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355 points pavel_lishin | 3 comments | | HN request time: 0.009s | 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. doctorpangloss ◴[] No.45392727[source]
Uh, no… they want to deny claims. The best situation for insurers is that you are healthy for a while, then abruptly die of something that cannot be treated.
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2. estearum ◴[] No.45392809[source]
Uh no, they don't. Not if they're also the ones who provide healthcare. Simply denying claims isn't even remotely close to the financially (and obviously not the politically) optimal strategy.

The optimal strategy if you own both the insurer and the provider is a combination of premiums, copays, deductibles, and maybe even some totally unnecessary care to drive up volume.

Lower margin on dramatically higher volume is still dramatically more money. Lower margin actually provides political cover for your $400 billion revenue years.

3. frollogaston ◴[] No.45432982[source]
They are accepting claims that are way more expensive than in any other country, so I don't think this is their game