They set the prices they would reimburse the providers for. So, that 10k MRI, Medicare says, we’re going to pay you 2k, and that’s that. The same with surgical procedures. And they can do the same with negotiating for pharma prices. The days of price gouging would be zero
Your costs would be zero. It would be free at the point of service.
Who makes up the $8k?
The billing department at your local hospital.
The current model in the US is health insurers negotiate with providers, but since its a for-profit enterprise, patients are also reduced to consumer.
So the hospital eats the $8k? How long are they going to stay in business eating 75%?
A lot of patients are starting to negotiate for things. I’ve done it for dental.
I had ACL surgery two years ago as an example. In the US, say in or around NYC, that would have run me 15K. 10% ‘coinsurance’, I’d be hit with a $1500 bill.
Same surgery in Italy cost me $0. I paid like $10 Euro for 5 days worth of painkillers.
My wife had two of our kids here. In the US, 30K easy for each child, plus 10-20% coinsurance.
Total cost in Italy = $0
And to where are they shifting that cost?
Why? My dad spent hours on the phone with supplemenal insurers and Medicare. He had prostate cancer. It’s absurd. The guys is ill, my mom and him are on the phone for hours.
Neoliberalism is also about increasing layers of complexity. This is a feature, not a bug.
No, under a single payer, Medicare would say, according to our book of set treatments and procedures, you get x amount, the days of the 2000% profit margins are over. Simple as that, literally.
Prices are set, that’s how.
Rome gives each province a per capita budget and they run with it. Let me put it to you like this: where I live in northern Italy (Veneto), you cannot tell the difference between a public and private hospital. Hospitals here a different, they don’t look like resorts. Very Spartan and clinical, you don’t think you’re on vacation, that’s for sure.
Quite frankly, if we weren’t in the Europen monetary union, we could devote even more resources to the Servizio Sanitario Nazionale (the national health care system). Even with our limited resources, it is still better than the US, in terms of efficiency and access. Italy is literally like a US state, in terms of budgeting, the EU doesn’t have fiscal transfers, but I digress.
They aren’t making 2000% profit.
And what happens when the providers decide it isn’t worth it?
I know they are; by the government.
They won’t.
And yes, being for-profit, their margins can be absurd. But the $8,000 night in a hospital, the $35 dollar tongue depressor must come to an end.
Leaving the for-profit insurance system in place keeps most of the objectionable and wasteful features of the US healthcare system intact. The gigantic profits in the US healthcare system are made possible by providers being able to charge whatever they can get away with. ($8000 night in a hospital, the $35 tongue depressor, etc).
Obviously, the for-profit insurance hospital industries have great political influence in the US. Their profit model and the political influence it buys would have a big impact on the planning and implementation of any system designed to retain them as for-profit actors.
Decisions, decisions, but its no longer something I have to deal with. Thank god.
How do you know?
Outside of your off the weird end with immigration I missed ya posts…
Because they’re still incentivized. That $8000 bill is a result of administrative costs (aka grift). Hospitals have lower overhead costs in single-payer systems for two reasons. Number 1) they’re paid with annual budgets, not on a per-patient or per-procedure basis, which means they don’t have to keep track of every procedure and pill for every patient. Number 2), for their covered services, say pumping that person’s stomach after the OD, they deal with only one payer, not hundreds, each with their absurd amounts of hoops to jump through.
^^^You could reduce costs 10-20% here alone.
I’ve only read Sander’s bill which is pretty comprehensive. His bill contains two of the four elements we have in Italy: fee schedules for doctors and limits on drug prices.
Jaypal’s bill wants ACOs to replace HMOs, but ACOs have failed to control costs.
Go read you some Arrow 1963 and learn why this statement is absolutely absurd.
Yeah, I think Sander’s bill is a good stepping stone. My biggest complaint is the fee-per-service approach, but that’s understandable given the paradigm shift going the annual budget route would be. I think we have to shift our mindset from an all-at-once approach. Let’s suppose by some miracle we could pass Sanders’ bill, we shouldn’t just think, “All right, we’re done.” The next step should then be working towards an annual budget approach as that would significant reduce overhead as well as help allocate resources where they’re actually ■■■■■■■ needed. It’d significantly shift resources from building luxury hospital suites to actually providing care to populations who need it. Our outcomes would skyrocket and costs plummet.
You are correct. I had my own experience with insurance panel. I have ridiculous sleep apnea. 62 events an hour. Not a night. And insurance company would not give me a study. Finally they did an at home study…that was so bad the sleep clinic let me do an onsite test for free…and two months later the insurance co approved my CPAP machine…
@adroit Yeah, I don’t envy the people that would have to implement it. Health insurers and these providers also have powerful lobbyists. Their entire business model is one of grift and rent extraction. It would be funny except it costs lives and financially ruins people.
It’s been almost six years since I moved to Italy, but I still keep up with what’s going on in the US because my family and friends are still there. Well…my pop’s family, my mom’s family is in Italy.
On a side note, even though I’m a dual citizen, I don’t feel comfortable voting in US elections since I no longer live there .
That’s insane.
you reek of books.
I’ll check it out later. Thanks.
