Top Hospitals Opt Out of Obamacare

http://health.usnews.com/health-news/hospital-of-tomorrow/articles/2013/10/30/top-hospitals-opt-out-of-obamacare

by wikiburner • 13 years ago

12 27 13 years ago

health.usnews.com

clavalle4• 13 years ago

This is going to precipitate one of two things:

If hospitals get federal money for anything they will be required to accept insurance offered on the exchange that meet some minimum qualification. At least the two that were blessed as the national options.

Or insurance companies will be required to put an offering on the exchange...likely both.

Like the states refusing to expand Medicaid and set up their exchanges, the hospitals are hastening the transition to a single payer healthcare system by refusing to play ball.

ams61102• 13 years ago

Maybe they'll opt out of "single payer" as well.

tunesmith2• 13 years ago

Sometimes I wonder if some genius "systems thinkers" in Washington planned that out as the end game all along. Add in the factor that some states have almost no hospitals, thus the insurance companies have no leverage to lower premiums, which leads to why certain states have very high ACA premiums. Theoretically the free market says that another hospital would pop up to compete on price, but theory ain't practice...

bcoates2• 13 years ago

The insurance companies supported and lobbied for the ACA -- which was the only reason it barely passed -- because they thought they were getting a gigantic payday from the employer mandate. With that gone they're doing their best to either kill the law or perhaps lean on it hard enough to get vastly broader subsidies to make it worth their while.

The 11-dimensional chess idea that passing a law to destroy the individual insurance market is going to bank-shot into single payer would require an absolutely massive outbreak of corporate and public support that really doesn't have any reason to appear.

glenra3• 13 years ago

Theoretically the free market says that another hospital would pop up to compete on price, but theory ain't practice

It is illegal to start a new hospital to compete on price with the existing ones. To open a new hospital, you need permission from the current existing hospitals. If they don't agree that the community you want to do business in is "underserved", you can't get licensed.

And yes, that policy is insane, moronic, a source of monopoly rents and probably one of the many reasons health care costs are so out of control. But it's the law.

https://en.wikipedia.org/wiki/Certificate_of_need

tptacek3• 13 years ago

A few, like No. 1-rated Johns Hopkins in Maryland, are mandated under state law to accept all insurance companies

That sounds like a totally sane statutory requirement. Why don't more states have it? Collusion between hospital chains and insurers is the crux of the health care cost problem in the US.

clavalle4• 13 years ago

If they are required to do business with one another how do they negotiate a price?

tptacek3• 13 years ago

How does it work in Maryland, where this is already the law?

toomuchtodo3• 13 years ago

You set the price based on what is reasonable and customary.

Like Medicare.

McDermot• 13 years ago

Lots of companies that are required to do business with each other (eg. utilities and the rest of the private sector or large retailers and large consumer goods companies) are able to do it, why would a statutory requirement be any different?

ams61102• 13 years ago

Johns Hopkins is a "chain" hospital?

tptacek3• 13 years ago

No, but most hospitals are.

bcoates2• 13 years ago

I'm guessing current laws were written around the "managed care" (HMO/PPO) system, the previous (70s-90s) attempt at healthcare reform.

For that one, the theory was that the payment/administration bureaucracy was the cause of the health care cost problem, and that by having insurance companies buy hospital service in bulk rather than doing individual-service billing the overhead could be reduced and accountability would be increased. This requires insurers to be able to assign customers to hospitals and doctors that work for them for it to work.

coreyh1444• 13 years ago

Note this is "authored" by watchdog.org which is a media outlet for the ultra conservative Koch brothers.

mjn• 13 years ago

I'm sort of confused by how authorship works in the US News & World Report generally, and clicking around a bit on the site doesn't clarify it. Do they have professional staff reporters? Is it just reblogging stuff from elsewhere? Are they buying freelance pieces? Is it like Forbes where there's a "Forbes proper" and an "anybody can blog on Forbes.com here" section (and if so, how do I tell which is which)? I can't really sort out what the intended semantics are for an article published on usnews.com but with a byline of another website.

Seems confusing, but in any case, letting outside lobbying groups run news articles in their pages, not marked as either contributed op-eds or paid messages, is a bit weird.

Top Hospitals Opt Out of Obamacare

Related Stories