[lotsofpulp]

A good deal is that doctors and healthcare providers in other countries don’t make well into the $300k+ range. There’s a lot of money to be made in the US versus other countries. Without the insurance companies, who would have the power negotiate pricing with the providers? Americans don’t find government intervention palatable unless the person is over 65.

[ajmurmann]

Recently the head of the Oklahoma Surgical Center was on [econtalk](https://www.econtalk.org/keith-smith-on-free-market-health-c...). That center was founded in the late 90s, had all their prices on their website, no insurance works with them and get their prices are effectively lower our equal to what they were twenty years ago and lower than at a regular hospital. On top of that the doctors make more when they work for this center than anywhere else.

One thing I learned from the episode is that insurance companies get a reward for the delta between their negotiated price and the price a uninsured person would pay. This creates incentive for hospitals to raise their base price tag. Of course their is more to it. I cannot recommend the episode strong enough.

To me the bottom line is that right now we don't have free market health care and we don't have socialized health care we have the worst of both. Maybe what we have is best received as crony capitalism health care.

Taking a look at their website and just seeing the prices for procedures is incredibly refreshing: https://surgerycenterok.com/pricing

[lotsofpulp]

That is very interesting. I had always thought that price obfuscation was good for both healthcare providers and insurance companies, since any price obfuscation is an advantage for the seller while the buyer is left confused about how much they are paying for what.

[bart_spoon]

> Without the insurance companies, who would have the power negotiate pricing with the providers?

Healthcare costs have skyrocketed because of the negotiators. PBMs are the middlemen who negotiate healthcare prices between insurance companies and providers. I can't speak for hospitals and procedures, but in the pharmaceutical industry, it actually has led to a system where insurers and PBMs both benefit from drug prices increasing as opposed to decreasing. They aren't driving costs down, they are directly contributing to driving costs up.

[lotsofpulp]

Negotiation does not cause costs to rise, it’s because of lack of price transparency that let’s insiders play games.

Make all the prices public, and watch all the excuses disappear. No insurance company will be able to answer the government or employer when they find out another insurance company was able to obtain the same medicine or healthcare for a lower price.

[ajmurmann]

I posted a link in a parallel thread to a surgical center that has all their prices on their website. Insurance companies refuse to work with them, supposedly for the reasons you state. So you are correct.