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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

#401

Post by hannasanarion »

skookumchuck wrote: post #367
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…

> allows for-profit health insurance companies to exist with ZERO regulation to cap healthcare prices. There's zero regulation on the software industry, and prices have trended to zero. I suspect the problem with the health care industry is much deeper than not enough regulation.

How often do you get rushed to your local software company in need of an immediate node.js webapp or you'll die within the hour?

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

#402

Post by kasey_junk »

istruble wrote: post #234
EvanAnderson wrote: post #183

Earlier quoted context omitted.

He may have been traveling when he had his heart attack: https://www.wsj.com/articles/john-stockmans-medical-bills-to... He may have been attended-to by out-of-network practitioner: https://www.nbcwashington.com/news/local/Out-of-Network-ER-S...

Number two for sure. You are almost guaranteed to be seen by an out-of-network provider. It does not matter if you go to an in-network hospital/ER, the providers go out of their way to work a couple hundred miles from home just to bring in the big OON prices. Out of three visits to in-network ERs (in two different states) in the last seven years, how many do you think resulted in crazy charges from OON providers? If…

I’ve been to the ER twice in the last 2 years. Once at the hospital blocks from my house & once while traveling for work 800 miles away. In neither case did I get charged out of network charges.

In fact in the 25 years I’ve paid for mine or my families health care I’ve never seen what you describe over lots of ER visits.

There are lots of things wrong with the US health system, providers systematically trying to get out of network fees isn’t one of them.

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

#403

Post by tripzilch »

krupan wrote: post #60
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…

Everyone asking for sources fornthis, just think about it. What if Europe decided that iPhones we're too expensive and implemented Single-Payer Phone Care? They'd dictate a price that the government would pay for iPhones in their countries and Apple would either not sell iPhones in Europe at all, or they would sell for the dictated price. They'd do their market studies and possibly conclude that they can jack up U.S.…

That is not how any of this works.

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

#404

Post by VBprogrammer »

narrator wrote: post #351
gumby wrote: post #241

Earlier quoted context omitted.

In a hospital you'll likely be seen by a variety of providers some, or even many of whom are not in your network. You insurer will pay some amount out and then the provider will bill you for the rest...which can be huge. This bill is unrelated to your insurance and is unrelated to any out of pocket maximum. That maximum only relates to copays etc as part of your insurance.

When I had a kidney stone, I made sure to get to Kaiser. Not the closest hospital, but at least everyone's going to be in network. That's the biggest benefit of Kaiser IMHO, no wacky out of network stuff at their hospitals.

In the UK which hospital you would go to is nearly 100% based on ease of getting there and the facilities they have on hand.

The idea of driving past a hospital to get to another which is more friendly to my insurance plan completely blows my mind.

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

#405

Post by isostatic »

marcus_holmes wrote: post #354
lostlogin wrote: post #279

Earlier quoted context omitted.

I understand this, but don’t understand why millions of people are ok with the system. It has a lot more in common with a protection racket than with patient care in my view.

yeah. Can you refuse treatment from an OON provider in a hospital? Because that would be my first question if approached by a doctor who could potentially bill me $100K

When I go to hospital, on the assumption I'm conscious, the last thing on my mind is deciding which doctor I want

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

#406

Post by rscho »

djrobstep wrote: post #299
vasili111 wrote: post #235

Earlier quoted context omitted.

If you need talents to stay in your country then you need to pay them more.

No, the US needs to stop over-paying their doctors. And doctors need to stop being corrupt by reducing supply of doctors through restrictive medical school entry.

Then, you should be targeting lobbyists and politicians. Front line workers (including doctors) are a very poor target for pressure if you want to achieve the same level of care for a cheaper price (including cheaper docs). The only result of your conspirationistic views will be worse care for a higher price.

But, I suppose no one will be able to sway you from your current opinion...

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

#407

Post by vasilipupkin »

nerdponx wrote: post #205
vasilipupkin wrote: post #84

Earlier quoted context omitted.

Canada has equivalent of Medicare for all. And Canada has at least some of these problems, for example longer wait times. These long wait times don’t ultimately affect average outcomes.

I think you misread my post. By "these problems" I meant "overspending on things that don't improve outcomes." But if paying for extra care is illegal in Canada then my argument doesn't work.

Being able to see my doctor for a health problem on short notice improves my quality of life but it probably doesn’t change outcomes as there is a very low likelihood that my problem is both life threatening and urgent. But choosing to pay doctors more to reduce wait times is not right or wrong - it’s just a different preference.

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

#408

Post by tripzilch »

rpedela wrote: post #95
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…

It is true that the US pays for a significant portion of drug R&D for the world. However the vast majority of that R&D is funded by the NIH which in turn is funded by U.S. taxpayers. It is a myth that it is the pharma companies who fund much of R&D even though they do spend some money on it. They set the prices so high because they can. The patents give them a monopoly, and they do everything in their power to "everg…

> One example is first patenting the left version of a molecule then patenting the right version (mirror image).

Just a small correction for accuracy; they actually patent the 50/50 mixture of both versions first. And then they patent the purified version that only contains the active enantiomer ("mirror image").

Because of how biology works, turns out that the "wrong" mirror image (that is absent from the new version of the drug) was in fact really inactive, doesn't do anything, and thus offers no advantage over the old version, except being covered by a new patent to milk.

These are the kind of drug research "advances" that the rest of the world is supposedly freeloading off of.

It's not freeloading, it's being dominated by a multi-billion dollar global marketing budget.

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

#409

Post by isostatic »

RHSeeger wrote: post #296
asdff wrote: post #262

Earlier quoted context omitted.

This is like if the whole town is on fire, but you have enough money to pay the fireman to save your house first. Priority access to universal needs shouldn't be given based on personal wealth. I wonder if the people who wrote this line jumping into law qualified for the public or private insurance.

> universal needs Not everyone agrees Person A's needs should be paid for by other people. The system described (that pays for everyone, but treats people that can afford it better) may be a reasonable compromise to those people.

That sounds like the UK system, where everyone gets NHS, but those that want to spend £1k a year extra or whatever get private healthcare (BUPA etc)

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

#410

Post by DennisP »

rscho wrote: post #373
arethuza wrote: post #369

Earlier quoted context omitted.

"there is no reason my money should pay for the care of others" Isn't the cultural issue largely a idealogical issue - things like the UK NHS are avowedly socialist? In the words of Aneurin Bevan, founder of the NHS: " A free health service is pure Socialism and as such it is opposed to the hedonism of capitalist society." https://en.wikipedia.org/wiki/Aneurin_Bevan Personally, at least when it comes to healthcare, I…

Indeed, I think so too. Ironically, people essentially tend to ask for freedom of choice above all in the US healthcare system (I want complete price info, yada yada...) when the US system is evidently already the one offering the highest level of patient autonomy, probably worldwide (regarding the ethics principles of beneficence, nonmaleficience, Justice and autonomy). But guess what? That has a price, who would ha…

People want complete price information because we don't have price controls, like they have in Germany, France, and Japan. Having a "free market" in healthcare without showing prices in advance of providing services is sort of obviously the worst way to get a reasonably priced healthcare system.

That's somewhat mitigated by negotiations between insurers and providers, but not entirely given out-of-network charges.

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