A big insurer backed off its plan to pay less for anesthesia. That’s bad.
A big insurer backed off its plan to pay less for anesthesia. That’s bad.
What the fight between Anthem and anesthesiologists was really about.
...
Private insurance companies have earned the public’s distrust. They routinely put profitability above their policyholders’ well-being. And a system of private health insurance provision also has higher administrative costs than a single-payer system, in which the government is the sole insurer.
But the avarice and inefficiencies of private insurers are not the sole — or even primary — reasons why vital medical services are often unaffordable and inaccessible in the United States. The bigger issue is that America’s health care providers — hospitals, physicians, and drug companies — charge much higher rates than their peers in other wealthy nations.
...
Anaesthesiologist take over your breathing and control your physiology when undergoing surgery. I want them handsomely compensated.
Edit: also let’s be honest here. Anthem isn’t going to take the savings from paying physicians less and pass them onto you the consumer. They’ll take the savings and issue a stock buyback.2nd Edit: Turns out that the ACA has a provision preventing the pocketing of premiums. Thanks FlowVoid for pointing this out and unironically thanks obama. My first point still stands though.
They’ll take the savings and issue a stock buyback.
They can't do that.
The ACA requires large health insurers to spend 85% of their income on health care providers. If they don't (eg because they start paying less to anesthesiologists) then the savings must be used to reduce premiums or give rebates to customers.
Sorry, they don't get handsome compensation. Not when they have to pay back those student loans.
The era of the rich doctor is over. Medical group and hospital CEOs are the ones getting rich these days.
Anaesthesiologists are not having trouble paying back student loans. It’s one of the highest paid specialties.
This article is BS as was Anthem’s policy. But, anaesthesiologists are doing just fine. If you want to feel bad for an MD, try pediatric oncologists or another specialty that isn’t in high demand.
A for-profit healthcare system is bad.
And I wish more mainstream outlets than Vox would talk about that. So many Americans are absolutely convinced that socialized medicine is a terrible idea. My mom watched British reality shows about hospitals on Netflix and if you would hear her talk about it, British people are dying in the streets because the ambulance doesn't get there for half a day and you have to wait five years to see a doctor.
And I've told her that she's watching a show put together by people who want you to see the worst possible side of things so you'll keep watching, but she just doesn't accept that.
I’m an American and I have to wait months to see a specialist. I think I’ll take my chances with socialized healthcare.
Yep. Me too. Took me nine months to get a new neurologist when my old one retired.
Edit: Apparently there are at least three fans of the American capitalist healthcare system.
My specialist won't even see patients anymore. You have to schedule to see a medical assistant, and even that is 12 months out.
I hate the argument that it's not the insurance companies fault for high prices. If they are struggling so much, how come they are so fucking profitable.
Lets fix both, and not complain about the order if we make incremental progress one-at-a-time.
how come they are so fucking profitable.
UHC has a profit margin around 6%, whereas Anthem's is around 3%. Those are not particularly high. For comparison, Toyota (8%) and Home Depot (10%) are both more profitable.
It's not useful to compare health insurance profit margins to other industries because the Federal Government requires that they spend 80% of all premium revenue on care. This is effectively a cap on profits and also creates an incentive for insurance companies to pay higher costs for care so they can make more profit.
Vox, do you want to know why those medical service providers charge much higher rates? Gee…
I’ll give you a hint. It requires a large bureaucracy and staff to deal purely with interfacing with this behemoth that’s somehow part of the healthcare but has nothing to do with actually providing the healthcare. You guessed it! It’s still the health insurance companies. I strongly disagree with the article conclusion.
Health insurance companies actually incentivize more expensive medical care because it allows them to show you the bigger discount and punish others for trying to go around the insurance mafia. Their goal is to force everyone to pay the toll, the maximum possible toll, and provide the least amount of service possible in doing so.
Don’t blame doctors. Hell, don’t even blame the hospitals even though they do have crappy administration. The heart of the problem is private insurance. Insurance games the system, and people die.
I worked in a hospital for a long time and oversaw an entire team of people whose only job was to interface and argue with insurance companies. For my small hospital, we had 7 people doing this averaging $85-$90K per year each.
And don't get me started on unfunded care. Since we live in Texas, which has not expanded Medicaid, there are a ton of people who end up in the hospital with no insurance and who will never pay a cent because they literally can't. Hospitals try to make up that funding gap by raising rates on everyone who does pay. We're already paying for other people's healthcare this way, I wish we would just nationalize health insurance and eliminate insurance companies entirely.
I think there is some blame to passed onto for-profit hospital conglomerates. They degrade care to drive down costs to maximize profits. They force doctors to do min-maxing and game theory shit to get bonuses that don't actually help the patients.
I agree that insurance companies are the biggest issue, but let's not absolve the big hospital corporations.
It’s because the ceos aren’t fearing their lives.
Health insurance companies actually incentivize more expensive medical care because it allows them to show you the bigger discount and punish others for trying to go around the insurance mafia
Wut? I don't expect a coherent response since lemmy loves conspiracy theories, but where did you get this from?
Health insurance companies are simply the wrong actors to be the vanguard against medical overcharging.
When
insuranceinsidious corporations claim they're protecting the common people from greedy doctors, I'll believe the doctors' point of view.It's not even corporate insurance vs doctors. It's corporate insurance vs corporate hospital who employ the doctors. A lot of doctors are pushed to up the numbers of patients they see by their corporate bosses even when everyone knows that will mean worse care.
See how it’s “a big insurer” so we don’t kill them?
Yeah, but then anesthesiologists could then just say they can only work a certain amount of time because it costs them too much money in billing and appeals. Thus rushing a surgeon that then has a set time limit. Any time an insurance company makes a decision about what care a patient needs over the advice of doctors, it will result in problems. Sure there are going to be abuses, but instead of a blanket policy, it should be the responsibility of the insurance company to investigate fraud and waste.
I mean what other job do they have to spend money on but reducing fraud and waste? Oh wait, they spend money on software that is designed to deny claims, so they can blame the software for being overzealous and not the policies.
And a system of private health insurance provision also has higher administrative costs than a single-payer system, in which the government is the sole insurer.
Clearly havent seen the german system
I haven’t. What’s up with the German system?
We don't have "one" health insurance, we have like 90 of them.
https://www.krankenkassen.de/gesetzliche-krankenkassen/krankenkassen-liste/
While a few of them are the same with the same administration, it's still like 50 individual ones. A few of those are also "special" and only accept certain people. But each has their own administration, "CEO" of sorts and people that have to be paid.
The german healthcare system is mismanaged beyond belief and complete and utter dogshit. Don't get me wrong, still better than the american system, but considering I'm paying 421,76€ a month in health insurance (and my employer pays the same amount aswell), I should be able to expect a certain level of service, but most of the money is lost in these administrations as it seems.
Many stuff isn't paid for either. Early checkups, for example, aren't covered. My girlfriend had to have her blood levels checked and it wasn't covered by the insurance which cost her like 500€.
It's just a fucking disgrace how bad the healthcare system in this country is.