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Insurance "Discounts" in themselves are a huge problem; and one rarely discussed. Imagine what would happen if you forced healthcare providers to offer flat pr
by Someone1234 2y ago
Insurance "Discounts" in themselves are a huge problem; and one rarely discussed.
Imagine what would happen if you forced healthcare providers to offer flat pricing? Meaning the "cash price" is always THE price, and either insurance companies pay that cash price or you pay it with literal cash. No biased pricing.
Suddenly in-network/out-of-network cannot exist, insurance companies and cash-paying patients are on the same side; both fighting overcharging TOGETHER. You've massively reduced admin overheads and made the market more efficient.
If we want to continue this "for profit" model we have today, we could make two changes, and it would hugely reform the market. Make it almost competitive and healthy.
1) Ban healthcare discounts across the board. Everyone pays a sane cash price. Meaning no more fake price + fake "discount" games. No more $100 bandaids with 90% discount.
2) Ban employer provided healthcare. Instead, increase the HSA cap, have employers pay pre-tax into that, and then consumers get to pick their insurance from the market. Therefore, they can "punish" insurance companies for misbehavior since they're now the actual customer (rather than their employer).
You've now created actual price competition for healthcare services and actual competition for insurance. That is how this is MEANT to work, but currently doesn't because you cannot pick either your healthcare providers OR insurance options, someone else is doing that for you.
- ryandvm 2y agoIt absolutely floors me that this isn't already illegal. I've been to healthcare providers that charge one a reasonable amount until you've hit your deductible and then they charge a higher amount. That was a real eye opener.
- Wowfunhappy 2y ago> Suddenly in-network/out-of-network cannot exist. ...I don't think that's true. There would presumably still be some providers who charge more than others. The insurance company will need to set a limit on how much they're willing to pay for a given service. Providers who charge above this limit are out of network; other providers are in network. I do still see the benefits of what you're proposing, but the question remains of what happens when you're accidentally at an out of network doctor.
- Someone1234 2y agoIf everyone is paying the cash-price, you'll get reimbursed up to whatever your policy says, and you'll be responsible for the rest. So no networks, but just like current vehicle coverage, the policy's estimation of the cost and what someone is trying to charge may not align.
- snapplebobapple 2y agoThis would probably be harder to implement in this manner than you think because insurers and hospitals have an increasingly financial/hedgefund owner slant and those guys basically specialize in fuckery to get around bans. You would probably be better off mandating each provider take medicare/medicaid for up to some percentage of their work (say 40%), negotiate a hard bargain on that pricing, and then opening whichever one you choose up to people that don't currently qualify for some reasonable premium upcharge. You could even integrate that into business insurance plans so that businesses can provide more on top of this service as a benefit if they chose (but you wouldn't lose basic coverage if you got unemployed)