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New health insurance “transparency data” looks suspiciously wrong

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Re: New health insurance “transparency data” looks suspiciously wrong

#101
post #86

Earlier quoted context omitted.

Well, it’s the same here for the existing healthcare system in the US. Even basic reforms (obamacare) get met with insane opposition.

The difference is who the opposition is from. In the UK, it's from the voters. In the US, it's from the Healthcare Industry.

Companies can’t vote.

Re: New health insurance “transparency data” looks suspiciously wrong

#102
post #81

Earlier quoted context omitted.

> why not move to somewhere in the US that has doctors? Do you have a suggestion where in the US that is? The US has many doctors but essentially all of them are gated behind insurances and especially hospitals.

What are you imagining it should be? You can see your doctor pretty much freely within the US for nearly any reason. This idea you cannot see your doctor in the US, or that you receive treatment from nurses or administrators is simply not true. > insurances and especially hospitals You may be confused, because some doctors operate private practices, while others choose to work for large hospital organizations. Privat…

I’m happy for you that you have been served so well. However that is not the case for everyone, and your dismissal of others’ experience is so strong and condescending to the point that you sound like a real jerk. Other people report a lot of problems with their healthcare. You should listen to them, as they have very little incentive to lie.

Re: New health insurance “transparency data” looks suspiciously wrong

#103
If you want to be a part of this battle while also not being a part of the "middleman" (e.g. price transparency venders), come join us at Yuzu Health. We are hiring for a senior engineer to help us build a modern health plan tailored to the needs of startups and their employees.

https://yuzu.health/careers

Re: New health insurance “transparency data” looks suspiciously wrong

#104

Earlier quoted context omitted.

Not a solution for everyone... but I have to ask, since you have the time to go to the EU for routine medical work, why not move to somewhere in the US that has doctors? Also looking at a primary care wait time is fine, but what is broken in most single player systems is specialists and "non-emergency surgery"... which is often stuff that significantly affects your quality of life. https://worldpopulationreview.com/c…

> why not move to somewhere in the US that has doctors? Do you have a suggestion where in the US that is? The US has many doctors but essentially all of them are gated behind insurances and especially hospitals.

I mean I've lived in 4 cities in the last 8 years, and in every single one I could see a primary care provider on a day's notice.

Although actually re-reading your post, it sounds like you're really just trying to take a dig at Nurse Practitioners, most of which hold doctorates.

I guess if you're too good for a DNP, the primary care must in fact seem like an impossible thing, in which case I do wish you good luck on the 8 hour flight for "all my medical tests".

Re: New health insurance “transparency data” looks suspiciously wrong

#105
post #45

Earlier quoted context omitted.

I live with free healthcare. The last three trips to the emergency department have been over eight hour waits. My father's cancer treatment was not covered so the last year of his life cost him everything. On the other side my child's healthcare is amazing and all free. We get instant access to great services.

I think another component to the equation in wait times is also doctors per capita and GDP per capita. It's hard to compare apples to oranges but with high doctors per capita, low wait times for speciality services, long lived citizens and a far lower percentage of GDP spent on health, I wonder if there are any serious holes to poke in Italy's system when compared to the U.S. or if they simply just beat us on every m…

Interestingly we do better on doctors per 1000 than the US.

https://data.worldbank.org/indicator/SH.MED.PHYS.ZS?location...

Re: New health insurance “transparency data” looks suspiciously wrong

#106
This could have been much much easier if they just required the medical equivalent of certificate transparency. Every insurance company is required to post publicly every single claim they receive, the full information of the provider(s), the name/code of the plan, the billing codes, whether it was approved or denied, how much the insurance was billed, and how much insurance actually paid (where paid doesn't mean discount, it means the literal dollars that left the insurance company's bank account), and the "patient responsibility" along with where the patient was with regards to their deductible and oopm. Every medical provider is required to do the same every time they create a bill.

Fine, "you don't know" how much things will cost. We can figure it out for you. No thoughts, head empty, just post and sign every bill you generate as it comes.

Re: New health insurance “transparency data” looks suspiciously wrong

#107
post #67

Earlier quoted context omitted.

Insuring massive populations isn't really insurance because of large numbers (there's no risk involved.) It's just an economic rent. It's a poker game where most of the players are cooperating.

Senior / elderly care can be enormously expensive. Especially towards end of life. I could agree with you if the population was all teen to 45 year olds but that is not realistic. The same dynamics play out with pension schemes. Declining birth rates play havoc with proposals that rely on a large, young employed base who's work supports a small, retired set of pensioners. My own perspective is that healthcare is extr…

I always believed that nurse practitioners would be just about as good at primary care as a doctor. But fuck me my nurse practitioner is useless. Like tons of British Columbia residents I don’t have a family doctor, so thought this would work. But they are afraid to do anything. At least a doctor will be confidently wrong like chat gpt.

Re: New health insurance “transparency data” looks suspiciously wrong

#108

Everyone assumed there would be malicious compliance here but it's definitely eye opening just how malicious they made it. Speaks volumes for the perceived risk releasing this data, IMO. Still waiting to hear about someone using this data to negotiate down a hospital bill, seems like it's just insurance companies that can weaponize this data for better rates.

For a customer advocate, the pervasiveness of the artificial low rates seems to be an interesting opening.

You should be able to go back to the hospital and say - based on the hospital public fee schedule , total FFS for CPT should be (very low number) . Therefore, my deductible payment is overstated, please reduce my bill dramatically.

A lawsuit would follow, which would make it very interesting. Chief argument:

The customer can clearly say its fraud - he/she looked at the public rate schedule and believed the charges would be based off the public rate schedule.

Ultimately, the disconnect between published rates and the EOB is going to come back to bite hospitals, once people shop around using the data.

Re: New health insurance “transparency data” looks suspiciously wrong

#109
post #101

Earlier quoted context omitted.

The difference is who the opposition is from. In the UK, it's from the voters. In the US, it's from the Healthcare Industry.

Companies can’t vote.

Why would they need to? Their lobbyists write the legislation and they finance the politicians who vote on it.

Re: New health insurance “transparency data” looks suspiciously wrong

#110

Earlier quoted context omitted.

> seems like it's just insurance companies that can weaponize this data for better rates. That’s because their negotiating power is mainly due to the size of their buying power, not special knowledge or skills. Health “insurance” is basically the lamest, most economically perverted form of collective bargaining ever.

>That’s because their negotiating power is mainly due to the size of their buying power, not special knowledge or skills. Health “insurance” is basically the lamest, most economically perverted form of collective bargaining ever. Now can you make a cogent argument for why more than one federal / national union should exist? Why does Europe allow multiple unions?

I don’t follow. What unions?
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