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India Aims for the World's Biggest Health Care Overhaul

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31–40 of 83 posts

Re: India Aims for the World's Biggest Health Care Overhaul

#31
post #25

>> which would offer the poorest half of India health insurance to apply toward private hospitals This is a terrible idea. Did they learn nothing from the failure of Health Care in the United States? When insurance pays for everything patients stop worrying about costs, which in turn causes hospitals and drug companies to raise prices. This is what has caused Health Care to fail from a costs point of view. The soluti…

With all due respect, the premise of this comment--that consumers reduce costs by "shopping around" and being cost conscious--is being misrepresented. The plan type I believe you are referring to is a high-deductible health plan. HDHPs have a little success at reducing costs, but mostly at the expense of compromising quality of care. They can be a part of the solution, but they are not "the" solution as you put it.

“Most Americans in HDHPs are not doing things that can help them get the care they need at the lowest possible cost, and even those who are doing so could realize more benefits,” says lead author Jeffrey Kullgren, M.D., M.S., M.P.H., an assistant professor of general medicine at U-M. (https://jamanetwork.com/journals/jamainternalmedicine/articl...)

"Research published last year in the American Journal of Managed Care showed that switching to a consumer-directed health plan—an HDHP paired with a health savings account—did, in fact, result in lower outpatient spending. But the researchers, led by Neeraj Sood, vice dean and professor at USC’s Price School of Public Policy at the University of Southern California, found no change in spending on 26 commonly used, low-value services." (https://www.managedcaremag.com/archives/2018/6/hdhps-cost-sh...)

"Current evidence suggests that HDHPs are associated with lower health care costs as a result of a reduction in the use of health services, including appropriate services" (https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2017.0...)

Re: India Aims for the World's Biggest Health Care Overhaul

#33

What happens when 500 million people start to go to the few private hospitals? It looks like there could be some nice election-year “progress,” but that isn’t going to magically make more private beds appear. Perhaps funding and fixing the public hospitals might be a higher priority otherwise, private hospital prices will increase. This plan has the potential to create some serious health cost inflation. If everyone…

Hahaha, we wish.

Poor people will be kept in different wards, or some understanding will be reached to ensure that the status quo is maintained.

Nothing in India is done just based on the rules, everything is done with the meta rules firmly in mind.

As for your other ideas- these are things you do when you have the ability and personnel to do it. Huge audits and legal systems capable of prosecuting the vast back log of cases.

Edit; That said, I do hope this takes off, healthcare investment in India needs to expand significantly and affordable healthcare is needed. We will definitely need state healthcare to help a lot of people.

Re: India Aims for the World's Biggest Health Care Overhaul

#34
post #25

>> which would offer the poorest half of India health insurance to apply toward private hospitals This is a terrible idea. Did they learn nothing from the failure of Health Care in the United States? When insurance pays for everything patients stop worrying about costs, which in turn causes hospitals and drug companies to raise prices. This is what has caused Health Care to fail from a costs point of view. The soluti…

> the maximum you will spend out of pocket per year is $2000.

Do the employees have to pay all of their medical costs up front out of pocket and are later reimbursed $4000 through the HSA? So an employee must have the available funds to pay more than $2000 up front.

Re: India Aims for the World's Biggest Health Care Overhaul

#35
post #25

>> which would offer the poorest half of India health insurance to apply toward private hospitals This is a terrible idea. Did they learn nothing from the failure of Health Care in the United States? When insurance pays for everything patients stop worrying about costs, which in turn causes hospitals and drug companies to raise prices. This is what has caused Health Care to fail from a costs point of view. The soluti…

Lol « participating for costs » is a staple of American healthcare and it’s 10x more expensive than not participating for cost literally every other country :-).

And then you get the usual people not going to the doctor when they’re sick (staple of american life) and infecting everyone.

Re: India Aims for the World's Biggest Health Care Overhaul

#36
post #2

The math doesn't check out. "Each family would get more than $7,200 in annual coverage"; "better health care for 1.3 billion people" and "Modicare is expected to cost the Indian government less than $2 billion annually" seem to be mutually exclusive. There's no reasonable way for health insurance/coverage to be so underutilized that on average only $1-$2 of $7200 would get used.

Coverage up to X does not mean people will use X. 7200$ is a shit ton of money in India.

Re: India Aims for the World's Biggest Health Care Overhaul

#37
post #17
post #4

Earlier quoted context omitted.

When they say it'll cost $2b I think that's in addition to what's already being spent.

$2 billion across 1+ billion people is the $1-2 he refers to. The implication is that the additional $7,200 is purely coming from efficiency gains, which he suggests seems improbable.

A lot of the maths in insurance seems improbable.

Re: India Aims for the World's Biggest Health Care Overhaul

#38

Earlier quoted context omitted.

Across almost all metrics, infrastructure, corruption, ease of business, electricity, even cleanliness India has improved on. This isn't just another election year innovation, this is just another list of innovations that have been added, which also include things like investments in clean energy, and providing rural impoverished citizen with gas to cook (people in rural areas would cook in wood fired stoves that wou…

> Across almost all metrics, infrastructure, corruption, ease of business, electricity, even cleanliness India has improved on You are drinking ruling party’s a lot of cool aid

What are you talking about? There are very few metrics that you can list that show a decline. So how about you show me the data for decline.

Re: India Aims for the World's Biggest Health Care Overhaul

#39
post #31
post #25

>> which would offer the poorest half of India health insurance to apply toward private hospitals This is a terrible idea. Did they learn nothing from the failure of Health Care in the United States? When insurance pays for everything patients stop worrying about costs, which in turn causes hospitals and drug companies to raise prices. This is what has caused Health Care to fail from a costs point of view. The soluti…

With all due respect, the premise of this comment--that consumers reduce costs by "shopping around" and being cost conscious--is being misrepresented. The plan type I believe you are referring to is a high-deductible health plan. HDHPs have a little success at reducing costs, but mostly at the expense of compromising quality of care. They can be a part of the solution, but they are not "the" solution as you put it. “…

The proposal seems to be for an HDHP with an employer-funded HSA, which would remove the inventive to save that money for non-healthcare-related expenses. It's not clear to me that those studies are valid for that particular model.

Re: India Aims for the World's Biggest Health Care Overhaul

#40
post #6

> The plan is to roll it out by the end of the year – ahead of elections expected early in 2019. Wow that seems to be a highly ambitious timeline. I hope India manages to setup the program enroll people onto it, but I'm also doubtful whether it can be achieved before the elections.

Having just gone to India everything is tied to the Aadhaar Identification: banks, schools, welfare, etc. It has overall completely replaces a bunch of different identifications into a single centrally located entity. However weird I feel about it being Orwellian I can't say it hasn't been good in terms of simplifying access and providing services since you just need a single identification. So it wouldn't be that ha…

And it's probably saving government some money: https://www.livemint.com/Politics/6NgxeSDqmL6BgrL0FS6RRI/Aad...
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