5 ms·

This is why we need to completely get rid of health insurance in the US. If Hospitals could only charge the actual value for their services, and not the inflat

This is why we need to completely get rid of health insurance in the US. If Hospitals could only charge the actual value for their services, and not the inflated insurance prices, the prices would be much lower. One of my friends is a Doctor. He told me that they need to over-charge for services because of the insurance companies. If they charge $20 (the actual cost of the service), they might get $4 back from the insurance company. If they charge $100, they might get the $20 from the insurance company for the service. We need to cut out the middle man. It's basic economics. The drug issue in the US is mostly the fault of the government. It takes hundreds of millions of dollars and 10+ years to get FDA approval. This stifles innovation and creates an environment where there are only a few players (IE: a monopoly). The result is ridiculous prices due to no competition.

ocean3 11y ago
If they charge $100, they might get the $20 from the insurance company - the remaining 80 goes to the insurance company?
- chimeracoder 11y ago
  > If they charge $100, they might get the $20 from the insurance company - the remaining 80 goes to the insurance company? He's saying they bill for $100, and the insurance company decides to pay $20.
  - ocean3 11y ago
    So where does the 80 go?
- deleted 11y ago
  [deleted]
mindslight 11y ago
Mandating identical pricing for all customers [0], published price lists, and all-inclusive standardized line items based on services rendered (not costs incurred) could accomplish the similar thing. Unpaid bills for emergency (non-deniable) services would come from a general state fund, which would then recover from the debtor (or not). Whatever the solution is, it's got to be stealthy enough to get past the "insurance" cartel. The grass roots demand for national Romneycare obviously came from legitimate problems, but the political machine twisted it into just further empowering the accounting-protection racketeers. [0] Providers would still be free to set whatever prices they wanted, they just could not have different rates "negotiated" for different customers. And obviously accounting-skirting kickbacks would be illegal.
- chimeracoder 11y ago
  > Providers would still be free to set whatever price they wanted, they just could not have different rates "negotiated" for different customers In theory, this could work in a totally free insurer market. Unfortunately, the current system relies on public insurers (Medicare/Medicaid) being able to set prices for their patients by fiat. Unless we required Medicare and Medicaid to accept providers' billing rates (which I could actually support, but would be a political non-starter), providers' prices can't be standardized. However, even if that happened, there's the other problem of actually enforcing this. Prices are set by billing codes and collections of codes that are billed simultaneously, and they may not be linear[0]. There are 70,000 billing codes, which are far more insanely detailed than you could imagine[1]. Mathematically, it would always be easier to play tricks with the particular codes submitted for billing than it would be to prove any misconduct. [0] So, billing for the sets {A, B} and {C} would not cost the same as {A, B, C}. Which is totally reasonable, because providing anesthesia (A) for a bronchotomy (B) is less complicated than providing anesthesia for a bronchotomy in which some complication (C) occurs during the surgery. [1] e.g, G44.82: "headache associated with sexual activity"
  - mindslight 11y ago
    But Medicare cannot dictate that a provider must provide services to Medicare, so the providers are obviously finding it beneficial to do so, right? If Medicare is paying only the variable costs and not the amortized fixed costs, this is a fundamental economic problem which must be fixed to have any hope of sanity. I've heard of how complex the condition codes are, but an individual should not need to understand that system to make financial decisions. The entire problem here is essentially one of complexity, much of it necessary but much of it unnecessarily generated as time goes on. A person has a procedure done for straightforward reasons, possible complications are enumerable, and anything more complex can be billed on prepublished hourly rates and cost-plus for materials. Individuals can only function as economic actors when they have understanding, with the current system being an abject failure of "nobody knows" as the end result of computers fighting computers.
    - 11y ago
ksk 11y ago
>If Hospitals could only charge the actual value for their services, and not the inflated insurance prices, the prices would be much lower. I don't quite understand how you're arguing using the term "basic economics" that Hospitals en-mass will leave money on the table in a capitalist economy.
GFK_of_xmaspast 11y ago
> The drug issue in the US is mostly the fault of the government. It takes hundreds of millions of dollars and 10+ years to get FDA approval Can you point to some jurisdictions where it does not take hundreds of millions to bring a drug to market.

ocean3 11y ago

If they charge $100, they might get the $20 from the insurance company - the remaining 80 goes to the insurance company?

chimeracoder 11y ago
> If they charge $100, they might get the $20 from the insurance company - the remaining 80 goes to the insurance company? He's saying they bill for $100, and the insurance company decides to pay $20.
- ocean3 11y ago
  So where does the 80 go?
deleted 11y ago
[deleted]

mindslight 11y ago

Mandating identical pricing for all customers [0], published price lists, and all-inclusive standardized line items based on services rendered (not costs incurred) could accomplish the similar thing. Unpaid bills for emergency (non-deniable) services would come from a general state fund, which would then recover from the debtor (or not). Whatever the solution is, it's got to be stealthy enough to get past the "insurance" cartel. The grass roots demand for national Romneycare obviously came from legitimate problems, but the political machine twisted it into just further empowering the accounting-protection racketeers. [0] Providers would still be free to set whatever prices they wanted, they just could not have different rates "negotiated" for different customers. And obviously accounting-skirting kickbacks would be illegal.

chimeracoder 11y ago
> Providers would still be free to set whatever price they wanted, they just could not have different rates "negotiated" for different customers In theory, this could work in a totally free insurer market. Unfortunately, the current system relies on public insurers (Medicare/Medicaid) being able to set prices for their patients by fiat. Unless we required Medicare and Medicaid to accept providers' billing rates (which I could actually support, but would be a political non-starter), providers' prices can't be standardized. However, even if that happened, there's the other problem of actually enforcing this. Prices are set by billing codes and collections of codes that are billed simultaneously, and they may not be linear[0]. There are 70,000 billing codes, which are far more insanely detailed than you could imagine[1]. Mathematically, it would always be easier to play tricks with the particular codes submitted for billing than it would be to prove any misconduct. [0] So, billing for the sets {A, B} and {C} would not cost the same as {A, B, C}. Which is totally reasonable, because providing anesthesia (A) for a bronchotomy (B) is less complicated than providing anesthesia for a bronchotomy in which some complication (C) occurs during the surgery. [1] e.g, G44.82: "headache associated with sexual activity"
- mindslight 11y ago
  But Medicare cannot dictate that a provider must provide services to Medicare, so the providers are obviously finding it beneficial to do so, right? If Medicare is paying only the variable costs and not the amortized fixed costs, this is a fundamental economic problem which must be fixed to have any hope of sanity. I've heard of how complex the condition codes are, but an individual should not need to understand that system to make financial decisions. The entire problem here is essentially one of complexity, much of it necessary but much of it unnecessarily generated as time goes on. A person has a procedure done for straightforward reasons, possible complications are enumerable, and anything more complex can be billed on prepublished hourly rates and cost-plus for materials. Individuals can only function as economic actors when they have understanding, with the current system being an abject failure of "nobody knows" as the end result of computers fighting computers.
  - 11y ago

ksk 11y ago

>If Hospitals could only charge the actual value for their services, and not the inflated insurance prices, the prices would be much lower. I don't quite understand how you're arguing using the term "basic economics" that Hospitals en-mass will leave money on the table in a capitalist economy.

GFK_of_xmaspast 11y ago

> The drug issue in the US is mostly the fault of the government. It takes hundreds of millions of dollars and 10+ years to get FDA approval Can you point to some jurisdictions where it does not take hundreds of millions to bring a drug to market.