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Insurance companies are hardly the only ones at fault here. Hospitals and Pharma companies are guilty of price gouging [1]. When insurance pays hospitals hike u

Insurance companies are hardly the only ones at fault here. Hospitals and Pharma companies are guilty of price gouging [1]. When insurance pays hospitals hike up the prices. When the patient pays (such as for cosmetic or plastic surgery) the prices charged by hospitals and doctors are more reasonable. [1] https://www.dolthub.com/blog/2022-05-31-hospital-price-gouging/ https://www.dolthub.com/blog/2022-05-31-hospital-price-gougi...

laimewhisps 2y ago
This is why CEO pay transparency is so important!
no_wizard 2y ago
Perhaps the house cleaning has only just begun
klysm 2y ago
The price hikes are enabled by our insurance structure
davideous 2y ago
Setting prices by supply-and-demand and having insurance "pay for whatever is needed regardless of the cost" are incompatible. Insurance blocks the pricing cost signal back to the patient. Insurance also prevents better doctors that provide better service from charging more because the patients will pay for it. An example: about 20 years ago I had just a major medical plan and I was at urgent care for a problem. After diagnosing the likely problem and prescribing the solution, they were about to run some tests "just in case." When I told them I would be paying for the tests due to the major medical plan, they explained that the tests didn't have any benefit, so we didn't run them. I don't know of a real solution to these problems. A partial solution is exposing some of the cost to the insured to create an incentive to save (like what I had when I was paying for the tests). At my company, we fully pay for a high-deductible plan AND a give company-funded contribution to a Health Savings Account that mostly covers the per-person out-of-pocket max. If the employee does not spend the HSA money (which is their money in their account), it can be used for retirement savings... so they have an incentive to save. But once someone hits the out-of-pocket max, there is no more incentive to save.
- breadwinner 2y ago
  Patients must be incentivized to understand their care and question care that is unnecessary and wasteful. The partial solution you mention is the way to go, and if every employer adopted it, it will change the culture, and will at that point become a full solution.
  - voisin 2y ago
    Capitalist structures have a long history of pushing ownership of problems to the powerless individual, then exploiting information asymmetries (and actively obfuscating the truth that would allow for better informed decisions) for profit. Suggesting that the average person should be able to make medical decisions and override their health care provider’s recommendation is ridiculous.
    - breadwinner 2y ago
      > Suggesting that the average person should be able to make medical decisions and override their health care provider’s recommendation is ridiculous. The situation is similar to taking your out-of-warranty car to a dealer for repairs. Sometimes, you may suspect they’re not being completely honest with you. What do you do in that case? You get a second opinion before agreeing to a costly repair.
      - voisin 2y ago
        Sure, and that’s possible (at significant added cost) in a portion of cases. But not all - you might be on an operating table or in the middle of a psychiatric event, etc etc, where time does not permit second opinions, and if the system is set up to “gotcha” as a baseline, then only the most minor, time insensitive, situations will receive fair pricing.
        breadwinner 2y ago
        > if the system is set up to “gotcha” as a baseline This is what we have to change. When physicians and hospitals know that patients are scrutinizing care plans they will find a new fairer baseline. That cultural change will subsume older practices.
slt2021 2y ago
not true, Insurance Pharmacies Doctors and Hospitals all work together. The high list prices you see are only exist there to scare uninsured/underinsured Americans and to force them to buy/pay more expensive insurance. As soon as you get treated, these list prices magically get reduced on the backend by factor of 2-3x. Doctors themselves cannot price gouge patients, but they can price gouge via middleman (insurance). The same procedure that costs $50 will be billed to insurance as $500 procedure. same with pharma drugs, there is a very complex system in place to keep the face of expensive prices, while keeping a system of rebates/discounts/pre-negotiated contracts between each big player. Americans are simply getting taken for a ride and their money being stolen by Pharma+Hospitals and Insurance is simply acting as a financial middleman. Also insurance literally FORCES americans to work, because thats the only way to get affordable health insurance. Aint noone is paying COBRA (list prices). If you do you are stupid and throwing money away. American population is being squeezed and extracted of their labor due to system that forces you to work to stay alive and healthy. for comparison, just go to Thailand or Vietnam to any of the private hospitals: you can get the same western standard treatment but for pennies (the actual cost of care). This is the healthcare that Americans COULD have, but unfortunately the American system would lose too much money so Americans are not allowed to have affordable health care. A lot of things in America is simply regulatory capture and requires Americans to keep ignorant of what they could have, what other countries enjoy, but Americans are not allowed to
- plagiarist 2y ago
  > Also insurance literally FORCES americans to work, because thats the only way to get affordable health insurance. This is really important. This system is artificially lowering the cost of labor and preventing people from immediately leaving workplaces where they are treated poorly by the employers or the customers.
  - slt2021 2y ago
    People sometimes ask why there are fewer independent artists or writers, or small artisans like in Europe. The reason is if you want to live, you need to get healthcare, and for that you need to be employed by BigCorp (because marketplace insurance is overpriced and crappy thanks to OBAMA). The system is set up in a way to keep extracting and exploiting people in their prime years of age
plagiarist 2y ago
The insurance model is for catastrophic care. It is completely failing us for long-term care, but has inserted itself in that process anyway. You can indeed see prices on elective procedures are at least adjacent to sanity, because insurance refuses to pay a cent for that.
xracy 2y ago
The Health Industry has this lovely 3-part structural defense they run behind every time that someone questions why the health industry costs so much. Step 1: "The other 2 entities in the health industry are to blame!" Step 2: Profit, because no one is going to succeed a battle here that knocks down only one of these. Every time, this is the response. In practice they are all to blame, and they could all be working to make this better. But none of them are incentivized to act in anything but their own self-interest. Insurance is definitely to blame, as are hospitals and pharmaceutical manufacturers. There's a reason the companies that ostensibly "save people's lives" are some of the most hated in the US. I hope that Insurance companies have an epiphany from the public sentiment about this, that they're messing this up spectacularly. But honestly, they seem more likely to wait for this to blow over.
consteval 2y ago
It's nobody's fault, it's the obvious and guaranteed result of a capitalist, for-profit healthcare industry. This is not only expected, but unavoidable. If health insurance typically only covers 150 dollars for a procedure, but one super duper premium plan may cover 600, you charge 600. End of. Because otherwise, what happens when patients with that super duper plan come in? You only make 150 instead of 600. Would you want to get paid 150 instead of 600? No, you wouldn't. Survey every American. None would. We aren't stupid. So, you charge 600, and by the shackles of capitalism, you have no choice. Your hands are tied - that decision is already made for you by the systems in place.

laimewhisps 2y ago

This is why CEO pay transparency is so important!

no_wizard 2y ago

Perhaps the house cleaning has only just begun

klysm 2y ago

The price hikes are enabled by our insurance structure

davideous 2y ago

Setting prices by supply-and-demand and having insurance "pay for whatever is needed regardless of the cost" are incompatible. Insurance blocks the pricing cost signal back to the patient. Insurance also prevents better doctors that provide better service from charging more because the patients will pay for it. An example: about 20 years ago I had just a major medical plan and I was at urgent care for a problem. After diagnosing the likely problem and prescribing the solution, they were about to run some tests "just in case." When I told them I would be paying for the tests due to the major medical plan, they explained that the tests didn't have any benefit, so we didn't run them. I don't know of a real solution to these problems. A partial solution is exposing some of the cost to the insured to create an incentive to save (like what I had when I was paying for the tests). At my company, we fully pay for a high-deductible plan AND a give company-funded contribution to a Health Savings Account that mostly covers the per-person out-of-pocket max. If the employee does not spend the HSA money (which is their money in their account), it can be used for retirement savings... so they have an incentive to save. But once someone hits the out-of-pocket max, there is no more incentive to save.

breadwinner 2y ago
Patients must be incentivized to understand their care and question care that is unnecessary and wasteful. The partial solution you mention is the way to go, and if every employer adopted it, it will change the culture, and will at that point become a full solution.
- voisin 2y ago
  Capitalist structures have a long history of pushing ownership of problems to the powerless individual, then exploiting information asymmetries (and actively obfuscating the truth that would allow for better informed decisions) for profit. Suggesting that the average person should be able to make medical decisions and override their health care provider’s recommendation is ridiculous.
  - breadwinner 2y ago
    > Suggesting that the average person should be able to make medical decisions and override their health care provider’s recommendation is ridiculous. The situation is similar to taking your out-of-warranty car to a dealer for repairs. Sometimes, you may suspect they’re not being completely honest with you. What do you do in that case? You get a second opinion before agreeing to a costly repair.
    - voisin 2y ago
      Sure, and that’s possible (at significant added cost) in a portion of cases. But not all - you might be on an operating table or in the middle of a psychiatric event, etc etc, where time does not permit second opinions, and if the system is set up to “gotcha” as a baseline, then only the most minor, time insensitive, situations will receive fair pricing.
      - breadwinner 2y ago
        > if the system is set up to “gotcha” as a baseline This is what we have to change. When physicians and hospitals know that patients are scrutinizing care plans they will find a new fairer baseline. That cultural change will subsume older practices.

slt2021 2y ago

not true, Insurance Pharmacies Doctors and Hospitals all work together. The high list prices you see are only exist there to scare uninsured/underinsured Americans and to force them to buy/pay more expensive insurance. As soon as you get treated, these list prices magically get reduced on the backend by factor of 2-3x. Doctors themselves cannot price gouge patients, but they can price gouge via middleman (insurance). The same procedure that costs $50 will be billed to insurance as $500 procedure. same with pharma drugs, there is a very complex system in place to keep the face of expensive prices, while keeping a system of rebates/discounts/pre-negotiated contracts between each big player. Americans are simply getting taken for a ride and their money being stolen by Pharma+Hospitals and Insurance is simply acting as a financial middleman. Also insurance literally FORCES americans to work, because thats the only way to get affordable health insurance. Aint noone is paying COBRA (list prices). If you do you are stupid and throwing money away. American population is being squeezed and extracted of their labor due to system that forces you to work to stay alive and healthy. for comparison, just go to Thailand or Vietnam to any of the private hospitals: you can get the same western standard treatment but for pennies (the actual cost of care). This is the healthcare that Americans COULD have, but unfortunately the American system would lose too much money so Americans are not allowed to have affordable health care. A lot of things in America is simply regulatory capture and requires Americans to keep ignorant of what they could have, what other countries enjoy, but Americans are not allowed to

plagiarist 2y ago
> Also insurance literally FORCES americans to work, because thats the only way to get affordable health insurance. This is really important. This system is artificially lowering the cost of labor and preventing people from immediately leaving workplaces where they are treated poorly by the employers or the customers.
- slt2021 2y ago
  People sometimes ask why there are fewer independent artists or writers, or small artisans like in Europe. The reason is if you want to live, you need to get healthcare, and for that you need to be employed by BigCorp (because marketplace insurance is overpriced and crappy thanks to OBAMA). The system is set up in a way to keep extracting and exploiting people in their prime years of age

plagiarist 2y ago

The insurance model is for catastrophic care. It is completely failing us for long-term care, but has inserted itself in that process anyway. You can indeed see prices on elective procedures are at least adjacent to sanity, because insurance refuses to pay a cent for that.

xracy 2y ago

The Health Industry has this lovely 3-part structural defense they run behind every time that someone questions why the health industry costs so much. Step 1: "The other 2 entities in the health industry are to blame!" Step 2: Profit, because no one is going to succeed a battle here that knocks down only one of these. Every time, this is the response. In practice they are all to blame, and they could all be working to make this better. But none of them are incentivized to act in anything but their own self-interest. Insurance is definitely to blame, as are hospitals and pharmaceutical manufacturers. There's a reason the companies that ostensibly "save people's lives" are some of the most hated in the US. I hope that Insurance companies have an epiphany from the public sentiment about this, that they're messing this up spectacularly. But honestly, they seem more likely to wait for this to blow over.

consteval 2y ago

It's nobody's fault, it's the obvious and guaranteed result of a capitalist, for-profit healthcare industry. This is not only expected, but unavoidable. If health insurance typically only covers 150 dollars for a procedure, but one super duper premium plan may cover 600, you charge 600. End of. Because otherwise, what happens when patients with that super duper plan come in? You only make 150 instead of 600. Would you want to get paid 150 instead of 600? No, you wouldn't. Survey every American. None would. We aren't stupid. So, you charge 600, and by the shackles of capitalism, you have no choice. Your hands are tied - that decision is already made for you by the systems in place.