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When I was working in healthcare, I found out that hospital groups negotiate their own Code prices with each carrier individually.

So one group will have one rate with Blue Shield vs what another hospital will have.

Its absolute bullshit.

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If youre mandated to have insurance - then procedures should be regulated to a set cost regardless of who performs the procedure.




Another thing is Medicaid pays below the cost of care so that is balanced by the private insurers payments. This is why you see many county and rural hospitals struggling because the private hospitals have taken the cream of the crop private insurers. First step is the make sure hospitals are not drowning in covering for costs of Medicaid and uninsured patient care.

This Frontline documentary talks about this issue.

https://www.youtube.com/watch?v=UVvEkeH4O8o


Alternative spin: Medicare/Medicaid are the only insurance that is any good at keeping prices under control. Everyone else in the medical industry is in the city, bilking people who have money. Expanding medicare/medicaid will help us slowly bring costs down, more in line (PPP-adjusted) with the rest of the developed world.




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