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Insurers are incentivized to set standards for spending as much money as possible on all health care. They have maximum profit rates, as a percentage of revenu

Insurers are incentivized to set standards for spending as much money as possible on all health care. They have maximum profit rates, as a percentage of revenue. So the two ways to grow the revenue, and therefore profit, are to 1) capture a larger percentage of patients, and 2) make sure that all patients, including competitors, start using more expensive care options all together. System-wide cost savings do not increase insurance company profits. This could be considered a good thing or a bad thing, depending on your point of view, I guess. I had always considered it a bad thing, but given the thrust of your comment, perhaps it's good that there's no incentive for health care companies to push cost-savings measures as an industry.

imtringued 3y ago
And this is why having government funded basic healthcare isn't as inefficient as so many people claim. For the government the only thing that matters is net tax revenue. Healthy people pay more taxes and unhealthy people cost money. So the solution is obvious: invest in effective low cost preventative treatments and cures. That maximizes net tax revenue. Meanwhile private insurers only care about your health to the extent that they get paid. Healthy people bring in less money than the chronically ill.
- refurb 3y ago
  This isn’t true. Insurers are incentivized by lowering healthcare costs as well. All you have to do is look at all the preventative care that they pay for - often with smaller or no copay (although no copay was mandated by Obamacare).
refurb 3y ago
You’re missing the part where insurers have to big for coverage. Companies will say “we want a plan that includes X” then get a bunch of proposals from insurers. Cost is a big factor in which one you go with. So while insurers do make more money by paying higher and more claims, that’s offset by customers wanting a low price.
- Brybry 3y ago
  That might be true in some regions but there also many regions in the US with very little health insurance competition.[1][2] [1] https://www.ama-assn.org/delivering-care/patient-support-advocacy/most-commercial-health-insurance-markets-are-highly https://www.ama-assn.org/delivering-care/patient-support-adv... [2] https://www.ama-assn.org/delivering-care/patient-support-advocacy/competition-health-care-research https://www.ama-assn.org/delivering-care/patient-support-adv...
- epistasis 3y ago
  I was talking about standard changes to what is deemed medically necessary, and the best medical course of action. Individual companies wanting particular things covered is quite different. And the topic of this thread is why is the entire field shifting in their care in terms of what's thought to be medically best.

imtringued 3y ago

And this is why having government funded basic healthcare isn't as inefficient as so many people claim. For the government the only thing that matters is net tax revenue. Healthy people pay more taxes and unhealthy people cost money. So the solution is obvious: invest in effective low cost preventative treatments and cures. That maximizes net tax revenue. Meanwhile private insurers only care about your health to the extent that they get paid. Healthy people bring in less money than the chronically ill.

refurb 3y ago
This isn’t true. Insurers are incentivized by lowering healthcare costs as well. All you have to do is look at all the preventative care that they pay for - often with smaller or no copay (although no copay was mandated by Obamacare).

refurb 3y ago

You’re missing the part where insurers have to big for coverage. Companies will say “we want a plan that includes X” then get a bunch of proposals from insurers. Cost is a big factor in which one you go with. So while insurers do make more money by paying higher and more claims, that’s offset by customers wanting a low price.

Brybry 3y ago
That might be true in some regions but there also many regions in the US with very little health insurance competition.[1][2] [1] https://www.ama-assn.org/delivering-care/patient-support-advocacy/most-commercial-health-insurance-markets-are-highly https://www.ama-assn.org/delivering-care/patient-support-adv... [2] https://www.ama-assn.org/delivering-care/patient-support-advocacy/competition-health-care-research https://www.ama-assn.org/delivering-care/patient-support-adv...
epistasis 3y ago
I was talking about standard changes to what is deemed medically necessary, and the best medical course of action. Individual companies wanting particular things covered is quite different. And the topic of this thread is why is the entire field shifting in their care in terms of what's thought to be medically best.