11–20 of 28 posts
This is going to precipitate one of two things: If hospitals get federal money for anything they will be required to accept insurance offered on the exchange that meet some minimum qualification. At least the two that were blessed as the national options. Or insurance companies will be required to put an offering on the exchange...likely both. Like the states refusing to expand Medicaid and set up their exchanges, th…
A few, like No. 1-rated Johns Hopkins in Maryland, are mandated under state law to accept all insurance companies That sounds like a totally sane statutory requirement. Why don't more states have it? Collusion between hospital chains and insurers is the crux of the health care cost problem in the US.
If they are required to do business with one another how do they negotiate a price?
A few, like No. 1-rated Johns Hopkins in Maryland, are mandated under state law to accept all insurance companies That sounds like a totally sane statutory requirement. Why don't more states have it? Collusion between hospital chains and insurers is the crux of the health care cost problem in the US.
Johns Hopkins is a "chain" hospital?
A few, like No. 1-rated Johns Hopkins in Maryland, are mandated under state law to accept all insurance companies That sounds like a totally sane statutory requirement. Why don't more states have it? Collusion between hospital chains and insurers is the crux of the health care cost problem in the US.
For that one, the theory was that the payment/administration bureaucracy was the cause of the health care cost problem, and that by having insurance companies buy hospital service in bulk rather than doing individual-service billing the overhead could be reduced and accountability would be increased. This requires insurers to be able to assign customers to hospitals and doctors that work for them for it to work.
This is going to precipitate one of two things: If hospitals get federal money for anything they will be required to accept insurance offered on the exchange that meet some minimum qualification. At least the two that were blessed as the national options. Or insurance companies will be required to put an offering on the exchange...likely both. Like the states refusing to expand Medicaid and set up their exchanges, th…
This is going to precipitate one of two things: If hospitals get federal money for anything they will be required to accept insurance offered on the exchange that meet some minimum qualification. At least the two that were blessed as the national options. Or insurance companies will be required to put an offering on the exchange...likely both. Like the states refusing to expand Medicaid and set up their exchanges, th…
Sometimes I wonder if some genius "systems thinkers" in Washington planned that out as the end game all along. Add in the factor that some states have almost no hospitals, thus the insurance companies have no leverage to lower premiums, which leads to why certain states have very high ACA premiums. Theoretically the free market says that another hospital would pop up to compete on price, but theory ain't practice...
The 11-dimensional chess idea that passing a law to destroy the individual insurance market is going to bank-shot into single payer would require an absolutely massive outbreak of corporate and public support that really doesn't have any reason to appear.
Earlier quoted context omitted.
If they are required to do business with one another how do they negotiate a price?
You set the price based on what is reasonable and customary. Like Medicare.
This is going to precipitate one of two things: If hospitals get federal money for anything they will be required to accept insurance offered on the exchange that meet some minimum qualification. At least the two that were blessed as the national options. Or insurance companies will be required to put an offering on the exchange...likely both. Like the states refusing to expand Medicaid and set up their exchanges, th…
Sometimes I wonder if some genius "systems thinkers" in Washington planned that out as the end game all along. Add in the factor that some states have almost no hospitals, thus the insurance companies have no leverage to lower premiums, which leads to why certain states have very high ACA premiums. Theoretically the free market says that another hospital would pop up to compete on price, but theory ain't practice...
It is illegal to start a new hospital to compete on price with the existing ones. To open a new hospital, you need permission from the current existing hospitals. If they don't agree that the community you want to do business in is "underserved", you can't get licensed.
And yes, that policy is insane, moronic, a source of monopoly rents and probably one of the many reasons health care costs are so out of control. But it's the law.
Earlier quoted context omitted.
Sometimes I wonder if some genius "systems thinkers" in Washington planned that out as the end game all along. Add in the factor that some states have almost no hospitals, thus the insurance companies have no leverage to lower premiums, which leads to why certain states have very high ACA premiums. Theoretically the free market says that another hospital would pop up to compete on price, but theory ain't practice...
> Theoretically the free market says that another hospital would pop up to compete on price, but theory ain't practice It is illegal to start a new hospital to compete on price with the existing ones. To open a new hospital, you need permission from the current existing hospitals. If they don't agree that the community you want to do business in is "underserved", you can't get licensed. And yes, that policy is insane…
I love the rationalization: "If there are too many hospitals many hospitals and doctors my recommend unnecessary hospitalization or overcharge existing patients to cover their overhead".
Amazing.
Earlier quoted context omitted.
You set the price based on what is reasonable and customary. Like Medicare.
There are lots of doctors who don't accept Medicare patients because the reimbursement rates are too low.