@packyM I didn’t realize this, but now that you say it I do believe this is a dominant strategy. I wonder why England hasn’t adopted this strategy. @AlexiLalas thoughts?
Long trend that will only continue to get worse.
It should be expected when every entity in the value chain makes more money as healthcare spend increases and not one individual has fiduciary responsibility to the patient.
A confluence of factors make it possible to address now and it is taking a lot of work!
https://t.co/5zBpulzNpQ
@DrDiGiorgio It really don’t think the answer is to increase funding…. $5t is not enough, but $6t will be sufficient!
They are trying to fill a leaky bucket as opposed to plugging the holes.
An expected behavior with Credence Goods - hard / impossible to determine quality before, and often after, purchase.
What makes healthcare unique, is that often you can’t determine the price as well (units - often unknowable, $/unit - often inaccessible).
Vertical integration only exacerbates these problems. Makes the invisible hand malfunction.
Fun fact: Atul Gawande did a New Yorker deep dive in 2012 on how big health-care systems are just abysmally run when compared to the juggernaut of efficiency that is Cheesecake Factory.
Really worth a read if you haven't read it before.
https://t.co/un0wIamZLQ
@chrissyfarr ~$5t in healthcare costs, as that number increases so does earnings of providers, payers, and pharma. Patients are the only ones that want/need lower costs.
@andrewarruda Like earlier waves of tech, we need to get the incentives right. To unlock a patient to agent future, the customer needs to be the patient.
“It makes you feel powerless as a consumer.”
HDHPs do not protect Americans from financial catastrophe. 88% of people with medical debt have it from bills <$10k.
Americans are more actively taking control of their health, but the financial support system is failing them.
https://t.co/pHfzKHE1sJ
@CBSNews Crazy thing is the $550 premium plan likely had a really high deductible and MOOP, effectively not covering them, just prepaying for preventative care through an inefficient mechanism.
It’s either a chance of a catastrophic event / debt or guaranteed financial hardship via outrageous premiums.
We need to make the affordable options available. They exist, but horribly distributed, explained, and supported.
After congressional Republicans let expanded subsidies for Affordable Care Act plans expire at the end of last year, some families have decided the price is too great of a financial burden and canceled their coverage. https://t.co/a23TWTttoS
The one subject every one of my favorite podcasts avoids is healthcare.
Sure, they talk about vaccines. They talk about peptides, longevity, and the latest medical device. Cool, bro. A new robot.
I do not care.
I care about the $30,000 disappearing every year before an American family receives a dollar of actual care.
I care about Medicare, insurers, and health systems extracting money from patients, employers, taxpayers, and physicians.
And increasingly, those are not separate institutions.
The insurer owns the physicians.
The health system owns the health plan.
The pharmacy benefit manager owns the pharmacy.
Everyone owns everyone, and the patient owns the bill.
Law makers talk about breaking up the insurance companies while protecting Certifiacte of Need laws in their own backyards and protecting their precious "non-profits".
And I would not care how large these organizations became if they won in an open market.
They did not.
They used government to restrict competition, protect reimbursement, block new entrants, and write rules that favor incumbents.
Then they spent nearly a billion dollars hiring lobbyists to keep it that way.
The lobbyists take their cut.
The lawmakers take the money.
The public elects the lawmakers.
And then people wonder why healthcare keeps getting more expensive.
Healthcare is not ignored because it is boring.
It is ignored because nearly everyone with a microphone is more comfortable discussing the symptoms than naming the people getting rich from the disease.
-Rojas out
Why did Obamacare fraud & improper and phantom enrollement explode?
Because everyone involved benefited.
Enrollee - free coverage.
Broker - commission.
Insurer - a taxpayer-funded subsidy to cover the entire premium.
The result? More than 25% of enrollees are improper. 1/5