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Employer health plans are getting pricier and skimpier

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Re: Employer health plans are getting pricier and skimpier

#431

Post by noobermin »

nostrademons wrote: post #345
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. Don't want to pay what the government says it is going to pay? Good luck finding customers then, because the government is bargaining on behalf of all of the customers in the US. So my mom and her boyfriend are both under Medicare now, as was her late 2nd husband. My mom and I had both ge…

You're not wrong they are deeper problems, but you say these things as if M4A would cause them when they are happening now. I was recently asked by a dentist if I wanted a special kind of cleaning. She then nervously admitted that it wasn't necessary, but she "wanted to make sure." M4A won't fix all the problems, but it would definitely make things better, and hopefully, lead to people demanding more.

Re: Employer health plans are getting pricier and skimpier

#432

Post by noobermin »

akhilcacharya wrote: post #366
romwell wrote: post #347

Earlier quoted context omitted.

Yes they would. The Americans also go to other countries to seek treatment in special cases. Also, if our healthcare works well to treat rich foreigners in special cases, but sucks otherwise — I say, we should scrap it. But sure, we can cherrypick metrics all day long.

This is a great point more people should make. There’s nothing “America first” about preserving the inefficiencies of a system just so that very wealthy people from everywhere can get care and leave (and ultimately specialists would anyway still exist, even if their treatments aren’t covered by Medicare)

Actually, that's completely what "America first" means by those who say it, at the least the ones who are in on the deal.

Re: Employer health plans are getting pricier and skimpier

#433

Post by dang »

JamesSchriver wrote: post #171
nickgrosvenor wrote: post #110

This is absolutely the biggest story in America, and most people aren't talking about it. An entire generation is draining their savings to keep up with premium costs. Not to mention the millions of people locked into careers they would otherwise get out of, if not for the health coverage. This situation is probably going to lead to unbelievable outcomes.

I realize the avg YC visitor will not want to hear this, but when you are taking care of 1) literally tens of millions of foreign nationals that have washed up on America's shored with all manner of maladies and even diseases that never existed in the USA before, and others that have been eradicated for decades, and all those people bring in multiples of their family members with all manner of other maladies and are…

We've banned this account for repeatedly posting flamewar comments to HN and ignoring our requests to stop.

https://news.ycombinator.com/newsguidelines.html

Re: Employer health plans are getting pricier and skimpier

#434

Post by noobermin »

fzeroracer wrote: post #335
eric_b wrote: post #248

Earlier quoted context omitted.

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' you receive in the US is entirely dependent on your wealth and it's only the upper class that actually benefit from it. You know what quality care I got as a poor person? Nothing, because my family couldn't afford it. I was given the privilege of going through highschool and college with teeth quite literally broken down to the gumlines and abscessed because it was either that or not being able…

Every time I read arguments online of people defending the American system, I almost always get hints that they are wealthy people, usually because they admit they can actually afford the care instead of essentially going broke over it. Healthcare debt is the leading cause of personal bankruptcy in the US, so it is statistically true that it is too much for the people below the median. Even for people in the middle class.

Re: Employer health plans are getting pricier and skimpier

#435

Post by nostrademons »

ohyes wrote: post #381
nostrademons wrote: post #353

Earlier quoted context omitted.

There is a very strong correlation between which additional tests are requested and what the hospital can charge under Medicare reimbursement codes. (My mother's boyfriend is a former doctor, and intimately familiar with the health-care system from the other side of the table.) Both of them are also in fairly good health (my mom has no pre-existing conditions, her boyfriend has some issues with his back but nothing u…

25 year olds have fewer health problems that need treatment than 80 year olds.

My point is that people are being treated for health problems that are not problems because the provider can then bill Medicare for it. That's not going to go away because there are fewer health problems; the whole issue is that it doesn't matter if there are health problems, the provider will find or create some that they can bill for.

Re: Employer health plans are getting pricier and skimpier

#436

Post by tanr54ok »

kuzimoto wrote: post #423
rubidium wrote: post #403

Earlier quoted context omitted.

If money were the only incentive to life no one would become a schoool teacher. Your summary is missing something.

That is true, but if you're the type of person that likes to help others it's much easier to become a teacher than doctor. Also, if you are a doctor and your primary motivation is helping people, wouldn't you want to help many people with simple problems, than few people with highly complex problems (which most likely have a higher risk of failure)? There is already a shortage of doctors doing the easy stuff. I just…

> Also, if you are a doctor and your primary motivation is helping people, wouldn't you want to help many people with simple problems, than few people with highly complex problems (which most likely have a higher risk of failure)?

Your analysis completely falls flat here. Not all doctors are motivated by the same things and yet most of them would consider their primary motivation helping people.

Neurosurgeons are a prime example. They would very much prefer few complex cases (not everyone gets a brain tumor thankfully) as their way to maximize benefit rather than manage cholesterol meds for 100s.

Speciality surgeons by their nature are motivated by a certain degree of risk.

The incentive for doing difficult procedures is often because they are challenging. Compensation for doctors in the US isn’t fully correlated with difficulty either... with no offense to my dermatology colleagues making more than most general surgery sub specialists.

Re: Employer health plans are getting pricier and skimpier

#437

Post by pembrook »

geggam wrote: post #195
weeksie wrote: post #165

Earlier quoted context omitted.

Free markets don't work with the information asymmetries involved in healthcare.

Odd how it worked before insurance took over the healthcare system. Care to share what you see would be different ?

Oh yea, we're forgetting about the no insurance glory days of pre-WW1 medicine!

If your definition of "worked" is letting everybody die because most of modern medicine hadn't been invented yet, than sure, going back to those days would certainly drive down costs. No need for those expensive CT scan machines anymore, just rub some dirt on it.

Re: Employer health plans are getting pricier and skimpier

#438

Post by deepaksurti »

greggman2 wrote: post #424
nine_k wrote: post #417

Earlier quoted context omitted.

Regarding Europe, which I happen to have friends all over: it's not exactly as rosy. European countries do have more doctors per capita, which is good. They don't have nearly as much resources in the system, though. Come to a doctor with a bad cough, get a prescription for Paracetamol. You got to have a pretty bad infection to get a prescription for an antibiotic. Endure a long discussion with a doctor to renew an an…

In the USA, at least in my experience. If I have a cold I still had to make an appointment which would be 2 to 3 days later. I got around this by joining a doctor in a clinic and they'd let me see any doctor if my doctor wasn't avaiable but i'd have to sit in the waiting room for 1 - 2 hrs. In Japan I have had mixed experiences: Good: * It's relatively cheap. Apprently the government sets prices. The government offer…

>> In Japan I have had mixed experiences:

Replace ‘Japan’ with ‘metro cities in India’ and its almost the same. I can’t still fathom why there would be no walk in facilities for ailments like cold.

I still remember my shock when in US I realised from a colleague that for my cold I need to wait because I can’t walk in and need to take an appointment.

Re: Employer health plans are getting pricier and skimpier

#439

Post by onion2k »

nine_k wrote: post #417
doctorpangloss wrote: post #404

Earlier quoted context omitted.

This isn’t a very good analogy. In a just world, nobody would go hungry, nor would anyone die prematurely or suffer needlessly due to lack of care. We can obviously afford both, in this country, just like they can everywhere else in Europe or Canada. So this entire argument about insurance is a straw man. It’s not the doctors who set up this world. It’s people who want to pay less taxes, but blame doctors.

Regarding Europe, which I happen to have friends all over: it's not exactly as rosy. European countries do have more doctors per capita, which is good. They don't have nearly as much resources in the system, though. Come to a doctor with a bad cough, get a prescription for Paracetamol. You got to have a pretty bad infection to get a prescription for an antibiotic. Endure a long discussion with a doctor to renew an an…

Wait for two weeks to get an appointment about your coughing and sneezing.

Here in the UK you can get an appointment to see your GP the following day most of the time, and we have walk-in clinics for same day check ups if you don't care which doctor you see. Availability varies a lot around the country but its mostly good.

Re: Employer health plans are getting pricier and skimpier

#440

Post by twobat »

nine_k wrote: post #417
doctorpangloss wrote: post #404

Earlier quoted context omitted.

This isn’t a very good analogy. In a just world, nobody would go hungry, nor would anyone die prematurely or suffer needlessly due to lack of care. We can obviously afford both, in this country, just like they can everywhere else in Europe or Canada. So this entire argument about insurance is a straw man. It’s not the doctors who set up this world. It’s people who want to pay less taxes, but blame doctors.

Regarding Europe, which I happen to have friends all over: it's not exactly as rosy. European countries do have more doctors per capita, which is good. They don't have nearly as much resources in the system, though. Come to a doctor with a bad cough, get a prescription for Paracetamol. You got to have a pretty bad infection to get a prescription for an antibiotic. Endure a long discussion with a doctor to renew an an…

I live in Eastern Europe so it's a bit like a third world country compared to Germany or Sweden. But let me tell you, it's not like you describe it at all. First of all, you don't get antibiotics just because you think you need antibiotics. And then, there's the private sector which has normal prices. And they treat you like a VIP.
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