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by tptacek 41 days ago
Show me the more recent NHE table where this effect shows up and I'll be ready to have the conversation, but right now this seems like a dodge. Whatever effect you're describing, if it's material, has to have started after the NHE data I just posted, from 2023. I don't remember thinking that the health system in 2022 was good.

Fun thing about the NHE: you can project it as far back as you want. The data is there.
1 comments
ceejayoz 41 days ago
> Whatever effect you're describing, if it's material, has to have started after the NHE data I just posted, from 2023.

What? Insurers have been playing this game far further back than 2023.

If an insurer doubles the time a doc has to fight over denials and has to hire extra billing staff to assist, where do you imagine that cost shows up?

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tptacek 41 days ago
I feel like we've been in this argument before, and I like you just fine as a commenter, but do feel like you're tying yourself into knots to avoid a simple conclusion plainly supported by the data. I didn't post a trend story about what companies are doing or who they're acquiring; I posted the macro NHE table from last year. It simply refutes the argument you're trying to make.
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ceejayoz 41 days ago
> I posted the macro NHE table from last year.

Again: how will the “insurers force provider costs up” show up in said tables?

It’s caused by the insurer. It shows as a provider’s cost. But it doesn’t mean said doc is making any more money at the end of the day.

The insurer does, though! Their 20% cut got bigger, and the "computer says no" denials are cheap!

TL;DR: Where in your link does "doc spends needless hours on phone fighting insurer" show up as a cost?

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tptacek 41 days ago
It literally breaks practice and net cost of insurance out!
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ceejayoz 41 days ago
> It literally breaks practice and net cost of insurance out!

But it's not a "Cost of Health Insurance" item. It's an expense at the practicioner level! They have to factor that non-billable time into what they charge for the procedure!

Read their definitions: https://www.cms.gov/files/document/quick-definitions-nationa...

"Administration" is the insurer's side of it.

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tptacek 41 days ago
This is special pleading.
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