Posted on 12/23/2025 12:18:08 PM PST by SeekAndFind
We recently endured the longest-ever U.S. government shutdown as part of a fight over expiring healthcare tax credits. Democrats insist that Americans can’t afford Obamacare plans without the enhanced subsidies that were temporarily added post-COVID, which certainly raises questions about the efficacy of their Affordable Care Act.
On top of proving a massive waste of time, the shutdown fight represented a misdirection of lawmaker energy. Rather than debating whether to paper over the healthcare affordability problem with yet another layer of subsidies, Congress instead should focus on finding cost-savings common ground like eliminating the abuse of the 340B drug discount program by large hospitals.
Created in 1992, 340B was intended to help hospitals and clinics serving vulnerable populations by allowing them to buy outpatient drugs from pharmaceutical manufacturers at steep discounts. These hospitals could then stretch those savings to fund charity care and community health. But that’s not what is happening.
Today, the program has ballooned into a multi-billion-dollar revenue stream for large health systems that often do little to serve the underserved. Hospitals buy drugs at 340B discounts -- sometimes 50% or more below list price -- and then turn around and bill Medicare, Medicaid, and private insurers at full price. Worse, many uninsured patients see no savings at all.
According to the Government Accountability Office, 340B hospitals on average have significantly higher drug spending than their non-340B peers. Many simply pocket the margin. There is no legal requirement that they use the proceeds to help low-income patients, and a growing body of research suggests they often do not.
Hospitals receive 37% of all Medicare spending and 32% of all Medicaid spending, which is around $650 billion per year. That flood of government money has created a perverse set of incentives: dependency, rent-seeking, and misaligned priorities.
(Excerpt) Read more at americanthinker.com ...
We need to stop subsidies to health insurance companies...they only make big profits and then increase premiums...
I believe a big problem with the medical sector is that it is mostly run by business professionals instead of medical professionals. They have different priorities.
Hospitals are hemoraging money thanks to illegal immigration and medicare.
That is almost a certainty. If you have to add subsidies to Obamacare to make it affordable, there is something very wrong, it seems to me.
Wow. I just checked to see if the hospital system where my wife works if they participate in this program. Because of the nature of their “customer” base, they do. 82% of their patients receive either Medicare, Medicaid, or other subsidized insurance plans…or they have no insurance. (No insurance in MA means that Medicaid picks up the tab.)
I was surprised that the hospital can turn around and charge Medicare, etc the full price for reimbursement. That means we subsidize the purchase of the drugs. We subsidize charges from the hospital. And then, in MA, the state eats the cost of the uninsured.
While I know the hospital system is in the process of going under in several communities I don’t think they are using this revenue stream to stay afloat…they have bigger issues. However, the cross subsidizing of a single pill seems nuts.
In my experience, which is 5 years of management in a health system, and “being in the room” with my wife who works with senior management in her hospital system,…they are some of the worst professional managers I’ve ever seen.
They protect data. They don’t train supervisors/managers. They are surprisingly technically illiterate. They have too many single points of failure. And their turnover would turn your stomach.
In short, they kind of treat their employees like crap which leads to turnover, mistakes, and cases of just poor results.
They are nice people. They just never took a management or accounting course.
Fraud upon fraud upon fraud
“I believe a big problem with the medical sector is that it is mostly run by business professionals instead of medical professionals. They have different priorities.”
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Physicians are generally brilliant people and scientists, but they’ve generally been crap administrators, running their own practices into bankruptcy.
Hospital administrators aren’t physicians, but they make sure the lights stay on and everyone working there gets paid.
“We need to stop subsidies to health insurance companies”
“people with health spending in the top 1% had average spending of $166,980 per year”
[That’s not going to be covered by $6,000 put into an HSA for 2026. A major medical problem can be as pricey as replacing a burned down house.]
“Roughly 14% of the population had $0 in health expenditures in 2021”
I haven’t received medical treatment from a M.D. or equivalent for 25 years.
The only medical treatment I’ve received in the last 25 years is three vaccinations.
Many healthy people won’t pay $10,000/year on average to have insurance. They know that such pricing is a rip-off for them. I went without medical insurance for 30 years.
If the government wants flat rate insurance (without risk pricing), it’s going to have subsidize it for people on lower incomes.
We also have tens of millions of dual nationals that if they get a $100,000 hospital bill, they’ll simply leave it and the USA behind.
Vermont Lt re post 7
Bob Wills is still the king re post 9
There are business aspects to just about any endeavor and sufficient attention to those business aspects must be applied for the endeavor to continue successfully, but unless the purpose of the endeavor was to be a business, elevating the business aspects to the point they are more important than the original purpose of the endeavor will likely hinder accomplishment of the original purpose.
As I recall, in some times and places, fire suppression was done on a for profit basis the business aspects of which took precedence over fire suppression and that didn’t work out so well for the communities involved. Subsequently municipal or volunteer fire departments were established whose purpose was to suppress fires with the business aspects of the department being important, but not the point of the department.
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