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Private insurance companies have earned the public’s distrust. They routinely put profitability above their policyholders’ well-being. And a system of private health insurance provision also has higher administrative costs than a single-payer system, in which the government is the sole insurer.
But the avarice and inefficiencies of private insurers are not the sole — or even primary — reasons why vital medical services are often unaffordable and inaccessible in the United States. The bigger issue is that America’s health care providers — hospitals, physicians, and drug companies — charge much higher rates than their peers in other wealthy nations.
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Anaesthesiologist take over your breathing and control your physiology when undergoing surgery. I want them handsomely compensated.
Edit: also let’s be honest here. Anthem isn’t going to take the savings from paying physicians less and pass them onto you the consumer. They’ll take the savings and issue a stock buyback.
2nd Edit: Turns out that the ACA has a provision preventing the pocketing of premiums. Thanks FlowVoid for pointing this out and unironically thanks obama. My first point still stands though.
They’ll take the savings and issue a stock buyback.
They can’t do that.
The ACA requires large health insurers to spend 85% of their income on health care providers. If they don’t (eg because they start paying less to anesthesiologists) then the savings must be used to reduce premiums or give rebates to customers.
Hmm I didn’t know this. But is there anything stopping health insurers from spending the money on businesses they own (i.e. their own clinics, pharmacies etc)? If not I still fear they’ll run off with the savings.
United Health actually bought a bunch of health care providers, so they basically own a good chunk of the entire ‘vertical’ and somehow still ended up denying record amounts of claims.
What I don’t understand is why Americans are still looking to the federal government to solve the issue, instead of getting together and building a non profit co-op to deal with health care. Do the insurance part, gain market share by being the ones that actually don’t deny valid claims, start/take over hospitals, start making your own generic medicine, etc. If you don’t have to make a profit and appease shareholders you can take over the entire market. Local/state governments could provide some of the seed capital for this and make it the ‘public option’ in that state.
Well, when you deny a claim from a clinic you own then it’s very likely your “savings” are losses for your clinic.
Sorry, they don’t get handsome compensation. Not when they have to pay back those student loans.
The era of the rich doctor is over. Medical group and hospital CEOs are the ones getting rich these days.
Anaesthesiologists are not having trouble paying back student loans. It’s one of the highest paid specialties.
This article is BS as was Anthem’s policy. But, anaesthesiologists are doing just fine. If you want to feel bad for an MD, try pediatric oncologists or another specialty that isn’t in high demand.
I don’t know why you think anyone isn’t having trouble paying back student loans at this point.
A for-profit healthcare system is bad.
And I wish more mainstream outlets than Vox would talk about that. So many Americans are absolutely convinced that socialized medicine is a terrible idea. My mom watched British reality shows about hospitals on Netflix and if you would hear her talk about it, British people are dying in the streets because the ambulance doesn’t get there for half a day and you have to wait five years to see a doctor.
And I’ve told her that she’s watching a show put together by people who want you to see the worst possible side of things so you’ll keep watching, but she just doesn’t accept that.
I’m an American and I have to wait months to see a specialist. I think I’ll take my chances with socialized healthcare.
I think it was a five month wait to see if I had cancer. Luckily it wasn’t a bad one, eh?
What kills me is this was literally the prime complaint against socialized healthcare. Then the covid lockdown hit and suddenly it takes 3 months for me to get an appointment with my primary doctor.
I hate the argument that it’s not the insurance companies fault for high prices. If they are struggling so much, how come they are so fucking profitable.
Lets fix both, and not complain about the order if we make incremental progress one-at-a-time.
how come they are so fucking profitable.
UHC has a profit margin around 6%, whereas Anthem’s is around 3%. Those are not particularly high. For comparison, Toyota (8%) and Home Depot (10%) are both more profitable.
It’s not useful to compare health insurance profit margins to other industries because the Federal Government requires that they spend 80% of all premium revenue on care. This is effectively a cap on profits and also creates an incentive for insurance companies to pay higher costs for care so they can make more profit.
they spend 80% of all premium revenue on care
True. Actually, large insurance companies need to spend 85%.
an incentive for insurance companies to pay higher costs for care so they can make more profit
That doesn’t make sense. Insurance companies have to pay health care providers for care. The more care costs, the less money is left for insurance companies. In fact, if health care costs are too high then the insurance company can go bankrupt.
That said, the converse is not true: insurance companies don’t directly profit by cutting health care spending. That’s because they need to use 80% or 85% of their revenue on care. However, cutting health care spending (by delay, denial, etc) allows insurance companies to lower their premiums.
And since people often want the cheapest possible insurance, lower premiums means more customers, which means more total revenue, which ultimately does mean higher profits.
Of course, the key assumption here is that customers will accept worse care if it means lower premiums. This is one of the few industries where you literally get what you pay for.
Vox, do you want to know why those medical service providers charge much higher rates? Gee…
I’ll give you a hint. It requires a large bureaucracy and staff to deal purely with interfacing with this behemoth that’s somehow part of the healthcare but has nothing to do with actually providing the healthcare. You guessed it! It’s still the health insurance companies. I strongly disagree with the article conclusion.
Health insurance companies actually incentivize more expensive medical care because it allows them to show you the bigger discount and punish others for trying to go around the insurance mafia. Their goal is to force everyone to pay the toll, the maximum possible toll, and provide the least amount of service possible in doing so.
Don’t blame doctors. Hell, don’t even blame the hospitals even though they do have crappy administration. The heart of the problem is private insurance. Insurance games the system, and people die.
I worked in a hospital for a long time and oversaw an entire team of people whose only job was to interface and argue with insurance companies. For my small hospital, we had 7 people doing this averaging $85-$90K per year each.
And don’t get me started on unfunded care. Since we live in Texas, which has not expanded Medicaid, there are a ton of people who end up in the hospital with no insurance and who will never pay a cent because they literally can’t. Hospitals try to make up that funding gap by raising rates on everyone who does pay. We’re already paying for other people’s healthcare this way, I wish we would just nationalize health insurance and eliminate insurance companies entirely.
I think there is some blame to passed onto for-profit hospital conglomerates. They degrade care to drive down costs to maximize profits. They force doctors to do min-maxing and game theory shit to get bonuses that don’t actually help the patients.
I agree that insurance companies are the biggest issue, but let’s not absolve the big hospital corporations.
Health insurance companies actually incentivize more expensive medical care because it allows them to show you the bigger discount and punish others for trying to go around the insurance mafia
Wut? I don’t expect a coherent response since lemmy loves conspiracy theories, but where did you get this from?
Health insurance companies are simply the wrong actors to be the vanguard against medical overcharging.
