[samstave]

But what rate is my insurance "billing" for the total price of the transaction with my insurance?

So - while you may be able to get nearish the same price (before the shipping) <-- But am I consuming less of my insurance and also paying less to insurance companies, which are just hedge funds anyway...

So, if Mark Cuban the Billionaire can start a pharmacy model such as this, not dealing with insurance, then what precludes market competition with his pharmacy?

Franchise license with supply chain to open ones own brick and mortar etc...

Serious questions.

[ipaddr]

Drug companies selling directly?

Brick and Mortor stores selling without dealer discounts?

Or others copying and marking up only 10% or 5%?

I guess nothing but greed stopped this before.

[samstave]

The most F'd up thing about our medical institution in the US, is that while "you must have insurance" is regulated - depending on the size of the Hospital Group - they all can (Could - may have changed since I last built a hospital) negotiate their individual rate with each insurance company based on the size/volume of patients.

This is wrong.

The coding for a given procedure should be standardized and priced as such.

This simple change could do great things for leveling the playing field for the nation of healthcare ;

If regardless of your volume of encounters on a particular code, the price should be set.

This may do several things:

Make rural hospitals/clinics more competitive with a major hospitals.

In my experience though - the big spending in non-medical areas that hospitals have are around "comfort aesthetics" (Art, pretty buildings etc)

Hospitals which cost $400MM -- to $1B facility (2009) spent a LOT on art. They seek donors constantly...

Maybe they should have the rich donors, as a requirement for their contribution, also require they provide a loaner art install.

This way - lets say you donate $1MM to a hospital, 100% of that donation should go to actual clinical build etc.. and the hospital should be precluded from your financial donation from being used to pay a digital arts company from being paid their ~250K fee through your donation...

I've built quite a few big facilities and art is a HUGE aspect in the health aesthetics of an environment ; but the cost is always exorbitant. Personally, having managed the install of such - I think that this should be outside of what the hospital should spend money on - unless the donation is specifically for art/aesthetics...

This lightens the build cost for large hospitals.

Source designer/TPM/etc on:

- El Camino CA (I just got this today: https://i.imgur.com/KFCX4N0.jpg)

- UCSF CA

- NOME AK

- Sequoia CA

- Methodist CA

- Others I cant even recall now...

---

All of these costs get baked into the overall cost of the facility - and guess who pays for that? (not only in monetary costs)

My brother was the head of the VA for AK - commander of 10th medical wing for the USAF and is currently the CMO for the largest hospital group in AK.

Familiar with both sides of the table on price-fixing...

I don't have pharma exp WRT drug costs... just sunk costs in the facilities I build - but I get info from my brother on certain things...

but pharma prices need to be heavily reg'd