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Reasons most think health insurance broken

Obvious Issues:

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Business leaders are routinely told by third party vendors that the high cost of “status-quo” health insurance is “just the way it is”, limiting leaderships’ ability to control an expensive and vital line item.  

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Employees are paying increasingly more for health insurance, which many cannot afford. The result is that dissatisfaction with employer-provided benefits continue to impact organizations. 

Less Obvious Issues:

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According to a study by The NY Times in 2017, many hospitals charge private insurance as much as 400% to 700% of what Medicare pays for the same procedure.

Did You Also Know?

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Specialty Drugs accounts for 51% of Rx spend in the U.S, but less than 2% of people take them

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Brokers need current and practical options that help lower costs while delivering better outcomes for their clients’ organization and their people.

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2% of doctors are responsible for 39% of malpractice lawsuits. Do you know who they are? Does your insurance company tell you? Are you going to one?

Why do you have to pay so much more?

Imaging

The imaging results show that average hospital prices range from 70 percent higher (magnetic resonance imaging [MRI]/magnetic resonance angiogram [MRA] other) to 208 percent higher (nuclear medicine) than the average prices at free-standing imaging centers. Lab prices are from 12 percent higher (pathology) to 285 percent higher (transfusion) than free-standing laboratory centers.

What is the problem? Hospitals

Hospitals can charge whatever they want

Hospitals With The Highest Charge-To-Cost Ratios:
Most hospitals are in the 3.5–4.0 range. However, the tail of this distribution is quite long, and the hospitals with the highest ratios charge, on average, 10.1 times their cost.
This means that they are charging markups of more than 1,000 percent. 

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