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by gambiting
3214 days ago
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I(as a European) think the difference is that at least in my country nearly all hospitals are public, there's very few private hospitals and they are not very good. So the government can afford to give everyone great healthcare because they are using their own hospitals to do it - they set the rates for operations and hospitals don't have billing departments because they don't need them - even if someone is technically not covered by our national health insurance(say, a non-EU visitor) they are usually treated for free anyway because finding out how to bill them is more hassle than it's worth, unless it's a major operation. If you just need an xray and a cast they will do it and send you home. In US almost all hospitals are privately run, so corporations dictate prices - even if the government wanted to pay for everyone's care it would end up paying a lot more than Europeans are paying, because once again, the money would go straight in corporations pockets. I mean, I'd be more than happy to learn more if I'm wrong about this, but at least this is my impression. |
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This is not at all how medical billing works.
First of all, many hospitals are structured as nonprofits. Whether or not they are, most hospitals are also barely staying afloat - a hospital that's turning 2 1-2% profit these days is doing astoundingly well. Many are going under and getting bought out by larger chains or by insurance companies.
The reason that they are doing so badly financially is because, in general, they are legally forced to lose money on half of their patients. Medicare sets its reimbursement rates unilaterally, and it reimburses about 7% less than COGS. In other words, if a vaccine costs the hospital $100/unit to purchase wholesale in bulk, Medicare pays them $93 for it. That means they've already lost money, even before they have to pay their doctors and nurses and building maintenance, etc.
Providers make up for this by over-billing the private insurers. That's why you see these stories of people who go to the ER and got charged an absurd amount for something. The hospital was presenting them with the same price they charge to private insurers (by law, they have to, at least on the initial bill). They don't actually expect individuals to be able to pay that, and in fact, an uninsured person is almost always able to negotiate that bill down if they know to try.
In short, yes, medical billing is totally fucked up. But it's not fucked up because the money goes to line corporations' coffers - it's fucked up because Medicare abuses the system to effectively pad its own budget instead of going to Congress to increase their budget.
And that's why, ultimately, Medicare will fight tooth and nail to prevent single-payer healthcare or any meaningful reform whatsoever in the US - they're the ones who stand to lose the most from it.