Sad to see that no one questions the validity of 75k charge. No Healthcare need should cost something that is unaffordable. I repeatedly say this is a prime example of price gouging and the community at large seem to thumb down my comments when technically it's to protect their own interests. System is not aligned with my commentary but it does not mean we ask for a change.
I agree with you. It’s sad that we argue and struggle to figure out how to pay for these bills when the real debate we should be resolving is why these bills are so astronomically high in the first place. Wouldn’t it be better to have reasonable prices to begin with than to charge outrageous amounts and then play a bunch of games to get the bills to a reasonable amount?
1,000% -- I would love to have a public option, but in the meantime, do we really expect insurance companies to pay these prices? Hospitals are consistently billing them $50k, $500k, $1M... I wouldn't pay that shit either. It's just extortion... It's absolutely necessary to solve for the greed problem on the provider side before solving for it on the insurance side because it's providers that are the primary drivers of these insane prices.
But they don't expect that payment at lest if they network with insurance. They know they are pricing high so they can still make money and insurance can justify themselves and say how good they are at negotiations. Plenty of rural hospitals are closing cause they can not keep up even with high billed rates cause the allowed amount are either not based on that billed amount at all or insurance wants to only pay 30% . Yea some chains are greedy but let's not pretend insurance is not the big player.
Except from a patient's perspective that's not how any of this works... No one thinks to themselves, "oh I love my insurance company because they're so good at negotiating on my behalf..." 🙄
For hospitals, employee salaries make up the vast majority of expenses, so if they can't stay open, then they should downsize or cut wages rather than passing the cost to patients These absurd bills are not always covered by insurance, and sometimes patients are stuck with the bill, which is why medical bills are the number one reason for personal bankruptcy in this country... Those are real lives that are being destroyed because hospitals are price gouging. Basically, what you're suggesting is that patients should be willing to go bankrupt to get the care they need so that hospital employees can enjoy cushy salaries and job security...
This is on top of the fact that a huge chunk of everyone's taxes already go towards hospitals as well as a sizable chunk of the revenue of many companies in the form of health insurance premiums for employees that could be redirected back to employees in the form of higher salaries. That is how insatiable and greedy providers are right now. They're taking money from patients, the government, insurance companies, and companies that employ Americans, and somehow it's still not enough 🤔
UHC leads all insurers with a 6% profit margin, which is a fraction healthcare costs... Again, I'm for a public option, because I believe that insurance is an unnecessary overhead, but the main villains in healthcare are not the insurance companies, it's the providers who are bottomless pits of greed that have been unable to self-regulate and now they need to be cut off...
This is just dead wrong. Physician "services" make up less than 15% of healthcare expenditures in the US as of 2020(this is counting money that goes towards running clinics and other outpatient services overhead, actual salaries are closer to 8%). Nursing is another 10-15% at most. Growth of administration in hospitals and healthcare over the past 30 years has vastly outpaced growth in physicians(and nursing for that matter.)
If you removed every doctor and nurse's salary in the country in the blink of an eye(you know, the ones that you actually go to the clinic or hospital to see and provide the actual healthcare) you would still have >70% of expenditures remaining. It would be a pretty worthless 70% too since there would be no diagnosis or treatment of disease which is kinda the whole point of, you know, healthcare.
Companies like UHC hide their profits by using their insurance arm to funnel money into their own hospitals by making them "preferred hospitals" in network and basically double, triple, or quadruple dipping on that money. So you are paying them a premium, then visiting their clinics/hospitals and paying copays and deductibles. Then they use that insurance to pay another portion to their hospital. Then that hospital or clinic uses that money to purchase drugs through their pharmacy benefit manager Optum. They've also been starting to hire doctors themselves so then they also get to keep the difference between what the doctor makes and the salary they pay them. They are getting a cut every step of the way.
So yes they make 6% after they've paid themselves a few times with your money.
It's not dead wrong. You just refuse to accept the truth because you want more job security and a higher salary. How can you not acknowledge your own bias on this topic? Maybe have some humility and consider that you're living in denial and spreading lies because it makes you sleep easier at night. Clinicians do valuable work, but it's not so valuable that patients should go bankrupt for it...
It's literally right there. If you pay 100 dollars for healthcare, about 8 dollars goes to the doctor, another 7 dollars to overhead, and another 10-15 to nursing care.
The other 70-75 dollars is going elsewhere through a labyrinthine network of insurance companies, hospitals, pharmacies, PBMs, and other subsidiaries. If it was me I'd be more worried about that.
You are right that our system has huge issues. We do spend too much on medical care. One of the biggest issues is that the very foundation of medicine (doctors and nurses), make up a small fraction of our spending and instead we are subsidizing large corporations to provide shareholder value with our healthcare dollars instead.
Combine this with a litigious and "more is more" atmosphere(always order more tests so you don't miss something - big corporations that provide these lab/imaging services love this by the way) and you get an explosion of healthcare spending which is funneled into administrative oversight and needless testing rather than high quality medical care.
If you want the doctor on call at 3 in the morning to save your life, who has been trained intensely for 10-12 years at a personal cost of 300k, to make less than a store manager at Walmart to save 4% of your insurance premium, I guess that's a choice.
I'd rather go after the 70% we're putting elsewhere including into the hands of large companies who deliver "shareholder value."
Of course you would think that... You're a clinician and you think clinicians should make more money than everyone... Again, examine your bias. You're cherry picking statistics, and they're all intended to paint the picture you're most comfortable with and not the truth. There's a lot of commentary you can find on this if you're interested, but I think Noahpinion laid it out most elegantly:
I give you numbers and you give me an opinion blog.
Ok thanks.
Also it's funny because I do not, in fact think clinicians should make more than anyone, and indeed big tech software engineers make far more than I ever will with a fraction of the schooling.
The blog post includes a thorough analysis of healthcare market forces and their underlying economics. There's plenty of numbers in there if you actually had any interest in learning the truth.
Why are you comparing clinicians to software engineers? And why do you think it matters how long someone went to school? Is that not a personal choice? Besides, I keep hearing how healthcare workers go into healthcare to help people-- or is that total BS? Hint: most ppl already know...
The vast majority of support staff is underpaid. These include nurses, radiology, lab, respiratory therapy etc. if you think Doctors are overpaid you should look at the amount of years of schooling they have to have and the average amount of debt they come out of school with.
Doctors having to go for excess of schooling and incur high student debt does not justify for a common patient to pay for thousands of dollars just to be seen..
Lol the entitlement and narcissism... Patients don't deserve to go bankrupt to pay the salaries of healthcare workers. The cost of schooling is a personal choice and patients shouldn't be on the hook for it.
"The cost of schooling is a personal choice and patients shouldn't be on the hook for it."
Of course they are? If you see a lawyer, the cost of their schooling is factored into the price you pay for services. If you pay an engineer, the cost of their schooling is factored into the price you pay for services. It is expensive to educate people with doctorates. Not to mention the cost of schooling may be a personal choice but if you want doctors in your society somebody is going to be paying for that cost so it'll be a factor in cost regardless.
Fortunately like we discussed above, the majority of the cost patients pay is in fact not for doctors so for the most part the patient is not "on the hook" for for a meaningful cost.
No... I see how you're trying to connect the dots, but unfortunately, you seem to have only a cursory understanding of economics. The salaries of lawyers and engineers are far more influenced by market forces because they operate in relatively free markets compared to healthcare. Also, no one says to themselves, "I'm paying my lawyer or engineer X amount of dollars because they worked hard in school and deserve it." That's an extremely childish worldview... It's well known that healthcare is a perversely distorted market and healthcare workers benefit greatly from a laundry list of curated market distortions including artificial labor shortages, a lack of price transparency, manufactured information asymmetry, institutionalized medical paternalism, etc...
Go somewhere else when you need medical care. You don’t deserve to be treated if you think the staff caring for you are overpaid. There is a lot wrong with healthcare in the US, the salaries of the patient care staff is not one of them, except perhaps that many are overworked and underpaid.
You do not work in healthcare and are very mis-informed in understanding where the actual costs lie.
Thanks for proving my point beyond a shadow of a doubt. The narcissism is unreal. If someone points out an inconvenient truth or pushes back on the narratives y'all tell yourselves in your echo chambers-- then, you tell them to go die in a ditch... It's textbook DARVO.
Keep living in denial. More and more patients are waking up to the truth and serious change is right around the corner. The latest round of Medicaid reforms is just the tip of the iceberg.
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u/Designer-Toe1955 13d ago
Sad to see that no one questions the validity of 75k charge. No Healthcare need should cost something that is unaffordable. I repeatedly say this is a prime example of price gouging and the community at large seem to thumb down my comments when technically it's to protect their own interests. System is not aligned with my commentary but it does not mean we ask for a change.