| "The money is still going into the pockets of practitioners." And by inflating that amount... > Using newly available federal price transparency data, the researchers found that UnitedHealthcare pays Optum physician practices about 17% more than non-Optum practices in the same region. In markets where UnitedHealthcare holds a large share of the insurance business, that difference was even larger, up to 61%. their capped-by-law 20% cut of premiums goes up, too. "Oh, those mean old providers we own charge so much! We have to raise premiums again!" |
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| ▲ | ceejayoz 2 hours ago | parent [-] | | > Whatever effect you're describing, if it's material, has to have started after the NHE data I just posted, from 2023. What? Insurers have been playing this game far further back than 2023. If an insurer doubles the time a doc has to fight over denials and has to hire extra billing staff to assist, where do you imagine that cost shows up? | | |
| ▲ | tptacek 2 hours ago | parent [-] | | I feel like we've been in this argument before, and I like you just fine as a commenter, but do feel like you're tying yourself into knots to avoid a simple conclusion plainly supported by the data. I didn't post a trend story about what companies are doing or who they're acquiring; I posted the macro NHE table from last year. It simply refutes the argument you're trying to make. | | |
| ▲ | ceejayoz 2 hours ago | parent [-] | | > I posted the macro NHE table from last year. Again: how will the “insurers force provider costs up” show up in said tables? It’s caused by the insurer. It shows as a provider’s cost. But it doesn’t mean said doc is making any more money at the end of the day. The insurer does, though! Their 20% cut got bigger, and the "computer says no" denials are cheap! TL;DR: Where in your link does "doc spends needless hours on phone fighting insurer" show up as a cost? | | |
| ▲ | tptacek an hour ago | parent [-] | | It literally breaks practice and net cost of insurance out! | | |
| ▲ | ceejayoz an hour ago | parent [-] | | > It literally breaks practice and net cost of insurance out! But it's not a "Cost of Health Insurance" item. It's an expense at the practicioner level! They have to factor that non-billable time into what they charge for the procedure! Read their definitions: https://www.cms.gov/files/document/quick-definitions-nationa... "Administration" is the insurer's side of it. | | |
| ▲ | tptacek an hour ago | parent [-] | | This is special pleading. | | |
| ▲ | ceejayoz an hour ago | parent [-] | | Oh, now who's dodging? If an insurer manages to double a doctor's administrative costs for billing/appeals/etc., where does it show up in your tables, per your link's PDF of definitions? | | |
| ▲ | tptacek an hour ago | parent [-] | | You have no evidence for this argument. It's just vibes. The numbers here are stark. It's not like it's close, between providers and insurers. Insurers are almost literally a rounding error. | | |
| ▲ | ceejayoz an hour ago | parent [-] | | You asserted "the macro NHE table from last year… simply refutes the argument you're trying to make", but that claim is false. You are welcome to answer the question about where "doc spends two hours on phone arguing with UHC" falls in the expenditure list; it's not insurance, but it's caused by it. > Insurers are almost literally a rounding error. Again, the argument is that the raw cost of health insurance does not reflect its externalities imposed on the other items in your list; that insurers drive up hospital and practice costs, as they have to staff up enormous amounts of staff and expensive physician time to deal with the insurer. | | |
| ▲ | tptacek an hour ago | parent [-] | | $360B in admin/net cost of insurance. $2.5T in practitioner costs. | | |
| ▲ | ceejayoz an hour ago | parent [-] | | > $2.5T in practitioner costs. Some of which is those practicioners' admin cost from dealing with the insurers. (And, you know, doing the actual work.) Denials are nice and cheap. Fighting them is not. | | |
| ▲ | tptacek 4 minutes ago | parent [-] | | You stated this claim upthread, for the record, and tracked down an actual Canada vs. US statistic on this, which turned out to account for roughly 3.6% of total provider inpatient/outpatient expense. |
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