Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Why Medical Bills Are Killing Us (2013) [pdf]

uta.edu

Post reply on HN
Print view View original

11–20 of 94 posts

Re: Why Medical Bills Are Killing Us (2013) [pdf]

#11

Post by rch »

no_protocol wrote: post #3

Why did the patient in the first story absolutely need to travel from Ohio to Texas for treatment? Isn't medical knowledge shared between providers? Some of the blame in many of these situations should fall upon the patients for choosing the care they did. Especially when it is a planned operation. I haven't finished reading the whole article, but so far it doesn't seem to be considering this point. I don't wish to d…

I used to work at M.D. Anderson and I can attest to their quality of care. People travel from around the world to receive treatment, for good reason.

Also, my mother was a patient there. She started treatment just a couple of months after I got my job actually. She's still doing well years later, and is glad she waited an extra month to get into M.D Anderson. The decision to wait was excruciating though.

Re: Why Medical Bills Are Killing Us (2013) [pdf]

#12

Post by ScottBurson »

throwaway729 wrote: post #7
ScottBurson wrote: post #2

I came across this last night and stayed up too late reading it. It's a fascinating exposé of where at least a good part of the money is going -- the extra money that we Americans spend on health care that doesn't bring us any better outcomes. I think it's relevant to HN because a lot of us with families and/or in middle age can't risk quitting our jobs to start startups without assurance that we'll be able to buy ad…

Relevant quote from the article re: what an effective solution needs to achieve: >The real issue isn’t whether we have a single payer or multiple payers. It’s whether whoever pays has a fair chance in a fair market. Congress has given Medicare that power when it comes to dealing with hospitals and doctors, and we have seen how that works to drive down the prices Medicare pays, just as we’ve seen what happens when Con…

I agree with most of this, but

> We should outlaw the chargemaster.

I don't know how that would work. My thought was to require it to be published.

Re: Why Medical Bills Are Killing Us (2013) [pdf]

#13

Post by nradov »

ams6110 wrote: post #6
ScottBurson wrote: post #2

I came across this last night and stayed up too late reading it. It's a fascinating exposé of where at least a good part of the money is going -- the extra money that we Americans spend on health care that doesn't bring us any better outcomes. I think it's relevant to HN because a lot of us with families and/or in middle age can't risk quitting our jobs to start startups without assurance that we'll be able to buy ad…

Routine medical care should be like food and shelter: something you are expected to pay for yourself. That would put price pressure on providers. Insurance should be a backstop for catastrophic accident or illness. It should be sold by competing local and national providers. It should be untangled from employment as a benefit. You should buy it like car insurance. Obama, Trump, Clinton. senators, representatives -- n…

Maybe it should be that way, however in practice it doesn't work. The ACA specifically requires free preventive services because research has shown that when patients have to pay they often skip it. And when they skip preventive care that causes the spread of infectious diseases, and allows small problems to turn into serious problems that are more difficult and expensive to treat. So this is important from a public health standpoint regardless of concerns over economic efficiency or personal responsibility.

https://www.healthcare.gov/coverage/preventive-care-benefits...

Re: Why Medical Bills Are Killing Us (2013) [pdf]

#14

Post by ScottBurson »

maxerickson wrote: post #10
ScottBurson wrote: post #2

I came across this last night and stayed up too late reading it. It's a fascinating exposé of where at least a good part of the money is going -- the extra money that we Americans spend on health care that doesn't bring us any better outcomes. I think it's relevant to HN because a lot of us with families and/or in middle age can't risk quitting our jobs to start startups without assurance that we'll be able to buy ad…

There's hundreds of things that can be done to chip away at them. A pet peeve of mine is certificate of need laws: http://www.ncsl.org/research/health/con-certificate-of-need-... The notion is to reduce capital expenditures and save costs, but they are a big part of why the hospital in the article can get away with charging so much for cat scans -- there's no competition. Of course it is going to be difficult to go t…

Seems like what you're saying is, we're damned if we do and damned if we don't. If we allow hospitals to build out as much as they want, they'll be underutilized and will have to raise prices to cover their capital costs; if we restrict them with CON laws, lack of competition will allow them to raise prices anyway.

Given that, I don't see how CON laws are either the problem or the solution. The problem seems to be more that patients just have no leverage to negotiate with providers.

Re: Why Medical Bills Are Killing Us (2013) [pdf]

#16

Post by yequalsx »

ScottBurson wrote: post #2

I came across this last night and stayed up too late reading it. It's a fascinating exposé of where at least a good part of the money is going -- the extra money that we Americans spend on health care that doesn't bring us any better outcomes. I think it's relevant to HN because a lot of us with families and/or in middle age can't risk quitting our jobs to start startups without assurance that we'll be able to buy ad…

It is immoral for someone to profit from denying someone healthcare. As I see it healthcare is a scare good and the Canadian system is the way to go. But socialism and all that... won't happen in the U.S. any time soon.

Re: Why Medical Bills Are Killing Us (2013) [pdf]

#17

Post by digler999 »

ams6110 wrote: post #6
ScottBurson wrote: post #2

I came across this last night and stayed up too late reading it. It's a fascinating exposé of where at least a good part of the money is going -- the extra money that we Americans spend on health care that doesn't bring us any better outcomes. I think it's relevant to HN because a lot of us with families and/or in middle age can't risk quitting our jobs to start startups without assurance that we'll be able to buy ad…

Routine medical care should be like food and shelter: something you are expected to pay for yourself. That would put price pressure on providers. Insurance should be a backstop for catastrophic accident or illness. It should be sold by competing local and national providers. It should be untangled from employment as a benefit. You should buy it like car insurance. Obama, Trump, Clinton. senators, representatives -- n…

> should

and minimum wage should be enough to live on, housing should be affordable a reasonable distance from where you work. but for some strange reason, the world doesn't work that way.

Re: Why Medical Bills Are Killing Us (2013) [pdf]

#18

Post by [deleted] »

no_protocol wrote: post #3

Why did the patient in the first story absolutely need to travel from Ohio to Texas for treatment? Isn't medical knowledge shared between providers? Some of the blame in many of these situations should fall upon the patients for choosing the care they did. Especially when it is a planned operation. I haven't finished reading the whole article, but so far it doesn't seem to be considering this point. I don't wish to d…

[deleted]

Re: Why Medical Bills Are Killing Us (2013) [pdf]

#19

Post by coredog64 »

nradov wrote: post #13
ams6110 wrote: post #6

Earlier quoted context omitted.

Routine medical care should be like food and shelter: something you are expected to pay for yourself. That would put price pressure on providers. Insurance should be a backstop for catastrophic accident or illness. It should be sold by competing local and national providers. It should be untangled from employment as a benefit. You should buy it like car insurance. Obama, Trump, Clinton. senators, representatives -- n…

Maybe it should be that way, however in practice it doesn't work. The ACA specifically requires free preventive services because research has shown that when patients have to pay they often skip it. And when they skip preventive care that causes the spread of infectious diseases, and allows small problems to turn into serious problems that are more difficult and expensive to treat. So this is important from a public…

Preventative care that actually works is super cheap and not controversial (mostly vaccinations). This idea that we can save vast sums via preventative care is a fantasy. You may find anecdotes to support it, but the serious literature doesn't bear it out.

Re: Why Medical Bills Are Killing Us (2013) [pdf]

#20

Post by caycep »

rch wrote: post #11
no_protocol wrote: post #3

Why did the patient in the first story absolutely need to travel from Ohio to Texas for treatment? Isn't medical knowledge shared between providers? Some of the blame in many of these situations should fall upon the patients for choosing the care they did. Especially when it is a planned operation. I haven't finished reading the whole article, but so far it doesn't seem to be considering this point. I don't wish to d…

I used to work at M.D. Anderson and I can attest to their quality of care. People travel from around the world to receive treatment, for good reason. Also, my mother was a patient there. She started treatment just a couple of months after I got my job actually. She's still doing well years later, and is glad she waited an extra month to get into M.D Anderson. The decision to wait was excruciating though.

But...Ohio has Cleveland Clinic, Case Western University Hospital, Ohio State Medical Center...it is not like it is a total medical backwater. Cynically, Cleveland Clinic has an InterContinental hotel inside the hospital for visiting dignitaries/medical tourists...
Post reply on HN