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Runaway health care costs. Is there a way for us to stop this?

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#1 Wigguns

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Posted 31 January 2017 - 11:17 PM

Greetings, all.  This is my first post!


Firstly, I think it's an utter travesty that we live in a society in which all people do not have inexpensive access to healthcare.  I hope this changes sooner than later.  I don't have the answers!  I wish I did.


I can share some background as to why healthcare costs in this country seem to be increase unfettered. I worked for several health plans in various positions for a number of years.  Here's a fundamental reason the cost of healthcare increases continuously:


  1. The healthcare industry (ie physicians, hospitals, clinics, etc) performs and bills for their services.  They bill either health insurance companies, Medicare/Medicaid or individuals.
  2. The healthcare industry negotiates rates with health insurance companies and the government.  These rates are generally based on what is considered "reasonable and customary" aka "R&C" for a given service in a given area.  You could say, the average.   
  3.  The problem lies in the fact that the healthcare industry continuously raises their charges and very often purposely bills outrageously high, ridiculously high for services.  Example:  charging $800 for a routine checkup office visit when they're only paid a negotiated rate of $150 by the insurance company or the government.  Why would they bill $800 if they're only paid $150?  As an aside, individuals without health insurance are forced to pay whatever they're billed.
  4. Remember, negotiated rates are set based on averages.  If the healthcare industry purposely bills outrageously high rates, that....skews the averages upward driving up negotiated rates.  

Again I don't have the answers, but hopefully this sheds some light on one of the reasons costs are so crushing.



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#2 gwochow

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Posted 24 March 2017 - 01:11 PM

30% of Medical Bills Go To Administrative CostsJuly 18, 2016 by SingleCare


"Duke University Hospital has 900 hospital beds and 1,300 billing clerks. The typical Canadian hospital has a handful of billing clerks. Single-payer systems have fewer administrative needs."


"When you visit the doctor, your medical bill isn’t just for your doctor’s time. You’re also charged for the personnel needed to process billing and insurance-related activities like chasing after unpaid medical bills, processing insurance claims and making sure the insurance on file is up-to-date. This is why administrative costs account for about 30 percent of of every dollar paid on a medical bill in the individual marketplace."


This is only one site,  there are plenty: https://singlecare.c...strative-costs/



Keep in mind, the above article is focusing on just the admin costs... there are still

the actual insurance costs/profits over and above actual medical cost payouts

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#3 merrill

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Posted 30 March 2017 - 10:45 PM

Obamacare offer consumers way more protection and more coverage than in the past 60 years. Yes the medical insurance industry proceeded to increase rates as usual.


The most practical,most fiscally responsible and fair to the consumers is IMPROVED Medicare Single Payer. This essentially removes the profiteering middle man from the equation = smart indeed.


HR676/S703 Healthcare Reform Report Card



How many republican, democrat, green party thinkers, fiscal conservative and independent voters are Trump conservatives and blue dog democrats willing to throw under the bus?


=== Government Services Are Good,Reliable , AFFORDABLE and Essential















How many republican, democrat, fiscal conservative and independent voters are Trump conservatives and blue dog democrats willing to throw under the bus?


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#4 Guiltywhite

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Posted 08 April 2017 - 09:19 AM

Yes, get rid of health insurance. Make it illegal for a pharmaceutical company to make medicines cost so much more here than anywhere else in the world and take away them from being able to have commercials running 24/7
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