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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.
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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 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.
Hmm I didn’t know this. But is there anything stopping health insurers from spending the money on businesses they own (i.e. their own clinics, pharmacies etc)? If not I still fear they’ll run off with the savings.
United Health actually bought a bunch of health care providers, so they basically own a good chunk of the entire ‘vertical’ and somehow still ended up denying record amounts of claims.
What I don’t understand is why Americans are still looking to the federal government to solve the issue, instead of getting together and building a non profit co-op to deal with health care. Do the insurance part, gain market share by being the ones that actually don’t deny valid claims, start/take over hospitals, start making your own generic medicine, etc. If you don’t have to make a profit and appease shareholders you can take over the entire market. Local/state governments could provide some of the seed capital for this and make it the ‘public option’ in that state.
You’re surprised that normal people don’t just start up their own multi-billion dollar corporation with assloads of liability and assloads of government oversight?
It’s how it’s done in many countries. You can bootstrap off unions, churches, etc.
The Blue Cross Blue Shield insurers are either nonprofits or mutuals (the shareholders are the policyholders). So are many smaller insurers.
But nonprofit insurers are subject to many of the same pressures as other insurers. They need to keep premiums low, and they would go bankrupt if they paid every claim.
Likewise, the vast majority of hospitals are nonprofits. But nonprofit hospitals have to pay for medicines, doctor salaries, etc too. Most are barely scraping by and can’t fund clinical trials into novel genetic medicines.
Why would hospitals need to run clinical trials? Just provide the basic health care.
Oops, I read “generic medicine” as “genetic medicine”. I thought you were suggesting that hospitals start competing with pharma over new mRNA designs!
Yeah, you don’t need a clinical trial to make generic medicine. But you do need special facilities, which most hospitals probably would be unwilling to pay for.
Well, when you deny a claim from a clinic you own then it’s very likely your “savings” are losses for your clinic.
I was thinking more along the lines of deny claims for clinics you don’t own but approving claims for clinics you do own. Effectively shifting premiums away from outside clinics and into your own pockets all while staying under the 80/20 rule.
Insurers already divide providers into in-network and out-of-network. They deny or pay very little for out-of-network providers, because they want their policyholders to stay in-network. The reason they prefer in-network providers is that they negotiate reduced/discounted rates with those providers.
Sure, they could outright hire those providers as employees, but that means they would have to start paying their entire salaries rather than just discounted fee-for-service. And that’s not necessarily a good idea, because health care clinics are not very profitable. Basically, this is the same question facing everyone who has to choose between hiring an employee and paying a subcontractor.
That said, some insurers do run their own clinics and hospitals, notably Kaiser Permanente.
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.
My cousin is one, he is not wealthy. He is solid middle class, not sure it’s about putting workers against workers here
I don’t know why you think anyone isn’t having trouble paying back student loans at this point.
Because, I know MDs with student loans. I don’t know why you think _everyone _ is having trouble paying back student loans.
I’m not saying the whole student loan business isn’t fucked up. Or, that there aren’t lots of people screwed over by the system.
But, of all the the people with student loans, anesthesiologists are the least of concern. It’s just stupidly laughable to show concern for an anesthesiologist‘s student loans. They’re fine. It’s one of the highest paid specialties.
Anthem’s policy proposal was dangerous and fucking scary from a patient treatment perspective. Arguing against it from the perspective of the anesthesiologist‘s loan payments makes no sense. The anesthesiologist would still be getting paid well while the patient laid on the table in agony or dying from lack of treatment.
Anthem’s policy wasn’t going to leave patients in agony. It was going to cap how much anesthesiologists could bill.
There are already plenty of billing caps in medicine. Medicare has a cap for every single patient in the hospital.
When a patient reaches the cap they aren’t dumped to the curb in agony, that would be an instant malpractice lawsuit. Instead, the hospital works for free. The same thing (in principle) happens when your plumber offers a flat rate for a job but it takes a lot longer than expected.
That’s why a large number of hospital patients actually lose money for the hospital, but the hospital (and presumably these anesthesiologists) make up for it on the other patients. In the end it all averages out.
Anesthesiologists base pay ranges from $350k to $550k. I don’t think most of them are having problems paying back $200k in student loans.