301–310 of 311 posts
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You're thinking of a clock. An orange man can be half-right, twice.
What’s with “orange man”. Can’t you people just say Trump? Would you like it if people referred to Obama as “black man”?
This is IMO the "simple solution" to healthcare - nothing will bring down healthcare costs faster than the following - be allowed to choose - know how much something costs - pay some of the cost themselves (co-pay, health savings account) etc.
I think a bit more is needed. Let's say it's 1990, and I'm in the market for a car. A Yugo costs a lot less than some other cars. But I'm getting a lot less for it, too - it's less reliable, won't last as long, and is less comfortable. But, as a car buyer, I can kind of tell that. It doesn't feel like it's as solid a car as some of the other options. Now say I'm trying to have a hip replacement. Here's a place that c…
I'm being offered $550 by my insurance in "gift cards" if I use certain facilities for any MRIs or other diagnostics. I think that shows just how wildly variable different locations charge, and how much they get away with. I'd love to see a published price list for standard procedures, because I think hospitals have become too used to being cash cows for administrators and CEOs. This isn't to say I think nurses or do…
> This isn't to say I think nurses or doctors are overpaid The probably are. Clearly hospital executives and administrators are raking in most of the money, but we can't sit here and pretend that caregivers don't directly benefit from such an arrangement as well. There's a reason urgent care centers and small clinics pay their doctors less than most of us make, or skip employing doctors at all in favor of nurse pract…
I agree with you but I think at least the nurses, doctors, NPs/PAs, bring more value than what I've seen within my own department at a hospital. A manager hits $100-150k pretty easy and the middle and upper middle ranks are stacked. We have someone that's a director of a three person team, and seven new middle management roles (being filled w/ no internal hires).
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I have never heard of anybody fly from Austria to the US because the medical care here wasn't good enough, or because some procedure was not available. I've only heard of people travel to get dental work done cheaper (not to the US). The only complaint I've heard is that some procedures (eg. joint replacements) have a waiting list, so if a doctor decides that you don't need it urgently, you may have to wait a few mon…
First of all, the idea of a “wait list” is terrible in and of itself. That’s called rationing. And it’s only “okay” for now assuming the public finances don’t deteriorate. Anecdotally you’re not the first person from a rationed system to mention long wait lines. Second, I believe Austria has great care and smart surgeons etc. But again there’s a vast difference between “good” and “outstanding/ first in class”. I’m no…
What do you want to do? There are only so many operating theaters, and only so many surgical teams, and demand is greater. So you have two options:
- offer the procedure to whoever pays the most / has the best insurance / has good connections
- prioritise patients based on how urgently they need the procedure
I prefer the latter -- grandma had to wait a few months, but she got her new knee joint. She gets the same medical treatment as the president. You could pay extra to get a nicer room in the hospital, but you can't pay to get better medical care (At least in theory -- we have some amount of corruption just like everywhere else)
Of course, it would be even nicer if nobody had to wait! I don't know what the situation in the US is like. Do hospitals in the US not need to "ration" certain procedures? Do they have enough capacity to treat everyone who needs a joint replacement without any waiting time?
I've read that a lot of people in the US don't have good health insurance and can't afford the care they need. To me that sounds like rationing care based on who has the most money.
Your other point, that most medical innovation originates from the US, sounds implausible to me. People from the US only hear about US achievements, so they think nobody else achieves anything.
For example, take the wikipedia article on fetal surgery: It lists 3 hospitals in the US that perform fetal surgery, and 1 in Canada. So clearly the US is the world leader in fetal surgery!
But then you look at the German wikipedia page, we see a list of 5 hospitals in Germany and 2 in the US. Obviously Germany is the world leader in fetal surgery!
(Neither article bothers mentioning Austrian hospitals that perform fetal surgery)
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What’s with “orange man”. Can’t you people just say Trump? Would you like it if people referred to Obama as “black man”?
"Orange man bad" is a phrase coined by Trump supporters to ridicule the supposedly knee-jerk reactions of those who oppose him.
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Unless the patient is prescribed a controlled substance. Then docs force patients to sign a waiver that enables the police and just any other state agency to take a peek for any reason. Of course, the patient always can refuse to sign the waiver and seek out non-traditional/conventional sources of treatment. As a lawyer it is shocking to see how far the medical profession has fallen w.r.t. patient privacy.
Can you elaborate a little? Where/when is this waiver signed? If I get a small pain killer for post surgery pain, like Vicodin, am I asked to sign this waiver by my doc? Or is it at the pharmacy counter?
For example, a healthcare provider in Seattle, WA (UW Physicians') uses a controlled substance privacy waiver that can be read to allow any state or local agency access to a patient's medical record for any reason.
https://www.washingtonpost.com/national/health-science/state...
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The problem is a lot of that isn't deterministic. There's a lot of "If Then" statements that aren't easy to price ahead of time. Like, your procedure is very different if your doctor decides they could use a specialist consult.
> your procedure is very different if your doctor decides they could use a specialist consult. The necessity of the specialist consult may be unexpected, but it doesn't follow that the cost of it should be secret or obscure, eh? The intrinsic unpredictability of health care isn't an excuse for additional unpredictability of cost.
We have obviously routed out a LOT of fraud by forcing the auto repair industry to change its practices to inspect -> quote -> customer decision. I guess the question becomes this - is there so much fraud in this industry that we need to do this change? Even if it's NOT fraud, have hospitals simply become used to charging anything they want because they have no competition?
The problem is you can't inspect -> quote -> customer decision with someone who's having a heart attack. Even if the person is lucid, they are unlikely to say no to any price if they're at death's door. No amount of competition changes the simple fact that health care is not a fungible service. CPR at facility A can't be exchanged for CPR at facility B if B is even a few minutes away. Combined with the emotional stat…
There's a problem with applying that logic to - hey I have a pain in my hand because I was rowing a boat today without warming up. Take this 800mg Ibuprofen. 3 months later $800. (So that's a true experience with my wife and rowing a boat)
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First of all, the idea of a “wait list” is terrible in and of itself. That’s called rationing. And it’s only “okay” for now assuming the public finances don’t deteriorate. Anecdotally you’re not the first person from a rationed system to mention long wait lines. Second, I believe Austria has great care and smart surgeons etc. But again there’s a vast difference between “good” and “outstanding/ first in class”. I’m no…
> First of all, the idea of a “wait list” is terrible in and of itself. That’s called rationing. What do you want to do? There are only so many operating theaters, and only so many surgical teams, and demand is greater. So you have two options: - offer the procedure to whoever pays the most / has the best insurance / has good connections - prioritise patients based on how urgently they need the procedure I prefer the…