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Aetna CEO Threatened Obamacare Pullout If Feds Opposed Humana Merger

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142 points helloworld | 5 comments | 17 Aug 16 17:52 UTC | HN request time: 0.024s | source
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seibelj ◴[17 Aug 16 18:06 UTC] No.12306806[source]▶
Can anyone succinctly explain the benefits of having a market for private health insurance companies, rather than a single provider of health insurance (government, aka "public option")? Can a capitalist case be made for their existence? Does the lack of a large private insurance market in countries with government-provided health insurance cause lots of inefficiencies and waste?
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1. lettergram ◴[17 Aug 16 18:14 UTC] No.12306896[source]▶
The main issue with healthcare in the u.s. actually has to do with Medicare, Medicaid, and social security.

All of the state options pay only ~10% of what they are billed no matter how large the bill (there is also usually a cap). This forces hospitals to charge exorbitant prices. Private insurance options pay larger percentages: 12 - 50%. People without insurance usually will pay either 100% or 0%, with some people negotiating in between.

Honestly, the easiest way to fix it is to get rid of Medicare, Medicaid, and social security or force everyone to pay 100% as opposed to negotiating lower rates.

Fyi I worked in a medical billing office for 5 years. We did payment processing for about 30% of all hospitals on the east coast and Midwest

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2. snsr ◴[17 Aug 16 18:16 UTC] No.12306925[source]▶
> Honestly, the easiest way to fix it is to get rid of Medicare, Medicaid, and social security or force everyone to pay 100% as opposed to negotiating lower rates.

Bullshit. This isn't an easy problem, and you're casually dismissing systems that support millions of people.

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3. username3 ◴[17 Aug 16 18:43 UTC] No.12307217[source]▶
> All of the state options pay only ~10% of what they are billed no matter how large the bill (there is also usually a cap). This forces hospitals to charge exorbitant prices.

True or false?

4. lbotos ◴[17 Aug 16 19:45 UTC] No.12307758[source]▶
I think the point was if everyone had to pay "full price" the full price would be lower, but right now the prices are inflated so 10% of the price is what they actually hoped to make.
5. lettergram ◴[17 Aug 16 22:33 UTC] No.12308988[source]▶
Supports millions of people in what way? I "casually" wrote off millions a dollars a day in the billing office for people who didn't have insurance. I "casually" wrote off 90% of people's bills who were state funded.

The only people we actually were forced to try and collect on were private companies and people making over $X per year.

I have no idea how much experience you have with this stuff, but the unfairness comes from the fact doctors/hospitals can effectively charge outrageous prices, knowing they will only make a percentage. On the state payments, they lose money and on the private insurance companies, wealthy and naive honest people they will make more. They have to charge that much to make up for the difference caused by the state options, and people who never pay.

Just like any system with a (semi)guaranteed payment (college tuition, healthcare, government contracts, minimum wage, etc.) Prices will inflate capturing the free market rate + the guaranteed amount. If you want to fix that, you have to force deflation by forcing everyone to pay equally. You can do that by removing the guaranteed payment and create competition.

Seriously, this is econ 101...

Also, antibiotics, insulin, and many of the other standard drugs doctors prescribe could essentially be free for everyone for half the cost of Medicare. Insurance companies only pay like 10% on the dollar for that stuff. So I would much rather "support" everyone by providing the basics, and having the rest be a free market. It would solve probably 80% of the issues with the current healthcare system.