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Researchers chart path to drastically lower administrative costs of health care

med.stanford.edu

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Re: Researchers chart path to drastically lower administrative costs of health care

#21

Post by dboreham »

creaghpatr wrote: post #11
taurath wrote: post #6

Can anyone grok what the actual proposed reforms are? It’s missing from the article.

Looks like it's mostly an abstract of something that was published in a journal but they hint at it saying 3 scenarios: simplifying/streamlining individual plans, standardizing plans across all groups ie. more standardization, and a combination of those two things. This would lead to less complexity and administrative overhead which would lead to savings etc.

Or perhaps look at other western countries that don't have any of this vampire squid stuff.

Re: Researchers chart path to drastically lower administrative costs of health care

#22

Post by shkkmo »

creaghpatr wrote: post #11
taurath wrote: post #6

Can anyone grok what the actual proposed reforms are? It’s missing from the article.

Looks like it's mostly an abstract of something that was published in a journal but they hint at it saying 3 scenarios: simplifying/streamlining individual plans, standardizing plans across all groups ie. more standardization, and a combination of those two things. This would lead to less complexity and administrative overhead which would lead to savings etc.

I thought a major aspect was also standardizing contracts between insurers and providers.

Re: Researchers chart path to drastically lower administrative costs of health care

#23

Post by whiddershins »

rscho wrote: post #13
jostmey wrote: post #2

I agree with the three issues they identify driving up costs. But I fear “Medicare for All” won't fix all the issues, which go much deeper. For example, the US has extremely high standards restricting who can practice medicine compared to the rest of world, limiting the supply of doctors and artificially driving up their demand. There is a need for standards, but perhaps the AMA has too much political influence. Like…

> For example, the US has extremely high standards restricting who can practice medicine compared to the rest of world Rest of the world, yes. Rest of the developed world, not at all. The major difference is that becoming a doc in the US is much more expensive than pretty much anywhere else. You could also argue it's proportionally harder because of the more numerous competitors. But on an absolute level of knowledge…

I believe it takes longer in the US, when all is said and done.

It’s hard to casually verify this because each country uses different terms and has a different track but I think, when you include the various phases of training, starting from the bachelors degree, the US one is more total years.

Edit:

So for example the UK and France don’t appear to require any sort of bachelor’s degree as a prerequisite for medical. Which saves you 4 years on average. So their tracks may be longer but you can start sooner.

Re: Researchers chart path to drastically lower administrative costs of health care

#25

Post by rcpt »

syops wrote: post #3
jostmey wrote: post #2

I agree with the three issues they identify driving up costs. But I fear “Medicare for All” won't fix all the issues, which go much deeper. For example, the US has extremely high standards restricting who can practice medicine compared to the rest of world, limiting the supply of doctors and artificially driving up their demand. There is a need for standards, but perhaps the AMA has too much political influence. Like…

The bottleneck is not the number of people with an MD. The bottleneck is the number of residency programs. These are funded by Medicare and I believe they are not profitable for hospitals.

I don't think it's about the profit it's the fact that anything involving Medicare is a big political fight

Re: Researchers chart path to drastically lower administrative costs of health care

#26

Post by intergalplan »

hpoe wrote: post #4

Recently I got laser eye surgery to help my vision. This was not covered by my insurance. It also happened to be the simplest medical procedure/payment I ever had to interact with. They told me "this procedure will cost $X.XX and we have a discount we can offer you that will save you X%" I said okay and paid them the money. Compare that to insurance being involved recently in my wife's diabetes supplies. My wife is a…

Time dealing with our shitty medical billing system is a huge hidden cost of it. I'm also not sure how well accountings of US healthcare costs factor in things like the hours HR folks spend negotiating rates, or government folks in areas related to benefits et c. have to screw around with sorting out who has what private insurance.

Re: Researchers chart path to drastically lower administrative costs of health care

#27

Post by ihsw »

HEmanZ wrote: post #16
syops wrote: post #3

Earlier quoted context omitted.

The bottleneck is not the number of people with an MD. The bottleneck is the number of residency programs. These are funded by Medicare and I believe they are not profitable for hospitals.

I don't know how residencies could not be profitable for hospitals. Hospitals receive something like $120k/yr per resident, then work residents 80+ hours/week at $50k/yr pay, amounting to right around minimum wage (for my city). Residents do a tremendous amount of work in supporting the hospital, so much so that a single resident getting deathly ill and needing to stay home (e.g a surgery resident getting covid, whic…

It sounds like we have a spending problem and not a funding problem.

Re: Researchers chart path to drastically lower administrative costs of health care

#28

Post by kingsuper20 »

creaghpatr wrote: post #11
taurath wrote: post #6

Can anyone grok what the actual proposed reforms are? It’s missing from the article.

Looks like it's mostly an abstract of something that was published in a journal but they hint at it saying 3 scenarios: simplifying/streamlining individual plans, standardizing plans across all groups ie. more standardization, and a combination of those two things. This would lead to less complexity and administrative overhead which would lead to savings etc.

I'm not much for the genius of government to correct things, but you really can make a strong argument for the standardization to a small number of insurance plans with stated rules, third party arbitration, etc.

You would definitely see more of a free market by producing fungible products with (hopefully) a bit less obfuscation. The insurance companies would still do their best to not cover a claim of course, so this is only a partial solution.

One nice side effect is that it's a small nudge in an organically 'designed' system rather than the inevitable chaos by changing the whole machine at once.

If you believe in single payer healthcare, it would be easy to attach redesigns in cash inflow to a set of standardized policies.

I've always admired the size of office staff in a doctor's office, no doubt mostly due to the complexity of the cashflow in the backend. Perhaps simplification of billing would result in less bookkeeping and more caregivers.

Re: Researchers chart path to drastically lower administrative costs of health care

#29

Post by DonnyV »

Worthless paper, administrative costs is only a piece of the many issues with US "Healthcare". Medicare For All is the better and cheaper way forward. No one ever talks about what is the value all these Health Insurance companies bring? The whole point of their existence when they were created was to control costs. Obviously they have failed miserably. Medicare For All handles lowering or eliminating student loans for Doctors and Nurses. It regulates costs for pharmaceuticals and medical equipment. By having the government be the insure. It relieves business on having to provide insurance and creates a much healthier workforce. It would also create an explosion of entrepreneurship. Now that insurance isn't tied to a job.

Re: Researchers chart path to drastically lower administrative costs of health care

#30

Post by whiddershins »

whowe1 wrote: post #18

So how do they plan on getting private capitalist enterprise to start implementing reforms that would lower their profits? Because by definition administrative cost to the consumer is profit for the company.

By making it possible for them to compete to the consumer on price versus quality?
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