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> Transparency is not going to work where there is no competition, Emily Gee, a health economist at the left-leaning Center for American Progress, told Healthca

> Transparency is not going to work where there is no competition, Emily Gee, a health economist at the left-leaning Center for American Progress, told Healthcare Dive. That's bs. I will drive to a further away hospital if it saves me $75 an hour of time spent... (edit: clearly I'm talking about non-emergency here)

bluGill 7y ago
But it won't. Your insurance will pay for it either way, so you are spending an hour of your time to save your insurance $75 - which won't even be given back to you in form of lower premium.
- maerF0x0 7y ago
  > Your insurance will pay for it either way This is an assumption based on a very good insurance package. Most have out of pocket co-pays . So yes, we have to gross it up by the co-pay percent and discount it by the Annual deductible limitt, but generally the point stands. If I can save enough money I might travel away from the monopoly. Until that data is transparently available I can't optimize that scenario w/ my own choices. > which won't even be given back to you in form of lower premium Systemically it will eventually if insurance companies are competing with eachother for your business
  - jonlucc 7y ago
    Sort of; in my experience, even with a high deductible health insurance plan, the insurance company's negotiated rates are still in effect. In other words, if a visit would be billed to an uninsured person at $200, but my insurance caps it at $100, then $100 is the price accepted by the doctor's office no matter if I'm paying because I haven't reached my high deductible or insurance is paying because I have a regular, not high deductible plan.
    - maerF0x0 7y ago
      right, but now you're talking about in-network vs out-of-network rates. I believe should disappear with price transparency...
froindt 7y ago
We've seen massive consolidation of health groups over the last 20 years. I believe that's the point Ms. Gee is making. There used to be competition 10 or 20 minutes away. Now it's entirely plausible you'll be driving for hours to find a different medical group with similar services available. In my area (250k people, Iowa) there are 2 health groups. I actively tried finding a PCP who wasn't part of the two health groups but accepted insurance - as mega health groups greatly increase the total cost of care. I gave up after looking up about 20 from the hundred or so names insurance sent me. Basically everyone Unity Point recently announced it wouldn't be merging with Sanford health group. That would have expanded Sanford's strong footing in northwest Iowa, gaining 5 hospitals in Des Moines and at least one hospital in most locally large cities across the east half of state. It's hard enough to make the math work for hospitals in rural areas. The merger would have made it more difficult for the entire region to find competition.
gamblor956 7y ago
That "further away hospital" is literally "competition." Also, 1 hour away is not much in terms of time or distance, considering that many metropolitan residents have a daily commute in excess of 1 hour, and many rural residents live several hours from the closest hospital.

bluGill 7y ago

But it won't. Your insurance will pay for it either way, so you are spending an hour of your time to save your insurance $75 - which won't even be given back to you in form of lower premium.

maerF0x0 7y ago
> Your insurance will pay for it either way This is an assumption based on a very good insurance package. Most have out of pocket co-pays . So yes, we have to gross it up by the co-pay percent and discount it by the Annual deductible limitt, but generally the point stands. If I can save enough money I might travel away from the monopoly. Until that data is transparently available I can't optimize that scenario w/ my own choices. > which won't even be given back to you in form of lower premium Systemically it will eventually if insurance companies are competing with eachother for your business
- jonlucc 7y ago
  Sort of; in my experience, even with a high deductible health insurance plan, the insurance company's negotiated rates are still in effect. In other words, if a visit would be billed to an uninsured person at $200, but my insurance caps it at $100, then $100 is the price accepted by the doctor's office no matter if I'm paying because I haven't reached my high deductible or insurance is paying because I have a regular, not high deductible plan.
  - maerF0x0 7y ago
    right, but now you're talking about in-network vs out-of-network rates. I believe should disappear with price transparency...

froindt 7y ago

We've seen massive consolidation of health groups over the last 20 years. I believe that's the point Ms. Gee is making. There used to be competition 10 or 20 minutes away. Now it's entirely plausible you'll be driving for hours to find a different medical group with similar services available. In my area (250k people, Iowa) there are 2 health groups. I actively tried finding a PCP who wasn't part of the two health groups but accepted insurance - as mega health groups greatly increase the total cost of care. I gave up after looking up about 20 from the hundred or so names insurance sent me. Basically everyone Unity Point recently announced it wouldn't be merging with Sanford health group. That would have expanded Sanford's strong footing in northwest Iowa, gaining 5 hospitals in Des Moines and at least one hospital in most locally large cities across the east half of state. It's hard enough to make the math work for hospitals in rural areas. The merger would have made it more difficult for the entire region to find competition.

gamblor956 7y ago

That "further away hospital" is literally "competition." Also, 1 hour away is not much in terms of time or distance, considering that many metropolitan residents have a daily commute in excess of 1 hour, and many rural residents live several hours from the closest hospital.