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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

#41

Post by EvanAnderson »

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…

You're talking about an elective procedure, too, re: your laser eye surgery. Arguably there's "sales" involved.

I required a non-elective procedure not covered by my grandfathered pre-ACA insurance back in 2014. I attempted to "shop" the procedure around. It was was not at all easy. I would have rather dealt with insurance.

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

#42

Post by KoftaBob »

calkuta wrote: post #37

I have an idea. Remove government management of this industry.

So your solution to overly complex/cumbersome regulations and laws...is to completely deregulate the healthcare industry? You can't think of something in the middle that's not as reckless?

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

#43

Post by TheRealDunkirk »

What a joke. The only thing that would lower the costs would be to increase the competition, but the government has allowed merger after merger after merger (in health insurance, and in providers, just like everything else lately), taking away more and more pressure to compete.

Why is every other ad on TV for one of the car insurance companies? Competition, which drives down price. The way to fix US health care is to create a market environment where I can buy health insurance like I can buy car insurance. It's too regionally regulated now. Make the market national. Make it possible for a young, unmarried man to buy into a group policy with other young, unmarried men (with zero benefits for maternity or female-specific illnesses), and let the market sort it out.

Tying insurance to employment has got to be one of the most BALLER moves of Capitalism the world has ever seen. I mean, how much harder could you force your employees to bend over than to tie their literal life and health to working for the company?

GET MY EMPLOYER OUT OF MY FUCKING INSURANCE. People say there's no money for nationalized healthcare. Bullshit. We're already paying it. Give me the money that my company is paying on my behalf -- about $20,000/year -- and let me combine that with my portion -- about $8,000 -- and let me go buy a plan that makes sense for me on the open market.

Do these 2 things, and the market would sort this out in a New York minute.

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

#44

Post by KoftaBob »

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.

The majority of hospitals in the US are non-profit. They don't benefit from passing administrative costs to patients.

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

#45

Post by 238475235243 »

calkuta wrote: post #37

I have an idea. Remove government management of this industry.

Exactly.

Everyone should know it's completely illegal to open a hospital. It's illegal to charge less at 3am when you're not busy.

Any and all competition, even weak competition like Urgent Care, should be encouraged.

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

#46

Post by IG_Semmelweiss »

gumby wrote: post #38
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, limiting the supply of doctors... Really? Can you give some examples? There are a lot of immigrant physicians in the USA. An anecdotal counter example: my mother is a physician with medical licenses from Australia, UK and the USA (obviously two have lapsed) and though she is quite critical of countr…

all those immigrant physicians went thru the same programs as the non-immigrants.

In fact, I hear this is continuously a problem for well qualified , practicing, and established physicians to migrate to the US. They are fed up with their own home countries lack of security, opportunities for their children, freedom etc, but they cannot imagine going back to medical school to be accredited to practice in the US.

This does not apply to every country. Notably, 4, all here:

https://www.theabfm.org/become-certified/i-am-certified-coun...

While many foreign physicians will have years of experiences diagnosing, treating patients, and administering medicine, in order to practice as a US doctor, it essentially requires them to start all over again academically, especially when the curriculum differs from overseas qualifications. [1] https://www.fnu.edu/foreign-physicians-work-healthcare-pract...

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

#47

Post by creaghpatr »

kingsuper20 wrote: post #28
creaghpatr wrote: post #11

Earlier quoted context omitted.

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 thi…

Yes, I'm bullish on the potential savings of standardization, of course in healthcare the devil is in the details so it matters what they mean by those things.

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

#48

Post by jimnotgym »

whiddershins wrote: post #23
rscho wrote: post #13

Earlier quoted context omitted.

> 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.…

Citation definitely needed here

And just to be sure, I would like you to start from the beginning of the person's medical training and not include the gatekeeping bit of having to get a bachelors in a random subject unrelated to medicine.

I note this Wikipedia article that suggests 4 years messed school plus 1 year internship could get me a license in the US. That sounds like Western Europe to me. Or India...

https://en.m.wikipedia.org/wiki/Medical_education_in_the_Uni...

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

#49

Post by 238475235243 »

KoftaBob wrote: post #42
calkuta wrote: post #37

I have an idea. Remove government management of this industry.

So your solution to overly complex/cumbersome regulations and laws...is to completely deregulate the healthcare industry? You can't think of something in the middle that's not as reckless?

It's not just cumbersome - it's completely illegal to open a hospital. The lack of competition is the root of all of this mess.

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

#50

Post by jollybean »

Some have noted 'bottlenecks' at the MD entrance level.

There is an opportunity to allow for procedural specialization so that 'techs' can do a lot of the work normally done by docs and nurses.

'Early detection' is a new, major shift in how medicine works, because the things we get now 'come on slowly in a hidden way'. Allowing for technical specialists to run operationalized testing with standards, clear rules etc. may enable us to get costs down and possibly improve outcomes.

My bet is that someone with very narrow and focused training may be even 'better' at that thing - so long as we can put a nice dotted line around it because of course it's always more complicated than just 'one thing'.

Perhaps requiring 'best price' for all so that individual payers can get the same price as insurers might work, though it's not exactly 'free market' it mostly is. Transparency - so that everything is published and public might work as well.

It may also be worth not billing specifically for low-cost materials used, and just roll it into the type of visit.

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