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The US spends more on healthcare for no gain says new report from Johns Hopkins

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Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#151

Post by MichaelApproved »

ModernMech wrote: post #78
MichaelApproved wrote: post #49

Earlier quoted context omitted.

> Let the free market work Respectfully, enough with this free market garbage. The healthcare industry is not a free market, it can never be. It's not possible for the consumer to be educated. Even if you put emergencies aside, when an unconscious person can't start price shopping emergency rooms, you still have regular office visits that are impossible to price shop. Ask yourself when the last time you asked your ph…

> They finally gave me an estimate of "it'll be nominal", so I accepted the procedure. Turned out to be ~$200. I'm currently disputing it and refuse to pay based on their original quote of "nominal". This is a case of expectations. $200 is nominal as far as medical procedures go. Based on my last couple encounters with healthcare, $200 barely gets you in the door. I paid $2000 on my last ambulance ride. My last stay…

I was having an office visit getting tested for the flu, not on my way to the emergency room.

The person who gave me the "nominal" quote also said my insurance would likely even cover the test. She was wrong.

I spoke to the office manager and she seems to agree with my take on the situation.

If you give a vague subjective word like "nominal" for a service, it's on you to hope the consumer agrees.

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#152

Post by Ericson2314 »

DennisP wrote: post #114
airstrike wrote: post #2

It's worth noting that the U.S. market does pay for the lion's share of patented drugs, effectively funding a significant portion of R&D that benefits the whole world years later when generics come into market (at least for those drugs which are not costly to manufacture, which happen to be the majority). I'm not saying this model is right. I'm just saying that doing away with it will have fundamental consequences to…

Yes, but there are better ways to do it. A natural group to pay R&D for patent-free drugs is health insurance companies, who would benefit from the lower costs, and perhaps even come out ahead. But its hard for those companies to organize such an effort, because they can get the same benefit even if they don't contribute. It's a classic public goods problem. Usually we solve public goods problems with taxes, and we c…

To the person elsewhere that complained in behalf of little drug R&D outfits, well, bounties vs patents would probably be beneficial to them too.

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#153

Post by DennisP »

philwelch wrote: post #144
DennisP wrote: post #104

Earlier quoted context omitted.

I read that book too, and agree it's phenomenal. It's not just about capping insurance profits. The countries doing the best also have price controls on the healthcare providers. Doctors make a lot less money. On the other hand they generally don't have to pay for medical school. France, Germany, and Japan all have similar systems, according to the book. They have private nonprofit insurance, some kind of mandate to…

> Japan has a clever way to handle the mandate. If you don't pay your premiums, nothing happens, but if you need healthcare you're not covered until you pay your back premiums. So what happens when you go to the ER? Obviously if it's a true emergency they'll save your life and try to bill you later, but then what? Would it ever make sense to deliberately stop paying your premiums? If you can pay "out-of-pocket" for m…

Maybe there's a little interest on back premiums. Whatever the details, it's working out very well for Japan. They get great results at very low cost.

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#154

Post by stuxnet79 »

euske wrote: post #131
DennisP wrote: post #104

Earlier quoted context omitted.

I read that book too, and agree it's phenomenal. It's not just about capping insurance profits. The countries doing the best also have price controls on the healthcare providers. Doctors make a lot less money. On the other hand they generally don't have to pay for medical school. France, Germany, and Japan all have similar systems, according to the book. They have private nonprofit insurance, some kind of mandate to…

One of the main reasons why I gave up career in the States and came back to my home country (Japan) was healthcare. I had a day surgery in the US and the whole experience (i.e. bills) just scared heck out of me. I am very happy with the system here. Everything is extremely efficient compared to the US. A little while ago, I had this mysterious headache and went to an orthopedist, dentist, psychiatrist, neurosurgeon t…

In Canada, if it was serious, half a year is actually even quicker than I'd expect. I'd really love to try out the Japanese healthcare system. As it stands, I'm convinced that healthcare is an impossible problem to solve.

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#155

Post by mikeg8 »

refurb wrote: post #150
will_brown wrote: post #124

Earlier quoted context omitted.

It’s more complicated, the insurers essentially tell providers how to practice (ie prescribe this generic not the name brand, don’t prescribe 30 day Rx prescribe 90 day and don’t see/treat them in the meantime, etc...) and if the providers don’t listen the provider gets dropped from the network and either the patients are forced to new providers who the insurers control behind the scenes, or more and more the patient…

Insurers control care to reduce costs. The upward pressure on prices is from providers. In terms of these insurers who control providers, can you give an example?

Kaiser

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#156

Post by mikeash »

drb91 wrote: post #75
hacknat wrote: post #70

Earlier quoted context omitted.

Some providers actually have policies that prohibit giving out any pricing information. There are so many reasons why healthcare isn’t close to a free market. Here are a few: 1. All medical residents receive their salaries from Medicare. 2. It is illegal not to treat people who go to the emergency room. This actually makes the whole system socialized in some ways in that there is a guaranteed way to get healthcare wi…

Nit, that’s not socialization, that’s just right to service. You still shoulder the bill entirely yourself. The only thing that approaches socialized healthcare is free flu shots.

People who get service and can’t pay effectively have their service paid for by all the other customers. That’s basically socialized, since all the other customers basically means all of us.

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#157

Post by jdhn »

DennisP wrote: post #104
mikeg8 wrote: post #81

The book The Healing of America by T.R. Reid, 2010 was a phenomenal look at this subject and the conclusion was this: we are the only developed nation whose government allows for-profit health insurance companies to exist with ZERO regulation to cap healthcare prices. Because of this, we spend 20% of every dollar on "administrative" costs compared to 3%-7% in the European and Asian countries. The goal for American he…

I read that book too, and agree it's phenomenal. It's not just about capping insurance profits. The countries doing the best also have price controls on the healthcare providers. Doctors make a lot less money. On the other hand they generally don't have to pay for medical school. France, Germany, and Japan all have similar systems, according to the book. They have private nonprofit insurance, some kind of mandate to…

>If you don't pay your premiums, nothing happens, but if you need healthcare you're not covered until you pay your back premiums.

So what happens if you don’t pay your premium but then have to use the ER? Do they refuse to take you, or are you stuck with a bill? Does that bill go away if you pay your back premiums or not!

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#158

Post by asdff »

airstrike wrote: post #2

It's worth noting that the U.S. market does pay for the lion's share of patented drugs, effectively funding a significant portion of R&D that benefits the whole world years later when generics come into market (at least for those drugs which are not costly to manufacture, which happen to be the majority). I'm not saying this model is right. I'm just saying that doing away with it will have fundamental consequences to…

R&D should be publically funded like basic research is. We can say 'these drugs are expensive because they are expensive to research' all we want because it's true, but this statement ignores the problem of it all, and that is every step of the way from a customers insurance payment to research and development, there is skimming.

Private health insurance cannot run at cost, private biotechnology companies cannot run at cost either, and this is because shareholders and executives demand it cannot. Every dollar of ROI in their portfolio is a dollar that could have gone to research and development or lowering drug prices, every yearly bonus could have tipped the scales and let one more person afford to save their life. It is tragically terrible that if you had the right books, you can calculate the exact x% of every dollar people spend towards healthcare that goes toward someone else's luxury rather than healthcare or in support of research. And thats ignoring the other half of the problem with private research, in that projects are decided by white collars and not white coats, so research efforts are focused on what will make a profit or what they can put out quickly before anyone else to dominate market share on a novel treatment, and not treatments for rarer diseases that might be backed with extensive basic research and only need to scale, but is marginally less profitable for the company.

However, if money for healthcare is taken publically, then there is no need to skim dimes on every dollar spent to grant someone a third house and a fifth car. Money can be earmarked directly for research, like basic research is, and what happens to that dollar would be of public record. Capitalism and its sole metric of success of infinite growth is inefficient by design and has no place when it comes to universal needs like healthcare.

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#159

Post by joering2 »

euske wrote: post #131
DennisP wrote: post #104

Earlier quoted context omitted.

I read that book too, and agree it's phenomenal. It's not just about capping insurance profits. The countries doing the best also have price controls on the healthcare providers. Doctors make a lot less money. On the other hand they generally don't have to pay for medical school. France, Germany, and Japan all have similar systems, according to the book. They have private nonprofit insurance, some kind of mandate to…

One of the main reasons why I gave up career in the States and came back to my home country (Japan) was healthcare. I had a day surgery in the US and the whole experience (i.e. bills) just scared heck out of me. I am very happy with the system here. Everything is extremely efficient compared to the US. A little while ago, I had this mysterious headache and went to an orthopedist, dentist, psychiatrist, neurosurgeon t…

Just got hemoroids frozen and cut with laser. Cost here in USA under premium insurance was $12,000. Went to Germany got it done on the same equipment in luxury stay for 14 days at $870. Plus $800 plane tickets. Meanwhile a friend of mine had a heart attack. As a Bank of America emplyee he had somewhat goog insurance that paid some. He was left with $180,000 bill.

Re: The US spends more on healthcare for no gain says new report from Johns Hopkins

#160

Post by [deleted] »

elipsey wrote: post #107

I think it would be worthwhile to discuss more than just per capita cost. The way that these costs are distributed is important and, I believe, problematic. The problem here is not just that per capita cost is high, it’s that for reasons that are partly structural, and partly demographic, healthy young payers with lower incomes can be burdened with the full, un-subsidised, costs of insurance, while others consume ser…

[deleted]
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