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Why doctors pay millions in fees that could be spent on care

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Re: Why doctors pay millions in fees that could be spent on care

#51

Post by qwytw »

nobodyandproud wrote: post #47
qwytw wrote: post #43

Earlier quoted context omitted.

> A better way to solve the problem is to go with a single-payer healthcare system Possibly. But there are countries in Europe where healthcare is primarily or to a large degree (or even entirely like in Switzerland, they don't even have any Medicare/Medicaid equivalents) financed through private insurance systems. Yet they manage to keep prices from spiraling through effective regulation.

Yes, but Switzerland also subsidizes premiums if your income is too low relative to the premium; and healthcare coverage is mandated by law. I don't know Swiss politics but I also assume there isn't a bickering back-and-forth by party lines that end up distorting/underfunding any sort of healthcare.

> but Switzerland also subsidizes premiums

True, however US spends huge amounts on MedicAid which sort of tries to do the same just seemingly way less efficiently and also less equitably. Capping insurance premiums at 10%(?) of income seems like a better idea than having a byzantine style system which discourages people from ever trying increase their incomes.

> I don't know Swiss politics but I also assume there isn't a bickering back-and-forth by party lines

Yeah, of course that's the real problem since we already know that any system ranging from fully private (with government subsidies) to single payer can work with proper regulation.

Re: Why doctors pay millions in fees that could be spent on care

#52

Post by francisofascii »

triceratops wrote: post #24
deniz_tekalp wrote: post #23

The comments so far miss the point. Off-the-shelf software is not HIPAA compliant. Government restricts supply through regulation, monopolists collect rent. If HIPAA were to be relaxed, off-the-shelf software can be used and fees would plummet. Don't blame "insurers", "middlemen", "capitalism" etc; blame well-intentioned / poorly designed regulations.

How is the government restricting the supply of HIPAA-compliant software?

I suspect HIPAA-compliant software is needlessly complex, such that only a few large companies can afford to supply it. Like the tax code.

Re: Why doctors pay millions in fees that could be spent on care

#53

Post by qwytw »

bombcar wrote: post #37
codegeek wrote: post #22

Earlier quoted context omitted.

Or imagine you had Car Insurance butting in everything including an Oil change and dictating which shop you can use for the oil change. I bet it won't be a $20-$30 oil change anymore and your premiums will be much higher than it already is. Btw, don't give the Food industry these ideas :). It would suck if we now have "Food Insurance"

"Food Insurance" does exist in some places and cases; many colleges charge for "room and board" if you live on-campus, so you're paying for meals even if you don't eat them that day, or at all.

I guess there is also "gym insurance" then, due to people who buy yearly memberships and never go subsidizing the costs for the rest.

Re: Why doctors pay millions in fees that could be spent on care

#54

Post by qwytw »

lotsofpulp wrote: post #32
codegeek wrote: post #22

Earlier quoted context omitted.

Or imagine you had Car Insurance butting in everything including an Oil change and dictating which shop you can use for the oil change. I bet it won't be a $20-$30 oil change anymore and your premiums will be much higher than it already is. Btw, don't give the Food industry these ideas :). It would suck if we now have "Food Insurance"

That exists, they are called high deductible plans, and people still complain about the high deductibles. The root problem is the tail end of healthcare is enormously expensive, into the millions of dollars. Insuring a car is a minor expense, max $50k for the vast majority. It is the healthcare, that could require years of therapy and work done by extremely highly qualified people in short supply, using patented medi…

That's all true. However it's also true in the rest of the developed world, and while almost all Western European countries have older populations than the US they still manage to spend significantly less as % of GDP with much better median outcomes (of course if we only compare US as a whole, states like Massachusetts are on part or even ahead of most of Europe outcome wise but still at much higher cost)

Re: Why doctors pay millions in fees that could be spent on care

#55

Post by codegeek »

no_wizard wrote: post #21

Medical Billing is ripe for disruption, but of note, I don't know of any startup that has made significant inroads into this market. Anyone know why its so tough to break?

Medical Billing issues are a symptom. The real cause is Middle Man Mafia Insurance companies dictating everything that happens b/w a Doctor and Patient.

Re: Why doctors pay millions in fees that could be spent on care

#56

Post by awongh »

hedora wrote: post #25

The last time I checked, 33% of US healthcare dollars went to paying people at the insurance company and people at the healthcare provider to negotiate with each other. One way to avoid this in the US is to go with an HMO, since they can be wildly profitable and still be much more efficient than an insurance company + independent providers. Of course, the problem with that is that non-emergency care from third-party…

wow 33%, I haven’t heard that specific statistic before. Any source for that where I can learn more?

Re: Why doctors pay millions in fees that could be spent on care

#57

Post by rjmunro »

neerajk wrote: post #41

Possibly naive, but hopefully trying to reason from first principles: The insurance companies are the ones paying for care. The hospital systems are the ones charging for care. The entity that pays for care has every incentive to keep costs _low_. The entity that charges for care has every incentive to charge as much as possible. i.e. The ire of consumers should be directed at hospital systems rather than insurance c…

It's only in the interests of health insurance companies to make costs lower if they do it in a way that doesn't make costs lower for other insurance companies. As long as costs are high for everyone they can charge more knowing the competitors cannot undercut them.

In fact it's often in the insurance companies interests to make premiums generally go up, because they make more actual money for taking the same percentage.

Re: Why doctors pay millions in fees that could be spent on care

#58

Post by skrbjc »

triceratops wrote: post #24
deniz_tekalp wrote: post #23

The comments so far miss the point. Off-the-shelf software is not HIPAA compliant. Government restricts supply through regulation, monopolists collect rent. If HIPAA were to be relaxed, off-the-shelf software can be used and fees would plummet. Don't blame "insurers", "middlemen", "capitalism" etc; blame well-intentioned / poorly designed regulations.

How is the government restricting the supply of HIPAA-compliant software?

Not sure if I agree with the other person, but I believe the point is that it takes more time and money to comply with regulations, which makes it harder to build that software, which means that fewer will do that, which means those that do can charge more.

Re: Why doctors pay millions in fees that could be spent on care

#59

Post by LatteLazy »

The US has two options:

* Start from scratch with a new system.

* Keep trying to make the current mess work. When it only came into existence as a way of evading price controls in WW2. And it's hopelessly wasteful and expensive and ineffective.

But the US system is institutionally opposed to reform.

Re: Why doctors pay millions in fees that could be spent on care

#60

Post by andromeduck »

jewayne wrote: post #34
hedora wrote: post #25

The last time I checked, 33% of US healthcare dollars went to paying people at the insurance company and people at the healthcare provider to negotiate with each other. One way to avoid this in the US is to go with an HMO, since they can be wildly profitable and still be much more efficient than an insurance company + independent providers. Of course, the problem with that is that non-emergency care from third-party…

Not every first world country has a true single-payer healthcare system. There are many variations that work better than what we have. The difference is that in the US we have accepted profit maximization as the legitimate primary goal in the healthcare system.

No they the problem with US healthcare system is it's too hard for a successful/efficient player in one state to expand to neighboring states because of overregulation.
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