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...
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u/Old_Glove9292 12d ago edited 12d ago
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...