So for these organizations, patients who are sick and suffering are seen as a product.
A day of reckoning is coming for these organizations because the sick and suffering are getting fed up with being treated like a product.
Hospital spend represents 30% of US healthcare spend, and physician spend represents 20%. Physician employment by hospitals is at an all-time high. Busting local healthcare monopolies would do a ton to lower healthcare costs
Unfortunately that is difficult. The hospital lobby spends about as much as the pharma lobby. But the hospital industry has much more "soft" political power. Hospitals are one of the biggest employers in almost every county. So for a politician to fight hospitals would mean fighting their largest employers.
Hopefully more people become aware of this behavior by hospitals. You dont read much about it in the media. I'd imagine this has is because no one is incentivized to call out this behavior by hospitals
So yeah, go ahead and hit my retirement account for 20% in exchange for fixing healthcare—properly, like a real friggin' modern country I mean. Seems like a bargain.
Hospital bills Insurance Company $XXX,XXX.XX and Insurance Company says, "No, we'll only pay $XX,XXX.XX" so Hospital pays it. What's not mentioned is that it only cost Hospital $XXX.XX for the procedure so while they're complaining that the insurance companies only pay them a fraction of what they billed for the procedure, they're still making a massive margin.
That's not to suggest they don't have real, valid expenses. That's not even to suggest their expenses aren't high but, how would we know? They won't even tell us, the patients, how much any given procedure costs. It all seems like a wink-wink-nudge-nudge between them and the insurance companies to me while the rest of us get screwed.
Plus hospitals cant just charge for procedures at cost. There are revenue sinks hospitals have no choice to deal with. If someone without insurance and no source of income gets hurt and has to go the ICU, it can cost upwards of 10k a day. Who pays the bill? The hospital. And they cant discharge such a patient until they're healthy.
Are hospital failures due to payers, or due to competition from other hospitals? If a payer is getting squeezed by a big hospital system, it may in turn squeeze a smaller hospital or provider.
One of the biggest for profit hospital chains, HCA, generates 20-25% EBITDA margins. Many non profits are very powerful and make lots of money, they just spend more on salaries so their net income is lower. But yes many hospitals do struggle.
Insurance companies must spend 80% of their premium revenue on healthcare services. So their profits are in effect capped.
This is true even in a socialized system like the military or VA, where the folks in leadership positions are seen in their own system. And that saves money, in no small part by reducing the amount of testing, improving continuity of documentation, etc. That savings doesn't just pad some executive's bank account. It makes it easier to give the nurses a raise, or keep a few more on staff through a recession. Makes it easier to buy that new 3 Tesla MRI for better resolution imaging, etc.