Quote:
Originally Posted by GoRedSox!
I don't think that large, for-profit national health insurers are evil. But we have to accept what the American healthcare delivery system is. It is filled with profit centers at multiple points throughout the process. Big Pharma is in there as well, with all the direct-to-consumer marketing. The health insurers keep getting bigger and bigger, and competition lessens.
It is what it is. Since publicly traded companies have a fiduciary responsibility to shareholders, it's hard to argue that the patient is the first priority.
|
What's evil is that the procedure rates / expected costs are unpublished. Like drugs at the pharmacy, the cash price might be lower than the insurance price, due to profit requirements. The cash price might also be discounted for same day pay to eliminate billing costs. Now, part of that is the complexity and uniqueness of each event, and part of is that each insurance company has contracted rates and coverages. However, that is just a math problem from the hospital's point of view. They can blend rates, they can average out procedures and normalize, and use statistics for standard deviations, etc.
The other evil part is that there are two classes of payers, the US government, and private insurers. From a hospital profitability point of view, and profitability means profits to invest in better outcomes, the US govt contracts the lowest margin / losing rates, and the private insurance has to make up the remaining difference. When payers such as UHC wants to contract rates lower than the US govt. . the hospitals can't repay both their employees and bonds and interest on their bonds. . . ie they go bankrupt. .
When UHC had a virus and caused physicians not to be able to bill and get reimbursed timely, UHC offered the physicians' offices LOANS with INTEREST . . . umm . . . that's evil. . .
monopolies are good if they are regulated with an oversite body representing the public.
oligopolies are better, as they try poaching customers from the others. .
competition is the best, but what good for the consumer is not great for companies and investment returns. . . that's the trap door of competition -> it all works great until one company reaches the ultimate corporate end goal -> MONOPOLY STATUS
Should health insurance be a utility financial model, with a limiting cap on profitability for the benefit of the population?