What's a company secret you can share now that you no longer work there?

CaspianXI@lemmy.world to Ask Lemmy@lemmy.world – 1253 points –
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The people who negotiate your medical claims make more money on the settlement commissions than the doctors even make from their procedures.

And there’s like 25-40 people total who handle the claims for every single health insurance company.

The US healthcare and insurance industry is such a scam. There are so many people making so much money off denying claims and overcharging for procedures.

Thats what happens when you dont regulate anything, evil people will just try to hurt the good people just for money

Healthcare is one of the heaviest regulated industries in the US. Less regulations would be better-you could go to a store, see a menu board and order an MRI with upfront pricing.

Healthcare is one of the heaviest regulated industries in the US

Okay, now compare to europe.

You want me to compare a country to a continent, which contains several different governments?

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Ah the classic "this wont work, you see bc USA has shown that and free market always wins"

Meanwhile the rest of the world have several different but similar blueprints showing how it works much much better. But americans must always go a different route and ignore as if nothing else exists.

The US system has it's problems, obviously, but it also has the best treatments in the world. People come from all over to get treatment in the US.

Money is a great motivator for "big pharma" to develop treatments.

Hospitals or healthcare insurance is so regulated?

you could go to a store, see a menu board and order an MRI with upfront pricing

Can you explain this? From what I understood, there is no upfront pricing because insurance companies are slow to provide a price. If there is no insurance company involved, then hospitals would be able to tell you the price.

speaking of mri's : https://www.reddit.com/r/explainlikeimfive/comments/196pfb4/eli5_if_an_operational_cost_of_an_mri_scan_is/

articles and discussion about comparison to other countries:

https://old.reddit.com/r/politics/comments/1acp24/why_an_mri_costs_1080_in_america_and_280_in_france/
"If the US Government was serious about lowering the costs of imaging on Medicare, Medicaid, and the health sector in general, they would out right outlaw Physician ownership, investment in imaging centers. It is proven over, over, and over again(http://www.jacr.org/article/S1546-1440(09)00346-9/abstract) that when docs own an imaging center utilization rates go up. However, the AMA is too large of a lobbying force. Instead, of addressing the root of the problem, the Government has taken the tact of lowering pay outs for the scans done. this has done nothing to curb the utilization rates. It has gotten so bad for IDTF centers, that they are closing, and the imaging is being hustled back into Hospitals, where the HOPPS rates are much higher, and usually more extensive(their claims that they treat the poor that don't pay(when in fact it makes up only 1%)."

https://old.reddit.com/r/Economics/comments/18tz4h/why_does_an_mri_that_costs_99_to_160_in_japan/
"..hospitals and radiology clinics bill based on their assumed reimbursement rate. See, they know that the insurance company will only reimburse them for a small percentage of their aggregate billing (10%-50%) depending on the insurance company. So they inflate all their prices in order to maximize the payout."

MRIs are always going to be expensive. Just how it is.

Anything with exotic physics and high precision requirements (MR, CT, PET, Nuclear Medicine) is already expensive just in raw material... There's also shipping costs. All of the engineering, R&D, that goes into it. Safety and regulatory testing.

Actually, most medical devices have razor thin profit margins. All of the money is made back through service contacts. Because adding another million to recoup engineering costs would make an MRI even more inaccessible.

Lot of efforts by the big players to make things cheaper and easier to produce. But MRI for example will require a LOT of helium until we get better superconductors. Anything radiation will always require a lot of lead. Anything nuclear will require specialized isotopes and detectors.

Machines will never be cheap. But the insurance companies and the US healthcare model sure as hell make things worse.

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