jacobpelz.bsky.social
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I think it does now - www.whitehouse.gov/presidential...
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Interesting point about integration. Kaiser, a fully-integrated healthcare deliverer, has a remarkably low denial rate. In cahoots with the insurer, Kaiser providers simply don’t offer services that would be denied - thus easing ire. Alas, I don’t think consolidation is the solution we’re after.
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UHG has plenty of clout between its clinics and weighty market share. But physician’s services make up only a portion of healthcare spend. The plurality is for inpatient services which UHG has not invested in. Consolidation has given hospitals even more clout than UHG in many areas.
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Some level of guardrail is good - it can help ensure that medical decisions are appropriately made. In the US, a physician’s incentive to maximize a patient’s bill has necessitated higher guardrails. This ProPublica article offers a timely and extreme example. Both issues must be addressed.
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In the US, coverage denials are the result of a poorly structured healthcare delivery system. We may have better luck imagining a solution if we broaden our focus to include the dynamics that produce them.