Hacker News Reader

Comment by helloguillecl | Hacker News Reader

The United States leads the way in treatments and medical tech, but this gives me the impression that the US society is not benefiting as it could from that.

View on HN

As someone who used to work for a company trying to get insurance to pay for medical technology, the US was typically the easiest and fastest country to get coverage in for both private and public insurance.

This seems poignant. The cost/benefit analysis does not seem to be aligned with the market. I suspect it’s driven purely by lack of qualified practitioners.

It's not. Physician reimbursement has been going down year over year since the late 90s. Each unit of physician work (relative value units, RVUs) is worth 50% of what it was in 1998 for Medicare at least, and most insurers peg their reimbursement at a specific multiple of the Medicare rate. Sorry, the insurance companies, PBMs, and hospital administration is to blame for the high cost of care, not the physicians who don't control how much they are reimbursed for each office visit or procedure.

Medicare and Medicaid are at best 50% of reimbursable amounts in most sub industries.

Also, while $/CPT code can go down, you can see more patients/day or alter your staffing ratios and other operating metrics to more than compensate.

Healthcare has some of the most "woo woo" hand wave-ey financial metrics around. Do a private equity quality asseatment on quality of earnings on "gross earnings" in most health care settings. Other than the Enron consolidations there can't be a more bullshit financial metric (heck entire area) under US GAAP than gross earnings. With that level of obfuscation (purposefull or not) it's no wonder you have almost full opacity into the cost chain.

If that’s true then why have physicians wages continued to increase for most specialties? Some have stagnated, but I wouldn’t say physicians are underpaid.

Reply on news.ycombinator.com