Wait till you find out how much it actually costs doctors/providers to render some of these services! Do you like 90% margins? Doctors sure do! :)
So do lawyers.
How much health insurers pay for almost everything is about to go public
41–50 of 370 posts
Re: How much health insurers pay for almost everything is about to go public
#42Earlier quoted context omitted.
In the US, isn't there regulations that effectively cap their profit margins? Since they have no incentive to increase their margin through negotiation, their only incentive would be to lower their costs below competition.
Medical Loss Ratio: https://www.healthcare.gov/glossary/medical-loss-ratio-mlr It says 80%/85% of premiums have to go back out as payments for claims. > Since they have no incentive to increase their margin through negotiation, I do not see why this would be true. The less an insurance company pays for healthcare, the lower the premiums or can offer and win more business.
This would be true if there were a reasonable amount of market understanding by customers and the friction to switching were low. Neither are the case. Most of the time, it takes a qualifying life event or open enrollment (once a year) to switch. And then, understanding the trade offs between plans, which are difficult to understand on a good day, is another barrier.
Re: How much health insurers pay for almost everything is about to go public
#43Re: How much health insurers pay for almost everything is about to go public
#44Earlier quoted context omitted.
No point? The point is that we should be doing what they are doing. When you're in a hole, stop digging. > WWYD I would get rid of private insurers and have the NHS negotiate prices.
This discussion is about insurers negotiating pricing, not about politicians enacting taxpayer funded healthcare.
Nice try.
It's a discussion about private insurers systematically sucking at their notional purpose. Which they absolutely do. They need to be replaced.
"They're doing as well as could be expected" might be an exoneration of a company, but it's an indictment of the system.
Re: How much health insurers pay for almost everything is about to go public
#45Question to somebody who might know as this seems like a relevant thread to ask in. If a person wants to pay directly in cash/credit-card for services rendered by a doctor, do doctors' agreements with insurance companies generally prevent them from offering a cash discount to cash-paying patiences lower than the insurance company negotiated price?
Sometimes they aren't allowed to offer a cash option at all, if you've told them you have insurance.
Re: How much health insurers pay for almost everything is about to go public
#46Anecdote: I recently had my yearly glasses update. Cost was $188 to me + $20 of insurance copay, so the glasses provider charged $208 for the glasses. That's not too bad, so I asked how much it would be to replace/update the lenses on my old frames, entirely at my charge. It would've been $450. Just for the lenses. I passed. I find it scandalous how much they can charge when just before they were perfectly happy to a…
They likely had lenses already available for the frames they had in stock, or were frequently making batches of them.
OTOH the frames you already owned may be out of style, so they would have needed to grind a totally custom pair of lenses, just for you.
Re: How much health insurers pay for almost everything is about to go public
#47Earlier quoted context omitted.
Medical Loss Ratio: https://www.healthcare.gov/glossary/medical-loss-ratio-mlr It says 80%/85% of premiums have to go back out as payments for claims. > Since they have no incentive to increase their margin through negotiation, I do not see why this would be true. The less an insurance company pays for healthcare, the lower the premiums or can offer and win more business.
This would be true if there were a reasonable amount of market understanding by customers and the friction to switching were low. Neither are the case. Most of the time, it takes a qualifying life event or open enrollment (once a year) to switch. And then, understanding the trade offs between plans, which are difficult to understand on a good day, is another barrier.
Then why are insurance company profit margins so low? Why wouldn’t they just jack up premiums irrelevant to their competitors and ignore negotiating pricing and see increasing margins?
Low profit margins/multiple sellers indicates a highly competitive field, which means the businesses must be doing something stay in business.
Re: How much health insurers pay for almost everything is about to go public
#48Earlier quoted context omitted.
If insurers’ customers were not price sensitive, then they would have higher profit margins than 5%.
In the US, isn't there regulations that effectively cap their profit margins? Since they have no incentive to increase their margin through negotiation, their only incentive would be to lower their costs below competition.
Wouldn't their incentive be the opposite? To get more total dollars so there is more profit at the capped margin.
Re: How much health insurers pay for almost everything is about to go public
#49Wait till you find out how much it actually costs doctors/providers to render some of these services! Do you like 90% margins? Doctors sure do! :)
Net margins != gross margins
Re: How much health insurers pay for almost everything is about to go public
#50Earlier quoted context omitted.
Doesn't that just mean that they have an interest in keeping these costs high ? The higher the costs, the larger that % is for the in absolute dollars. If all the costs come down, they are allowed to make less money.
Yes, this is one of the more unfortunate unintended consequences of the ACA.
"unintended"
Insurance companies wrote the bill.