Center for the Digital Future at USC Annenberg (Feb 19, 2020):
Many Americans are willing to make significant personal tradeoffs to lower their health insurance rates or medical costs, such as agreeing to 24/7 personal monitoring or working with artificial intelligence instead of a human doctor, the Center for the Digital Future at the USC Annenberg School for Communication and Journalism finds.
Among the study’s findings:
- Nearly 1 in 4 Americans (24%) would work with an artificial intelligence-based technology if it lowered the cost of their health care.
- Most Americans (80%) think that access to health care is a basic right that should be available to all citizens regardless of their ability to pay. This is a view shared even by a majority of citizens who identify themselves as very conservative (56%).
- Significant percentages of Americans are willing to make profound lifestyle choices in exchange for lower insurance rates. For example, one-third of Americans would agree to 24/7 personal monitoring by insurance companies or health care professionals if their insurance rates were reduced.
- Twenty-one percent of Americans said they would stay in their current job if leaving it meant losing their current health coverage.
- Almost all Americans say health care is a key issue in the 2020 presidential election (92%).
- Even though Americans say they are satisfied with their current health insurance, they are open to alternatives. Thirty percent of Americans would consider buying health coverage from any company that offers lower costs, including a variety of non-insurance companies such as Amazon, Google, or Costco.
In rural towns across the U.S. hospitals are in crisis. Since 2010, 121 rural hospitals have closed. And, the National Rural Health Association says more than one-third of all rural hospitals in the U.S. are at serious risk of shutting down.
But not all hospitals are losing money. A series of mergers and acquisitions that began in the 1990’s has created massive hospital groups. Many of these hospital consortiums are turning huge profits every year by offering high priced services to well insured patients.
From a JAMA Network online article (February 4, 2020):
High medical prices and billing practices may reduce public trust in the medical profession and can result in the avoidance of care. In a survey of 1000 patients, 64% reported that they delayed or neglected seeking medical care in the past year because of concern about high medical bills. The field of quality science in health care has developed measures of medical complications; however, there are no standardized metrics of billing quality.
A recent study found that only 53 of 101 hospitals were able to provide a price for standard coronary artery bypass graft surgery. Notably, among the hospitals that provided a price, the price ranged from approximately $44 000 and $448 000 and was not associated with quality of care as measured by risk-adjusted outcomes and the Society of Thoracic Surgeons composite quality score.
In the same way that there is wide variation in pricing, aggressive collection tactics also can be highly variable by institution. In a recent analysis, 36% (48/135) of hospitals in Virginia garnished wages of patients with unpaid medical bills, and 5 hospitals accounted for 4690 garnishment cases in 2017, representing 51% of all cases.7 In total, 20 054 lawsuits were filed in Virginia against patients for unpaid debt. For many hospitals that sue patients, legal action follows multiple attempts to contact patients through letters and calls, and some hospitals may offer to set up payment plans or even negotiate charges.
From a Harvard Gazette online article:
“This work cements the idea that, for the right patients, we can deliver hospital-level care outside of the four walls of the traditional hospital, and provides more of the data we need to make home hospital care the standard of care in our country,” said corresponding author David Levine, a physician and researcher in the Division of General Internal Medicine and Primary Care.
“It opens up so many exciting possibilities — it’s exciting for patients because it gives them the opportunity to be in a familiar setting, and it’s exciting for clinicians because we get to be with a patient in that person’s own surroundings. As a community-minded hospital, this is a way for us to bring excellent care to our community.”
The home hospital model of care — in which select patients receive hospital-level care for an acute illness from the comfort of their own home instead of in a traditional hospital — has become increasingly popular across the U.S.
To read more: https://news.harvard.edu/gazette/story/2019/12/home-hospital-model-reduces-costs-by-38-improves-care/
“Will price transparency lower health care costs? Economic theory and hospital opposition suggest it would, but the answer is not as straightforward as you might expect and could differ from market to market. Health care is a really strange economic sector, and it doesn’t always follow the usual rules.”
- …hospitals with low fees may demand the higher prices charged by sister institutions. Since 70% of hospital markets are so consolidated that they lack effective competition, the ability of low-priced institutions to push fees up should not be underestimated.
- …some research also shows that in the absence of understandable quality information, some consumers assume that high price means high quality and are actually drawn to higher-priced institutions. There’s a reason, after all, that the Ritz is more expensive than Motel 6.
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