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In 2011 I had major surgery. The hospital first billed the insurance company for $100,000. The insurance company then paid $20,000. Of course, the insurance ra

In 2011 I had major surgery. The hospital first billed the insurance company for $100,000. The insurance company then paid $20,000. Of course, the insurance rate was negotiated in advance. There was no reason to bill for 5x the negotiated rate. IMO: We need to start fining hospitals for billing errors like this.

Cthulhu_ 5y ago
I'm sure they play tons of games so it's not considered an error. That said, the government needs to step in and set prices for health care. The free market has failed, in this case. Nobody can afford to shop around for a cheaper health care provider in an emergency, and even then there's no real competition.
- giantg2 5y ago
  "That said, the government needs to step in and set prices for health care." I don't see this working without other substantial changes. They do this with Medicaid and Medicare already. The reimbursement rate is pretty low and the actual costs of some services actually exceed the payment. Without fully going to a government run system, I don't think setting standard prices will work well due to the quality and cost differences from location to location. A better solution might be some sort of truth in advertising/billing that changes how the providers and insurance companies run that process, like presenting actual cost of care, actual payment by insurance, and protecting individuals from any charge that exceeds the cost of care plus some profit limit like 2%. I'm sure there are a lot of details to prevent loopholes, but that's my general view.
  - gwbas1c 5y ago
    Plenty of countries have affordable healthcare. I don't think we need to reinvent the wheel, (in the US,) when we can look at how other countries run their healthcare systems and see what works and what doesn't. The economics of treating rare diseases and is very different than handling a broken leg or a heart attack. Unfortunately, when we talk about healthcare we tend to lump both problems into the same boat, when paying for rare conditions versus common conditions are two very different things with very different solutions. If you've read this far, you probably realize that I'm beating around the bush, but if you understand how technology development starts with an expensive iPad, and then a decade later there are cheap generic tablets, I think you can understand the gist of what I'm saying.

Cthulhu_ 5y ago

I'm sure they play tons of games so it's not considered an error. That said, the government needs to step in and set prices for health care. The free market has failed, in this case. Nobody can afford to shop around for a cheaper health care provider in an emergency, and even then there's no real competition.

giantg2 5y ago
"That said, the government needs to step in and set prices for health care." I don't see this working without other substantial changes. They do this with Medicaid and Medicare already. The reimbursement rate is pretty low and the actual costs of some services actually exceed the payment. Without fully going to a government run system, I don't think setting standard prices will work well due to the quality and cost differences from location to location. A better solution might be some sort of truth in advertising/billing that changes how the providers and insurance companies run that process, like presenting actual cost of care, actual payment by insurance, and protecting individuals from any charge that exceeds the cost of care plus some profit limit like 2%. I'm sure there are a lot of details to prevent loopholes, but that's my general view.
- gwbas1c 5y ago
  Plenty of countries have affordable healthcare. I don't think we need to reinvent the wheel, (in the US,) when we can look at how other countries run their healthcare systems and see what works and what doesn't. The economics of treating rare diseases and is very different than handling a broken leg or a heart attack. Unfortunately, when we talk about healthcare we tend to lump both problems into the same boat, when paying for rare conditions versus common conditions are two very different things with very different solutions. If you've read this far, you probably realize that I'm beating around the bush, but if you understand how technology development starts with an expensive iPad, and then a decade later there are cheap generic tablets, I think you can understand the gist of what I'm saying.