#senators, if you pass a law forbidding any healthcare healthplan from neotiating network discounts greater than 20%. People will never pay more than 20% of what an insurer pays! Prices will drop dramatically over night!
Why? Health plans contract to pay doctors 40% and hospitals 10% of billed prices. So a day in the hospital is billed at $25,000 per day and the contracted “reimbursement” pays hospitals $2,500! If you are a consumer? You pay the full rate! The effect? You must get insurance.
New models of healthcare? HSAs are great, major medical (catastrophic only coverage) and pre-tax deposits to cover outpatient services. This is much more cost effective. Future Crypto-HSA might be even better!
Today Healthplans and the government have deployed ACOs (accountable care organisations) and imagine these as smaller subcontracted HMOs of older days. The problem, insurers are delegating the risk to ACOs which are micro ecosystems of hospitals, clinics and doctors. This creates higher risks for managing smaller patient populations. Many of these are failing, hospitals going bankrupt.
None of these newer directions of healthcare are curing our $3.2 Trillion health insurance bill. 95% of payments are through insurance claims (e billing) and adjudication, repricing, authorizations, network leasing and fees. 45% of healthcare $$ are wasted!! In addition, fraud accounts for $250 billon (FBI) in losses! We need new identity management systems to AUTHENTICATE patients, doctors, facilities and insurance claims!!!
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