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Private insurance companies have earned the public’s distrust. They routinely put profitability above their policyholders’ well-being. And a system of private health insurance provision also has higher administrative costs than a single-payer system, in which the government is the sole insurer.
But the avarice and inefficiencies of private insurers are not the sole — or even primary — reasons why vital medical services are often unaffordable and inaccessible in the United States. The bigger issue is that America’s health care providers — hospitals, physicians, and drug companies — charge much higher rates than their peers in other wealthy nations.
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Anaesthesiologist take over your breathing and control your physiology when undergoing surgery. I want them handsomely compensated.
Edit: also let’s be honest here. Anthem isn’t going to take the savings from paying physicians less and pass them onto you the consumer. They’ll take the savings and issue a stock buyback.2nd Edit: Turns out that the ACA has a provision preventing the pocketing of premiums. Thanks FlowVoid for pointing this out and unironically thanks obama. My first point still stands though.
They’ll take the savings and issue a stock buyback.
They can’t do that.
The ACA requires large health insurers to spend 85% of their income on health care providers. If they don’t (eg because they start paying less to anesthesiologists) then the savings must be used to reduce premiums or give rebates to customers.
Hmm I didn’t know this. But is there anything stopping health insurers from spending the money on businesses they own (i.e. their own clinics, pharmacies etc)? If not I still fear they’ll run off with the savings.
Well, when you deny a claim from a clinic you own then it’s very likely your “savings” are losses for your clinic.
I was thinking more along the lines of deny claims for clinics you don’t own but approving claims for clinics you do own. Effectively shifting premiums away from outside clinics and into your own pockets all while staying under the 80/20 rule.
Insurers already divide providers into in-network and out-of-network. They deny or pay very little for out-of-network providers, because they want their policyholders to stay in-network. The reason they prefer in-network providers is that they negotiate reduced/discounted rates with those providers.
Sure, they could outright hire those providers as employees, but that means they would have to start paying their entire salaries rather than just discounted fee-for-service. And that’s not necessarily a good idea, because health care clinics are not very profitable. Basically, this is the same question facing everyone who has to choose between hiring an employee and paying a subcontractor.
That said, some insurers do run their own clinics and hospitals, notably Kaiser Permanente.
Sorry, they don’t get handsome compensation. Not when they have to pay back those student loans.
The era of the rich doctor is over. Medical group and hospital CEOs are the ones getting rich these days.
Anaesthesiologists are not having trouble paying back student loans. It’s one of the highest paid specialties.
This article is BS as was Anthem’s policy. But, anaesthesiologists are doing just fine. If you want to feel bad for an MD, try pediatric oncologists or another specialty that isn’t in high demand.
My cousin is one, he is not wealthy. He is solid middle class, not sure it’s about putting workers against workers here
I don’t know why you think anyone isn’t having trouble paying back student loans at this point.
Because, I know MDs with student loans. I don’t know why you think _everyone _ is having trouble paying back student loans.
I’m not saying the whole student loan business isn’t fucked up. Or, that there aren’t lots of people screwed over by the system.
But, of all the the people with student loans, anesthesiologists are the least of concern. It’s just stupidly laughable to show concern for an anesthesiologist‘s student loans. They’re fine. It’s one of the highest paid specialties.
Anthem’s policy proposal was dangerous and fucking scary from a patient treatment perspective. Arguing against it from the perspective of the anesthesiologist‘s loan payments makes no sense. The anesthesiologist would still be getting paid well while the patient laid on the table in agony or dying from lack of treatment.
Anthem’s policy wasn’t going to leave patients in agony. It was going to cap how much anesthesiologists could bill.
There are already plenty of billing caps in medicine. Medicare has a cap for every single patient in the hospital.
When a patient reaches the cap they aren’t dumped to the curb in agony, that would be an instant malpractice lawsuit. Instead, the hospital works for free. The same thing (in principle) happens when your plumber offers a flat rate for a job but it takes a lot longer than expected.
That’s why a large number of hospital patients actually lose money for the hospital, but the hospital (and presumably these anesthesiologists) make up for it on the other patients. In the end it all averages out.
Anesthesiologists base pay ranges from $350k to $550k. I don’t think most of them are having problems paying back $200k in student loans.
A for-profit healthcare system is bad.
And I wish more mainstream outlets than Vox would talk about that. So many Americans are absolutely convinced that socialized medicine is a terrible idea. My mom watched British reality shows about hospitals on Netflix and if you would hear her talk about it, British people are dying in the streets because the ambulance doesn’t get there for half a day and you have to wait five years to see a doctor.
And I’ve told her that she’s watching a show put together by people who want you to see the worst possible side of things so you’ll keep watching, but she just doesn’t accept that.
I hate the argument that it’s not the insurance companies fault for high prices. If they are struggling so much, how come they are so fucking profitable.
Lets fix both, and not complain about the order if we make incremental progress one-at-a-time.
how come they are so fucking profitable.
UHC has a profit margin around 6%, whereas Anthem’s is around 3%. Those are not particularly high. For comparison, Toyota (8%) and Home Depot (10%) are both more profitable.
It’s not useful to compare health insurance profit margins to other industries because the Federal Government requires that they spend 80% of all premium revenue on care. This is effectively a cap on profits and also creates an incentive for insurance companies to pay higher costs for care so they can make more profit.
they spend 80% of all premium revenue on care
True. Actually, large insurance companies need to spend 85%.
an incentive for insurance companies to pay higher costs for care so they can make more profit
That doesn’t make sense. Insurance companies have to pay health care providers for care. The more care costs, the less money is left for insurance companies. In fact, if health care costs are too high then the insurance company can go bankrupt.
That said, the converse is not true: insurance companies don’t directly profit by cutting health care spending. That’s because they need to use 80% or 85% of their revenue on care. However, cutting health care spending (by delay, denial, etc) allows insurance companies to lower their premiums.
And since people often want the cheapest possible insurance, lower premiums means more customers, which means more total revenue, which ultimately does mean higher profits.
Of course, the key assumption here is that customers will accept worse care if it means lower premiums. This is one of the few industries where you literally get what you pay for.
A 90 Billion dollar profit is OK with you?
GTFO with that. Lmao
Health insurance companies are simply the wrong actors to be the vanguard against medical overcharging.
Yeah, but then anesthesiologists could then just say they can only work a certain amount of time because it costs them too much money in billing and appeals. Thus rushing a surgeon that then has a set time limit. Any time an insurance company makes a decision about what care a patient needs over the advice of doctors, it will result in problems. Sure there are going to be abuses, but instead of a blanket policy, it should be the responsibility of the insurance company to investigate fraud and waste.
I mean what other job do they have to spend money on but reducing fraud and waste? Oh wait, they spend money on software that is designed to deny claims, so they can blame the software for being overzealous and not the policies.
