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Steve66 • 3 years ago

What does "Regulating healthcare provider prices" mean exactly? Price controls and rationing? (one begets the other).
On the other hand "price transparency" as being implemented by previous administration mandate, can be effective.

Jaci • 3 years ago

The problem with price transparency is that insurance plans can get the information, find out what competing plans are paying for these services, and slowly but surely cut reimbursement rates to providers to Medicare, if not Medicaid rates. Our healthcare system CANNOT afford this, as Medicare and Medicaid don't even cover the cost of providing care for their beneficiaries.

Joshua2415 • 3 years ago

Fascinating that they target "provider prices," but are silent about hospital CEO pay, or the amount of money that gets Hoovered up by insurance companies.

Nathan Kaufman • 3 years ago

They Say Academicians Live "Where the Rubber Meets the Sky" This Was Reinforced In the Publication '1% Steps For Health Care Reform'

PEOPLE IN THE REAL-WORLD ARE TOO BUSY CARING FOR PATIENTS TO MAKE POLICY RECOMMENDATIONS SO WE ARE STUCK WITH THIS NONSENSE

1) Eliminating Out-of-Network Billing by Hospital-Based Physicians: The theorists forgot the REAL-WORLD PROBLEMS of payers abusing the system by offering below-market rates as they have in CA.

2) Capping Prices and Price Growth in the US Commercial Health Sector: The theorists did not address the REAL-WORLD PROBLEMS of how this regulation will force hospitals to restrict access, eliminate services, consolidate (see below), and many will be forced to close.

3)Addressing Hospital Concentration, Consolidation, and Hospital Ownership of Physician Practices: The theorists did not address the REAL-WORLD PROBLEMS of why this consolidation occurred in the first place (i.e., below-market rates from grossly profitable monopolistic payers) nor did they deal with the fact that without consolidation, these providers were financially unsustainable.

Not a mention of the payers' disproportionate share of the premium dollar they take relative to the value they provide including the 20+% of the drug costs as rebates.

Just Sayin' n8

Jaci • 3 years ago

They're restricting the wrong end of the healthcare industry. What they need to do is put controls on the costs that providers have to pay for the items they need to provide patient care, instead of squeezing them into an untenable position, where their reimbursement rates no longer cover the expenses of providing healthcare services to the communities they serve.

Problem is that this will never happen. People make too much money on their stock portfolios that include a LOT of these vendors, which are posting higher and higher profits at the expense of the healthcare providers and ultimately, the patients.

Michael Anthony Angelillo • 3 years ago

If you don't address the year over year growth rate in healthcare spending you'll only kick the can down the road.

For instance healthcare grows at about 5% let's say (I think actual is somewhere between 4-8%)
Current cost 4 trillion
Let's say I magically reduce it by 9% by perfectly implementing 16 reforms.
Current cost 3.64 trillion + 5% inflation
3.822 after 1 year
4.01 trillion after 2 years

So while I suspect his study was well meaning, the reality is even perfectly implementing all of these solutions would at best, buy us 2 more years, maybe a little more depending on how fast or slow the GDP grows, or worst case, shrinks.

The real issue is the US by per capita or as % of GDP spends 2x what every developed nations does and our overall access and quality are lower. In a real sense US citizens are paying 2x as much for 3/4 the service.

While US healthcare is complicated by our country size/diversity, and underlying poor health we could easily drop this number to 1.25-1.5x what other countries spend by simply modernizing our systems and creating one base risk pool with the individual market allowing for buy up, i.e. the model that currently functions in the UK and Germany. I think it's doubtful we'd ever be average or below the average in terms of spend as a % of GDP or per capita given our unique set of challenges, but we definitely don't need to be an extreme outlier and I don't think 1% solutions are anything more than a stop gap, but my solutions are likely not realistic to be employed. If I were betting I would bet on total collapse or a complete save our bacon by medical advancement, perhaps in terms of nano-tech, anti-aging treatments, genetics, etc.

Steve66 • 3 years ago

"Modernizing"? "One base risk pool"?
That's rationing.
"Buy up" means rich could cut the line.

Sandra_Raup • 3 years ago

More incremental stuff? That's worked so well for the last 3+ decades it's been done.