose any doctor because they aren't limited to in-network only and the doctors couldn't charge different prices for insurance vs. cash, and if patients actually knew what the prices were beforehand there would be actual competition and downward pressure on prices. This implies that there are enough doctors. But current reality is that supply is artificially limited and there are not enough doctors.
    - imgabe 7y ago
      If supply is already limited, then surely further limiting it by restricting patients to only "in-network" doctors can't be helping anything.
kova12 7y ago
Insurance should be just that - insurance. It's for catastrophies, not for sore throat visits. You should only claim health insurance benefits in exceptional circumstances. You don't use Geico for oil changes. And at the same time there shouldn't be any place that would charge you without warning about cost. Analogy: when you go to Firestone to rotate tires, they tell you upfront what's it gonna cost. You don't go there and they would be like: "we can not tell you how much it would cost. Every car is different. We might need to call for specialist from discount tire and he would bill you for consultation separately". No, that does not happen. They take your car, and they tell you exactly what they need to do and what will be the cost. Health care should be the same, competition on price and quality, and none of this insurance third party nonsense
- jefftk 7y ago
  > And at the same time there shouldn't be any place that would charge you without warning about cost This isn't unique to healthcare, though it's worse in healthcare than other places. Say I hire a plumber to put in a toilet, and when they open up the wall to run their pipes they find major problems that need dealing with. It wouldn't be code compliant to seal things back up without fixing them. Now it's going to cost me $10k instead of $1k. (Analogy to complications during surgery, though it's less time sensitive and I would have the option of evaluating multiple people to fix the bigger problem.)

by imgabe 7y ago

jefftk 7y ago

If the patient chose to see someone who charged $200 vs $50 would the patient pay a different amount?

imgabe 7y ago
Perhaps the insurance would choose an amount to reimburse and the patient could pay the difference if they want to go somewhere more expensive. Isn't that the way most other insurances work? If my homeowner's insurance pays me to repair my house, they don't make me go to an "in-network" contractor. And if that contractor has an "out-of-network" subcontractor I don't suddenly get charged 10x more. If the patient could choose any doctor because they aren't limited to in-network only and the doctors couldn't charge different prices for insurance vs. cash, and if patients actually knew what the prices were beforehand there would be actual competition and downward pressure on prices.
- vl 7y ago
  > If the patient could choose any doctor because they aren't limited to in-network only and the doctors couldn't charge different prices for insurance vs. cash, and if patients actually knew what the prices were beforehand there would be actual competition and downward pressure on prices. This implies that there are enough doctors. But current reality is that supply is artificially limited and there are not enough doctors.
  - imgabe 7y ago
    If supply is already limited, then surely further limiting it by restricting patients to only "in-network" doctors can't be helping anything.

kova12 7y ago

Insurance should be just that - insurance. It's for catastrophies, not for sore throat visits. You should only claim health insurance benefits in exceptional circumstances. You don't use Geico for oil changes. And at the same time there shouldn't be any place that would charge you without warning about cost. Analogy: when you go to Firestone to rotate tires, they tell you upfront what's it gonna cost. You don't go there and they would be like: "we can not tell you how much it would cost. Every car is different. We might need to call for specialist from discount tire and he would bill you for consultation separately". No, that does not happen. They take your car, and they tell you exactly what they need to do and what will be the cost. Health care should be the same, competition on price and quality, and none of this insurance third party nonsense

jefftk 7y ago
> And at the same time there shouldn't be any place that would charge you without warning about cost This isn't unique to healthcare, though it's worse in healthcare than other places. Say I hire a plumber to put in a toilet, and when they open up the wall to run their pipes they find major problems that need dealing with. It wouldn't be code compliant to seal things back up without fixing them. Now it's going to cost me $10k instead of $1k. (Analogy to complications during surgery, though it's less time sensitive and I would have the option of evaluating multiple people to fix the bigger problem.)