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Started By
Message
Adam Ruins Everything- "Why US Healthcare is so Expensive"
Posted on 7/29/17 at 8:56 am
Posted on 7/29/17 at 8:56 am
8
Posted on 7/29/17 at 8:58 am to Roaad
Without even reading
I'm going to say fat assess putting a strain on the system
When your general population lives an active and healthy lifestyle, you don't get the problems we get.
I'm going to say fat assess putting a strain on the system
When your general population lives an active and healthy lifestyle, you don't get the problems we get.
Posted on 7/29/17 at 9:00 am to Roaad
Hospitals definitely overcharge, but they are a symptom and not the problem.
They are forced to see any patient that comes in the door and given no way to actually collect any money from uninsured patients.
I don't blame them for overcharging when they have a chance.
It's basically an unfunded mandate.
They are forced to see any patient that comes in the door and given no way to actually collect any money from uninsured patients.
I don't blame them for overcharging when they have a chance.
It's basically an unfunded mandate.
Posted on 7/29/17 at 9:00 am to StraightCashHomey21
Collusion between hospitals and Insurance
Posted on 7/29/17 at 9:03 am to Bjorn Cyborg
The amount of people who the hospitals lose money to treat is extremely small. Less than 4% of net profit goes to charity care.
The reason the hospitals are able to charge the kind of prices they do is that we have removed the direct price competition from the market.
The reason the hospitals are able to charge the kind of prices they do is that we have removed the direct price competition from the market.
Posted on 7/29/17 at 9:05 am to Roaad
Not really. He didn't mention that medicaid is the problem.
Posted on 7/29/17 at 9:06 am to cokebottleag
As I said, the hospitals are a symptom of a broken system, not the problem. That includes lack of price competition and the unfunded mandate of forced care to uninsured patients, as well as many other factors.
Posted on 7/29/17 at 9:17 am to Bjorn Cyborg
Does it mention n that the "charges" really aren't what they collect? They charged $52,000 for a surgery I had, but between my insurance company and me, they collected $6,500 per their contracts with the insurance company.
Posted on 7/29/17 at 9:17 am to Roaad
The main problem is the over-utilization of insurance.
Imagine how expensive an oil change for your vehicle would be if everyone's auto insurance paid for it.
Imagine how expensive an oil change for your vehicle would be if everyone's auto insurance paid for it.
Posted on 7/29/17 at 9:24 am to Roaad
That's a very oversimplified take, but the gist is mostly correct. Essentially insurance companies hold hospitals hostage. "If you don't agree to our discounted reimbursement rates (aka contractural adjustments), we'll take our block of patients to another system and make you out of network." The hospital is forced to either accept the rates and jack up prices so they don't lose money, or lose that particular block of patients. The more patients in that insurance plan in the area, the more negotiating power the insurance company has.
Hospitals are not allowed to adjust their billed charges based on whether or not a patient has insurance, so they are forced to jack up prices to overcome the discount that the insured patients get in order to continue being profitable (and stay open in most cases).
For example, if the true cost to provide a service to a patient is $1000, and the insurance company negotiates a %50 reimbursement rate for that service, the hospital has to adjust its billed charge to stay in the black. They may charge $2200, which would allow $1100 in reimbursement for a total profit of $100.
Along comes an uninsured patient who gets the same service. The hospital is not allowed to adjust its billed charge because the patient doesn't have insurance, so they get the entire $2200 bill. Now in reality, hospitals will usually settle for a much lower payment, but a lot of time won't tell you this up front. Some states have laws that prevent uninsured patients from paying higher than the average allowable cost (how much a patient with insurance would pay) in that area.
There's more than just this, such as adjustments for the percent of non-paying uninsured patients that hospitals are mandated to provide care for by law.
It's very complex. Here's a good article that does a pretty good job explaining.
LINK
Hospitals are not allowed to adjust their billed charges based on whether or not a patient has insurance, so they are forced to jack up prices to overcome the discount that the insured patients get in order to continue being profitable (and stay open in most cases).
For example, if the true cost to provide a service to a patient is $1000, and the insurance company negotiates a %50 reimbursement rate for that service, the hospital has to adjust its billed charge to stay in the black. They may charge $2200, which would allow $1100 in reimbursement for a total profit of $100.
Along comes an uninsured patient who gets the same service. The hospital is not allowed to adjust its billed charge because the patient doesn't have insurance, so they get the entire $2200 bill. Now in reality, hospitals will usually settle for a much lower payment, but a lot of time won't tell you this up front. Some states have laws that prevent uninsured patients from paying higher than the average allowable cost (how much a patient with insurance would pay) in that area.
There's more than just this, such as adjustments for the percent of non-paying uninsured patients that hospitals are mandated to provide care for by law.
It's very complex. Here's a good article that does a pretty good job explaining.
LINK
Posted on 7/29/17 at 9:29 am to Roaad
If he doesn't mention the creation of Medicare, it's complete bullshite.
Posted on 7/29/17 at 9:29 am to cokebottleag
quote:Its borne disproportionately by non-profit hospitals. Do you have a link for that 4% figure? I'd like to see how they came up with that number. It seems really low.
The amount of people who the hospitals lose money to treat is extremely small. Less than 4% of net profit goes to charity care.
quote:Im definitely a free market guy, but can you be more specific? If you're talking about allowing more competition in insurance markets, they I definitely agree.
The reason the hospitals are able to charge the kind of prices they do is that we have removed the direct price competition from the market.
This post was edited on 7/29/17 at 9:32 am
Posted on 7/29/17 at 9:35 am to Roaad
Healthcare is expensive because we have to pay for him and his community's anti AIDS medicine
Posted on 7/29/17 at 9:37 am to Roaad
Medical pricing is insane
Imagine a non emergent elective surgery. You can't get a real amount of what the surgery will cost before it happens. Would you buy a car without knowing the price and fine print? frick no.
But you're forced to in medical care
Imagine a non emergent elective surgery. You can't get a real amount of what the surgery will cost before it happens. Would you buy a car without knowing the price and fine print? frick no.
But you're forced to in medical care
Posted on 7/29/17 at 9:37 am to Bjorn Cyborg
What market pressure is conceivable on hospital in non urban region?
None.
None.
Posted on 7/29/17 at 9:41 am to stniaSxuaeG
Sorry, it was a while since I quoted it. It's 4% of expenses
I'm not talking about insurance. I'm talking about non-insurance cost. A menu of "if you have a surgery, it costs this".
I'm not talking about insurance. I'm talking about non-insurance cost. A menu of "if you have a surgery, it costs this".
Posted on 7/29/17 at 9:45 am to StraightCashHomey21
quote:
I'm going to say fat assess putting a strain on the system When your general population lives an active and healthy lifestyle, you don't get the problems we get.
I agree. And the odd thing is that it's more important for older folks to work out regularly and watch their diet. But you would shocked at how many older folks check into my gym every day and sit in the lounge watching TV, drinking coffee, eating donuts and chatting. Then they go home and tell their spouse they spent an hour at the gym.
Posted on 7/29/17 at 10:39 am to stniaSxuaeG
People also don't understand just how expensive it is to staff and run a hospital or medical office. I did the books for a dental office - 2 docs, a hygienist, 2 assistants, 1 or 2 people at the front desk. This was in a low rent middle class suburb - just a basic practice in an old building. The overhead ran around $1,100/day. I can't imagine the overhead in a hospital or even an outpatient surgery facility.
The insurance industry tried to force the hmo/ppo thing into dentistry back in the '90s-early '00s, and especially the reduced fee-for-service type of plans where the insured pays a premium, the insurance pays nothing (even no capitation), and the dentist works for a reduced fee schedule. Dentists resisted this to a large extent, so you generally ended up with just a coule guys in town getting on all of these plans, scooping up all these patients (who no one else wanted), and then busting there arse to do shitty work on a ton of patients to make a living. Also many quit seeing medicaid patients because they were unreliable and the fees were too low. Hospitals don't have that luxury to pick and choose their patient base.
I'm not saying healthcare isn't overpriced, but it's not as cut and dry as it appears on the surface. I doubt that they are all just charging out the arse and printing money while the docs and hospital admins run around high fiving each other.
The insurance industry tried to force the hmo/ppo thing into dentistry back in the '90s-early '00s, and especially the reduced fee-for-service type of plans where the insured pays a premium, the insurance pays nothing (even no capitation), and the dentist works for a reduced fee schedule. Dentists resisted this to a large extent, so you generally ended up with just a coule guys in town getting on all of these plans, scooping up all these patients (who no one else wanted), and then busting there arse to do shitty work on a ton of patients to make a living. Also many quit seeing medicaid patients because they were unreliable and the fees were too low. Hospitals don't have that luxury to pick and choose their patient base.
I'm not saying healthcare isn't overpriced, but it's not as cut and dry as it appears on the surface. I doubt that they are all just charging out the arse and printing money while the docs and hospital admins run around high fiving each other.
This post was edited on 7/29/17 at 10:42 am
Posted on 7/29/17 at 10:41 am to TigrrrDad
The U.S. government created this monster, so any attempts by them to fix it are laughable.
It cannot be fixed without a reduction in care. Period.
It cannot be fixed without a reduction in care. Period.
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