wait I hear a lot of theories about how Big Pharma has an incentive to keep people sick, but until now I didn't even think about how Big Insurance has an incentive to keep people healthy. Do Big Pharma and Big Insurance hate each other?
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That's a misconception at its worst, big pharma doesn't have that incentive, because people get sick all the time anyway, and if they don't - big pharma always can rock up the drugs prices (which it was doing for the last 40 years) 1/2
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I'm not sure they do actually have that incentive. Premiums being overall cost of entire customer base +5% (as an example) works out to be a bigger number with more sick people.
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And big insurance doesn't have that incentive either, because if everybody'd be healthy all the time, nobody would use their services. That's why it has two other incentives - sign more people into insurance and negotiate with hospitals and pharma to lower the healthcare costs
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Big Insurance incentive is to not pay out. Healthy may come into it but ultimately small print is Big Insurance’s best friend.
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They pretty much do, but not for that reason. Big Pharma: intensely interested in making ppl healthy, because new drugs are priced based on effect size & outcomes. Insurance co’s profits are based on denying payment after care has already been provided. Not outcomes.
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I joked about this with my physician once and he made a good point: the pharma co selling a treatment for a chronic disease might not have an incentive to cure it, but another company without a treatment for the same disease would.
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It's more complicated than that. Insurance companies also operates hospitals in U.S.
If there is a mandated buyer, for example, government welfare, then it's actually profitable for healthcare providers to have repeat treatment for whatever programs someone is mandated to pay.
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No.
If the administration gets it's way, the regulations on insurers will be gutted. Then insurance companies will be able to exclude the "high risk" patients because they can be classified as having pre-existing conditions. Then insurance won't be conflicted with pharma.