That said, the question “why aren’t people doing this more already?” is not very informative to figure if this is a good idea or not.
As economists joke, the twenty dollar bill on the sidewalk is probably too good to be true, otherwise someone would have picked it up already. In reality, new solutions and arrangements are not easy to discover, or to bootstrap, and they take time to become adopted.
What the post describes sounds a lot like fraternal societies, which were a common model for healthcare a century ago (before most government welfare programs). It’s a kind of insurance cooperative.
Regarding your last question, I am curious too (why would this solution be sustainable and cheaper than alternatives). I think there is a difference between the price that hospital advertise for people without insurance and the price they charge for people who pay cash.
People without insurance and don’t pay basically allow the hospital to collect federal money for “uncompensated care”. The incentive is to inflate those prices (so-called charge master) and collect more subsidies. If I remember correctly, the States benefit from the scam as well (again at the expense of the federal government/taxpayers).
On the other hand, my understanding is that people who pay cash can get much better prices, because the hospital isn’t dealing with a third-party (but instead with someone who is sensitive to spending their own money) and also avoiding bureaucratic messes (medicare/medicaid/insurance paperwork and regulations for covered patients). There are doctors who don’t accept Medicaid and also doctors who are now opting-out of insurance (switching to direct payment only). My impression is that those are cheaper.
I’m deriving some of this understanding from how the founder of the Surgery Center of Oklahoma describes the industry. His firm is operating on direct payment model only and appears to be spurring some price competition. His claims deserve a pinch of salt, but they also seem consistent with what I’m reading from various economists (admittedly more of the free-market kind).
I agree with you that the post seems like an ad.
That said, the question “why aren’t people doing this more already?” is not very informative to figure if this is a good idea or not.
As economists joke, the twenty dollar bill on the sidewalk is probably too good to be true, otherwise someone would have picked it up already. In reality, new solutions and arrangements are not easy to discover, or to bootstrap, and they take time to become adopted.
What the post describes sounds a lot like fraternal societies, which were a common model for healthcare a century ago (before most government welfare programs). It’s a kind of insurance cooperative.
Regarding your last question, I am curious too (why would this solution be sustainable and cheaper than alternatives). I think there is a difference between the price that hospital advertise for people without insurance and the price they charge for people who pay cash.
People without insurance and don’t pay basically allow the hospital to collect federal money for “uncompensated care”. The incentive is to inflate those prices (so-called charge master) and collect more subsidies. If I remember correctly, the States benefit from the scam as well (again at the expense of the federal government/taxpayers).
On the other hand, my understanding is that people who pay cash can get much better prices, because the hospital isn’t dealing with a third-party (but instead with someone who is sensitive to spending their own money) and also avoiding bureaucratic messes (medicare/medicaid/insurance paperwork and regulations for covered patients). There are doctors who don’t accept Medicaid and also doctors who are now opting-out of insurance (switching to direct payment only). My impression is that those are cheaper.
I’m deriving some of this understanding from how the founder of the Surgery Center of Oklahoma describes the industry. His firm is operating on direct payment model only and appears to be spurring some price competition. His claims deserve a pinch of salt, but they also seem consistent with what I’m reading from various economists (admittedly more of the free-market kind).