Hacker News Reader

Comment by geogra4 | Hacker News Reader

Its been said before by some I went to high school with that now has a PhD in public health that America's Healthcare system is first and foremost about paying insurers and everything else is just considered a loss

View on HN

It's the hospital that wants 18k, not the insurer.

Why does a non-profit hospital even remotely need 18k for that though? What is inflating costs so much?

Hospitals must stabilize anyone who walks through the ER door by law, no matter their ability to pay. They do not receive any funding for that mandate, however, so they have to make up the cost across their patients that do have the ability to pay. The stitches don’t cost $18k, but the ten people who walked in prior with no insurance and a broken leg or heart palpitations do.

Edit: to be clear I’m not defending this awful system.

Highly skeptical of this explanation as this would mean about 90% of the US population is going bankrupt on the regular. No way this is true. Most likely just perverse incentives.

Perverse interaction with insurance companies. Insurance companies have list of prices for operations. If the hospitals rate is higher than their price they have negotiated only to pay their list price. On other hand if the hospital price is lower they only get that much. So logical result is that hospitals maximise their prices to always be above what insurance is willing to pay. And then they can just negotiate lower rate for someone promising to pay in cash, which could be fraction.

That is my understanding from Europe. From outside the logical way would be to mandate single pricing structure and ban any direct discounts.

Reply on news.ycombinator.com