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Private insurance companies have earned the public’s distrust. They routinely put profitability above their policyholders’ well-being. And a system of private health insurance provision also has higher administrative costs than a single-payer system, in which the government is the sole insurer.
But the avarice and inefficiencies of private insurers are not the sole — or even primary — reasons why vital medical services are often unaffordable and inaccessible in the United States. The bigger issue is that America’s health care providers — hospitals, physicians, and drug companies — charge much higher rates than their peers in other wealthy nations.
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Anthem’s policy wasn’t going to leave patients in agony. It was going to cap how much anesthesiologists could bill.
There are already plenty of billing caps in medicine. Medicare has a cap for every single patient in the hospital.
When a patient reaches the cap they aren’t dumped to the curb in agony, that would be an instant malpractice lawsuit. Instead, the hospital works for free. The same thing (in principle) happens when your plumber offers a flat rate for a job but it takes a lot longer than expected.
That’s why a large number of hospital patients actually lose money for the hospital, but the hospital (and presumably these anesthesiologists) make up for it on the other patients. In the end it all averages out.