Americans Are Going Bankrupt from Getting Sick • Hacker News Board

Re: Americans Are Going Bankrupt from Getting Sick

#11

Post by rubicon33 » Sat, Mar 16, 2019, 7:04 PM UTC

tapland wrote: post #7

i_am_proteus wrote: post #6

Earlier quoted context omitted.

Interesting logical jump from "medical facilities overcharge" to "we desperately need single-payer healthcare in this country." Single payer is certainly one possible solution, but it's not the only feasible solution, despite conclusions that availability bias might lead us to. I'm curious: what was the final price after insurance negotiated on your behalf?

You need single payer because you can overcharge anyone who can't negotiate lower rates (i.e. individuals who's personal business with the healthcare system doesn't have much if any effect on it). Compare that to a state bargaining on behalf of 10+ million customers.

Ah, so then that's what this boils down to? The high cost of health care is a symptom of capitalism run a muck? We're being charged these exorbitant rates simply because they can get away with it? If only we had a single payer that was able to negotiate, these costs would evaporate over night? Not sure it's that simple...

Although, in a way it does kind of make sense. Unlike consumer goods (television, cars, etc.), one's health is something they're likely willing to break-the-bank for. So without any kind of restraint, I could see costs getting out of control. The hospital is focused on making as much money as they can, and the consumer is focused on preserving their health. If one doesn't have their health after all, what do they have?

Add an ever increasing demand (baby boomers are aging rapidly) and suddenly, things begin to look much worse for the demand side of the equation.

Re: Americans Are Going Bankrupt from Getting Sick

#12

Post by enraged_camel » Sat, Mar 16, 2019, 7:04 PM UTC

tapland wrote: post #5

Don't fall for the 'yes, but countries that have cheap healthcare pay for it with taxes'. The US pays more than most from taxes[0]. In Sweden we pay less per capita than americans do (from taxes) and my total _maximum_ healthcare costs for _all_ treatments, medications, surgury etc, that in the US would be paid by your employer or yourself are: $125/year max for all visits and procedures [1] + $250/year max for all p…

>>Don't fall for the 'yes, but countries that have cheap healthcare pay for it with taxes'. The US pays more than most from taxes[0].

Americans don't actually have an objection to paying more for healthcare.

What they do have an objection to is paying for other people's healthcare.

America is a deeply individualistic society, and the idea of one's tax dollars being spent to benefit others lies at the root of most people's objections to single-payer, or anything else that smells like "socialism".

Re: Americans Are Going Bankrupt from Getting Sick

#13

Post by enraged_camel » Sat, Mar 16, 2019, 7:05 PM UTC

i_am_proteus wrote: post #6

enraged_camel wrote: post #2

I accidentally stabbed myself in the finger while cutting open a package using a knife. Stupid, I know. The would was small, maybe 1 centimeter, but deep enough that it wouldn't stop bleeding on its own. My girlfriend insisted we go to the ER (urgent cares around here are closed on Sundays), so we did. I was the only one there that day. I was ushered in to see a doctor. The doctor looked at the wound, and said, "this…

Interesting logical jump from "medical facilities overcharge" to "we desperately need single-payer healthcare in this country." Single payer is certainly one possible solution, but it's not the only feasible solution, despite conclusions that availability bias might lead us to. I'm curious: what was the final price after insurance negotiated on your behalf?

I think the final amount I had to pay was around $1,150.

Re: Americans Are Going Bankrupt from Getting Sick

#14

Post by scarface74 » Sat, Mar 16, 2019, 7:05 PM UTC

anoncoward111 wrote: post #3

And it is entirely because the powers that be have rigged the market so that they can charge whatever they want. How have they accomplished this? First, they set strict quotas on who can be a doctor. Then, they set strict quotas on who can offer what medical goods and products. Then, they strap everyone up with student and business debt. I'm not saying it is the correct way or not, but there's a reason that in other…

There is something more direct. When Bush signed the prescription drug add on for Medicare, it was made illegal for Medicare to negotiate rates - even though the VA can.

Re: Americans Are Going Bankrupt from Getting Sick

#15

Post by Pharmakon » Sat, Mar 16, 2019, 7:07 PM UTC

anoncoward111 wrote: post #3

And it is entirely because the powers that be have rigged the market so that they can charge whatever they want. How have they accomplished this? First, they set strict quotas on who can be a doctor. Then, they set strict quotas on who can offer what medical goods and products. Then, they strap everyone up with student and business debt. I'm not saying it is the correct way or not, but there's a reason that in other…

Every functional society regulates who can be a doctor and who can produce medical goods and services, that really isn’t a problem. It can probably be helpful to try and look for differences between countries as opposed to just going for a libertarian end-run. Problems with the US system are an out-of-control pricing structure due to fragmentation of bargaining power, insane patenting laws which allow evergreening strategies, ideological opposition to functional and prove reforms, and good old fashioned cronyism.

The need to regulate the healthcare space is unavoidable, but simply bending over in the name of a free market that isn’t free is quite avoidable. The nature of for example, pharmaceuticals as a natural monopoly is acknowledged and confronted in those countries which offer OTC or generic options where the US doesn’t. The need for a strong bargaining position to negotiate pricing has been consistently undermined in the US.

Re: Americans Are Going Bankrupt from Getting Sick

#16

Post by tapland » Sat, Mar 16, 2019, 7:07 PM UTC

i_am_proteus wrote: post #10

tapland wrote: post #7

Earlier quoted context omitted.

You need single payer because you can overcharge anyone who can't negotiate lower rates (i.e. individuals who's personal business with the healthcare system doesn't have much if any effect on it). Compare that to a state bargaining on behalf of 10+ million customers.

Cf. the insurance company negotiating on the above poster's behalf, and my curiosity about the result of those negotiations.

Well. A for profit entity can hardly be regarded as bargaining on your behalf. They are bargaining on behalf of their revenue. The difference between what they negotiate and what they charge you is their entire business.

Re: Americans Are Going Bankrupt from Getting Sick

#17

Post by bluecalm » Sat, Mar 16, 2019, 7:07 PM UTC

tapland wrote: post #7

i_am_proteus wrote: post #6

Earlier quoted context omitted.

Interesting logical jump from "medical facilities overcharge" to "we desperately need single-payer healthcare in this country." Single payer is certainly one possible solution, but it's not the only feasible solution, despite conclusions that availability bias might lead us to. I'm curious: what was the final price after insurance negotiated on your behalf?

You need single payer because you can overcharge anyone who can't negotiate lower rates (i.e. individuals who's personal business with the healthcare system doesn't have much if any effect on it). Compare that to a state bargaining on behalf of 10+ million customers.

You just need more competition and regulations to make prices public and stated before the procedure. I live in a country with single payer healthcare. It sucks tremendously. Instead of paying there is waiting, sometimes for long months for absolutely crucial procedures. Fortunately I also live in a country with reasonable regulations and sizeable private healthcare facilities. I pay reasonable prices (which means often 5x-20x less than in US) if I need treatment and I can get it in timely manner.

It's not single payer that makes our system better. It's competition and reasonable regulation that makes it possible to have cheap services available.

Re: Americans Are Going Bankrupt from Getting Sick

#18

Post by tapland » Sat, Mar 16, 2019, 7:09 PM UTC

rubicon33 wrote: post #11

tapland wrote: post #7

Earlier quoted context omitted.

You need single payer because you can overcharge anyone who can't negotiate lower rates (i.e. individuals who's personal business with the healthcare system doesn't have much if any effect on it). Compare that to a state bargaining on behalf of 10+ million customers.

Ah, so then that's what this boils down to? The high cost of health care is a symptom of capitalism run a muck? We're being charged these exorbitant rates simply because they can get away with it? If only we had a single payer that was able to negotiate, these costs would evaporate over night? Not sure it's that simple... Although, in a way it does kind of make sense. Unlike consumer goods (television, cars, etc.), o…

> Not sure it's that simple...

There aren't that many countries that pay as much as the us from public funds (two, see my previous link) or out of pocket (none).

The problem is localized to the US.

Re: Americans Are Going Bankrupt from Getting Sick

#19

Post by raesene9 » Sat, Mar 16, 2019, 7:09 PM UTC

enraged_camel wrote: post #12

tapland wrote: post #5

Don't fall for the 'yes, but countries that have cheap healthcare pay for it with taxes'. The US pays more than most from taxes[0]. In Sweden we pay less per capita than americans do (from taxes) and my total _maximum_ healthcare costs for _all_ treatments, medications, surgury etc, that in the US would be paid by your employer or yourself are: $125/year max for all visits and procedures [1] + $250/year max for all p…

>>Don't fall for the 'yes, but countries that have cheap healthcare pay for it with taxes'. The US pays more than most from taxes[0]. Americans don't actually have an objection to paying more for healthcare. What they do have an objection to is paying for other people's healthcare. America is a deeply individualistic society, and the idea of one's tax dollars being spent to benefit others lies at the root of most peo…

It's interesting you say that, I've heard that line of argument before but it is quite puzzling.

Are you suggesting that a person on Low income in the US doesn't object to paying more than they have for their own healthcare (i.e. that they wouldn't like that healthcare to be cheaper)

That seems a bit counter-intuitive, as usually people don't like being bankrupt.

Re: Americans Are Going Bankrupt from Getting Sick

#20

Post by rayiner » Sat, Mar 16, 2019, 7:12 PM UTC

tapland wrote: post #5

Don't fall for the 'yes, but countries that have cheap healthcare pay for it with taxes'. The US pays more than most from taxes[0]. In Sweden we pay less per capita than americans do (from taxes) and my total _maximum_ healthcare costs for _all_ treatments, medications, surgury etc, that in the US would be paid by your employer or yourself are: $125/year max for all visits and procedures [1] + $250/year max for all p…

> In Sweden we pay less per capita than americans do (from taxes)

Taxes as a percentage of GDP in Sweden is 37%, versus about 27% in the United States.