21–30 of 171 posts
If anyone is interested, the arm and a leg podcast covers how people leverage transparency data and other strategies to fight hospital bills. Most recently it was covered that so few people take hospitals to small claims court over their billing practices that hospitals can afford exorbitant teams of lawyers to establish more case law that their behavior is legal. https://armandalegshow.com/
There are two problems here: 1) Hanlon’s razor 2) The author doesn’t understand health insurance data. I’m not trying to excuse the other bad behavior, but within the data itself, he’s experiencing a combination of health insurers’ incompetence, the kludged up data models they’ve had to build to represent the output of the multiple generations of claims processing systems and other administrative processes, and the g…
Riiiiiight…
Imagine a world where one entity received all the peoples medical bills and was incentived to negotiate for the lowest possible rate from each provider. Imagine the savings alone from reducing a massively overly bureaucratic and complicated system down to just one entity negotiating and paying the health service providers. Just imagine in that world this article would have never needed to have been written.
There are two problems here: 1) Hanlon’s razor 2) The author doesn’t understand health insurance data. I’m not trying to excuse the other bad behavior, but within the data itself, he’s experiencing a combination of health insurers’ incompetence, the kludged up data models they’ve had to build to represent the output of the multiple generations of claims processing systems and other administrative processes, and the g…
I've worked within the health insurance industry (workers' comp, specifically); I know what a shitshow it is. As a fairly green programmer, I was tasked with creating a flat file export from our IBM mainframe's database for a new/changed regulatory requirement, and within just a few weeks (including a bunch of time spent waiting for return files from overnight batches), my export complied with the stated spec better than the agency's own files did.
But the health insurance industry makes absolutely jaw-dropping profits. The only reasons they can't harmonize their systems and produce something at least resembling standard outputs are because it would cost them slightly (on their scales) more money than just continuing to do what they're doing now, and because the higher-ups are (as with many industries) chronically unwilling to commit to one particular standard if it will make it even a little bit harder for them to change their minds whenever they want.
There are two problems here: 1) Hanlon’s razor 2) The author doesn’t understand health insurance data. I’m not trying to excuse the other bad behavior, but within the data itself, he’s experiencing a combination of health insurers’ incompetence, the kludged up data models they’ve had to build to represent the output of the multiple generations of claims processing systems and other administrative processes, and the g…
I absolutely don't believe this complexity is inherent in the problem space, because it very much looks like it is not. I'd believe that one or more actors in our healthcare system really like for it to be this way, though.
Imagine a world where one entity received all the peoples medical bills and was incentived to negotiate for the lowest possible rate from each provider. Imagine the savings alone from reducing a massively overly bureaucratic and complicated system down to just one entity negotiating and paying the health service providers. Just imagine in that world this article would have never needed to have been written.
So, not an entity which by its very nature spends other people's money and can never run out? I agree, sounds like a great idea, but someone will have to invent such an entity first. The ones we have would not meet the requirement.
His nominal role is to assist with Medicare-related matters, but given that the ostensible goal here is to compare rates (and most payors define rates as a percent of Medicare), I think the request wouldn’t be too much of a stretch.
Similarly, might be possible to get some congressional offices to lend their weight. Happy to personally lend a hand with the outreach if there’s interest.
Earlier quoted context omitted.
"Never come between a man and his meal" playing out right here
Unfortunate that the man in this analogy is Hannibal Lecter (Silence of the Lambs, Hannibal is a violent psychopathic cannibal in that movie), and should be stopped from getting his meal. Insurance companies are a problem, and they've grown fat skimming a fair fraction of this nation's GDP for no observable value provided. Our healthcare system is more expensive and has on average worse outcomes than other first worl…
Imagine a world where one entity received all the peoples medical bills and was incentived to negotiate for the lowest possible rate from each provider. Imagine the savings alone from reducing a massively overly bureaucratic and complicated system down to just one entity negotiating and paying the health service providers. Just imagine in that world this article would have never needed to have been written.
> was incentived to negotiate for the lowest possible rate from each provider So, not an entity which by its very nature spends other people's money and can never run out? I agree, sounds like a great idea, but someone will have to invent such an entity first. The ones we have would not meet the requirement.