You’re Insured But Still Owe $109K For Your Heart Attack

FAH1223

FAH1223

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Call Me James said:
Unless prices are kept in check. Medicare for all is doomed from jump.

American healthcare is a for profit business with huge margins.
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Two Challenges The Single-Payer Movement Must Address

Challenge 2: Provider rates
What really makes single-payer “work” in other countries is that other governments don’t allow hospitals and doctors to rip people off. Yet in America we are being ripped off to an incredible degree.

If you listen to speeches or watch videos from politicians backing Medicare for All, you would never know this. You would think the reason why our health care system is so much more expensive than any other country’s had to do with administrative overhead and drug prices.

While there is a lot of administrative waste due to our private insurance system, even relatively optimistic estimates put savings that could be wrung from administrative simplicity at around 13 to 15 percent. You can do a lot of good with an extra 10 to 15 percent, like covering the current uninsured and improve people’s benefits somewhat, but you will never get American health care spending anywhere close to other industrialized countries. There is not enough waste in administration to expand coverage, increase benefits, and let most Americans spend significantly less of their income (be it in premiums or taxes).

Most single-payer bills heavily promote expanding coverage to the uninsured or underinsured, but what voters care about most is bringing down their own health care spending. With average family premiums having increased by $6,658 in just the past decade, that is not an unreasonable desire. Particularly when one considers that Canada spends just $6,604 Canadian ($5,056 US) per person to provide universal care.

American health care spending cannot be lowered anywhere close to Canada or Sweden or France levels unless salaries for American doctors, lab cost, MRI scans, and hospital prices are lowered as well. Prices would need to be cut across the board because the United States overpays in basically every part of the industry.

American specialists make effectively three times what similar doctors make in Sweden and twice what they do in France or the UK. This is a problem that is only getting worse.

Hospital prices for the same procedures have grown dramatically faster than inflation. Many hospitals are so comically bloated and inefficient they don’t even know how much it actually cost them to perform common procedures. Average physician income has grown by nearly $100,000 since 2011.

If doctor salaries had remained flat over the last decade — like most other workers’ salaries, since increased health care costs ate up all of their potential income gains — we would be spending $100 billion less a year on health care. To put that in perspective, that is roughly how much it would cost for federal tuition free college and paid family leave legislation. These inflated salaries, lab fees, and hospital prices cost the average family thousands a year in higher premiums (or will cost them thousands a year in higher taxes if a single-payer plan is adopted without addressing the issue).

The movement has two options for broaching the issue of America’s out of control hospital and doctor prices.
  1. Ignore the problem. While not explicitly acknowledging it, this seems to be the main strategy of the single-payer movement. High hospital prices and doctor salaries are rarely mentioned, and regular people are almost never told how much of their income is going to pay for them. The informal plan seems to be to make private insurers and drug makers the bad guys, and hope to squeeze enough money from them to make the financing work while trying to effectively buy-off the hospitals and doctors with the promise of no cuts. This has two big problems. The first is there is no reason to believe hospitals and doctors won’t oppose any single-payer bill even if it doesn’t stop them from overcharging people right now. The Federation of American Hospitals, the American Medical Association, and the American College of Radiology have already joined a new industry alliance with the insurers and drug makers to kill any form of single payer. They oppose single-payer because they love how bad private insurers are at negotiating lower prices. Prices paid by private insurers have risen much faster than for Medicare or Medicaid. Even keeping prices the same would not appease them since they know keeping private insurance alive will mean even crazier prices down the road. If hospitals start to oppose single-payer and supporters have laid none of the groundwork to counter or explain their opposition, it could hit the movement like a semi-truck. The other is that it’s tough to make single-payer an overwhelming net gain for most voters if you don’t actually take advantage of what makes the system so much cheaper. Letting hospital prices be unreasonably high means higher taxes, and every increase in taxes moves millions of voters from the category of clear financial “winners” to potential losers. A single-payer plan that doesn’t stop this overcharging could actually increase net health care spending.
  2. Tell people just how much they are being ripped off. This would take a real educational effort, but it is a message the public has not gotten before. It is a strategy that has not really been tried. Obviously, it would be high risk because it would ensure hospital opposition, but it would also be high reward. You can promise basically everyone not only total coverage with no deductibles but also thousands more in income or big sweeping new programs. The data is there. The concern about prices is there. People just need to be honest with the public about who bears a lot of the blame.
 
hashmander

hashmander

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hospital: give us $109k now. :birdman:
patient: i don't owe you that much, i have insurance.
hospital: yeah you do. :birdman:
patient: contacts reporter :mjcry:
hospital: we'll settle for 8.
patient: $8k, i can't even afford that. i don't owe you anything.
hospital: no, $800. we could put you on a payment plan and everything.
patient: :martin:
 
hashmander

hashmander

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Serious said:
Crazy enough I decided to watch John Q, a couple weeks ago. And kept thinking about how nearly 20 years later not much has changed.
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hospitals are the enemies of change. they got a nice little racket going and the insurance company gets everyone's contempt distracting them from the real scumbags.
 
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