Insured price $2,758, cash price $521 • Hacker News Board

Re: Insured price $2,758, cash price $521

#301

Post by cma » Sat, Aug 03, 2019, 6:28 AM UTC

epmaybe wrote: post #250

avocado4 wrote: post #41

Earlier quoted context omitted.

https://www.politico.com/agenda/story/2017/10/25/doctors-sal... Providers are the core problem. Various doctor associations (AMA et al) have strangled supply side of healthcare through State licensure and scope of practice laws. Just read medical forums to get an idea of what an average doctor thinks about competition in the form of midlevels: https://www.auntminnie.com/Forum/tm.aspx?m=581583 "Don’t teach your mid le…

Disclaimer: I'm still a medical student, take my biases into account when you read this. It seems like mid level providers are being granted more and more autonomy each year. In fact, they have full practice authority in 20 states (no need to work under a physician). Knowing that, are the AMA et al truly strangling the supply side of healthcare? From the politico article you linked, it seems that the number of specia…

The mean doctor salary is significantly higher than that, $294,000.

Re: Insured price $2,758, cash price $521

#302

Post by novaRom » Sat, Aug 03, 2019, 6:29 AM UTC

namibj wrote: post #204

konschubert wrote: post #133

Earlier quoted context omitted.

The real problem is that the x-ray costs 400. It doesn’t have to be that way

Here in Germany it's less than 20. I think it was between 10 and 15 € for a finger. This includes an expert's opinion, albeit a succinct one. I wish they'd do technical/industrial things in a similar fashion. Make appointment, bring piece, get xray, wait a few minutes, leave with xray image/dataset. For cheap. Require bagging for contamination reasons.

Here in Germany we pay highest healthcare insurance costs in the world. If you earn more than 55000 Euro/year, you have to pay 9600 Euro/year for health insurance alone!

And you cannot opt out!

Together with your spouse you have to pay insane 19200 Euro annually!

No wonder it is between 10 and 15 Euro for a finger. In USA if you pay $20000 you will be fully ensured and you will not need to pay anything for your finger check.

Re: Insured price $2,758, cash price $521

#303

Post by aj7 » Sat, Aug 03, 2019, 6:32 AM UTC

dpq wrote: post #286

onlyrealcuzzo wrote: post #275

Earlier quoted context omitted.

I once went to an emergency room near Philadelphia -- Bryn Mawr -- and I was there for tops 2 hours. They didn't do anything fancy, beside an EKG (if you can even call that fancy). They sent me a bill for $15k. Luckily insurance covered 80% of it... But still! It basically maxed out my out-of-pocket for the year. And for what? An EKG -- at the time -- cost, on average, less than $100... I remember calling the billing…

So basically it would be cheaper to fly to Canada (/Europe/Russia/where er) for $500 roundtrip and get an EKG for $100 there. You know something's weird when this is what a better solution looks like.

My ex-wife regularly scheduled medical checkups in Korea. For $1500, they did very extensive tests and examinations, all in an 8-hour day.

Re: Insured price $2,758, cash price $521

#304

Post by octorian » Sat, Aug 03, 2019, 6:33 AM UTC

drblast wrote: post #107

Insurance is not supposed to make routine things more affordable. It's supposed to spread the risk of catastrophic loss from unlikely events around to a large group of people so you don't have to worry about losing your house if you get struck by lightning. Everyone needs routine medical care at some point so an insurance model doesn't work there. You don't have gas or grocery insurance, do you? If that were a thing…

> Insurance is not supposed to make routine things more affordable. It's supposed to spread the risk of catastrophic loss from unlikely events around to a large group of people so you don't have to worry about losing your house if you get struck by lightning. Everyone needs routine medical care at some point so an insurance model doesn't work there.

And this is why all of our heated political debates go nowhere in the US. You have Democrats ranting and raving over how they want to provide health insurance for everyone, even if private companies help provide it. (With their supporters full of sob stories.) You have Republicans ranting and raving over how great it is to keep everything private and allow insurers to not cover everyone. (With their supporters pretending its just "insurance" you can live without.)

Meanwhile, its not really "insurance" at all. Its basically a cartel of companies that negotiate a situation where healthcare is effectively unaffordable without them acting as an intermediary.

Re: Insured price $2,758, cash price $521

#305

Post by jopsen » Sat, Aug 03, 2019, 7:59 AM UTC

namibj wrote: post #205

jopsen wrote: post #104

Earlier quoted context omitted.

If the x-ray is better in any way, it's not wise to recommend anything else. It's better to ensure that the very treatment is affordable

Xrays are not universally good. It's always exposure to ionizing radiation.

True, but I'm not a domain expert, so I can't make that call. But I'm sure someone did the math on this risk.

Mistreating a broken finger could also leave you with reduced function in the hand. Needless to say that's also a risk.

Re: Insured price $2,758, cash price $521

#306

Post by Gibbon1 » Sat, Aug 03, 2019, 8:03 AM UTC

novaRom wrote: post #302

namibj wrote: post #204

Earlier quoted context omitted.

Here in Germany it's less than 20. I think it was between 10 and 15 € for a finger. This includes an expert's opinion, albeit a succinct one. I wish they'd do technical/industrial things in a similar fashion. Make appointment, bring piece, get xray, wait a few minutes, leave with xray image/dataset. For cheap. Require bagging for contamination reasons.

Here in Germany we pay highest healthcare insurance costs in the world. If you earn more than 55000 Euro/year, you have to pay 9600 Euro/year for health insurance alone! And you cannot opt out! Together with your spouse you have to pay insane 19200 Euro annually! No wonder it is between 10 and 15 Euro for a finger. In USA if you pay $20000 you will be fully ensured and you will not need to pay anything for your finge…

> In USA if you pay $20000 you will be fully ensured and you will not need to pay anything for your finger check.

Oh my sweet summer child.

Re: Insured price $2,758, cash price $521

#307

Post by neya » Sat, Aug 03, 2019, 8:44 AM UTC

seanmcdirmid wrote: post #78

neya wrote: post #66

Earlier quoted context omitted.

Then how do you explain countries like India where it's drastically affordable and high quality at the same time?

You pay at the entrance, not at the exit. Also, standards of care, facility costs, and compensation for medical professionals is much lower.

This is simply not true enough to be generalized. In most hospitals always pay at the exit unless you weren't there for some pre defined checkup package instead of proper consulting.

Re: Insured price $2,758, cash price $521

#308

Post by jcl » Sat, Aug 03, 2019, 8:53 AM UTC

drblast wrote: post #107

Insurance is not supposed to make routine things more affordable. It's supposed to spread the risk of catastrophic loss from unlikely events around to a large group of people so you don't have to worry about losing your house if you get struck by lightning. Everyone needs routine medical care at some point so an insurance model doesn't work there. You don't have gas or grocery insurance, do you? If that were a thing…

> You don't have gas or grocery insurance, do you?

Some people do have analogous "insurance" for gas or groceries: Anyone with a Sam's Club, Costco, or Amazon Prime membership pays a subscription fee so that they can get a negotiated discount on routine, affordable expenses.

So, yeah, I guess most "health insurance" could be more accurately called "healthcare buyer's clubs (that also happen to include some insurance)". Unfortunately, we're in the late stages of an economy where the buyer's clubs have eaten the entire market and are free to extract fat margins with little consequence.

Re: Insured price $2,758, cash price $521

#309

Post by germanier » Sat, Aug 03, 2019, 10:13 AM UTC

novaRom wrote: post #302

namibj wrote: post #204

Earlier quoted context omitted.

Here in Germany it's less than 20. I think it was between 10 and 15 € for a finger. This includes an expert's opinion, albeit a succinct one. I wish they'd do technical/industrial things in a similar fashion. Make appointment, bring piece, get xray, wait a few minutes, leave with xray image/dataset. For cheap. Require bagging for contamination reasons.

Here in Germany we pay highest healthcare insurance costs in the world. If you earn more than 55000 Euro/year, you have to pay 9600 Euro/year for health insurance alone! And you cannot opt out! Together with your spouse you have to pay insane 19200 Euro annually! No wonder it is between 10 and 15 Euro for a finger. In USA if you pay $20000 you will be fully ensured and you will not need to pay anything for your finge…

> If you earn more than 55000 Euro/year, you have to pay 9600 Euro/year for health insurance alone!

Half of which is paid by your employer. If you earn less, you pay less and still get access to the same health care.

> Together with your spouse you have to pay insane 19200 Euro annually!

Only if they also earn as much. If they don't work, your don't pay anything to insure them.

> And you cannot opt out!

Employees earning more than 60k and freelancers can opt out of the system.

> No wonder it is between 10 and 15 Euro for a finger.

With insurance you don't pay anything for getting your finger checked. That was the price without insurance (full bill including consultation would be probably 50€ or so).

Re: Insured price $2,758, cash price $521

#310

Post by lotsofpulp » Sat, Aug 03, 2019, 11:42 AM UTC

ZhuanXia wrote: post #299

lotsofpulp wrote: post #209

Earlier quoted context omitted.

There better be a $300k+ payday at the end of a doctor’s training, otherwise I don’t see how the gauntlet they get put through is worth sacrificing their best years (20s and early 30s).

If you are trying to make free market arguments for doctors salaries come on. The doctors guild restricts supply through the state. No free market here.

I’m saying with the current requirements of becoming a doctor, a very high pay is needed to incentivize smart people who have options to choose to become a doctor.