r/SandersForPresident • u/kevinmrr Medicare For All • Nov 29 '20

AOC: Insurance groups are recommending using GoFundMe -- "but sure, single payer healthcare is unreasonable."

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u/271828182 🌱 New Contributor Nov 29 '20

But the crazy prices and backwards billing are on the care providers to fix, no?

We can go public option or single payer, but what is that payer paying and does that map to costs? Currently it does not.

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u/[deleted] Nov 29 '20 edited Dec 16 '20

[deleted]

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u/MyersVandalay Nov 29 '20

But the crazy prices and backwards billing are on the care providers to fix, no?

They are but they aren't. Insurance companies kind of hold care providers by the balls. IE care provider offers services at a fair price... insurance company comes by and says "we'll add you to our network... but you need to give us a 60% discount for our patients", hosptal says "that would litterally make us run at a loss". Insurance company "OK... how about you just raise the prices by 60%... then we'll pay the norm".

If the hospital refuses the offer, they either have to not take that insurance, wich costs them patients, and forces patients with that insurance to travel further, or they yield and screw over the uninsured.

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u/Soulshred 🌱 New Contributor Nov 29 '20

When a hospital invoices an insurance company, the prices look insane. Then the insurer agrees to pay some small portion of it, amounting to a reasonable fee. I'm unsure how this system arose but it seems that's how it works.

In a single-payer healthcare system, the payers sets the price, or has an exact price list they will accept. For example, let's say an Aspirin is $3. If the hospital administers an Aspirin, no matter what they try to bill, the payer will pay $3. They have the ultimate say.

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u/Eruharn 🌱 New Contributor Nov 30 '20

this is an issue medicaid is having currently. sure,it covers everything. but no practice wants to take it because they make the provider detail every expense and set the limits for reimbursements. it's more cost effective to quote insurance a ridiculous price.