[1] https://www.dolthub.com/blog/2022-05-31-hospital-price-gougi...
An example: about 20 years ago I had just a major medical plan and I was at urgent care for a problem. After diagnosing the likely problem and prescribing the solution, they were about to run some tests "just in case." When I told them I would be paying for the tests due to the major medical plan, they explained that the tests didn't have any benefit, so we didn't run them.
I don't know of a real solution to these problems.
A partial solution is exposing some of the cost to the insured to create an incentive to save (like what I had when I was paying for the tests). At my company, we fully pay for a high-deductible plan AND a give company-funded contribution to a Health Savings Account that mostly covers the per-person out-of-pocket max. If the employee does not spend the HSA money (which is their money in their account), it can be used for retirement savings... so they have an incentive to save. But once someone hits the out-of-pocket max, there is no more incentive to save.
Suggesting that the average person should be able to make medical decisions and override their health care provider’s recommendation is ridiculous.
The situation is similar to taking your out-of-warranty car to a dealer for repairs. Sometimes, you may suspect they’re not being completely honest with you. What do you do in that case? You get a second opinion before agreeing to a costly repair.
This is what we have to change. When physicians and hospitals know that patients are scrutinizing care plans they will find a new fairer baseline. That cultural change will subsume older practices.
Wish I can say the same about health. If the doctor who has my entire medical history recommends x procedure, yes I'm not going to risk potentially having irreversible damage to my body.
You think your primary care physician is the one that recommends surgery, and not a specialist?
Step 1: "The other 2 entities in the health industry are to blame!" Step 2: Profit, because no one is going to succeed a battle here that knocks down only one of these.
Every time, this is the response. In practice they are all to blame, and they could all be working to make this better. But none of them are incentivized to act in anything but their own self-interest. Insurance is definitely to blame, as are hospitals and pharmaceutical manufacturers. There's a reason the companies that ostensibly "save people's lives" are some of the most hated in the US.
I hope that Insurance companies have an epiphany from the public sentiment about this, that they're messing this up spectacularly. But honestly, they seem more likely to wait for this to blow over.
The high list prices you see are only exist there to scare uninsured/underinsured Americans and to force them to buy/pay more expensive insurance.
As soon as you get treated, these list prices magically get reduced on the backend by factor of 2-3x.
Doctors themselves cannot price gouge patients, but they can price gouge via middleman (insurance). The same procedure that costs $50 will be billed to insurance as $500 procedure.
same with pharma drugs, there is a very complex system in place to keep the face of expensive prices, while keeping a system of rebates/discounts/pre-negotiated contracts between each big player.
Americans are simply getting taken for a ride and their money being stolen by Pharma+Hospitals and Insurance is simply acting as a financial middleman.
Also insurance literally FORCES americans to work, because thats the only way to get affordable health insurance. Aint noone is paying COBRA (list prices). If you do you are stupid and throwing money away.
American population is being squeezed and extracted of their labor due to system that forces you to work to stay alive and healthy.
for comparison, just go to Thailand or Vietnam to any of the private hospitals: you can get the same western standard treatment but for pennies (the actual cost of care). This is the healthcare that Americans COULD have, but unfortunately the American system would lose too much money so Americans are not allowed to have affordable health care.
A lot of things in America is simply regulatory capture and requires Americans to keep ignorant of what they could have, what other countries enjoy, but Americans are not allowed to
This is really important. This system is artificially lowering the cost of labor and preventing people from immediately leaving workplaces where they are treated poorly by the employers or the customers.
The reason is if you want to live, you need to get healthcare, and for that you need to be employed by BigCorp (because marketplace insurance is overpriced and crappy thanks to OBAMA).
The system is set up in a way to keep extracting and exploiting people in their prime years of age
If health insurance typically only covers 150 dollars for a procedure, but one super duper premium plan may cover 600, you charge 600. End of. Because otherwise, what happens when patients with that super duper plan come in? You only make 150 instead of 600.
Would you want to get paid 150 instead of 600? No, you wouldn't. Survey every American. None would. We aren't stupid.
So, you charge 600, and by the shackles of capitalism, you have no choice. Your hands are tied - that decision is already made for you by the systems in place.