Why the healthcare system is considered broken.
The current healthcare system is commonly referred to as broken, it’s rife with fraud and abuse and it has little transparency.
Insights from Axios on the current state of healthcare
1/ Both Democrats and Republicans support Medicare Advantage, so the enrollment wave likely won’t subside in the near term. But there are still deep concerns about insurers gaming the program.
2/ The entire Medicare Advantage industry — estimated to cost the federal government $250 billion in 2019 — remains under the microscope for gaming the payment system. Dialysis chain DaVita agrees to pay $270 million to settle allegations of fudging claims billed to Medicare Advantage plans.
3/ Getting an unexpected bill for thousands of dollars is a problem for many Americans. The problem is a product of the system’s complexity and every potential solution runs into roadblocks from an industry that wants to protect its profits; or skepticism from policy experts; or political opposition.
4/ Balance billing is especially common for emergency-room care, where patients are often in no position to inquire about their insurance networks.
5/ Putting a stop to balance billing requires shifting the cost to someone else, or reducing the size of the bill, or both.
The definition of insanity is doing the same thing over and over again, but expecting different results. ~Albert Instein
