Marshall, you certainly are entitled to your own opinion, but I take issue with your example of comparing the Medicare Advantage reimbursements to the insurance company's reimbursement rate. First, referring to the rate that the insurance carrier reimburses at and implying that this is the rate that "working Americans" pay, is misleading, and incorrect. These are, in fact, the rates that the carrier has negotiated with the hospital. You are not taking into account what these services actually cost the hospitals to provide.
One of the complaints that the hospitals and the doctors have is that the Medicare reimbursement rate for varied procedures is not sufficient to cover their costs. Subsequently,
the providers recover the loss by transferring those losses to the insurance companies hence the higher charge that you referred to as what "working Americans" pay. This transference of loss is what leads to increased premiums for insurance. It is a matter of cause and effect.
Hi Bob - thank you for your comment! I know how the cost shifting works. The providers claim they can’t make it on Medicare rates so they just have to make up for it by overcharging working Americans. That’s what I would call discrimination against working Americans. There is no good reason working Americans should be required to subsidize others. Also, the rates for working Americans are many times higher - not a small amount to make up some supposed shortcomings of Medicare payments. I have sat in the offices of hospital executives and asked them how it is fair to cost-shift in this way. Their answer? It’s not fair. So why should we accept it? And finally - whose money do you think the insurance companies are spending? Insurance companies are spending the money of employers and working people. The insurer is not the payer. The insurer is a middleman, taking a cut. The people funding the premiums are the actual payers. The insurance companies profit more when costs go up, and they simply raise the rates for their members. So that’s another reason for the employers and working Americans to push back against the unreasonable prices being negotiated by insurance companies.
Marshall, you certainly are entitled to your own opinion, but I take issue with your example of comparing the Medicare Advantage reimbursements to the insurance company's reimbursement rate. First, referring to the rate that the insurance carrier reimburses at and implying that this is the rate that "working Americans" pay, is misleading, and incorrect. These are, in fact, the rates that the carrier has negotiated with the hospital. You are not taking into account what these services actually cost the hospitals to provide.
One of the complaints that the hospitals and the doctors have is that the Medicare reimbursement rate for varied procedures is not sufficient to cover their costs. Subsequently,
the providers recover the loss by transferring those losses to the insurance companies hence the higher charge that you referred to as what "working Americans" pay. This transference of loss is what leads to increased premiums for insurance. It is a matter of cause and effect.
Hi Bob - thank you for your comment! I know how the cost shifting works. The providers claim they can’t make it on Medicare rates so they just have to make up for it by overcharging working Americans. That’s what I would call discrimination against working Americans. There is no good reason working Americans should be required to subsidize others. Also, the rates for working Americans are many times higher - not a small amount to make up some supposed shortcomings of Medicare payments. I have sat in the offices of hospital executives and asked them how it is fair to cost-shift in this way. Their answer? It’s not fair. So why should we accept it? And finally - whose money do you think the insurance companies are spending? Insurance companies are spending the money of employers and working people. The insurer is not the payer. The insurer is a middleman, taking a cut. The people funding the premiums are the actual payers. The insurance companies profit more when costs go up, and they simply raise the rates for their members. So that’s another reason for the employers and working Americans to push back against the unreasonable prices being negotiated by insurance companies.