Price transparency. Require medical providers to publish a price list for every service they provide, then let there be Expedia for scheduled medical procedures.
> Don't force insurance companies to take a fixed percentage of revenue as profit so that they are actually incentivized to care about the cost of medicine.
This wouldn't really work. The nature of the insurance market is they predict how much it would cost at what probability and then add a percentage as a risk premium. If you lowered the risk premium in absolute dollars against the same level of risk and cost, nobody would provide insurance. If you lowered the cost of claims for the same absolute dollar amount of risk premium, more companies would provide insurance and the competition would reduce the absolute amount of the risk premium per customer back to the original percentage (which is based on risk-adjusted reward) of the now-smaller cost/risk -- which is what they're trying to prevent.
What you need is for people to be buying less insurance, i.e. insurance covers what it's supposed to -- losses greater than what you can afford -- rather than covering routine low and medium cost procedures and removing anyone's incentive to care about prices when choosing a provider.
> Price transparency. Require medical providers to publish a price list for every service they provide, then let there be Expedia for scheduled medical procedures.
For providers that service insurance companies, its impossible. The insurance decides what to charge.
Price transparency is important for functioning markets, but im unconvinced its a key piece of health service costs. First, it doesnt matter if the doctor charges 100 or 1000, if the insurance covers it. Second, most health-services that matter are insurance-based: its a cost after you got the disease, which changes the decisions you get: if you are on Anthem and get cancer and see cancer treatment is cheaper on Cigna, are you going to change the entire doctor panel that diagnosed you? (Which btw ,is a degrade of medical care).
The only person that could benefit from high provider price transparency is insurance companies, since then they can choose to keep or not keep providers in their network: but they already have full price transparency, they get all the claims.
> For providers that service insurance companies, its impossible. The insurance decides what to charge. First, it doesnt matter if the doctor charges 100 or 1000, if the insurance covers it.
That's a fair point -- so fix that. The insurance company wants to decide how much they'll pay, so let them, and let it be on the low side and then let there be lower cost plans that only pay 80% or 65% of even that cost. Then publish the price list and let the customer choose their provider and pay out of pocket any amount above what the insurance company pays. This deal where the customer pays the same amount no matter which provider they use is poison.
> Second, most health-services that matter are insurance-based: its a cost after you got the disease, which changes the decisions you get: if you are on Anthem and get cancer and see cancer treatment is cheaper on Cigna, are you going to change the entire doctor panel that diagnosed you? (Which btw ,is a degrade of medical care).
Which is another reason why they should stop doing that, and just have a list of services they cover and the amount they pay under your plan. Then you go wherever and get the service and pay the difference between the insurance coverage you bought and the price the provider charges. There should be no such thing as out-of-network. If someone else charges more and you're willing to pay the difference, there you go.
> Price transparency. Require medical providers to publish a price list for every service they provide, then let there be Expedia for scheduled medical procedures.
Good one.
> This wouldn't really work. The nature of the insurance market is they predict how much it would cost at what probability and then add a percentage as a risk premium. If you lowered the risk premium in absolute dollars against the same level of risk and cost, nobody would provide insurance. If you lowered the cost of claims for the same absolute dollar amount of risk premium, more companies would provide insurance and the competition would reduce the absolute amount of the risk premium per customer back to the original percentage (which is based on risk-adjusted reward) of the now-smaller cost/risk -- which is what they're trying to prevent.
Hmmm...that's an interesting point. You might be right. However, it would incentivize them to control costs that are in some way unique to them. In other words, it'd incentivize them to negotiate deals with providers, or incentivize their customers to reduce their spending. Because while it is true that the equilibrium is the same level of profit for them, in the shorter run, each incremental unit of downward price movement they get within their own customer base is valuable to them. But I definitely agree my point here isn't as strong as I thought it was, thanks.
> What you need is for people to be buying less insurance, i.e. insurance covers what it's supposed to -- losses greater than what you can afford -- rather than covering routine low and medium cost procedures and removing anyone's incentive to care about prices when choosing a provider.
Ya, totally agree here too. I was just contemplating the fact that I pursue this exact strategy for my own insurance...when I pay for it out of pocket. My employer provides health insurance, so I choose the platinum-plated super deluxe package, and pay only a bit of the cost myself. For my car insurance, which I pay for on my own...I pay for the financially correct amount of insurance: insurance against ruin. I want to be insured against an unexpected cost that would financially ruin me...and aside from that, i'm happy to eat the costs of random fender benders myself, and rely on my own driving habits to minimize those costs.
> Don't force insurance companies to take a fixed percentage of revenue as profit so that they are actually incentivized to care about the cost of medicine.
This wouldn't really work. The nature of the insurance market is they predict how much it would cost at what probability and then add a percentage as a risk premium. If you lowered the risk premium in absolute dollars against the same level of risk and cost, nobody would provide insurance. If you lowered the cost of claims for the same absolute dollar amount of risk premium, more companies would provide insurance and the competition would reduce the absolute amount of the risk premium per customer back to the original percentage (which is based on risk-adjusted reward) of the now-smaller cost/risk -- which is what they're trying to prevent.
What you need is for people to be buying less insurance, i.e. insurance covers what it's supposed to -- losses greater than what you can afford -- rather than covering routine low and medium cost procedures and removing anyone's incentive to care about prices when choosing a provider.
All your other ones are good.