Skack
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| Quote : | "and what happens, then, if the hospital only charges that "fair rate" you speak of? the insurance company STILL pays x% of that fair rate.
let's test your business acumen here: if you know that the vast majority of your customers will get a 50% discount on their purchases from you, no matter what, how do you respond?
Do you:
A) keep prices the same and go out of business
B) double your prices and stay in business" |
They wouldn't expect a 50% cut in the bill if it wasn't inflated to begin with. I'm not saying they wouldn't continue trying to negotiate for the best price, but they wouldn't have a leg to stand on if they were already receiving a fair price.
You think people wouldn't crack jokes if Honda put a $60k price tag on the Accord tomorrow and then selling them to private citizens for $30k or as fleet vehicles for $25k? Do you think they'd ever sell an Accord for $60k?
The healthcare industry knows that insured patients are what is keeping them afloat. Take away their insured customer base and see how long they survive when only 5% of the bills are paid in full. And you want to challenge my business acumen? 11/22/2011 4:50:21 PM
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aaronburro
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thanks for fuckin up the thread, tardmo
| Quote : | | "They wouldn't expect a 50% cut in the bill if it wasn't inflated to begin with." |
and the bill wouldn't be inflated if they weren't expecting a 50% cut to begin with. see how that works?
[Edited on November 22, 2011 at 4:50 PM. Reason : ]11/22/2011 4:50:23 PM |
Skack
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Which came first, the chicken or the egg?
I think we're going to have to agree to disagree on this one.
[Edited on November 22, 2011 at 4:54 PM. Reason : l] 11/22/2011 4:52:28 PM |
aaronburro
Sup, B
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exactly. in this case, though, I'd say the expectation that the insurance company would get a price-cut came first, which then drove up prices, when then caused more people to get insurance, which then caused the insurance companies to demand more cuts, when then caused the prices to go up, which then caused more people to get insurance, which then...
at some point, the insurance company comes into existence, probably for benign reasons. but then it got perverted and caused this death spiral we have today. moreover, it's also possible (and likely) that, as in the case of student loans, the hospital knows the insurance company will pay, so the price can be insulated even moreso from typical market forces. 11/22/2011 4:55:48 PM |
1337 b4k4
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| Quote : | | "The fatal flaw in that statement is that hospitals charge insurance companies much less for their services than they do private individuals. " |
I can't speak for hospitals, but for pharmacies, you have this completely backwards. Every pharmacy bills the insurance companies for the full price and then some, and they take whatever the insurance company pays per the contracts (which are a percentage of the pharmacy equivalent of UCR, and is constantly decreasing, which in turn causes pharmacies to increase their prices). The goal when billing the insurance company is to bill a high enough amount that the insurance company pays you less then what you asked for. It's sort of the opposite of buying a car. If you walk up to a guy selling a car and offer him 5k and he says "Deal" without blinking an eye, it means you paid too much and should have offered less. Similarly if you bill an insurance company and they pay what you asked for, it means you billed too little and you should bill more.
It's really all a stupid song and dance where insurance companies pretend they're saving you money by saying they've negotiated a discount off the UCR, willfully ignoring the fact that the UCR is about as meaningless as MSRP.11/23/2011 9:07:59 PM |
