[random023987]

> Awkwardly, it's the other way around. Providers and private insurers would actually love a transparent pricing system.

Incorrect. back room deals and discounts is how providers and insurers jockey for advantage.

> The entity that benefits the most from the lack of transparency is Medicare,

Again, incorrect. Medicare ENFORCES a transparent pricing scheme, see https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Paymen... for details.

Unfortunately for most of us, we can't simply pay the medicare rates out of pocket, because... f-you, pay more.

[chimeracoder]

> Unfortunately for most of us, we can't simply pay the medicare rates out of pocket, because... f-you, pay more.

We can't pay Medicare rates because Medicare rates are not high enough to be self-sufficient in the absence of other payers[0].

If everyone could pay Medicare rates, every hospital and practice across the country would close up shop immediately, because they'd be operating at an actual loss.

[0] http://classic.ncmedicaljournal.com/wp-content/uploads/NCMJ/...

[random023987]

> We can't pay Medicare rates because Medicare rates are not high enough to be self-sufficient in the absence of other payers

This is incorrect, and you're going to need a better citation than industry self reporting on how they simply want more money.

Assuming medicare prices are fixed, and assuming that insurance companies negotiate deals on par with medicare, and assuming that most uninsured people don't pay their bills... where are these magic "other payers" that are keeping hospitals open?

In fact the opposite is true. If hospitals could get 100% of their patients to pay their bills at medicare rates, they would save money on defaults, billing overhead, and the people who spend hours on the phone fighting with insurance companies.

This is why so many health care professionals advocate for single-payer; having 100% of bills paid according to a fixed price list means greater efficiency and less waste. (and I mean individuals, as an industry the corporations involved prefer the status quo, as it entrenches insurance companies,creates barriers to entry, and drives consolidation)

== EDIT ==

Just to clarify. I'm talking about a situation where 100% of all services provided by a hospital are covered at medicare rates. If 50% are covered by medicare, and 50% are written off, obviously hospitals would have a problem. But medicare is currently reimbursing at break-even rates, kill the collections and billing and insurance departments, and hospitals make a profit at medicare rates.

[chimeracoder]

> and assuming that insurance companies negotiate deals on par with medicare

They can't. By law, they can't reimburse less than Medicare does. In reality, they end up pegging their reimbursement rates to multiples of what Medicare pays.

> In fact the opposite is true. If hospitals could get 100% of their patients to pay their bills at medicare rates, they would save money on defaults, billing overhead, and the people who spend hours on the phone fighting with insurance companies.

No, and there are multiple links downthread that disprove that claim.

> But medicare is currently reimbursing at break-even rates,

Medicare does not reimburse at break-even rates, or anything close to that.