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> if they are not providing the best prices, their customers will go elsewhere Nope. Not if they can inject enough noise into the comparison process to hide th

> if they are not providing the best prices, their customers will go elsewhere Nope. Not if they can inject enough noise into the comparison process to hide the differences. There's a reason they threw so much money at getting bronze/silver/gold standards killed. They knew it was critical to avoid being squeezed. > pharmacists complaining Pharmacists are a tiny part of the bloat picture and it's always easier to put the screws to smaller players. Come back when drugs and hospital stays stop costing twice as much as the rest of the developed world, or stop growing 10% y/y (on top of regular inflation) and then I'll believe that insurance companies are doing their negotiating job.

lotsofpulp 4y ago
> There's a reason they threw so much money at getting bronze/silver/gold standards killed. I am not aware of these standards being killed. I select a Gold HSA plan every year. https://www.healthcare.gov/choose-a-plan/plans-categories/ https://www.healthcare.gov/choose-a-plan/plans-categories/ > Come back when drugs and hospital stays stop costing twice as much as the rest of the developed world, and then I'll believe that insurance companies are doing their negotiating job. > Come back when drugs and hospital stays stop costing twice as much as the rest of the developed world, and then I'll believe that insurance companies are doing their negotiating job. How are they supposed to negotiate if there is only 1 hospital in an area or a drug company owns the patent to a drug so they are the only seller? The insurance company is mandated to cover emergency care at the hospital and pay whatever price for the medicine if it has sufficient efficacy data, per the laws. When there are generic drugs available, insurance does pay less for those drugs.
- jjoonathan 4y ago
  I could be wrong or I could be remembering that they were effectively killed by inserting a key loophole. I'll have to dig up my notes and probably do some research to figure that out. My point about performance -- 2x, 10%y/y -- stands.
  - lotsofpulp 4y ago
    There is no point to comparing US expenses to other countries where drug manufacturers and hospitals and doctors are not allowed to negotiate, and have to accept what the government gives them. What would you do if you were the insurer and there was one hospital in an area or 1 patented medicine and the government forced you to cover it?
    - jjoonathan 4y ago
      No point? The point is that we should be doing what they are doing. When you're in a hole, stop digging. > WWYD I would get rid of private insurers and have the NHS negotiate prices.
      - lotsofpulp 4y ago
        This discussion is about insurers negotiating pricing, not about politicians enacting taxpayer funded healthcare.
        jjoonathan 4y ago
        Nice try. It's a discussion about private insurers systematically sucking at their notional purpose. Which they absolutely do. They need to be replaced. "They're doing as well as could be expected" might be an exoneration of a company, but it's an indictment of the system.

lotsofpulp 4y ago

> There's a reason they threw so much money at getting bronze/silver/gold standards killed. I am not aware of these standards being killed. I select a Gold HSA plan every year. https://www.healthcare.gov/choose-a-plan/plans-categories/ https://www.healthcare.gov/choose-a-plan/plans-categories/ > Come back when drugs and hospital stays stop costing twice as much as the rest of the developed world, and then I'll believe that insurance companies are doing their negotiating job. > Come back when drugs and hospital stays stop costing twice as much as the rest of the developed world, and then I'll believe that insurance companies are doing their negotiating job. How are they supposed to negotiate if there is only 1 hospital in an area or a drug company owns the patent to a drug so they are the only seller? The insurance company is mandated to cover emergency care at the hospital and pay whatever price for the medicine if it has sufficient efficacy data, per the laws. When there are generic drugs available, insurance does pay less for those drugs.

jjoonathan 4y ago
I could be wrong or I could be remembering that they were effectively killed by inserting a key loophole. I'll have to dig up my notes and probably do some research to figure that out. My point about performance -- 2x, 10%y/y -- stands.
- lotsofpulp 4y ago
  There is no point to comparing US expenses to other countries where drug manufacturers and hospitals and doctors are not allowed to negotiate, and have to accept what the government gives them. What would you do if you were the insurer and there was one hospital in an area or 1 patented medicine and the government forced you to cover it?
  - jjoonathan 4y ago
    No point? The point is that we should be doing what they are doing. When you're in a hole, stop digging. > WWYD I would get rid of private insurers and have the NHS negotiate prices.
    - lotsofpulp 4y ago
      This discussion is about insurers negotiating pricing, not about politicians enacting taxpayer funded healthcare.
      - jjoonathan 4y ago
        Nice try. It's a discussion about private insurers systematically sucking at their notional purpose. Which they absolutely do. They need to be replaced. "They're doing as well as could be expected" might be an exoneration of a company, but it's an indictment of the system.