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Hospitals have incentives to have a high sticker price - it benefits everyone. The insurance companies negotiate to something closer to the "real" price. That

Hospitals have incentives to have a high sticker price - it benefits everyone. The insurance companies negotiate to something closer to the "real" price. That makes them happy. Government through Medicaid/Medicare has a way of giving money to hospitals. Customers only care about the out of pocket cost - indeed if they happen to notice the sticker price it'll only be after they know what they're actually paying - so that will actually make them happy. There's a very small group. 5% or so of people, those who don't have private insurance and aren't on the public insurances - edicare/Medicaid/VA - . Those people are actually in a position where they get to see the sticker price but might have to actually pay it. Which sucks. But I don't see how that changes. The people getting abused are - despite what you might hear - are small in number, typically healthy and not particularly poor or old. The ACA actually went after those people - that was what the mandate was about - and tried to get them to buy a lot of insurance. More insurance then they wanted - and the end result was that the mandate's been effectively gotten rid of.

zerd 5y ago
Plus out of network emergency visits, which isn't uncommon https://www.kff.org/health-costs/press-release/about-1-in-6-emergency-visits-and-hospital-stays-had-at-least-one-out-of-network-charge-in-2017/ https://www.kff.org/health-costs/press-release/about-1-in-6-...
noelsusman 5y ago
Part of the issue is that Medicare and especially Medicaid pay providers below cost for services. That money needs to be made up somewhere. Private insurers pay above cost, but they have too much leverage to get squeezed by the hospitals. That leaves uninsured patients to hold the bag. They could try to cut costs, but that puts them at a competitive disadvantage because most patients don't actually care about how much their care costs, they only care about how much they have to pay. If you're an uninsured patient who isn't in poverty then hospitals are going to squeeze you for as much as they can get away with. It's how they keep the lights on. None of this makes any real sense, but hospitals are just doing what they have to do to survive in the system we've created for them.

zerd 5y ago

Plus out of network emergency visits, which isn't uncommon https://www.kff.org/health-costs/press-release/about-1-in-6-emergency-visits-and-hospital-stays-had-at-least-one-out-of-network-charge-in-2017/ https://www.kff.org/health-costs/press-release/about-1-in-6-...

noelsusman 5y ago

Part of the issue is that Medicare and especially Medicaid pay providers below cost for services. That money needs to be made up somewhere. Private insurers pay above cost, but they have too much leverage to get squeezed by the hospitals. That leaves uninsured patients to hold the bag. They could try to cut costs, but that puts them at a competitive disadvantage because most patients don't actually care about how much their care costs, they only care about how much they have to pay. If you're an uninsured patient who isn't in poverty then hospitals are going to squeeze you for as much as they can get away with. It's how they keep the lights on. None of this makes any real sense, but hospitals are just doing what they have to do to survive in the system we've created for them.