Hospital monopolies get the headlines – but new research shows health insurance markets are highly concentrated in every state, giving insurers more pricing power than most policymakers realize.
A community's awareness of what it's anchor institutions do is one thing. How those institutions are financed is a mystery for most. Too many people remain uneducated about why hospitals are more than just care centers, and need to be part of every civic plan, just like schools, transportation, and infrastructure. That major insurance companies continue to broker fees that ultimately do little for health outcomes and everything for shareholder quarterly profits is shameful.
"Competition among insurers and hospitals matters ...".
This is a political POV designed to support legislation aimed at "breaking up big medicine" - now including big insurers - because why not?
Breaking up quasi monopolies may succeed tactically - but the idea that this will automagically result in huge price cuts is both theoretical and delusional - and the framing this creates is both hostile and combative over money.
This is not the patient-centered framing we need because patients don't need a war between payers and providers - or legislators and healthcare never was (nor can it ever be) a true "consumer market."
* We never know when we'll need expensive healthcare
* We never know how much big expensive healthcare we'll need
* We often arrive to expensive healthcare on a gurney - unconscious
* Genetics (i.e. luck) plays a huge role in our need for expensive healthcare
* There's no 'demand elasticity' for life/living
* The stakes are high (as in possible death or lifelong impairment)
* We don't want tiered healthcare by "budget" and "luxury."
* We all want the best available - for ourselves (and our loved ones)
FWIW: The corollary to competition is cooperation.
Don Berwick, MD (IHI Keynote - December 2017):
“This talk is a heresy – and I’m going to start with the punchline. The punchline is that competition is not the answer – it is the problem. We are in trouble. Healthcare is not meeting the social need. We are not accomplishing the triple aim – and we will not do that as long as we bet on competition as the remedy. Competition is not the answer. Cooperation is the answer.”
Ironically, this strengthens the arguments for universal/ M4A/single payor systems. It recognizes that consolidation and integration into a single system gains efficiency and lowers costs. When done privately, those savings equal profits going into owners’ pockets. It also creates monopoly pricing power that further increases profits. However, if done publicly the profits stay in the system to reduce prices or increase quality.
A community's awareness of what it's anchor institutions do is one thing. How those institutions are financed is a mystery for most. Too many people remain uneducated about why hospitals are more than just care centers, and need to be part of every civic plan, just like schools, transportation, and infrastructure. That major insurance companies continue to broker fees that ultimately do little for health outcomes and everything for shareholder quarterly profits is shameful.
"Competition among insurers and hospitals matters ...".
This is a political POV designed to support legislation aimed at "breaking up big medicine" - now including big insurers - because why not?
Breaking up quasi monopolies may succeed tactically - but the idea that this will automagically result in huge price cuts is both theoretical and delusional - and the framing this creates is both hostile and combative over money.
This is not the patient-centered framing we need because patients don't need a war between payers and providers - or legislators and healthcare never was (nor can it ever be) a true "consumer market."
* We never know when we'll need expensive healthcare
* We never know how much big expensive healthcare we'll need
* We often arrive to expensive healthcare on a gurney - unconscious
* Genetics (i.e. luck) plays a huge role in our need for expensive healthcare
* There's no 'demand elasticity' for life/living
* The stakes are high (as in possible death or lifelong impairment)
* We don't want tiered healthcare by "budget" and "luxury."
* We all want the best available - for ourselves (and our loved ones)
FWIW: The corollary to competition is cooperation.
Don Berwick, MD (IHI Keynote - December 2017):
“This talk is a heresy – and I’m going to start with the punchline. The punchline is that competition is not the answer – it is the problem. We are in trouble. Healthcare is not meeting the social need. We are not accomplishing the triple aim – and we will not do that as long as we bet on competition as the remedy. Competition is not the answer. Cooperation is the answer.”
Ironically, this strengthens the arguments for universal/ M4A/single payor systems. It recognizes that consolidation and integration into a single system gains efficiency and lowers costs. When done privately, those savings equal profits going into owners’ pockets. It also creates monopoly pricing power that further increases profits. However, if done publicly the profits stay in the system to reduce prices or increase quality.
Only support services from one contractor with care close to wherever you need it…..***Traditional Medicare For ALL***
Who should be paying attention and why aren't they?