Earlier quoted context omitted.
Senators and congresspeople get their own very high quality insurance. They have no incentive to fix it, their own health care is world-class.
That's too easy an answer. They get basically the same options for health insurance as other federal employees. And that insurance is not materially different from the insurance you'd get from any other major employer.
Hospitals lift curtain on prices, reveals giant swings for hips, knees and more
141–150 of 283 posts
Re: Hospitals lift curtain on prices, reveals giant swings for hips, knees and more
#142Earlier quoted context omitted.
It is not a 'broken mess'. It is an 'engineered mess'. The difference is in intent.
Who is making the profits? Most health insurance orgs, mine included, are not for profit. BCBS, Kaiser, Wellmark, etc
The administration & C suite.
Non for profit is a nice smokescreen. Nonprofit status is a nice little windfall fir the permanent bureaucrat class at payors and hospitals.
Starting from cancer children's hospitals that do all kinds of tricks to energize fundraisers and draw donations.. which amount to a paltry 30% of their CEO's salary....
To payors colluding with hospitals to raise "gross" prices in order to get more government payments for medicare disproportionate share funding (DCH) https://en.wikipedia.org/wiki/Disproportionate_share_hospita...
THe profits go to the permanent administration.
Is it any surprise that admins then balk at putting prices online, with an argument that can be summed up as "OMG, you make us put online the price from 2000 contracts!! Its too hard! "
Here is a little nugget. Nonprofit designation for hospital is a recent development. It didn't exist before 1900. The designation was effectively "compensation" by the government to hospitals, so the latter would agree to admit patients regardless of ability to pay. Quid pro quo.
Dont feel bad for hospitals and their "curse" of nonpaying patients. They got their pound of flesh.
Nonprofit status its not just federal exemption.. its ALL Taxes (state, local, real estate, commercial, etc).
Imagine your life if you didn't have to pay sale tax? Property tax? State tax ? FICA, FUTA SDI?
That is the life nonprofit hospitals enjoy.
Re: Hospitals lift curtain on prices, reveals giant swings for hips, knees and more
#143Earlier quoted context omitted.
That would lead to a model where healthcare spending is directed to attracting healthy patients and refusing unhealthy patients.
In other words, the pre-ACA individual insurance market.
This is the result of the principal-agent problem, which is inherent to insurance itself.
Re: Hospitals lift curtain on prices, reveals giant swings for hips, knees and more
#144Earlier quoted context omitted.
That would lead to a model where healthcare spending is directed to attracting healthy patients and refusing unhealthy patients.
No, you’re right. Capitalism makes this a really difficult problem, even if we’re just doing hypothetical scenarios.
It's the same problem in non-capitalist systems that decide this by selecting what is covered or not.
Re: Hospitals lift curtain on prices, reveals giant swings for hips, knees and more
#145Earlier quoted context omitted.
The mess is by design. Goldman Sachs asks in biotech research report: ‘Is curing patients a sustainable business model?’ https://www.cnbc.com/2018/04/11/goldman-asks-is-curing-patie... >
Someone said something somewhere is not actually evidence of anything. Also, the answer is "yes", because new patients are always being born.
Try a web search for the most profitable drugs in pharma. They're not one-off cures. They're drugs the same patient takes repeatedly for decades: insulin, statins, pain-killers, etc.
Re: Hospitals lift curtain on prices, reveals giant swings for hips, knees and more
#146I'm the technical cofounder of a mid-sized healthcare startup, and when I start explaining hospital administration to people, I start with this - every person working in your hospital or clinic has no incentive whatsoever for you to emerge healthier. The only goal is to maximize the ratio between the amount your insurance is willing to pay, and the amount of care that is provided. In the case of joint replacement, ea…
I'm not following your example. I don't want to end up in the ER requiring another surgery. If the provider can do something such that I can avoid that, I feel that's healthier.
So the provider "hammers" me with reminders which makes that less likely to happen. Sure, they might not be doing it out of the kindness of their hearts (I've worked in a hospital and many people definitely do want patients to be healthier, but that's neither here nor there), but it seems like they're "incentiv[sized] for you to emerge healthier."
Re: Hospitals lift curtain on prices, reveals giant swings for hips, knees and more
#147The U.S. healthcare system cannot be fixed. Period. Full-stop. The only solution is to nuke it from orbit, pave it over, and start again. It's very easy to point the finger at the conservative party as the one who's screwed it all up, but the other parties are not really putting forward models for successful healthcare systems. If one were to sit down and try to create the most absurd approach to healthcare that guar…
Senators and congresspeople get their own very high quality insurance. They have no incentive to fix it, their own health care is world-class.
Many companies maintain VIP lists to provide better service to celebrities and politicians. When a senator calls Comcast, they are not talking to the same call center the average customer is.
Re: Hospitals lift curtain on prices, reveals giant swings for hips, knees and more
#148People here comparing medicine with car mechanics don't have the slightest idea of what they're talking about. The US system is in the hands of the administrators. Not docs, not even the govt: administrators, usually belonging to a behemoth (private) company that has immense and intrinsic lobbying power due to the nature of the industry. There can be no shortage of buyers. Well, admins wanting to earn more just have…
That's not entirely true; doctors have massive political and financial power. The AMA is run by doctors and has consistently lobbied against government funded healthcare for more than a century. They killed FDR's and Truman's proposals and lobbied hard against Medicare and Medicaid in the 1970s.
Re: Hospitals lift curtain on prices, reveals giant swings for hips, knees and more
#149I'm the technical cofounder of a mid-sized healthcare startup, and when I start explaining hospital administration to people, I start with this - every person working in your hospital or clinic has no incentive whatsoever for you to emerge healthier. The only goal is to maximize the ratio between the amount your insurance is willing to pay, and the amount of care that is provided. In the case of joint replacement, ea…
I'm not following your example. I don't want to end up in the ER requiring another surgery. If the provider can do something such that I can avoid that, I feel that's healthier. So the provider "hammers" me with reminders which makes that less likely to happen. Sure, they might not be doing it out of the kindness of their hearts (I've worked in a hospital and many people definitely do want patients to be healthier, b…
It’s the counter example that makes the point. The only reason it seems a better outcome is coincidence.
Re: Hospitals lift curtain on prices, reveals giant swings for hips, knees and more
#150Earlier quoted context omitted.
Should we be upset that people can't afford to provide cures we don't want to pay for? When I work, I get paid. I expect pharmaceutical companies feel the same way. And if you look at how the world dealt with the hep c cure, it was pretty much trying as hard as possible to pay as little for a cure because the cost was front loaded.
We should certainly be upset that a giant bank is effectively advising them not to create cures.
The math is fairly simple. (Monthly drug price) * (number of months they take it) > (one time cost)
Unless that one time cost is huge.