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'A full-blown crisis': Americans brace for a surge in healthcare costs

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Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#151

Post by fragmede »

simianwords wrote: post #150
ETH_start wrote: post #105

The root cause: https://www.researchgate.net/figure/Healthcare-administrator... "Healthcare administrator's growth in the US. Healthcare administrator's growth by 3200% between 1975 and 2010 compared to 150% Physician growth according to Athena Health analysis of data from Bureau of Labor Statistics, the National Center of Health Statistics, and the United States Census Bureau's Current Population survey in accordanc…

What value addition do the administrators provide? It might be helpful to understand why competing hospitals still find it useful to employ these people even if the cost is so high. If a competing hospital can provide equivalent service while also not spending so much on an administrator, why didn't they already do it?

The administrative overhead is necessary in order to get money from the insurance companies. Without the administrators too administrate and fill out copious amounts of paperwork, the hospital won't get paid by the insurance companies, and if the hospital don't get no money, they can't pay their staff, and staff tend to like getting paid.

Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#152

Post by simianwords »

simianwords wrote: post #150
ETH_start wrote: post #105

The root cause: https://www.researchgate.net/figure/Healthcare-administrator... "Healthcare administrator's growth in the US. Healthcare administrator's growth by 3200% between 1975 and 2010 compared to 150% Physician growth according to Athena Health analysis of data from Bureau of Labor Statistics, the National Center of Health Statistics, and the United States Census Bureau's Current Population survey in accordanc…

What value addition do the administrators provide? It might be helpful to understand why competing hospitals still find it useful to employ these people even if the cost is so high. If a competing hospital can provide equivalent service while also not spending so much on an administrator, why didn't they already do it?

Answering myself, apparently it is a fight between administrators on the hospital end and the administrators on the insurance company end.

The insurance administrators are fighting to provide as less reimbursement as possible and the hospital administrators are fighting to provide as much reimbursement as possible. The administrators are probably doing compliance work, negotiations.

I wonder whether regulations can be used to cap the role of administrators at the expense of slightly less efficient market - this might work if administrators are just adversarially interacting and reducing their scope can help the overall picture.

Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#153

Post by KevinMS »

frankest wrote: post #59

In case you are wandering where the money goes. If you need a gall bladder removed or an appendix removed the bill to you might be $10,000-30,000 but the surgeon, for all of their care and time with you, is compensated less than $100.

I did get my gall bladder removed in July, and I know paid my surgeon a lot more than a 100 bucks, which was just the smaller deductible portion of the bill.

Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#154

Post by dumbmrblah »

frankest wrote: post #59

In case you are wandering where the money goes. If you need a gall bladder removed or an appendix removed the bill to you might be $10,000-30,000 but the surgeon, for all of their care and time with you, is compensated less than $100.

It’s actually about $600 just for the surgery. It’s about 10 RVUs x $60 per RVU. You add some RVU modifiers to get it to about $1000.

Your point still stands, but it’s still a bit more than $100

Source: I’m a MD

Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#155

Post by supermatt »

tirant wrote: post #64
Avicebron wrote: post #9

Earlier quoted context omitted.

Excuse me, but how in the world were you able to afford 1200/month, you know that's like cheap rent right?

That’s absolutely not an exception. I’m in Germany, and for a family of four, the public healthcare system, covering my wife and my two kids costs us around 2,200€ per month. The company pays half. A switch to a private insurance would lower the costs around half.

You must be mistaken…

The maximum personal contribution to public health insurance (GKV) is capped at around 400/m for healthcare (and an additional 200 towards long-term/elderly care). Spouse and children are free if they are unemployed.

https://www.tk.de/resource/blob/2189790/9321e565c304a9cc33bb...

If you are paying more than that then you are already paying for private health insurance (PKV) or private supplementation on top of GKV for some premium coverage.

Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#156

Post by SpicyLemonZest »

changoplatanero wrote: post #70
SpicyLemonZest wrote: post #40

Earlier quoted context omitted.

Which are the specific things you think most people don't need coverage for? Prior to the ACA, it was pretty common to hear stories of people not on employer plans who were shocked to discover a coverage gap they have. Most people don't have much expertise in evaluating healthcare coverage and deciding which services they might need.

In California, apparently acupuncture is required to be covered. I’d be happy to give up my acupuncture coverage for a lower premium. https://www.fiercehealthcare.com/payer/states-essential-bene...

Same, but it’s hard to imagine these kind of alternative medicine services are driving huge premium increases. Because they don’t work they tend to be pretty cheap to provide.

Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#157

Post by altairprime »

czhu12 wrote: post #49

One thing that I’ve been trying to understand about this discourse: Is the sum of the increase in costs some people are now paying greater than the subsidies that previously existed? In other words: was there always a massive bill to be paid here, but it was just previously socialized and hidden in the form of taxes/ public debt? Or does the act of subsidizing it actually decrease the total?

Year-over-year increase in GDP in the U.S. right now is almost exclusively “production” output from the healthcare industry, whose profits are stratospheric and rising. So there’s two useful datapoints here: first, the bill must be paid, or U.S. GDP growth year-over-year falters, not because healthcare costs this much; and second, household debt continues to increase year-over-year to permit continued wage stagnation. Whether insurers end up lowering their profits (and thus prices) as the subsidy expires centers around whether banks extend further debt as a household wages subsidy. As of right now, that seems to be continuing, even though some of that debt market is in the midst of a small crash, so insurers (who have no regulatory limits on profit levels) are unlikely to lower their profit targets as subsidies end.

So long as the political will of U.S. leadership supports that continued profit, and either government and/or banks subsidize worker wages to cover the increased profits, then we’ll continue seeing growth in costs on paper before subsidies. This growth in profits/prices could not be sustained on wages alone, given the continuing decline of inflation-adjusted worker earnings; and so to answer your question, yes: the act of subsidizing is what’s enabling the prices being charged; but, no: the costs of providing healthcare to any one person of a given age are not increasing due to subsidies; just the profits.

Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#159

Post by dogemaster2028 »

dboreham wrote: post #88
dogemaster2028 wrote: post #30

Earlier quoted context omitted.

[flagged]

You're forced to buy auto insurance.

You aren’t. You are required to buy LIABILITY, which is protection in case you harm SOMEONE ELSE. You are not required to protect YOURSELF.

In some states, if you can post a bond, you aren’t even required to carry liability.

The government does not coerce you to buy a product for yourself.

Re: 'A full-blown crisis': Americans brace for a surge in healthcare costs

#160

Post by seinvak »

silexia wrote: post #135
choeger wrote: post #47

Where does all that money go to, though? Is there a rich caste of doctors or pharmaceutical shareholders that don't need to work and live off these dividends? Or is the system so inefficient that most people in it aren't contributing to actual health care?

Doctors are by far the highest paid professional occupation in America. The AMA is the most powerful trade union in history and restricts the number of new doctors, pushing up prices.

Specialist doctors are one of the highest paid professions in almost all countries. There are hardly any jobs more important than those of say a heart surgeon or a neurosurgeon.
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