3 ms·

> are no “innocent” parties in the payer-provider-patient triangle not the patient?

• LorenPechtel 5mo ago
  No. Lots of problems with patients wanting things they've heard of. Think all that drug advertising is for nothing??
• fiej 5mo ago
  Over utilization, especially after deductibles are met. Demanding tests and treatments that aren’t warranted, and physicians have huge pressure to comply because they’re very heavily goaled on patient happiness (rather than quality outcomes). Patients have zero incentive to shop around on price, so if an academic research hospital MRI costs $6,000 and an independent lab has the same machine and charges $600, most patients don’t care or even know the price difference and let insurance foot the bill. There’s also a small but expensive population of people who are uninsured and go to the ER very frequently and stay for a while (faking illness, requesting drugs, or simply a warm bed and meal). Clearly a societal problem, but hospitals foot the bill for those stays and raise prices for everyone. A lot of the structure of insurance plans (deductibles, co-pays, co-insurance, HMO/PPO, enrollment periods) emerged to provide a counterbalance to patient behavior, characterized by adverse selection and moral hazard primarily