Julien Posted March 1, 2013 Posted March 1, 2013 Hi, I am trying to reconcile some observation of Brill's essay (1, 2) with the data and analysis in Stefan podcasts on healthcare (4) and Dr Doug McGuff's excellent presentation on the effects of piled up interventions (3). Most observations are consistent (cost shifting, small practices closing, crowded ER), but some stick out: A) Brill notes a number of hospital making nice profits. Stefan and McGuff show that Medicare prices and various regulations make it hard for hospitals to survive financially. B) Brill observes that some hospitals advertise to attract Medicare patients. But Stefan and McGuff note that such patients are a financial loss center (price controls), C) Brill points out that not only uninsured patients pay close to the crazy official price (recorded in chargemaster), but many insurances do too nowadays (those without enough leverage to negotiate rates closer to low Medicare prices). Stefan on the other hand claimed that hospitals charge the Medicare rate to insurances. Any clues how to reconcile both analyses and facts? Regards, Julien Couvreur [1] http://healthland.time.com/2013/02/20/bitter-pill-why-medical-bills-are-killing-us/ (very long essay for the Time by Steven Brill) [2] http://www.npr.org/blogs/money/2013/02/26/172996963/episode-439-the-mysterious-power-of-a-hospital-bill (Steven Brill interview) [3] (Doug McGuff presentation)[4] FDR 2166, True News 46 and 47
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