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How do you know (and why do you assume) goofnoff's doc is getting fee-for-service reimbursement rather than a case rate? In lots of metropolitan areas Blue Cross and other insurers are paying case rates - approx $300 whether you're in for one night or 100.Because goofnoff said so - he noted in his original post that his doctor waived the fee that he normally would have collected for the extra day, and had to go to the hospital to ask them to waive their fee for the extra day.One side is entirely levered to not being negligent and doing what's right for the patient, and the other side is levered to profitability for shareholders. It's an uneven playing field if there ever was one.Exactly - and you need both sides if you're going to have any kind of balancing between service and cost. Medical insurance is not some magical "all-you-can-eat health care" device - you (the enrollees collectively) have to pay for those services in the form of premiums. That means that I (like all insureds) have two competing interests - I want my consumption of health care to be unfettered, but since I have to pay for it I also want to make sure that it's worth the expense. The doctors, hospitals, and other providers lack any economic incentive to try to minimize costs that will be paid for by third-party insurance. Indeed, quite the contrary - their economic incentives go the other way. It's not just avoiding negligence and doing what's right for the patient - they have an economic incentive to be overly cautious and to get paid for more work.As I noted above, I don't want my health care decisions to be made exclusively by either the insurance companies or the medical service providers. Both have interests that do not completely align with my own.Albaby
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