The federal government estimates we’ll be spending more than $6 trillion annually by 2028. As of 2019, the total had more than doubled to $3.8 trillion. healthcare spending totaled $74.1 billion in 1970.īy 2000, healthcare expenditures reached about $1.4 trillion. According to the Kaiser Family Foundation, U.S. This is an inefficient and arguably ineffective way of reducing healthcare costs. In fact, America is one of the few countries that allows medical providers to charge as much as they can get away with, and to rely on private insurers to haggle individually with each provider. Whenever patients and their advocates have called for healthcare price caps in the past, the various corporate players - doctors, hospitals, drugmakers, insurers - clutched their pearls and swooned over the prospect of “socialized medicine.” It’s asking lawmakers to impose a “market-based pricing benchmark for tests.” Such systems place the onus on doctors and hospitals to provide superior service at the best possible price if they want to win people’s business, rather than allowing for-profit insurance companies to dictate terms that best serve their own interests.Īnd let’s not overlook how the insurance industry has responded to this coronavirus-testing loophole. Most other developed countries rely instead on single-payer insurance systems that negotiate uniform rates with all providers, thus allowing patients to be treated anywhere they please, at the same cost. While such networks can play a role in keeping healthcare costs down, they’re not the only way. Such networks are nothing more than sweetheart deals intended to save insurers a fat stack of cash in return for steering policyholders to specific medical providers. It called on Congress to “eliminate the ability for price gouging to occur by setting a reasonable market-based pricing benchmark for tests delivered out of network.”Īnother, as I’ve been advocating throughout the pandemic, is to do away with coverage networks. Fred Turner, Curative’s 25-year-old founder, thinks otherwise. But can its results be trusted?Ĭurative’s mouth swabs should be administered only under strict protocols, federal regulators caution. In some cases, the insurance group said, out-of-network labs are charging almost $400 to process each test.īusiness COVID-19 turned a tiny start-up into a testing giant. (The actual reimbursement rate for insurers is probably much lower.) In a recent report titled “Price Gouging in a Public Health Crisis,” America’s Health Insurance Plans, an industry group, said that “health insurance providers proactively eliminated patient cost-sharing for COVID-19 diagnostic testing and treatment.”īut it said a growing number of medical providers are relying on labs outside the coverage networks of leading insurers, and that many of these facilities are charging more than the average in-network $130 cost of processing a coronavirus test. The insurance industry has known about this loophole for months - and insists these charges aren’t insurers’ fault either. “You would need to connect with the patient’s insurance carrier to determine why they have opted not to cover the lab fees,” said Joseph Goode, a spokesperson for the pharmacy chain. The insurer covered the bulk of the cost and then passed along $47.50 of the charge to the patient.ĬVS Health says such fees aren’t its fault or the fault of labs it uses.
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