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355 points pavel_lishin | 4 comments | | HN request time: 0.631s | source
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RobKohr ◴[] No.45389953[source]
"Federal funding typically covers 80% of bus purchases, with agencies responsible for the remainder."

Well, there is your answer. The one making the purchase isn't the one primarily paying for the purchase. This makes them less sensitive to pricing.

Kinda like how expensive healthcare is since it is paid for by insurance.

Or how you don't care how much you put on your plate or what you choose to eat at an all you can eat buffet.

The second you detach the consumer from the price of something, even through an intermediary such as health insurance, that is when they stop caring about how much something costs, and so the price jumps.

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frollogaston ◴[] No.45390102[source]
Shouldn't insurance care about the pricing though? I get why federal govt isn't sensitive, given 0 competition.
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SoftTalker ◴[] No.45390166[source]
Insurance profit is limited to a percentage of what they pay out. So the more they pay, the more money they make.
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estearum ◴[] No.45390640[source]
Also the largest insurers increasingly own the doctors you’re seeing too.

Also the pharmacy you get your drugs from.

Also the entity that negotiates prices between pharma companies and your insurer.

More healthcare consumption = better, across the board

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1. hibikir ◴[] No.45390979[source]
Even when it's not the insurer, it's at least a hospital. Many a doctor around me that used to have a private practice sold to one of the hospital chains, as they promised more money than by owning, solely due to superior collective action advantages. A large insurer can bully a private practice into cutting costs, but a hospital network that handles 40% of ERs in the metro area? The insurance company can lose. So everyone makes more money but the people paying insurance.
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2. dnissley ◴[] No.45392376[source]
On top of that the ACA prevents new physician owned hospitals from being established and placed restrictions on expansions of existing ones
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3. estearum ◴[] No.45392590[source]
To be fair, this is because there's long-standing [but disputed] evidence that healthcare providers drive up costs/utilization when they can refer to hospitals they have equity stakes in.

Messy business!

4. MostlyStable ◴[] No.45392712[source]
Are you talking about Certificates of Need? Those have been around for a lot longer than the ACA [0]

[0] https://en.wikipedia.org/wiki/Certificate_of_need#History