Not knowing what things cost is one of the reasons why we pay so much. I don't care to know the cost myself, but _nobody_ can figure out the cost structure of our system.
Now you know how your insurance company makes so much money.
They pay $200 for a service you think costs $800 and WILL cost you $800 if you buy it yourself.
You buy insurance based on the FULL cost of the procedure. If you could access $200 yourself you wouldn;t need insurance. You can self insure at these prices.
For the benefit of running the "self insurance" plan they are taking the difference between $200 and $800
Anyone else have a company and know what usual profit margins are? Your local pharmacy is lucky to pull off 35%.
This is 400% markup that a "retail" person pays over the insurance company.
It's not hard to make money when you buy at $200 and sell at $500-600-700 through an insurance policy.
This is how companies like AIG (anybody remember them) buy things like ski hills for their executives.
See www.stowe.com
Americas are building up the next generation of their royalty.
Companies with a mission in "health care" that mae 400% margins and buy ski hills for their executuves to use on "retreats".
Yup, that makes total sense, to a lobbyist, lawyer or other enemy of the public and democracy.
Crony capitalism, not true capitalism and market economy that people think of in the USA.
The insurance companies got a major windfall with Obamacare. That lobbying really worked out.
He could has just as easily allowed Medicare/Caid to negotiate prices and take over mre of the health care.
That wouldn;t give jobs to people that Obama really cares about. North east Liberal lawyers.
Under the ACA, when the insurance company pays a hospital (or any other medical provider) $200, it is allowed to spend $50 (less for larger programs) on salaries and profits and other expenses.
If it gets $300 of premiums and only spends $200 on medical care, it has to send the extra $50 back to the customers (larger programs have to send back $65).
Clearly they have found ways around the rules or it's still way too much money.
The fact health insurance companies invest in ski hills is very telling about lack of focus on their real business.
Either their real biz makes so much money that they can spend it like drunken sailors or they don;t care about the primary mission of the company and are just buying perks they can use themselves.
Either way you split it, it's still a total mess and not what shareholders or customers (patients) are expecting in an healthcare insurance company.
In Canada's case, 100%. I have seen one hospital bill, and that was $200 for a single room when my wife gave birth to my son. Which my supplementary insurance then paid. It is the only time I've ever even had to use my work insurance plan.
Insurance companies negotiate discounts so they make massive profits.
Hospitals negotiate discounts so they can make massive profits.
The govt makes it illegal for medicare/caid to negotiate prices or buy in bulk.
This is a massive transfer of wealth from the public to these companies.
The average citizen cannot negotiate and pays full price.
The people least able to afford the "retail" price pay the most.
Meanwhile the insurance companies/hospitals are making money hand over fist to pay out to their CEO's.
It's simply a scam of legislation that is unlikely to end because the people that benefit the most also have access to the most profit and can therefore affords the most lobbying.
A bunch of lawyers, CEO's and politicians arn;t going to change the system for a bunch of poor folk.
How do you expect them to send their kids to Harvard or pay for the shell companies needed to hide income?
There's ~3 hospitals in the USA that have transparent pricing.
If you're interested in disrupting healthcare the founder of The Surgery Center of Oklahoma has a blog on pricing transparency. http://surgerycenterofoklahoma.tumblr.com/
Some additional resources:
Free Market Medical Association website. http://marketmedicine.org/members/ It lists all the resources and providers that provide transparent pricing.
The Pricing Healthcare Blog and Pricing Healthcare website is a crowd sourcing project where patients can input their medical bills and get the cash price of procedures in their area. (The CEO of Safeway started a company with Safeway's similar, proprietary, data, however they only sell the pricing data to companies with ~10,000+ employees).
The Self Pay Patient is a blog and resource for those that choose to self insure:
http://selfpaypatient.com/
16 comments
[ 3.2 ms ] story [ 54.9 ms ] threadBilled: $800
Paid by insurance: $200
You owe: $0
They pay $200 for a service you think costs $800 and WILL cost you $800 if you buy it yourself.
You buy insurance based on the FULL cost of the procedure. If you could access $200 yourself you wouldn;t need insurance. You can self insure at these prices.
For the benefit of running the "self insurance" plan they are taking the difference between $200 and $800
Anyone else have a company and know what usual profit margins are? Your local pharmacy is lucky to pull off 35%.
This is 400% markup that a "retail" person pays over the insurance company.
It's not hard to make money when you buy at $200 and sell at $500-600-700 through an insurance policy.
This is how companies like AIG (anybody remember them) buy things like ski hills for their executives.
See www.stowe.com
Americas are building up the next generation of their royalty.
Companies with a mission in "health care" that mae 400% margins and buy ski hills for their executuves to use on "retreats".
Yup, that makes total sense, to a lobbyist, lawyer or other enemy of the public and democracy.
Crony capitalism, not true capitalism and market economy that people think of in the USA.
The insurance companies got a major windfall with Obamacare. That lobbying really worked out.
He could has just as easily allowed Medicare/Caid to negotiate prices and take over mre of the health care.
That wouldn;t give jobs to people that Obama really cares about. North east Liberal lawyers.
If it gets $300 of premiums and only spends $200 on medical care, it has to send the extra $50 back to the customers (larger programs have to send back $65).
More here:
http://kff.org/health-reform/perspective/beyond-rebates-how-...
The fact health insurance companies invest in ski hills is very telling about lack of focus on their real business.
Either their real biz makes so much money that they can spend it like drunken sailors or they don;t care about the primary mission of the company and are just buying perks they can use themselves.
Either way you split it, it's still a total mess and not what shareholders or customers (patients) are expecting in an healthcare insurance company.
Hospitals negotiate discounts so they can make massive profits.
The govt makes it illegal for medicare/caid to negotiate prices or buy in bulk.
This is a massive transfer of wealth from the public to these companies.
The average citizen cannot negotiate and pays full price.
The people least able to afford the "retail" price pay the most.
Meanwhile the insurance companies/hospitals are making money hand over fist to pay out to their CEO's.
It's simply a scam of legislation that is unlikely to end because the people that benefit the most also have access to the most profit and can therefore affords the most lobbying.
A bunch of lawyers, CEO's and politicians arn;t going to change the system for a bunch of poor folk.
How do you expect them to send their kids to Harvard or pay for the shell companies needed to hide income?
If you're interested in disrupting healthcare the founder of The Surgery Center of Oklahoma has a blog on pricing transparency. http://surgerycenterofoklahoma.tumblr.com/
Some additional resources:
Free Market Medical Association website. http://marketmedicine.org/members/ It lists all the resources and providers that provide transparent pricing.
The Pricing Healthcare Blog and Pricing Healthcare website is a crowd sourcing project where patients can input their medical bills and get the cash price of procedures in their area. (The CEO of Safeway started a company with Safeway's similar, proprietary, data, however they only sell the pricing data to companies with ~10,000+ employees).
The Self Pay Patient is a blog and resource for those that choose to self insure: http://selfpaypatient.com/
The Health Care Blue Book lists the price insurance companies have negotiated with providers: https://www.healthcarebluebook.com
Source: http://www.quora.com/What-health-care-providers-in-the-USA-o...