re: Data for you to ponder tonight: insurers are not the villain. Providers are

If we paid cash for healthcare, prices are estimated to come down 40%-60% - my healthcare plan does that.

The entire system is broken right now: providers, insurers, government. Every piece is dysfunctional.

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Say a doctor would charge a patient $100 for a procedure and the insurer will only cover 10%. Should the doctor provide the care at $100, or should the doctor charge $1000 and get his $100 paid at 10% from the insurer?

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Yeah, that’s not how it works. Medicare sets how much they pay for each CPT code. Every other insurer pays a percentage of that. Many private insurers will pay a little more, Medicaid pays a lot less.

As an example to illustrate how it works: the price they set for taking out an appendix is $1000. I can charge $1000, I can charge $1,000,000. What I get paid is a portion of that $1000, no matter what I charge.

Where I land on how big that portion is, is totally dependent on my negotiating power to get a better contract with the insurer. As a solo practitioner, there’s no negotiating, you take what they say or you don’t take that insurance. Which is partly why many doctors are becoming hospital employed.

Another reason they are becoming hospital employed is because of the amount of overhead to just chase insurers for denials, and the amount of government regulations/paperwork that make it impossible to just treat patients.

Medicare. Since the government got into health care the cost of it has skyrocketed. Accelerated by Obamacare!.

You are a GD idiot if you think doctors are the problem, doctors make less and less every year but ole insurance companies are sitting in high cotton, you’re dumb as shite if you don’t think that insurances don’t share data and strategies to max their profits, if you worked in legal field you see this all time

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nsurers are not the villain. Providers areby Lake Vegas TigerYou are a GD idiot if you think doctors are the problem, doctors make less and less every year

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Are you a doctor?

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The average physician income in 2023 was $363,000 annually, compared to $352,000 in 2022 and $339,000 in 2021.

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So a 3% increase every year.

Insurance companies control the amount a doc is allowed to charge, what medication you are allowed to use, what procedure you're allowed to perform, what doc you're allowed to see. Then they deny a certain amount of claims regardless of medical necessity in order to save money, so then a doctor has to have well payed/trained staff to chase payments. But yea it's the doc's fault

Are there bad actors on the physician's side? Sure. But it's a system created by the government & insurance that individual doctors have essentially zero control over

Comparing US to UK salaries could be done across professions with similar results. They make less, yet have a better quality of life. They don’t work near the amount of hours we do, either. We should look at what they do in a lot of areas to see where we waste and they don’t.

Lmao

The fact is that playing this game where we sit in the middle on the healthcare issue instead of choosing a lane is the absolute worst way to do it. You have to go full private (still with some government oversight) or you go full single payer. When you muddy the water by dipping your toes in both it just makes both systems worse.