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Does not support the claim
> we let insurance companies label government triage as "death panels"
The simpler explanation is that political Party A proposed legislation, and political Party B attacks it because a win for Party A is a loss for Party B.
And digging into just slightly further makes the claim make even less sense:
https://en.wikipedia.org/wiki/Death_panel
> Palin's spokesperson pointed to Section 1233 of bill HR 3200 which would have paid physicians for providing voluntary counseling to Medicare patients about living wills, advance directives, and end-of-life care options. Palin's claim was reported as false and criticized by the press, fact-checkers, academics, physicians, Democrats, and some Republicans.
Why would managed care organizations (aka health insurance companies) oppose the government paying for more healthcare services?
MCOs earn 2% to 3% of the premiums that flow through them. The higher the healthcare spend, the higher the premiums, the higher the profit for MCOs.
Insurance companies spent billions of dollars on advertisements against the ACA. This is public record. They did it because they opposed all of the good things the act required - such as prohibiting discrimination base on pre-existing conditions or demographics (other than age), requiring many basic procedures to be covered, bans on lifetime/annual coverage maximums, bans on dropping policy holders when they get sick, prohibiting copays on various services such as vaccines, requiring that insurers spend at least 80% of their premiums on health costs, a wide array of reforms to constrain costs, and so on.
No one is ranting, but there does seem to be a lot of “I feel like this could have happened, so I am going to choose to believe this happened because it confirms my priors”.
>we let insurance companies label government triage as "death panels"
Who said the term first doesn't matter. Who popularized it does. Insurance lobbyists and the conservative politicians they funded did.
In the US, all political speech is bought and sold on the open market. Especially statements made by (most) politicians.
They would rather hold on to 20% of a huge number than 20% of a big number.
Average cost of 1 vial of insulin in France: $9.08
Average cost of 1 vial of insulin in the US: $98.70
HDThoreaun: huffing some libertarian shit "The people are using too much insulin."
https://www.rand.org/pubs/articles/2021/the-astronomical-pri...
https://www.visualcapitalist.com/cost-of-insulin-by-country/
https://aspe.hhs.gov/reports/comparing-insulin-prices-us-oth...
In the US healthcare chain, the ranking of profit margins goes (and this is public info from public financials):
Pharmaceutical companies
Healthcare software companies (based on other software company margins)
Healthcare providers (doctor groups)
Hospitals (HCA, tenet, etc)
Managed care organizations and retail pharmacies at the very bottom.
The big one I don’t know is legal, which I assume slots between hospitals and healthcare providers, but could be higher. Those millions and tens of millions of dollar judgments don’t come from thin air.
Go ahead and get rid of MCOs, and at best you will reduce costs by 5%. That’s an objective fact. They are just allocating the very limited resources among more and more demand.
That doesn't make any sense. Profit margin is meaningless if you are spending billions on a bunch of useless administrative staff pushing paperwork for no reason.
Obviously some of that is necessary, but certainly not nearly all of it. I don't care about a company making 5% on top of a $150k/yr admin salary. I care about the $150k/yr salary which is the true cost added to the system.
Having watched from afar my friends in healthcare who actually provide bedside care vs. the administrative bloat - it's going much like education. Tons of admin staff added that don't ever touch patients that seemingly just get in the way of the folks doing the actual work.
Margin is a meaningless number if you can just pump your expenses to increase the total dollar amount.
That doesn’t make any sense. If one MCO were to pump their expenses, there are 4 to 6 others waiting to take their customers with lower premiums.
Currently, medical loss ratios are around 85% to 90%, which means MCO administrative costs are 8% or maybe 10%, at most.
However, getting rid of the MCO doesn’t mean those costs go away. Government employees will have to do the prior authorizations rather than MCO employees. So I split the difference, and you end up with a net savings of 5%. Make it 10% if you want to be super optimistic and think the government will streamline paperwork for healthcare providers.
The other 90% of healthcare costs are still there.
Why do people believe this?
Healthcare isn't widgets and factories in an ECON-101 class.
The chances of anything short of an extremely large and well-funded consortium of investment bankers and private equity firms starting a new MCO is exactly and precisely 0.0%.
And those groups have the same incentives to maximize the payouts to all parties involved that the incumbents do.
Of course, they would never do that because increased competition would threaten their already-extensive investments in the sector.
The problem isn't regulation, or regulatory capture, or any other buzzword a podcast full of morons bandies about.
The problem is that you need at least $10 billion just to open the doors.
Because there are.
UNH/Elevance/CVS/Cigna/Humana/Centene/Molina are just the biggest publicly listed ones. They might not all offer plans in all states on the exchange, but there’s a decent amount of competition for employer subsidized plans.
The low single digit profit margin proves the competition exists such that the sellers don’t have pricing power to earn a higher profit margin.
>The PBMs also have incredible profit margins, upwards of 80%.
I would love to see a single SEC filing showing this, mostly because there exist no standalone PBM.
Also, YouTube is not a source for financial information. 10-Ks, for example, would be.
Does anyone have a good reference for this? It's something that I inherently assume exists but would love to see a flowchart of how rampant it is and where different layers are siphoning their penny.
Would that even be possible?
all their salaries and profits are coming from patient's pocket
It doesn't have to be 17%, it can be an arbitrary number because the ones who decide on the nominal pricing are the ones who make money on them being extremely high. These same procedures can in some cases cost even 2-3 orders of magnitude less - and not in another country but in the same hospital but with a patient willing to pay in cash.
they want Americans be scared of going bankrupt from medical bills.
on the backend, between insurance and hospital, these giant list prices are automatically lowered by factor of 10 to the actual cost of procedure
the business model is: 1. insurance scares people with huge prices 2. healthy americans buy a lot of expensive insurance 3. money is injected into healthcare system from healthy patients 4. money is split among insurance/pbm/providers/pharma
No, come on man, this is easily googleable. Americans go to the doctor less than other countries, they stay in the hospital less than other countries, they have lower life expectancy, infant and mother mortality than other countries. If you want to know why we spend so damned much, it's because we're billed 2-3x as much for the same care as other countries.