Political funny pictures thread, part V *** If I don't laugh, I'll cry***

[nonobaddog]

If we break the link between insurers and providers, it’s always YOU who is the payer. Providers would have to figure out the real market value of their services.

I know it’ll never happen. It’s currently designed to extract the most wealth from the most people possible. No one with any power wants to upset that cash cow. Providers would be clueless how to operate in an open market.

Not true. An open market would be quite a bit easier than dealing with the complications caused by medicare.

 

[jamil]

Not true. An open market would be quite a bit easier than dealing with the complications caused by medicare.

I'm comparing now to an open market, not complications caused by medicare. But nevertheless, no one in the health industry seems to know anything about open markets. They're so used to insurance companies and government determining prices, I think they'd be very confused about how to value their services on an open market. I don't think anyone's really had to do that in maybe 20 or so years.

 

[DoggyDaddy]

There are more differences than just that. The cost of Medicare is spread across society whether individuals want it or not. If you’re insured, you opted in. But aside from that the main point is right. The things that are similar enough are the things that cause healthcare to be so expensive. In both cases, the market that is created involves the payor and provider, but excludes the actual consumer, so there’s no incentive to provide the highest quality product for the lowest price.

I think we would have a much better system if we broke the relationship between insurers and providers. The way it is now, and would be made worse with medicare for all, the transaction is pretty much between the payer and provider, neither of which, are you. In both cases, you’re the product.

I think a better system is a free market system where all the transactions are with the consumer. So, insurers describe their coverage and compete on coverage and price, and consumer’s buy whatever level of coverage they want. Healthcare providers compete on quality and price. You shop around for the best healthcare providers. When you need healthcar, you file the claim with your insurance company, they pay you the agreed upon amount for the service. You pay the provider.

Healthcare should be like any other market. You shop around. You know what the insurance will pay (which is none of the provide’s business) maybe you find someplace that will provide the servers for less than the insurance company pays for that procedure. You pocket the difference. Maybe your standards are high, and that costs more than your insurer will pay out, you’re willing to pay the difference so you go to that provider. That market transaction is then between you and the provider.

Not exactly this situation, but I had an odd experience a couple of weeks ago. I was scheduled for an MRI on my knee. The day before the appointment, I got a call from my insurance company (I forget the department but it was something like customer relations or some such). They were giving me the names of other providers and their average prices and offering to set me up at one of the lower cost options. I told them I just wanted to know what my out of pocket was going to be (turned out to be zero I just found out today). They (St. Francis) charged my insurance company $125. Much less than the $900 to $1100 that the insurance rep said was their average. I've never gotten a call like that before.

 

[BugI02]

This is so common, the medical staff have no idea what the changes are. A recent news story told of a woman who needed a procedure under her deductible, she diligently determined the costs by checking with all involved as she was on a tight budget, when the bills arrived there was one that doubled the total expense, the hospital never informed her of the charge when she asked.

For scheduled procedures the patient should be given an itemized disclosure of the costs much like mortgage lenders are required do for their customers. And since the hospitals are buying out the practices and labs, make them responsible for the accuracy of the disclosure.

They do need some 'wiggle room' because of complications that cannot be predicted (like if you code on the table) but they should be able to give you an accurate estimate without complications and justify any additional charges. When I had a laparoscopic hernia repair, not only did the operating theatre know my max out of pocket, but oddly enough their charges rubbed right up against it and they claimed they couldn't provide an itemized bill. The operating theatre charged twice what the cost of an excellent surgeon and anesthesiologist combined were

 

[nonobaddog]

I'm comparing now to an open market, not complications caused by medicare. But nevertheless, no one in the health industry seems to know anything about open markets. They're so used to insurance companies and government determining prices, I think they'd be very confused about how to value their services on an open market. I don't think anyone's really had to do that in maybe 20 or so years.

We will just have to disagree on this. Medicare has been causing complications for over 50 years now. Open market pricing would be easy enough but medicare means some patients only pay a fraction of the cost of their care while other patients are paying more to make up for it. These games are forced on the providers by medicare pricing which in no way reflects reality and everybody knows it.
The providers know very well what it costs them to provide services. I'm not sure why you would think otherwise. What they don't know exactly is how many medicare-only patients are coming in which affects the pricing for all the other types of patients.
These games are a real pain in the *** to providers and open market would be such a welcome change.
I worked at Mayo Clinic for 35 years and while I was not directly involved in patient billing it is common knowledge there.

 

[SEIndSAM]

 

[BugI02]

I find your faith that providers would charge reasonable prices in an open system ... likely misplaced. Perhaps it's the circles I travel in, but I know few doctors who don't ring up well north of $200K and who don't want to live in pricey digs in nice neighborhoods

And how will you shop around for the best deal from the back of an ambulance during your heart attack? Not all, or even most, surgery is elective and fear of imminent death will tend to erode the consumer's pricing power

 

[Ingomike]

Keep in mind the difference between cost and price. The cost to a provider is one thing and the price charged is another.
Lets say it costs the provider $1000 for a service.
The medicare bean counter bureaucrats decide they will pay $300.
A medicare-only patient comes in and the price will be $300 but the cost is still $1000. The provider loses money.
Now a well insured patient comes in and the price might be $1700 but the cost is still $1000. The provider makes up for the medicare-only patient and breaks even between the two patients.
So the more medicare-only patients that come in the more the provider gets behind and the more they need to make up to stay in business.
Right now there is an overabundance of medicare-only patients because the baby-boomers are getting to the age where they need more medical care. This is tough on providers.

That entire post has nothing to do with medical providers giving clear disclosure of their charges before treatment. If you have ever had a elective procedure like LASIK, they know to the penny what it costs. It is 3rd party pay that unbalances the system.

 

[Doug]

 

[Doug]

 

[Doug]

Maybe Joe has more in common with Mayor Pete than we thought.

 

[indiucky]

Stolen off of Twitter from Kirk ....

 

[nonobaddog]

That entire post has nothing to do with medical providers giving clear disclosure of their charges before treatment. If you have ever had a elective procedure like LASIK, they know to the penny what it costs. It is 3rd party pay that unbalances the system.

That is exactly what I am saying.
Nobody knows EXACTLY what LASIK costs because of variables in followup care but that is beside the point. Lets say on average it costs $808.75 per eye. Lets pretend medicare covers LASIK (I didn't pick the example) and they pay $350. If the provider accepts medicare assignment they do the LASIK for what medicare pays. That means they have to charge other patients more to make up for the loss. Now a patient with insurance "A" comes in and the provider can get $900 per eye from that insurance by prior agreement. They do the LASIK and have made up part of the difference. Now another patient comes in with insurance "B" and the provider can get $1100 per eye from that insurance by prior agreement. The provider has made up another part of the medicare loss.
The COST is pretty well fixed - the PRICE varies - a lot.
The PRICE won't be fixed under the current system of medicare and insurance agreements. In an open market without medicare and without prior insurance agreements it would be much easier to set a price and let people know what that price is.

LASIK is a bad example in this case because medicare doesn't cover it unless certain specific conditions are met. It is pretty easy to replace LASIK with another procedure that medicare covers and the above would apply better. It is much easier to get up front pricing for LASIK than most procedures simply because medicare complications don't usually apply.

 

[nonobaddog]

I find your faith that providers would charge reasonable prices in an open system ... likely misplaced. Perhaps it's the circles I travel in, but I know few doctors who don't ring up well north of $200K and who don't want to live in pricey digs in nice neighborhoods

Not sure where you picked that up. I never said health care providers would charge reasonable prices in an open system. I personally have little or no faith in that.
An open market would allow competition though and maybe, just maybe, some would charge reasonable prices, who knows. That would be up to pressures from the market.
Also reasonable would be in the eye of the beholder.

 

[BugI02]

View attachment 80721

 

[BugI02]

View attachment 80723

 

[indiucky]

 

[mmpsteve]

What the Dems are really after, since everything else they touch turns to gold:



.

 

[BugI02]

View attachment 80727


For jamil

 

[sharkey]