Money Won’t Buy You Health Insurance • Hacker News Board

Re: Money Won’t Buy You Health Insurance

#301

Post by pessimizer » Tue, Feb 22, 2011, 6:33 AM UTC

mikebike wrote: post #247

pessimizer wrote: post #215

Earlier quoted context omitted.

I had a bad asthma attack while uninsured and got hit with a bill that took me 7 years to pay off.

Yipe! Were you able to negotiate the bill down at all when working out a payment plan, or did the hospital end up charging you the full amount?

Didn't negotiate a thing. I was pretty naive about that sort of thing at the time (really was still until the last few years, and I'm 35 now) and didn't know that bargaining was an option. I was just unemployed, broke and 22 and had a giant bill that I didn't know what to do with. I thought a bill was a bill and a debt was a debt, and had never even had a credit card in my life. Soon after that, I got a $9 an hour job at a factory and started making payments...

Re: Money Won’t Buy You Health Insurance

#302

Post by wisty » Tue, Feb 22, 2011, 6:34 AM UTC

Groxx wrote: post #22

acabal wrote: post #2

This really highlights how utterly insane our system is. I'm living off of my own business, which means that I don't have an employer to cover me under group insurance. But I really only make enough to live frugally and save a tiny amount each month--to me, an affordable health insurance plan would be between $50-$100 a month. Fat chance of that happening. And if it did, the deductible would be so high as to make the…

> to me, an affordable health insurance plan would be between $50-$100 a month. Fat chance of that happening. And if it did, the deductible would be so high as to make the plan worthless for anything short of a car-crash-emergency-type-situation. This fits a fair number of cost complaints I hear over healthcare. Who wouldn't like to pay $50-100/month to have something better than emergency healthcare support? But thi…

Hospitals in the US over-prescribe, and over-treat, because health insurers will pay.

Drug companies will charge US customers more, because health insurers will pay. Good luck importing drugs from ebay - it's not legal!

Doctors, and hospital managers charge more, because health insurers pay. Good luck getting an unqualified doctor to prescribe penicillin - it's not legal!

If the government was paying for more of it, they would train more doctors, and force drug companies to lower prices (as they do in most countries). Removing the profit motive in public hospitals makes them focus on better care, not more expensive care. Then the private sector has some real competition (Australia and Canada both have private health ... it's better than the US for most people).

Re: Money Won’t Buy You Health Insurance

#303

Post by WildUtah » Tue, Feb 22, 2011, 6:35 AM UTC

dalke wrote: post #100

old-gregg wrote: post #91

Earlier quoted context omitted.

Doctors and nurses and supporting staff must exist I got a $800 bill for 10 minutes doctor visit (swollen toe). Not exaggerating a tiny bit. No insurance company involved. "Must exist" is not an argument. Something is broken in the system where a doctor charges you $4,800 per hour. Insurance companies, obesity, poor lifestyle choices (all usual BS reasons I hear on TV) do not explain why this particular ####le charge…

Last year visiting California I was sick for over a week. 30 minutes for a prescription (which I knew would be the result of that visit) cost me $600. $300 for the doctor and the same for the hospital. In New Mexico (one of the poorest states in the US), the equivalent a few years previous cost me about $100. I stopped getting insurance because as a self-employed person it was expensive and rising. I played the odds…

In a civilized country, if you knew what the prescription would be, you could just walk into a pharmacy and buy it. The dotor charges $600 and provides no value. He exists to charge rent on his DEA license.

Re: Money Won’t Buy You Health Insurance

#304

Post by yaix » Tue, Feb 22, 2011, 6:38 AM UTC

hartror wrote: post #129

I might be living in a socialist paradise (Australia) or some thing but my last visit to the doctor (broken toe) was free. I am truly horrified by the state of the US health system, sure Australia's might be a bit messed up at times but it is so much better than what Americans have to deal with. Move your startup to Australia! Seriously, cheap/free heathcare for minor->medium problems (the bad stuff is still going to…

Good to know, thanks. I am actually considering moving to AUS, however not because of health care, being from Europe. Good to know its "socialist" in Australia too ;D

Re: Money Won’t Buy You Health Insurance

#305

Post by zach » Tue, Feb 22, 2011, 6:39 AM UTC

WalterBright wrote: post #292

acabal wrote: post #2

This really highlights how utterly insane our system is. I'm living off of my own business, which means that I don't have an employer to cover me under group insurance. But I really only make enough to live frugally and save a tiny amount each month--to me, an affordable health insurance plan would be between $50-$100 a month. Fat chance of that happening. And if it did, the deductible would be so high as to make the…

Here's why it's broken. It's a long read, but worth it. The reasons are not what you'd expect, and not what you usually hear. http://www.theatlantic.com/magazine/archive/2009/09/how-amer...

You beat me to it! Fantastic article from a former startup CEO (I worked for him about 10 years ago). I thought I had heard all the arguments before I read it.

Re: Money Won’t Buy You Health Insurance

#306

Post by pyre » Tue, Feb 22, 2011, 6:42 AM UTC

mikebike wrote: post #246

tptacek wrote: post #200

Earlier quoted context omitted.

This is basically a recap of the Japan segment of the Frontline special "Sick Around The World", which you can watch online at: http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/ . The Japanese system is not without its problems. More importantly, the "price fixing" approach to health insurance simply isn't going to happen in the US. What parts of it do you think we really can adopt? Because nobody is going…

Isn't price fixing is done for U.S. Medicare payments to doctors, hence the constant wailing over the "doc fix" issue? I can imagine a scenario where the age for Medicare was lowered slowly over time to cover more and more people. (Unlikely, but not beyond the realm of possibility).

I think that someone else said it here (somewhere in these threads), but I believe Medicare mandates that everyone is charged the same price for procedure X, but doesn't mandate what that price is. The point being that if everyone gets the same price, than Medicare always pays the cheapest rate (since there is only one rate).

Re: Money Won’t Buy You Health Insurance

#307

Post by intended » Tue, Feb 22, 2011, 6:47 AM UTC

rdouble wrote: post #231

muhfuhkuh wrote: post #228

Earlier quoted context omitted.

"Say goodbye to hospitals for rural and poor areas." That was happening anyway, if it weren't for Medicaid, that is. There was a definite brain drain of doctors (especially specialists) who choose to go to affluent suburbs and urban areas simply because they get more (and better quality, AKA rich) patients. You think if we _further_ privatized the market, those in rural areas would be _better_ served? Isn't that the…

Few doctors want to live in a rural area for lifestyle reasons more than salary. A GP or surgeon can make more money in a rural area.

How? Do they charge higher rates than elsewhere - effectively using supply and demand and saying: "You don't have anywhere else to go, so pay my rates."

Re: Money Won’t Buy You Health Insurance

#308

Post by davidw » Tue, Feb 22, 2011, 6:54 AM UTC

DanielBMarkham wrote: post #17

krschultz wrote: post #8

Earlier quoted context omitted.

But it's written by someone involved in the tech world, that makes it hacker news

I find that if the article slants one way, it can be the third cousin of a long-distant relative who knew Bill Gates and suddenly it's something hackers are direly interested in. If it slants another, it can be study of small startups and the economic principles that drive success or failure using a double-blind study and suddenly it's too political for us to touch. For me, the best metric is just looking at what kin…

Nope, it's politics, it should be banned, period. I agree heartily with the point of the article, but it should not be here.

Re: Money Won’t Buy You Health Insurance

#309

Post by maxharris » Tue, Feb 22, 2011, 7:06 AM UTC

damoncali wrote: post #201

muhfuhkuh wrote: post #110

Earlier quoted context omitted.

Japan forces their doctors to charge only what's published in a book that the government issues and negotiates prices periodically. Simple price fixing in an otherwise private healthcare market. In return, Japanese doctors and hospitals (FYI, there are more private hospitals in Japan than the US) are allowed to set whatever prices for ancillary services (like private or semi-private rooms) that they want. BTW, the av…

What people don't like to admit is that free markets don't work for healthcare. What is the price you're willing to pay for curing that tumor in your gut? Everything you have. There is no supply vs. demand. Only supply vs infinity. What would happen to the food market were it not for the generally high supply of food? It wouldn't be pretty. Because of that, some sort of non-market intervention is simply unavoidable.…

Few will admit that we don't have anything close to a free market in healthcare today (or for the past several decades). A truly free market is one unfettered by the FDA, medicare, medicaid, doctor regulations, hospital regulations, HMO regulations, insurance regulations, etc. All of these controls were ostensibly put in place to protect patients, but in actuality they serve to slow innovation and true access to medicine to a crawl.

It is true that some people will choose badly when left to their own devices, but that's better than forcing the same dumb rule on everyone. Each of us is an end in ourselves. So long as we do not violate the negative rights of others, we are responsible only for our own lives, not the lives of our brothers.

Re: Money Won’t Buy You Health Insurance

#310

Post by Confusion » Tue, Feb 22, 2011, 7:15 AM UTC

Groxx wrote: post #22

acabal wrote: post #2

This really highlights how utterly insane our system is. I'm living off of my own business, which means that I don't have an employer to cover me under group insurance. But I really only make enough to live frugally and save a tiny amount each month--to me, an affordable health insurance plan would be between $50-$100 a month. Fat chance of that happening. And if it did, the deductible would be so high as to make the…

> to me, an affordable health insurance plan would be between $50-$100 a month. Fat chance of that happening. And if it did, the deductible would be so high as to make the plan worthless for anything short of a car-crash-emergency-type-situation. This fits a fair number of cost complaints I hear over healthcare. Who wouldn't like to pay $50-100/month to have something better than emergency healthcare support? But thi…

  At $50-100/month, they would have to sap you for nearly a 
  decade to make up a single surgery.

The point of insurance is that the risk that you need a lot of attention is diluted by being in a pool with insurance takers that mostly don't need that attention. You pay for your surgery together. Insurance has the interesting property of being an inherently Socialist service that you are purchasing from capitalist companies: Big Brother takes care. The main problem in the US seems to be that people refuse to accept the Socialist nature of the service, which means they feel everything above their own medical expensen is too expensive. That means you just don't understand the service you are purchasing.