American Council on Science and Health September 21, 2020
The RAND corporation just released a study of hospital pricing for commercial insurance versus the de facto standard, Medicare. It is no surprise that commercial insurance pays more than double Medicare and that those payments are not evenly distributed nationally, within states, or even health systems.
Commercial insurance, that employer-provided benefit, initially a workaround to World War II price controls, provides most health coverage to Americans. In 2018, this insurance covered a third of health care spending, for 57% of the “nonelderly” population, about 153 million of us. Government-funded programs, Medicare and Medicaid, fulfill that role for most remaining Americans, leaving 8.5% paying entirely out of their pocket.
The study used claims data supplied by self-insured employers, state-based all-payer...