{ "media_type": "text", "post_content": "Why is US healthcare so expensive?", "post_id": "6167838fef278400359b8d02", "reply_count": 35, "vote_count": 3, "bowl_id": "552d1d24dc1c586b09d2d051", "bowl_name": "Consulting" }

Why is US healthcare so expensive?

like
Posting as :
works at
You are currently posting as works at
Highlighted IconHIGHLIGHTED

Love it when people use other countries in comparison and they're a fraction of the size. I'm not saying that healthcare is perfect, it's actually downright absurd, but still. Before my wife's insurance approved a particular prescription I paid out of pocket for a 3 month supply for $157. Shortly after that my wife's insurance approved it and I started filling it once a month after my 3 month supply ran out. They process a claim once a month for $380 for something I paid $53 (157/3). It's a joke really.

I haven't because I don't have a co-pay. My wife's insurance is fully funded by her employer. I didn't even use a coupon when I paid out of pocket. I still don't understand why insurance pays 10x what I paid the exact same CVS.

You should try working on a Healthcare Revenue Cycle project - it was illuminating to me. Almost every healthcare patient is subsidized by a very small group of payers. Folks earning less than $50K get entirely free healthcare if they apply for charity care. Medicaid/Medicare/VA generally pay less than what it takes the hospital to deliver services, but contractually only pay 15-30% of list price. Commercial insurances usually pay 60-70% of list price. Self-pay patients usually only end up paying 30-40% of list price if they can show they’re middle income / fight with the hospital enough. Almost every contract is structured around X% of list price. Insurance in the US works for most people. Around 1/3 of folks have Medicare/Medicaid (which represents what single payer looks like), and 50% are covered by employer insurance. There are many folks with a platinum healthcare plan from their employer that do significantly better than from a single payer plan.

like

Platinum is essentially folks with amazing health insurance plans. My friend’s tech company for example has 100% employer paid for premiums for both him and his family. $0 deductible, 10% copay and the max he’ll have to pay out of pocket is $1000 a year in network, $3000 out of network. Single Payer is essentially saying we know almost no one pays list price for healthcare so let’s just stop the charade and charge what the hospital actually wants to get paid. If a hospital needs $1000 per ER stay per night per patient, we can just have 1 health insurance that will actually pay that. Instead of having some folks pay $500, others pay $1000, some pay $10K and others pay $15K to get the hospital a blended average of $1K. Everyone gets off their current health plan and there’s one single health plan for everyone.

likehelpful
Recent IconRecent

Because they hire and pay people like me to fix their problems and then turn around and reverse course after I roll off.

likefunnysmart

Damn.. Superman over here

Funding the world’s R&D

like

So middlemen like insurance and PBMs can skim their cut

like

And hospital administrators! And doctors!

Because we subsidize healthcare to poorer countries and low income individuals, and many of our healthcare companies are for-profit entities.

like

Well this is wrong but go ahead believing this

like

No price transparency, the AMAs lobbying efforts, and artificially limiting the supply of MDs graduating/obtaining residencies; to name a few.

like

Unhealthy population, no central govt body that force the prices down, pharma companies making their margin here, a focus on treatment rather than prevention, hugely tainted food sources, artificial low doctor population,etc

like

Because there's no universal healthcare

funnyuplifting

Can’t have it all…

Post Photo
like

Three main reasons: -No single entity that can set a price schedule for drugs and procedures -Bloated admin costs from our multi-payer system -Unhealthy population + high incidence of chronic disease

like

Because our loose justice system allows people to sue for basically nothing

like

I don't know, but between PwC and myself we pay over $20k in premiums for my family to then pony up $7.5k before insurance covers anything. I pay for scripts with GoodRX coupons. It's a friggin joke. I'm about to just go self payer for everything and just keep the insurance for legit emergencies like cancer.

like

Yeah insurance is getting worse every year

Uhh probably a mix in reality: - No one likes to admit this as an answer, but health care providers are paid a lot more here than in many other countries - Prescription drugs are much more expensive due to lack of a single payer (you can go down a rabbit hole of discussing if this is a de facto subsidy for the rest of the world) - Idk litigation and bureaucracy for a very complex system?

smart

Health insurance model (versus government funded healthcare) plus lack of price transparency. Germany and France do it very well. The Dutch and Swiss are awful models. Canada is eh. The UK is better than the US but still eh. Look around the world. It would be better if we got rid of Medicare and left it up to the states. As a California resident I would love to get rid of health insurance through Deloitte and have MediCal through the state instead. It won’t work in the current model because California subsidizes Medicare and the Feds won’t let us opt out of the program.

As a German citizen, I never understood why Americans are like „we love our free country“ and then turn around and complain about student loans and medical bills. We don’t have either and let me tell you, still a free country 🤷‍♀️ even free from student debt and medical debt

USA 🇺🇸 FTW!

Because they can

Because it’s privatized, which means any healthcare company can set their own prices for services (to an extent)

Because it’s half free market and half regulated. That being said, the US does have the highest survival rate for complicated surgeries, develop most of the new and effective drugs, etc. But we need to work on affordability for sure

Because you get any care that you want as soon as you want if you spend $$$

Related Posts

Anyone know good companies in the area for healthcare consultant in a non travel role?

like
likeuplifting

I've heard that fasting one day a week is a form of intermittent fasting. Does anyone follow that and any benefits? Thanks

like

Sources or references available on operating model/business processes specific to health plans (for example: sales and marketing, provider management)?

like

Temp rate- Is $25/hr an interesting rate for a high volume temp remote recruiter? Company would like experience in recruiting Behavioral Health? Or is it too low?

like

NYC UI: I applied 3/9 and claimed weekly benefits every week while pending. My claim was approved 5/13 (with a crazy low of $182/wk). The NY Labor system now says I haven’t claimed my weekly benefits since I applied. Beyond frustrating.

like

So if I took out a loan against my 401k can someone tell me the penalty percentage I will get hit with if I get a new job before I finish paying the loan back? TIA 😉

like

Anyone have any advice on the ways I can provide my life insurance beneficiaries the information that they will need in the event something happens to me? Should I print out a document with all of the policy details including my personal info and distribute it to all my beneficiaries (5 total)?

like

Anyone start a consultancy on their own? How was it? Looking at my rate, partner pension definitely soaks up all the winnings (not complaining, we are paid well), but I’d like to be the captain of my own ship and take more of the earnings.

like

Posting for a friend — “Hi everyone, I’m a recent grad of Gettysburg college with experience in federal healthcare policy and major interests in healthcare business operations and management. I am looking to connect with employees at Cigna, Mitre, Attain, and Prosidian Consulting. Any advice is much appreciated!”

like

Has anyone else here experienced significant weight gain due to the medication they are on? Could be medical or mental health-related. If so, does eating well and exercise still help reduce it?

like

Can someone share with me the benefits associated with MBA sponsorship at Bain? What does the firm cover? Do they cover tuition as well as room & board? What is the expectation for returning to Bain?

like

Looking to hire a full-time junior designer in Chicago. Multinational agency, cool clients, all the benefits and unlimited PTO. Message me with q’s and for more info.

Nearing 4 yrs of work in US and 7 years overall - single F only have 70k in savings and 16k in 401k ; no other investments - feeling scared that I am not saving enough

like

Is a 401k still worth it without any employer match? I'm guessing it'd have to do with your expected salary at retirement but I'm interested to hear others' thoughts

like

Health Insurance? What are your premiums , deductibles and max out of pockets for a family plan w kids ?

like

Will start at Deloitte within a month within GPS Advisory. Trying to get into a Analytics/Product/PM project within Health sector (FDA, HHS, state or local). Open to USDA, Commerce, USPTO, etc. Not too keen on DOD or anything similar. I have experience in SQL, Tableau, and Python and coming in as SC. Anyone got a project I can join or tips/strategies to navigate into a the clients I mentioned earlier. Private message me if you have an available project!

like

How long you need to be with EY before being eligible for paternity leave?

like

I think women (or primary care taker) should get more parental leave benefits than men

likefunny

I’m 26 and have ~40k sitting in my savings account. Annual income 140k. Maxing out 401k. No debt. Planning to invest 25k but don’t know where to start. Should I get a wealth manager? What is the best way to approach this?

like

Additional Posts

My current CTC is 25 L , bellow is the package I got of 37L , they have calculated hr on bench pay , does any one has any clear idea about project pay , is this good idea to join epam anywhere , I heard that epam systems also provide remote work , let me know all of your thoughts

Post Photo

For the CFE, did you do anything in addition to the ACFE prep course? The course is just practice questions, so I’m wondering where I can actually learn the information first before that.

Currently work at AWS in Business Intelligence and am looking to transfer into Product Management. Looking at MBB eventually. In my experience, most people from MBB have FAANG as their exit op. Why?

like

What’s the vibe of AML groups at the big 4 right now? Hiring?

like

Who else is sick of anamorphic lenses for online videos? We aren't at the theatre - Now my video is half the size of a youtube square.

like

When you think about an agency being a good or bad place to work, does it depend on the client you’re working on, or the culture of the agency itself?

like

Does anyone own a business and they’re applying to b school? Trying to figure out if the small business exclusion applies if you’re filling out FAFSA for grad school and listing as an independent. The language on the federal student aid website isn’t exactly clear.

like

ECD, during a covid briefing, verbalizes profound dismay with how people are receiving covid ads. Cannot understand why people do not like separated arches and soda billboards. "They're great."

Post Photo
likefunny

If you are happy in NYC and your parents and sibling are in the same city so you can see them a few times a month. How much does a new job in San Francisco needs to pay you for you to move?

like

CA attorneys: I have a client who got a court order that the kids are supposed to visit with him (kids are in another state) and now it appears that the kids may not follow the order, client already paid for their flights. Any suggestions on what to do? Ex parte? File the order in the other state to enforce the order? Hold the other parent in contempt? Thanks!

like

Frigging Chicago.. hate flying to ORD.. 'weather' in summer, snow in winters.. and then a taxi to the end of the world! Yes I am venting #fridaytravel #whyaminotatabeachdrinking

like

Help! What's the best online CFP course?

like

Does it matter what headphones you use on a zoom interview in terms of looks for prestigious companies MBB, Big 4 and others? I’ve been told that that my Sony noise cancelling headphones don’t look good and I should invest in AirPods.

like

How do I get travel medical insurance for travel to Europe? As in what’s the best option?

like

Wanted to know your thoughts about the KPMG Deal Advisory and Strategy team. How is the strategy work and are there good exit opportunities into Corporate Strat or MBB and does it look good for an MBA? Thanks

likehelpful

For those of you who make less than 200k per year but have 1M+ in savings/investments, how long did it take? Currently at 250k at 24 but I don’t see my salary breaking 200+ ever, and without a bull market giving me 80% returns it looks like it’ll take me till 40

funnylike

Tested positive for COVID two weeks ago. Last dose Moderna in April. How long should I wait until getting a booster?

like

What are the best things about working at Bain? Especially interesting in if their mba sponsorship is good

like

Heard there’s a bro culture and long hours. They’re hiring but concerned Momentum won’t be a fit for a working mom creative. Who has insight into the vibe there?

like

New to Fishbowl?

Download the Fishbowl app to
unlock all discussions on Fishbowl.
Download Fishbowl to see what others are saying
That was just a preview…
Sign Up to see all discussions
  • Discover what it’s like to work at companies from real professionals
  • Get candid advice from people in your field in a safe space
  • Chat and network with other professionals in your field
Sign up in seconds to unlock all discussions on Fishbowl.

Already a user?
Login here

Share

Embed this post

Copy and paste embed code on your site

Preview

Download the Fishbowl app

Get realtime notifications and see
what's happening in your industry
from the palm of your hand.

For account settings, visit Fishbowl on Desktop Browser or

General

Legal