Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Employer health plans are getting pricier and skimpier

axios.com

Post reply on HN
Print view View original

451–460 of 539 posts

Re: Employer health plans are getting pricier and skimpier

#451

Post by kuzimoto »

ClumsyPilot wrote: post #413
kuzimoto wrote: post #399

Earlier quoted context omitted.

According to Wikipedia, there are only .5% of all physicians in the US who can perform neurosurgery. So it's probably safe to say the demand for brain surgery is much higher than the supply. This incentivises people to become doctors that perform such complecated procedures as it takes a lot of time and a lot of money to be able to do those things. If you were to force doctors to perform work on people that can't aff…

How did you come to your concluding without looking at demand? I don't need brain surgery every tuesday.

This article suggests that there is a gap, and is widening. Only 1 to 61,000 people. It also mentions that they tend to be clustered in more populated areas, leaving some places without any coverage.

https://aansneurosurgeon.org/departments/neurosurgical-workf...

Re: Employer health plans are getting pricier and skimpier

#452

Post by GrayTextIsTruth »

Where's the regulation?

I'm upset that the democratic party has been increasingly more focused on social issues than worker issues in the last decade. Once neither political party cares about the working man then you'll start to see unregulated capitalism like whats happening with healthcare/insurance costs.

The republicans are starting to care more (or at least pay lip service) for the working person but neither party is fully committed.

Re: Employer health plans are getting pricier and skimpier

#453

Post by Wh1skey »

rubidium wrote: post #403
kuzimoto wrote: post #399

Earlier quoted context omitted.

According to Wikipedia, there are only .5% of all physicians in the US who can perform neurosurgery. So it's probably safe to say the demand for brain surgery is much higher than the supply. This incentivises people to become doctors that perform such complecated procedures as it takes a lot of time and a lot of money to be able to do those things. If you were to force doctors to perform work on people that can't aff…

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

Entry-level teachers earn over $40,000 according to Payscale. Median income for the lower class is about $25,000. Anecdotally, it's not unreasonable to become a millionaire in real estate by the time you retire on a teachers salary.

https://www.pewresearch.org/fact-tank/2014/12/17/wealth-gap-...

Re: Employer health plans are getting pricier and skimpier

#454

Post by kuzimoto »

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…

Did something happen to your teeth that basic maintenance like brushing and flossing wouldn't have prevented?

What you're describing doesn't sound very normal, even if you never went to the dentist in your life.

Re: Employer health plans are getting pricier and skimpier

#455

Post by nextstep »

comnetxr wrote: post #360

Imagine if grocery stores forced us to choose one of a few dozen grocery "insurance" memberships to buy groceries, and negotiated directly with the insurers. No prices are labeled in store, they just detect whatever you take and send you a bill at the end of the month. (Differing brands of the same food product are not available in store of course.) Individuals are charged 3-100x more per product than negotiated rate…

This would be great if health choices were being made by rational consumers. But when I break my leg, I want services quickly and I don’t have time or energy to price compare ambulances. Healthcare is not a marketplace that will have compassionate outcomes if we allow deregulation.

Re: Employer health plans are getting pricier and skimpier

#456

Post by mosselman »

nextstep wrote: post #455
comnetxr wrote: post #360

Imagine if grocery stores forced us to choose one of a few dozen grocery "insurance" memberships to buy groceries, and negotiated directly with the insurers. No prices are labeled in store, they just detect whatever you take and send you a bill at the end of the month. (Differing brands of the same food product are not available in store of course.) Individuals are charged 3-100x more per product than negotiated rate…

This would be great if health choices were being made by rational consumers. But when I break my leg, I want services quickly and I don’t have time or energy to price compare ambulances. Healthcare is not a marketplace that will have compassionate outcomes if we allow deregulation.

Yes, because in countries where health care prices are 3-100x lower it is total anarchy. People lie on the streets for hours, browsing price comparison websites while bleeding out.

Re: Employer health plans are getting pricier and skimpier

#457

Post by kuzimoto »

tanr54ok wrote: post #436
kuzimoto wrote: post #423

Earlier quoted context omitted.

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 p…

> Not all doctors are motivated by the same things and yet most of them would consider their primary motivation helping people.

That's fair. I probably over-emphasized the money part of it.

> The incentive for doing difficult procedures is often because they are challenging.

We can assume that since doctors aren't doing this for free or at least cheap already, that they require at least some amount of compensation. To return to my original point, if you force doctors to perform procedures on people that can't afford them, and the amount they receive is less than they want, then there be a greater shortage of such doctors.

> 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.

Not directly anyway, it's probably more supply/demand. Low supply of neurosurgeon means high cost. Whether that's from artificially suppressing the supply of these doctors or because it's very challenging is up for debate.

I'd guess dermatologists make so much because people are more willing to spend money on that sort of work.

Re: Employer health plans are getting pricier and skimpier

#458

Post by bluecalm »

ergothus wrote: post #320
bluecalm wrote: post #281

Earlier quoted context omitted.

MRI is like 5x cheaper here (I paid less than 300$ for both knees) without any insurance just doing it privately. The reason I think is that it's easier to open a medical business here, people can't sue for damages (or they can but will never be awarded anything substantial), there is less regulation you need to comply with and the doctors and technicians make less money. All this makes it possible to provide medical…

> The quality of service is low but higher than in major metro areas in US This is always my question when I hear about service being "great" or "terrible" - relative to what? I honestly have no idea if my healthcare is "good" or "bad", because I've only experienced one system. I have plenty of complaints, but there are also lots of things that don't go wrong that could. People complain about lines in other countries…

I am assessing it in two ways. One is comparing it to other services: do they have modern equipment? Is bureaucracy a burden? Do people working in those services generally act like decent human beings? Are doctors/technicians competent? Is it easy to imagine a service at higher quality and how much would it cost? Using those criteria I think medical services in my country are low quality, especially the public option.

Another way is comparing to other countries. I have family living in US (both immigrants from different countries, now US citizens, having children there) and very close friends living in Switzerland. Both lived in Poland for many years and often visit so we are all in good position to make comparisons. Both US and Poland suck in comparison to Switzerland in all imaginable respects. They comparison between US and Poland comes out about equal at least according to us.

Re: Employer health plans are getting pricier and skimpier

#460

Post by dbmikus »

jorblumesea wrote: post #285
eric_b wrote: post #204

Earlier quoted context omitted.

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.

You realize there multiple working examples of a national healthcare plan right? Including one very obvious example to our northern border. You're arguing like this is some huge open ended problem like climate change. Almost every developed country has a national system that provides excellent care for far more reasonable costs. Except the US, of course. I'm starting to realize why America will never get its shit tog…

Switzerland doesn't have nationalized healthcare and Singapore has a hybrid model. In a ranking of top 5 healthcare systems, on average you will find some that are nationalized and some that are not.

One thing that is unequivocally a mistake in healthcare in the US is making it a "free market" and then having employers pick the insurance for their employees.

Post reply on HN