Ge Bai
@GeBaiDC
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Professor of Accounting @JHUCarey @JohnsHopkins, Professor of Health Policy & Mgt @JohnsHopkinsSPH @BSPH_HPM, former visiting scholar @USCBO, CPA, Healthcare $
Washington, DC
Joined December 2015
The less we abdicate our buying power or any power the better.
When you pay cash, you decide. Otherwise, your insurer does.
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“As insurers and government programs seize control of health care dollars, medicine has become a compliance industry rather than a healing profession.” @GeBaiDC @PaulaMutoMD
“In control of their dollars, patients make the best choices. When they pay directly, care happens faster. Providers must satisfy patients to earn their business ‒ aligning incentives, fostering competition and innovation, and creating a dynamic, vibrant marketplace for care.”
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“In control of their dollars, patients make the best choices. When they pay directly, care happens faster. Providers must satisfy patients to earn their business ‒ aligning incentives, fostering competition and innovation, and creating a dynamic, vibrant marketplace for care.”
usatoday.com
Trump and Republicans have proposed allowing Americans to directly control their subsidized health care dollars. Is this the right approach?
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Related to this, health insurance costs borne by U.S. employers have risen so sharply in recent years that it has cost workers "through lost pay raises they could have received otherwise". To an employer, compensation paid for an employee's health insurance/healthcare is still
healthjournalism.org
Rising health insurance premium rates have cost families with workplace coverage more than $125,000 in earnings over three recent decades,…
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When you pay cash, you decide. Otherwise, your insurer does.
Who decides what healthcare you get , the ins company or your doctor ? https://t.co/Xm7ga7AsKf #
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Great piece by @DrDiGiorgio featured in today's @ocregister "If we care about Americans’ health, independence, and pocketbooks, we need to change the game. By re-establishing patients as the customers and consumers, we can simultaneously maximize patient autonomy, re-invigorate
ocregister.com
If we care about Americans’ health, independence, and pocketbooks, we need to change the game.
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"We should remove the word unintended from ACA posts." "The company aim is to vertically integrate using Uncle Sam at the doorway to point guns at citizens to force them to sign in." "HITECH imposed billions in direct implementation costs (plus massive admin burden
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Medicaid is a national security risk.
Similar Medicaid fraud will continue as long as federal taxpayers largely foot the bills. Medicaid’s funding structure gives states little reason to care about fraud.
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"The ACA's ban on lifetime and annual limits increased premiums, a predictable outcome when insurers can no longer cap exposure. It's a classic "feed the dragon" problem: the system becomes dependent on ever-larger subsidies to sustain itself, masking the true economics
The ACA’s ban on lifetime and annual limits raised premiums. "Feed the dragon until it's so large that it demands to be fed whether the resources are there or not." "The architects figured we'd become addicted to the system and consent to ever-expanding subsidies intended to
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For the ACA's Medical Loss Ratio mandates: "when you cap margins, it forces premiums up. No company is happy with flat year-over-year financial performance." Medical Loss Ratio mandates "created a target for those integrated plans to hit with intercompany eliminations and
Consequences Of the ACA's Medical Loss Ratio Rule 1⃣Inflating Premiums With the MLR requirement capping profit margins and administrative costs, insurers are discouraged from containing health plans’ premium increases. The MLR rule effectively turns health insurers into
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"The government somehow believes it knows the right price for every hospital, clinic, and outpatient visit... The mystery is why we still pretend they make sense." "Insurance performs best when it's focused on true catastrophic protection..." Appreciates these comments to our
Honored to coauthor with Professors David A. Hyman and Charles Silver: Improving Health Care Affordability, Access, and Innovation https://t.co/VUuDAaPN5X
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Appreciate invaluable comments from Dr. Philip Auerswald @auerswald and Dr. John H. Cochrane @JohnHCochrane. Full text: https://t.co/a1YFBaDW9t
Honored to coauthor with Professors David A. Hyman and Charles Silver: Improving Health Care Affordability, Access, and Innovation https://t.co/VUuDAaPN5X
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Third-Party Payment and Regulation: Less Is Often More -coauthored with David A. Hyman and Charles Silver Our current healthcare system relies almost entirely on third-party payment. Providers understandably view private insurance companies and public programs as their
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@mcuban @DrDiGiorgio The soil has been so poisoned by Congress that only big boys can survive. It’s already too late by the time cases reach the DOJ, which can treat only symptoms not the disease Congress created.
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“The ACA redesigned the market. Industry consolidated exactly as predicted. Vertical integration isn’t the failure of markets. It’s a survival mechanism under central planning. The cure isn't better regulators. It’s fewer laws to exploit in the first place.”
@mcuban When government controls an industry, it replaces customer choice with regulatory loopholes, and you’re shocked when companies respond to the incentives you created. Companies didn’t accidentally become conglomerates. They did exactly what central planners incentivized. The ACA:
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This is the real issue: physicians face arrest, Medicare exclusion, Stark penalties, and board discipline for errors—yet we control the least amount of money in the system. Insurers can up-code and bill billions with no individual accountability. No deterrent = no change.
And we will never see one health system CEO, or insurance CEO, or state bureaucrat go to jail.
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@GeBaiDC This is the core flaw of government programs. When someone else pays the bill, no one has an incentive to protect the money. Waste and fraud aren’t surprises. They’re the predictable outcome.
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@Tcell_bodyshot @DrDiGiorgio People who are paying directly for their care do shop. That’s how I wound up getting my shoulder surgery at a facility that offered a cash price of ~$7k rather than the one I was referred to that cost ~$14k (and that wasn’t really self-pay friendly).
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"Consumers collectively know best." "Competition exposes liars fast and healthcare avoids it." "Capitalism: no coercion, no force, just mutual benefit evolving over time."
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A critical conversation on system incentives and behavior. Are doctors providing quality of care or quantity of services? Or both?
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