4 ms·
It seems more than coincidental that many of these problems began around the same time insurance companies began large health maintenance organizations (HMO's).
by cmollis 12y ago
It seems more than coincidental that many of these problems began around the same time insurance companies began large health maintenance organizations (HMO's). It's clear that the original intent was to keep costs lower for the participants by spreading the fee-for-service billing model among a larger pool of subscribers. However, this has completely subverted the incentive structure. Doctors bill higher (and differently) for equivalent procedures while insurance companies spread that 'risk' by charging higher premiums. Couple that with Hospital consolidation, and incredibly strong lobby, monopoly pricing power with zero cost visibility and you have.. this.
.. opaque pools of collateral (subscriber) tranches, zero cost visibility, monopoly pricing power.. sounds like they're trading mortgage-backed securities. That didn't end well either.
- zo1 12y agoI'd also like to point out, as it doesn't seem like people go far enough in these sorts of analysis. We tend to draw some arbitrary line of causation, conveniently where it suits us. Obviously, the further back you go, the more difficult it is to draw conclusions and link causation/incentive, but it's important to at least try. E.g. You claim that the problem stems from HMO's spreading risk/cost using premiums, and doctors using that to over-charge fraudulently. But, have you considered why the doctors are able to do so (and get away with )? Perhaps because there is a shortage of them. Or something else, the point I'm trying to make is that we need to go a little bit further.
- deleted 12y ago[deleted]