Employer health plans are getting pricier and skimpier • Hacker News Board

Re: Employer health plans are getting pricier and skimpier

#271

Post by throw_xyzyz » Wed, Sep 25, 2019, 9:33 PM UTC

eric_b wrote: post #248

mullen wrote: post #218

Earlier quoted context omitted.

> One thing that will not make healthcare less expensive is "Medicare For All". It will just shift the bill to different people. Now, you can argue it's the morally correct course of action, or those people who will be forced to foot the bill (upper middle class taxpayers) are more capable of doing so, but you cannot credibly claim with a straight face that it will make anything cheaper. In fact, the opposite will oc…

Sure, the government can say they'll only pay half as much as they do now, so providers will only provide half the care. Have you ever actually done any government procurement? Saying the government can just wave a magic wand and lower prices because "they said so" will only hurt the quality of care patients receive in the US.

The quality of care is already so low that you're better off financially and health wise just flying to Europe, or fleeing to Canada.

Re: Employer health plans are getting pricier and skimpier

#272

Post by romwell » Wed, Sep 25, 2019, 9:33 PM UTC

simonsarris wrote: post #239

mullen wrote: post #218

Earlier quoted context omitted.

> One thing that will not make healthcare less expensive is "Medicare For All". It will just shift the bill to different people. Now, you can argue it's the morally correct course of action, or those people who will be forced to foot the bill (upper middle class taxpayers) are more capable of doing so, but you cannot credibly claim with a straight face that it will make anything cheaper. In fact, the opposite will oc…

> Having every person under the same plan that has the negotiating power of 327.2 million people will definitely drive costs down. Why do you think this would be true? Why do you think the bargaining power would work the way you think it would? If you were correct, then cop cars must be fairly cheap compared to normal cars. Is this the case? What about other goods? Laptops? Cruise missiles? etc. Actually is it true f…

Perhaps this is a good reason:

>Literally, every Industrial Nation has addressed this problem for much lower costs with better out comes.

Re: Employer health plans are getting pricier and skimpier

#273

Post by throwaway5752 » Wed, Sep 25, 2019, 9:34 PM UTC

eric_b wrote: post #148

The problem is that there is not a single reason that healthcare is so expensive. Even if you list the top 15 reasons, you still have to apply the "5 whys" to each of them to find root causes and possible solutions. - Doctor's are paid too much... why? - Well they need to be paid a lot because medical school debt is 250k or more... why? - Medical schools/the AMA are artificially limiting the number of students and re…

"Medical schools/the AMA are artificially limiting the number of students and residents for their own ends (keeping wages and scarcity high) so they need to charge a lot."

That is the peril of this type of analysis. Clinician cost is only 20% of total healthcare spend. Your premise is flawed so your conclusion is invalid.

Re: Employer health plans are getting pricier and skimpier

#274

Post by glitcher » Wed, Sep 25, 2019, 9:34 PM UTC

eric_b wrote: post #148

The problem is that there is not a single reason that healthcare is so expensive. Even if you list the top 15 reasons, you still have to apply the "5 whys" to each of them to find root causes and possible solutions. - Doctor's are paid too much... why? - Well they need to be paid a lot because medical school debt is 250k or more... why? - Medical schools/the AMA are artificially limiting the number of students and re…

> But the current political climate in the US is incapable of dealing with any kind of multifaceted problem.

I fear this may be true of all political issues now.

Sound bites and catch phrases that way oversimplify complex issues to the point of absurdity seem to sway a lot of voters.

Re: Employer health plans are getting pricier and skimpier

#275

Post by throwaway5752 » Wed, Sep 25, 2019, 9:35 PM UTC

geddy wrote: post #180

eric_b wrote: post #148

The problem is that there is not a single reason that healthcare is so expensive. Even if you list the top 15 reasons, you still have to apply the "5 whys" to each of them to find root causes and possible solutions. - Doctor's are paid too much... why? - Well they need to be paid a lot because medical school debt is 250k or more... why? - Medical schools/the AMA are artificially limiting the number of students and re…

> Doctor's are paid too much... why? You can also branch off here: because malpractice insurance is insanely expensive. Why? Because people sue over absolutely everything. Why? Because lawyers in this country are vultures. If anything is overly expensive, you can usually track it back to insurance costs somewhere, which can typically be tracked back to the fact that we live in a litigious society.

Malpractice insurance is < 3% of total healthcare cost in the US. Considering malpractice occurs and has an actual cost, not even all of that is wasted.

Re: Employer health plans are getting pricier and skimpier

#276

Post by oarabbus_ » Wed, Sep 25, 2019, 9:36 PM UTC

eric_b wrote: post #148

The problem is that there is not a single reason that healthcare is so expensive. Even if you list the top 15 reasons, you still have to apply the "5 whys" to each of them to find root causes and possible solutions. - Doctor's are paid too much... why? - Well they need to be paid a lot because medical school debt is 250k or more... why? - Medical schools/the AMA are artificially limiting the number of students and re…

The AMA is a cartel, and we (in the US) are all suffering for it.

Re: Employer health plans are getting pricier and skimpier

#277

Post by [deleted] » Wed, Sep 25, 2019, 9:38 PM UTC

romwell wrote: post #272

simonsarris wrote: post #239

Earlier quoted context omitted.

> Having every person under the same plan that has the negotiating power of 327.2 million people will definitely drive costs down. Why do you think this would be true? Why do you think the bargaining power would work the way you think it would? If you were correct, then cop cars must be fairly cheap compared to normal cars. Is this the case? What about other goods? Laptops? Cruise missiles? etc. Actually is it true f…

Perhaps this is a good reason: >Literally, every Industrial Nation has addressed this problem for much lower costs with better out comes.

[deleted]

Re: Employer health plans are getting pricier and skimpier

#278

Post by jorblumesea » Wed, Sep 25, 2019, 9:39 PM UTC

eric_b wrote: post #148

The problem is that there is not a single reason that healthcare is so expensive. Even if you list the top 15 reasons, you still have to apply the "5 whys" to each of them to find root causes and possible solutions. - Doctor's are paid too much... why? - Well they need to be paid a lot because medical school debt is 250k or more... why? - Medical schools/the AMA are artificially limiting the number of students and re…

> I don't want to hear one thing about negotiating power. That is a debunked line of reasoning. Medicare/Medicaid cover more people than many single payer systems in other countries

That's... not true at all. In European countries, single payer covers almost everyone, and the government has negotiating power to drive down prices. This is proven workable and effective in many places, including Canada. Literally every other industrialized nation has solved this problem.

If you don't agree with universal healthcare, fine, whatever, but don't go throwing around clearly obvious falsehoods.

This is like one of those "we can't solve it" arguments like gun violence where literally every developed country except for the US has solved it.

Re: Employer health plans are getting pricier and skimpier

#279

Post by romwell » Wed, Sep 25, 2019, 9:39 PM UTC

eric_b wrote: post #204

evantahler wrote: post #201

Earlier quoted context omitted.

This episode of planet money talks about this https://www.npr.org/2019/09/04/757645741/what-medicare-for-a... Because of redundancies in the US system, there are like 5:1 administrators for each doctor. That’s a huge source of the costs. Medicare for all will likely cut a lot of those jobs to gain the savings. This show talks about if that’s good or bad for society.

It amuses me when people think that letting the government run something will make it more efficient. I do not disagree there is tremendous waste in the current system. I strongly believe that expanding the government's role will only make it worse.

If only we had examples where the government running something like healthcare resulted in a better outcome for citizens.

Perhaps a country in Europe, as developed as the US is. I mean, a country that we literally border with would be too much to ask for.

Perhaps some of us would be less amused by the concept of government-run healthcare.

Too bad we don't have the example of literally all of Europe, Australia, and Canada to kill that amusement vibe.

Re: Employer health plans are getting pricier and skimpier

#280

Post by oarabbus_ » Wed, Sep 25, 2019, 9:39 PM UTC

throwaway5752 wrote: post #273

eric_b wrote: post #148

The problem is that there is not a single reason that healthcare is so expensive. Even if you list the top 15 reasons, you still have to apply the "5 whys" to each of them to find root causes and possible solutions. - Doctor's are paid too much... why? - Well they need to be paid a lot because medical school debt is 250k or more... why? - Medical schools/the AMA are artificially limiting the number of students and re…

"Medical schools/the AMA are artificially limiting the number of students and residents for their own ends (keeping wages and scarcity high) so they need to charge a lot." That is the peril of this type of analysis. Clinician cost is only 20% of total healthcare spend. Your premise is flawed so your conclusion is invalid.

His premise is not flawed; yours is.

Looking only at clinican costs is akin to saying that a sandwich should only cost $1.50 because that's the cost of the ingredients.

Doctor wages tie into personal health insurance, medical malpractice insurance costs, hospital system insurance costs, and more.

Even if you were correct on the cost bit (you aren't), you're completely ignoring that artificially constraining the SUPPLY of doctors causes massive cumulative ripple effects adding up to significant costs across the system.

The AMA is absolutely a cartel restricting supply and artificially keeping wages high. Have you taken a look at any other health care system in the world?