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The World’s Cheapest Hospital Has to Get Even Cheaper

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Re: The World’s Cheapest Hospital Has to Get Even Cheaper

#191

Post by bzbarsky »

ams6110 wrote: post #26
notyourday wrote: post #19

Earlier quoted context omitted.

High Deductible Plan. Takes care of big ass expenses, steep cost in the beginning.

It's a start, but imperfect because most people with a high deductible plan will also have a health savings account (HSA). The HSA may even be required, not sure. The problem with HSAs is that although it's "your" money, it can only be spent on qualified health expenses. So there's a reduced incentive to spend carefully, because you can't use the money for anything else.

> it can only be spent on qualified health expenses

Once you reach retirement age it can be used like any Traditional IRA account, except for inability to roll it over to another IRA or do a Roth conversion, if I understand correctly.

Re: The World’s Cheapest Hospital Has to Get Even Cheaper

#192

Post by omegaworks »

kbutler wrote: post #189
omegaworks wrote: post #173

Earlier quoted context omitted.

It is no free lunch, but I never claimed it was. It is an option on the table, not one without consequences. It’s never just healthcare, sure: move the goalposts and set up your slippery slope. But consider this: what if the tax produced value over the cost of its implementation? What if it prevented harder, more expensive downline complications or made the population more productive —more likely to gain, retain and…

Proposing that it is a justifiable tax for investment is very different from saying "the concept of 'a nation can't afford' does not make sense [for] a nation-state with control of its own currency". It looks like you understand why even a nation that controls it's own currency may not be able to afford nationalized healthcare: 1) because creating and allocating currency inflates prices, it just hides the cost rather…

If printing the money results in commensurate levels of increased productivity, then printing the money will not cause price inflation.

That’s why most nations grow their money supply over time, after all :)

Re: The World’s Cheapest Hospital Has to Get Even Cheaper

#193

Post by leetcrew »

ams6110 wrote: post #164
leetcrew wrote: post #42

Earlier quoted context omitted.

if you end up with "too much" money in your HSA, can't you just reduce the amount of money that goes into it? obviously you can't just go buy a car with the money, but to me it seems like there is a strong incentive not to overspend from your HSA if you control how much of your paycheck goes into it.

Yes but I always contribute the max to get the most tax reduction. I like paying taxes less than I like paying doctors.

have you already maxed out your company 401k and IRA contributions?

Re: The World’s Cheapest Hospital Has to Get Even Cheaper

#194

Post by dredmorbius »

notyourday wrote: post #190
dredmorbius wrote: post #188

Earlier quoted context omitted.

No, it is not. It's an argument for structural rather than individual change.

Yes, the structural change is "make individuals be on a hook for overpayments"

Actually, the best cost-containment strategy is to make the provider liable.

That's the notion behind comprehensive HMO systems, with fixed capitated premiums, minimal copayments (a very low friction suffices against most frivolous use0, penalties for failed delivery (see also the Chinese doctor model: the patient pays when healthy), comprehensive monitoring and routinisation, a public health model, and som external oversight.

Within the US, that model describes the Kaiser Permanente healthcare model. Or Medicare I'd add a Danish malpractice remedy to that (provision of care to correct or mitigate mis-delivery or errors), but it's remarkably effective.

Pharmaceuticals remain outside the Kaiser and Medicare systems, a chief weakness.

There's also the fact that virtually all improvements over pre-modern longevity come from public health rather than acute medical interventions.

http://1.bp.blogspot.com/-uTWEATUzgxk/TXQoTibILtI/AAAAAAAAAA...

Re: The World’s Cheapest Hospital Has to Get Even Cheaper

#195

Post by ketcomp »

onetimemanytime wrote: post #179

>> The tubes that carry blood to heart-and-lung machines are sterilized and reused after each surgery; in the West, they’re thrown away. Just cancelled my surgery :). Seriously, this is not an area to maximize savings.

It sounds like a bad idea - but scalpels and metal tools are not thrown away either - they're sterilized. Something like a plastic tube may have 2 or 3 uses in it instead of just 1 - as long as the sterilization is within acceptable tolerances - why not? A reusable rocket too was unthinkable until a private company did it. One shouldn't discard experimental evidence just because it conflicts with one's belief systems.

Re: The World’s Cheapest Hospital Has to Get Even Cheaper

#196

Post by shripadk »

fwip wrote: post #148
thatoneuser wrote: post #140

Earlier quoted context omitted.

OK so if humans didn't toil to create tools and housing and technology then how did it arise?

The fundamental assertion of capitalism is that capital should beget capital. Under capitalism, wealth is created by labor and taken by those already wealthy.

> The fundamental assertion of capitalism is that capital should beget capital.

This quote explains just half the story. The half of the story being: "success".

Pray tell me how is wealth created by labor without someone investing the necessary capital required to begin with? It is not like the labor worked for free.

The "wealthy" laboured at one point to earn that capital. They just "chose" to invest their hard-earned capital wisely which helped them beget more capital. Upto that point, your assertion holds true.

There are many who were "wealthy" who made blunders when they did not invest their capital wisely and lost it all. Would the fundamental assertion of capitalism "capital should beget capital" hold true in this case? And for all the Zuckerbergs, Jobs and Gates out there, there are a million more who failed. Those million are proof that the fundamental assertion of "capital should beget capital" is false.

The only assertion that fits Capitalism is "Survival of the fittest". I can live with that!

Re: The World’s Cheapest Hospital Has to Get Even Cheaper

#197

Post by thatoneuser »

BucketSort wrote: post #149
thatoneuser wrote: post #144

Earlier quoted context omitted.

I'll be honest - I don't know many people who are of sound mind and body and who consistently make level headed choices living in constant fear of having basic necessities. I know a LOT of people in this situation because they don't improve their skills, don't work many hours, had kids young, had numerous kids, want to live in a high demand area despite low income or because they prioritize luxury items over quality…

> I know a LOT of people in this situation because they don't improve their skills, don't work many hours, had kids young, had numerous kids, want to live in a high demand area despite low income or because they prioritize luxury items over quality necessities. Yes, of course. Are you suggesting all people are wise and have this foresight? Are you suggesting that people aren't raised in stressful and violent environm…

See you're still trying to be condescending. You don't know me and you made all those lurching assumptions. You asked insulting questions and tried talking down to me. Enjoy your feeling of superiority.

Re: The World’s Cheapest Hospital Has to Get Even Cheaper

#198

Post by digitaltrees »

notyourday wrote: post #85
digitaltrees wrote: post #59

Earlier quoted context omitted.

Were these amounts after insurance? just your share out of pocket? Or actual total?

These were the actual costs that I have to pay out of pocket until I reach the deductible of my insurance ( yearly ). I was at zero since it is a new year. In my case it is coming out of my HSA. Basically, cash price.

That means you don’t actually know the real cost since insurance shields you from the actual amount and it can be drastically different for each insurance company. You’re just estimating with a false sense of information.

Re: The World’s Cheapest Hospital Has to Get Even Cheaper

#199

Post by BucketSort »

thatoneuser wrote: post #197
BucketSort wrote: post #149

Earlier quoted context omitted.

> I know a LOT of people in this situation because they don't improve their skills, don't work many hours, had kids young, had numerous kids, want to live in a high demand area despite low income or because they prioritize luxury items over quality necessities. Yes, of course. Are you suggesting all people are wise and have this foresight? Are you suggesting that people aren't raised in stressful and violent environm…

See you're still trying to be condescending. You don't know me and you made all those lurching assumptions. You asked insulting questions and tried talking down to me. Enjoy your feeling of superiority.

Those were rhetorical questions. I am sorry I offended you.

Re: The World’s Cheapest Hospital Has to Get Even Cheaper

#200

Post by sovnade »

noelsusman wrote: post #107
DesiLurker wrote: post #58

Earlier quoted context omitted.

that is the whole point of publishing prices. with it implicitly you have to adjust your billing to be able to charge predictably for a service such as MRI etc. and if you dont you dont survive in long run as people gravitate towards the providers that give them clarity. why should be hospitals be the only ones allowed to do this highly anticompetitive practice?

The vast majority of patients don't care about price because their insurance is covering it.

That's shifting though with the rise in popularity of high deductible plans.

My plan is 5k deductible, 5k OOP Max, so I'm acutely aware of how much everything costs.

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