You are misdirecting where you think the costs are being generated. It doesn't matter who the insurance provider is, or where they can sell their product. Every insurance rate is based on several factors - the number of individuals being covered, the age of each individual, their overall health status (pretty much every health insurance provider charges smokers more money), and most importantly, what they have to pay medical providers for services rendered. ACA is no different than what large companies provide for their employees. My wife's hospital subsidizes the cost for their employees and family members. ACA essentially does the same for any US citizen that doesn't have the luxury or opportunity to work for large company that offers benefits. ACA subsidized costs get paid by American taxpayer's. The subsidized costs that corporations pay out for their employees are recouped by charging more for their services or products. You honestly think Fortune 500 companies are eating those costs just to keep their employees happy?
If you want to reduce premium costs, whether it's for ACA or an employee working for a company that provides health insurance, you have to regulate what medical providers charge for their services and what pharmaceuticals charge for their drugs. Unfortunately, ACA didn't do this because the health provider lobbyists in Washington are WAY to powerful to let that happen. You have thousands of hospital and medical treatment centers, and millions of healthcare providers like doctors, surgeons, nurses and all the other medical staff across this country. There are no standardized rates that any of these individuals or organizations are forced to charge for the services. My Internal Medicine doctor charges $60 for any office visit. Because of my insurance, I only pay a $10 co-pay to see him. When I get my report from BCBS, it shows he submitted a request for a $60 payment, BCBS countered with a negotiated price of $35. The longest time I've ever spent with the guy during an office visit is 20 minutes. That's three patients in an hour, which comes to $105/hr. for one hour's work. Granted, him and his partners have the overhead of paying for office space, staff, office equipment, medical equipment, etc., but there's 10 doctor's that work in his group. They also have their own lab in their office so patients don't have to go elsewhere to get blood work or urinalysis. I get labs every time I go in to check my cholesterol and other chemical balances. I pay 15% of the services provided. The BCBS bill shows the lab charged them $425 for the blood work and urine samples, they negotiated the service to $280, and I pay whatever 15% of that $280 for my part. How long does it take a tech to do the various tests on my blood to get the results my doctor is looking for? Is it worth $280? Multiply that number by a few hundred per day. Also remember my doctor does see Medicare patients, so I can just imagine what kind of charges they're sending to them, and what they are getting paid by Medicare. I guarantee you it's more than $280.
My kids and wife go to their own doctors. I see the BCBS bills when they go to the doctor, and the charges for the services they get are completely different. I believe their doctor's office visit is $80, and BCBS negotiates it to $50. The services they receive are no different than mine (with the exception of what they look at "down there". :laughing: ), so why a $15 difference in an office visit?
Then there's the specialists. I've been diagnosed with fibromyalgia and other neurological disorders due to problem with my back. When I first started having symptoms, I went to go see a neurologist to get a diagnosis on the problem. His standard office visit rate is $250. BCBS negotiates a rate of $175, and I still pay the $10 co-pay. I spent maybe 30 minutes with the guy, and he orders X-Ray's, MRI's, and what I call getting zapped with a cattle prod to see where the issues may lie. So he gets $175 for 30 minutes of work. The two MRI's I get cost $2800. After it was all said and done, I paid $425 for the service. My insurance company picked up the rest.
My wife is a surgeon. Do you really want me to go through what her hospital charges, and what she gets paid for her services?
So the moral of this story is if you really want to curb what you pay for your health insurance, don't point your anger at what some private provider charges you, or why ACA is gigging the taxpayers to help subsidize those same ridiculous rates they and large corporations are being charged by the same insurance providers. Go after the real villain in this picture - the Providers who are making a killing in the long run, and essentially charge whatever they feel or the market will bare.
My wife is a surgeon. Do you really want me to go through what her hospital charges, and what she gets paid for her services?
So the moral of this story is if you really want to curb what you pay for your health insurance, don't point your anger at what some private provider charges you, or why ACA is gigging the taxpayers to help subsidize those same ridiculous rates they and large corporations are being charged by the same insurance providers. Go after the real villain in this picture - the Providers who are making a killing in the long run, and essentially charge whatever they feel or the market will bare.
Which has been my point about the bill from the start. It does nothing to curb costs. It just shifts cost. 2500 pages to shift the cost.
As I have been saying all along. The across state lines would encourage competition for pricing amongst the insurance companies. Force them to negotiate more about the cost of medical care. How much it would reduce the cost is unknown. might be insignificant. However, as I stated, You have yet to give a valid reason why allowing this would be bad. Aside from it being a Republican proposal.
There are three main areas that drive up medical costs.
The first is administration cost. 25% of the cost comes from administration. We have the highest administration costs in the world. The next closest to us is only 15%, the average is 7%. Duke University Hospital has 900 hospital beds and 1,300 billing clerks. Does that seem a bit out of proportion? 1.5 billing clerks for every hospital bed. Hell compare that to nurses to hospital beds and it doesn't come even close.
The second is Prescriptions. Drug companies sell individually to hospitals. Our prescriptions are usually 75% higher for name brand drugs than other countries. Why? Because the government of those countries is the one negotiating price and making the purchases in lump sum amounts. Then the government sets the price for the prescriptions to the consumer. Similar to how Medicaid and medicare handle their payments.
The third thing is Americans receive more medical care than any other country. We go to the hospital for everything. Even something as minor as a cold. This ties up administrative costs, handed out prescriptions and doctor offices. And the cost various so much from office to office and hospital to hospital. Insurance companies should give a person an allowed amount depending on the procedure. For example. A person needs a knee replacement and there are a couple doctors that will do it for 8,000 dollars in the area. Everyone else charges 12-20,000. The insurance company should say ok, we will pay 8,000...anything over that is now your cost. Instead of deductibles and percentages paid, move everything to standardize copayments based off the market low-to average cost of procedures. If insurance companies knew the average cost that might be dished out for procedures ahead of time, this might reduce the insurance cost as they wont be footing an entire bill after a deductible and people getting 20,000 dollar knee replacements when 8,000 will do the same thing. It will put the decision in the hand of the consumer. If they want a 20,000 dollar knee replacement, their portion would be 12 grand.
