Posted on 03/27/2014 10:13:38 AM PDT by Star Traveler
The problems with the implementation of the Affordable Care Act may be masking another major change in the way health care is delivered to U.S. consumers, experts believe.
At a conference in Washington on Thursday, health care and business professionals said that there’s an increasing trend in the industry toward cutting insurance companies out of the process entirely, as large, regional hospital systems move into the insurance business.
Dr. Kenneth L. Davis, CEO and president of Mount Sinai Health System, the largest health care provider in the state of New York, said that starting next year, Mt. Sinai will begin offering its own Medicare Advantage plan. It will look for other opportunities to bring premium payments directly into the hospital system, rather than filtering them through insurance companies.
Davis said he expects organizations similar to his to move in the same direction. “Inevitably the large systems are going to move to take part of the premium dollar,” he said.
(Excerpt) Read more at thefiscaltimes.com ...
Its probably good. Depends on the checks and balances. Insurance companies sure don’t have our best interest in mind.
I was wondering when they would start this....................
Imagine, paying the hospital, in advance, for their services in case you need them................
Cuts out the middleman. Huge profit incentive for the hospital.
Not exactly a recipe for success, but the Insurance execs that Obama scammed probably didn’t see that one coming
The law of unintended consequences can be a bitch
If they did, they wouldn’t have allowed themselves to be cut out of the system for a quick profit.
Considering that insurance companies have driven up the cost of doing business in healthcare, I am all for this.
I read elsewhere a few months ago that solutions like this will force people to travel less for fear of getting hurt while being too far away from their covered hospital.
-PJ
How do they answer that for HMO-type plans that have limited coverage areas, right now?
Sounds to me like the push is now full on to cut out insurance companies and go straight to single payer, i.e., Government, which was always the leftist intent from the get-go.
It may be ... simply ... the hospitals looking out for their own well being. And from their own standpoint, it does make a lot of sense. From the consumer standpoint, I just don’t know.
Still, these costs are offset somewhat based on your group. It's hard to say what the concept of "group" would be at a hospital-centered plan, if at all. Your "group" will be people who live in the vicinity of the hospital, without any other health, age, or occupational considerations taken into account?
-PJ
My wife is a nurse working for an insurance company. She is paid to evaluate insured members fresh out of the hospital with the goal of preventing any repeat visits. The insurance company would much rather spend $5,000 on rehab and rehab equipment, for example, than have their member return for another $60,000 hospital visit. She sometimes seems to be the only person reviewing the total list of prescriptions to check for adverse side affects or harmful drug interactions.
Insurance companies help to control costs. Sometimes that involves - gasp! - rooting out fraud. Yes, there are people who go to hospitals with false ailments to get drugs, or who seek a doctor’s justification to collect SS disability. She saw that often while working as a nurse in a large local hospital.
Obamacare was never meant to be the ends, only the means.
You’re right. Seems like the insurance companies help build the scaffold thinking someone else would hang. Now they don’t like what they’re seeing.
Liberty and the free market is the way to go.
Insurance companies would wind up offering popular catastrophic insurance for peanuts. Consumers would pay much less because insurance/government/most-bureaucracy would be cut out of the equation. With some tort reform, costs would plummet even further.
Case in point: Doctor's today that have opted out of dealing with any insurance company.
I should add that as a nurse in a hospital, she often heard doctors discussing what the state’s medicaid program would pay before deciding on what was ‘wrong’. In one case, they decided to replace both knees on a woman with knee pain. The woman was 4’11” tall and weighed 300 lbs...but Medicaid would pay for knees. What she needed was a diet! With her weight, the artificial knees were doomed before they ever were inserted.
I’ve got friends that work medical accounts payable. Many of the problems with our healthcare system start with insurance companies. The big problem is they’re cheap, they never want to pay the bill handed to them, so there’s this crazy high/low game AP has to play to get the money they want they increase the bill knowing the insurance company will pay only a fraction of it (and then send you a letter bragging about how much they “discounted” your bill). And that cheapness also causes them to deny treatment plans that will work because they’re expensive and there’s some other way cheaper method that almost never works but they want that to fail first. Played tag with that when my wife ruptured her achilles, about 1% it will regrow all by itself if you keep the foot immobile for about six weeks first, or you can fix it with surgery (which also takes about 6 weeks to recover from), they wanted to try the regrow, we didn’t want her in a cast for 3 months with the first half doing nothing; took a lot of phone calls and threats and a smart doctor to navigate their idiocy.
And in the end this all costs everybody money. Doctors and hospitals spend a lot of money arguing with insurance companies, who spend a lot of money saying no, and we get sicker requiring more expensive treatments while all this happens. If you ever really want to see how much insurance companies cost everybody next time you need treatment whip out your Visa instead of your insurance card, guaranteed the price drops by at least 50%, probably over 60%.
I think that's the role of a good insurance company...they can direct your dollars to where you want to go (or need to go, if you're away from home)...
Which is not to say that all insurers are equal, but I do not foresee a system of insular single entity hospital care/insurance provider collectives ending well for consumers OR their doctors...
Why can't we just have health savings accounts, free-market access to insurers (across state lines, etc.), and at least general information published about pricing for services? and a "cash option"?
Another impact: This could tremendously affect house values. Think it’s a big deal to find a house in a good school system? Imagine when you have to live near a good hospital, or go without?
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