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I know that insurance companies are rich targets, but I believe that when it comes to the cost of health care, the rise of hospital monopolies is a very signifi

I know that insurance companies are rich targets, but I believe that when it comes to the cost of health care, the rise of hospital monopolies is a very significant factor. If a hospital is effectively a monopoly for an entire region, then they just have a lot of leverage bargaining on prices with insurers.

JohnFen 5y ago
I think that the rise of hospital monopolies and the abuse by insurance companies are related.
- jonnycomputer 5y ago
  They may be, if in fact the people sitting on the boards of both are the same...
m-ee 5y ago
Or not working with insurers at all. SF general chose to be out of network with all insurance providers which led to patients getting astronomical bills. SF has other hospitals, but SFGH is the only trauma center in town. If you're injured in a auto collision you'll end up there whether you want to or not.
missedthecue 5y ago
I agree with this. It really is a curiosity to me how much blame gets pinned on healthcare insurance firms. Many are already non-profit, (Kaiser, BCBS, Wellmark, etc...) and the ones that are for-profit (Humana, Aetna, United) have net profit margins around 2-5%. Eliminate their profitability, and suddenly we all save a whopping $10 a month on our premiums.
- tdfx 5y ago
  Insurance companies easy to hate. It's harder to vilify the doctors because people have a more personal relationship with them. Also, many people don't realize they're paying the doctor in the US 300-500% more than other countries where they would receive more or less the exact same level of care. It's not just hospitals charging ridiculous amounts... going to see your PCP for a sore throat can cause a $200 consultation bill to your insurance company. The $25-50 co-pay you're paying out of pocket is just the tip of the iceberg of what these doctors are charging for routine, unremarkable services.
  - OrvalWintermute 5y ago
    I don't know that in the US you are paying a doctor for 300-500% more because you may be comparing unlike costs. If many doctors in foreign countries are state subsidized throughout their education, and the educational system itself is state subsidized, and they are operating in state subsized facilities, that you are supporting through taxes. > the exact same level of care Medical care and medical standards are not the same per country. > doctors are charging for routine, unremarkable services. Most doctors are floating 10 - 20% uninsured/charity cases, and a number of patients that skip out on bills. They also have their own facilities, staff/payroll, and their own personal salary, as well as malpractice 40k a year (depending on specialty). I do not know a doctor (and I know many) that makes near what the MBA "nonprofit" executive types at the local "nonprofit" hospital cartel make. > It's not just hospitals charging ridiculous amounts If you wanted to make your text more accurate specific to doctors you'd examine the differences between in-network rates, and out-of-network rates, malpractice expenses, and capping out-of-network rates to a multiple of medicare.

JohnFen 5y ago

I think that the rise of hospital monopolies and the abuse by insurance companies are related.

jonnycomputer 5y ago
They may be, if in fact the people sitting on the boards of both are the same...

m-ee 5y ago

Or not working with insurers at all. SF general chose to be out of network with all insurance providers which led to patients getting astronomical bills. SF has other hospitals, but SFGH is the only trauma center in town. If you're injured in a auto collision you'll end up there whether you want to or not.

missedthecue 5y ago

I agree with this. It really is a curiosity to me how much blame gets pinned on healthcare insurance firms. Many are already non-profit, (Kaiser, BCBS, Wellmark, etc...) and the ones that are for-profit (Humana, Aetna, United) have net profit margins around 2-5%. Eliminate their profitability, and suddenly we all save a whopping $10 a month on our premiums.

tdfx 5y ago
Insurance companies easy to hate. It's harder to vilify the doctors because people have a more personal relationship with them. Also, many people don't realize they're paying the doctor in the US 300-500% more than other countries where they would receive more or less the exact same level of care. It's not just hospitals charging ridiculous amounts... going to see your PCP for a sore throat can cause a $200 consultation bill to your insurance company. The $25-50 co-pay you're paying out of pocket is just the tip of the iceberg of what these doctors are charging for routine, unremarkable services.
- OrvalWintermute 5y ago
  I don't know that in the US you are paying a doctor for 300-500% more because you may be comparing unlike costs. If many doctors in foreign countries are state subsidized throughout their education, and the educational system itself is state subsidized, and they are operating in state subsized facilities, that you are supporting through taxes. > the exact same level of care Medical care and medical standards are not the same per country. > doctors are charging for routine, unremarkable services. Most doctors are floating 10 - 20% uninsured/charity cases, and a number of patients that skip out on bills. They also have their own facilities, staff/payroll, and their own personal salary, as well as malpractice 40k a year (depending on specialty). I do not know a doctor (and I know many) that makes near what the MBA "nonprofit" executive types at the local "nonprofit" hospital cartel make. > It's not just hospitals charging ridiculous amounts If you wanted to make your text more accurate specific to doctors you'd examine the differences between in-network rates, and out-of-network rates, malpractice expenses, and capping out-of-network rates to a multiple of medicare.