Are you talking about patient paid procedures, insurance paid procedures, or Medicaid paid procedures? I've heard that Medicaid is poor pay, and that the rest of us have to make up the difference True or not true?
Here's info on those out of control drug prices. They're more costly here than anywhere else.
All of the above.
Most procedures are "insurance paid". Most people have insurance.
So.. if you have insurance.. you have a contracted rate that the insurance will pay. EVEN if you have a high deductible, and you are paying "out of pocket".. you only have to pay to that contracted rate.. which is considerably lower than charges. (this is why.. it would be better without insurance argument is pretty much pure bunk).
If you don't have insurance, you will generally have to pay the charge rate (which is much higher), unless the provider can figure out how to give you a cash discount. It gets really tricky because insurance companies do not want to see you have different charges for different folks depending on insurance.
Generally.. you are way better having insurance even if you have a high deductible because generally the contracted rate will be lower than what you can get in a cash discount.
As far as who is the lowest payer?
VA is generally the lowest payer. I take it only because of the sacrifices our servicemen and women do. But I break even and in some cases lose money with VA reimbursement.
Medicaid used to be the lowest payer and a terrible payer.. usually denying payment (and for the longest time, we would not accept it. It was better just for me to decide to treat patients for FREE.. who had Medicaid rather than accept it, because I could pick and choose patients I was willing to treat for free.).
However, since OBamacare.. Medicaid rates are now comparable to Medicare in the states that we have businesses in. Different states might be different however.
When it comes to government insurance.. they are all the lowest payers in general. And yes.. to some extent private insurances make up the difference. IF I had to subsist solely on government insurances.. we probably could not remain in business as a for profit entity.
On the flip side.. if we only relied on private insurances.. we probably could not remain in business as a for profit entity. And that's because while private pay has better rates, government insurance has way more patients. And so its a compromise between volume, and payment rate.
One possible option in the future for us is to sell out a larger portion of our business.. and then go to concierge cash only service for only those things in healthcare that are profitable.
Oh.. and I looked at your article. their are issues with pharma since the government does not negotiate for drug prices. BUT on other procedures.. the government most certainly swings a big negotiating stick at what providers get paid. And that has been going on since the 1990's. And private insurance rates, generally follow the government rates (as I have shown) so they get advantage of that giant negotiating power.
AS to pharma.. one of the reasons that places like Britain etc.. can enjoy such lower prices.. is because the US basically subsidizes those prices with our higher payment rates.