Which firms profit most from America’s health-care system (2018) • Hacker News Board

Re: Which firms profit most from America’s health-care system (2018)

#71

Post by FpUser » Sat, Jul 04, 2020, 3:28 PM UTC

quadrifoliate wrote: post #35

standardUser wrote: post #13

Earlier quoted context omitted.

And as a result we have bigger homes, bigger cars, bigger TVs.... but worse healthcare outcomes? Seems like some of that excess spending yields us more returns than others.

The things you mentioned are almost all inversely related to better healthcare outcomes, to grossly oversimplify a contributing factor. * Bigger homes means you feel more comfortable being lazy and spending all your time indoors * Bigger cars means you are incentivized to drive 20 miles to a restaurant in comfort instead of walking over to a closer one * Bigger TVs means you spend all day "watching the game" instead…

* Bigger homes means you feel more comfortable being lazy and spending all your time indoors

I call BS on that. Accordingly to this logic homeless must be the healthiest people. That aside, rich people (who also happen to have bigger houses) actually exercise more than the poor.

* Bigger cars means you are incentivized to drive 20 miles to a restaurant in comfort instead of walking over to a closer one

You telling that person with the smaller car would rather walk to the store (often VERY long walk in the US)? I call another BS here.

* Bigger TVs means you spend all day "watching the game" instead of going out and playing a sport.

Same argument as for size of the houses. I think you pulled these arguments right out of the place where the sun does not shine.

Re: Which firms profit most from America’s health-care system (2018)

#72

Post by vishnugupta » Sat, Jul 04, 2020, 3:30 PM UTC

epistasis wrote: post #56

quadrifoliate wrote: post #35

Earlier quoted context omitted.

The things you mentioned are almost all inversely related to better healthcare outcomes, to grossly oversimplify a contributing factor. * Bigger homes means you feel more comfortable being lazy and spending all your time indoors * Bigger cars means you are incentivized to drive 20 miles to a restaurant in comfort instead of walking over to a closer one * Bigger TVs means you spend all day "watching the game" instead…

> Bigger cars means you are incentivized to drive 20 miles to a restaurant in comfort instead of walking over to a closer one For many (most?) people in the US, the idea of walking anywhere of consequence from their home is simply ludicrous. Restaurant, convenience store, grocery store, all are completely inaccessible except by car. Suburb planning has explicitly disallowed that sort of living for most people. It has…

> Restaurant, convenience store, grocery store, all are completely inaccessible except by car.

This particular aspect of USA struck me as quite bizarre whenever I visited on business trips. More so as I’m from India where it’s almost a given that things that you need on a day to day basis (grocery, bakery, pharmacy, convenience store etc.,) are available within walking distance. Apart from an opportunity to get some fresh air it’s also a good way to interact with my neighborhood community.

I assumed this is how it’d be in any developed country until I moved to Netherlands. It’s not too different from India at all in that respect here.

So now I wonder, what factors lead to that kind of city planning in US. It was a real ordeal for me to get a meal outside in US, had to either walk for an hour or order taxi service (those were pre-Uber days).

Re: Which firms profit most from America’s health-care system (2018)

#73

Post by lotsofpulp » Sat, Jul 04, 2020, 3:31 PM UTC

tryptophan wrote: post #65

lotsofpulp wrote: post #43

Earlier quoted context omitted.

That is the situation I see with pretty much all businesses. 2 to 3, maybe 5 large organizations who can outcompete everyone due to economies of scale, especially due to advancements in technology.

Healthcare administration isn't really a high tech business though. I think the culprit here is obamacare; after all it was written by the insurance companies. Who's surprised that it benefits them the most? Insurance stocks absolutely took off after it was passed.

Databases, instant communications, time And chart tracking all allow healthcare facilities (and every other private business) to scale up much easier and with far less labor than ever before.

I can right now download all my health info into Apple health app from my healthcare provider’s website and use that anywhere I want, whereas that might have required a few calls and someone’s time.

Re: Which firms profit most from America’s health-care system (2018)

#74

Post by hagy » Sat, Jul 04, 2020, 3:32 PM UTC

dominotw wrote: post #38

jacobush wrote: post #31

Earlier quoted context omitted.

A) don’t subsidise sugar B) tax sugar

> B It was tried and rolled back in chicago because it was deemed as unfairly targeting the poor.

Since there is a higher incidence of smoking among poorer folks[0], couldn't the same argument apply to the massive sin tax on cigarettes? We justify such sin taxes as being to the benefit of discouraging a harmful health behavior and personally I see the same link with higher sugar consumption.

[0] https://truthinitiative.org/research-resources/targeted-comm...

Re: Which firms profit most from America’s health-care system (2018)

#75

Post by momokoko » Sat, Jul 04, 2020, 3:32 PM UTC

dan-robertson wrote: post #9

knubie wrote: post #5

> Every year America spends about $5,000 more per person on health care than other rich countries do. Yet its people are not any healthier. I think part of the reason Americans spend more on healthcare is precisely because they're unhealthy. According to the American CDC the obesity rate has reached a staggering 42.4% of adults[0], which brings with it a slew of health problems. This accounts for an additional $147 b…

A counter argument I see sometimes is that the reason Americans spend more on healthcare compared to other rich countries is that American consumers spend more on just about everything than most other rich countries (and also earn more money). I don’t really know how much merit the argument has.

Or even more simply a stronger currency valuation.

Re: Which firms profit most from America’s health-care system (2018)

#76

Post by NicoJuicy » Sat, Jul 04, 2020, 3:32 PM UTC

francisofascii wrote: post #8

Just got the bill yesterday for my "free" Covid test. $250, insurance pays $105, you owe $145. (The test was free, the office visit was not.)

Belgium

On your own initiative ( partially paid back):

- 9.6€ for the Covid test

- 17 € for the doctor visit

By Government:

- fully paid back by our health care, including doctor visit

I love transparent pricing :)

Re: Which firms profit most from America’s health-care system (2018)

#77

Post by vertbhrtn » Sat, Jul 04, 2020, 3:32 PM UTC

Auracle wrote: post #61

vertbhrtn wrote: post #30

Earlier quoted context omitted.

I'd argue it's unfixable for low income workers. Excessive sugar in all the cheap food is a trap they can't avoid. They don't have money to buy better food and don't have time to shop and cook for themselves. That's assuming they recognize this problem at all.

Vegetables are cheap. Beans are cheap. Chicken and turkey are cheap. McDonalds is not cheap, but it’s easy. It astounds me how many people eat out almost every meal.

Beans and all that isn't cheap overall: it takes will, effort and time to figure out what to buy and how to cook it. If that was packaged into cheap ready to eat burgers, spiced with something to make it more tolerable, then poor folks would switch to it. This approach isn't economically sound, though: it has 0 profit margins and it cuts deep into the fastfood & healthcare owners.

Re: Which firms profit most from America’s health-care system (2018)

#78

Post by phaemon » Sat, Jul 04, 2020, 3:33 PM UTC

enaaem wrote: post #29

ntsplnkv2 wrote: post #6

> Everyone hates pharmaceutical firms, but their share of health-care rent-seeking is relatively trivial, especially once you include the many midsized and small firms that are investing heavily. This article misses the point. People hate pharmaceuticals because of ridiculously high drug costs, and that's about it. If they can't produce drugs at profit without gouging potential end users then it should be nationalize…

Developing new drugs takes over a decade and costs billions. European countries are free loading of US drug research. https://www.wsj.com/amp/articles/how-other-countries-freeloa...

(I'm using 2015 figures because they were the latest available the last time I challenged this bullshit)

Nope, drugs sales in the EU alone are enough to cover pharmaceutical R&D costs worldwide. What they aren't enough to cover is Marketing costs, but that's OK since most EU countries don't allow direct marketing of drugs.

That's what the US covers. Not quite so noble sounding that you're covering the cost of advertising though, is it?

Pharmaceutical R&D spending in 2015: USA $47B, Europe: $33B.

Total drug sales Europe 2015: $190B

Re: Which firms profit most from America’s health-care system (2018)

#79

Post by ebg13 » Sat, Jul 04, 2020, 3:33 PM UTC

dominotw wrote: post #38

jacobush wrote: post #31

Earlier quoted context omitted.

A) don’t subsidise sugar B) tax sugar

> B It was tried and rolled back in chicago because it was deemed as unfairly targeting the poor.

> It was tried and rolled back in chicago because it was deemed as unfairly targeting the poor.

There's no reason why you couldn't pair taxing sugar with price-subsidies on non-sugary foods. The US already knows how to subsidize food production. Just stop subsidizing corn syrup and shift the subsidies to something less clearly destructive.

Re: Which firms profit most from America’s health-care system (2018)

#80

Post by cpursley » Sat, Jul 04, 2020, 3:36 PM UTC

take_a_breath wrote: post #66

knubie wrote: post #5

> Every year America spends about $5,000 more per person on health care than other rich countries do. Yet its people are not any healthier. I think part of the reason Americans spend more on healthcare is precisely because they're unhealthy. According to the American CDC the obesity rate has reached a staggering 42.4% of adults[0], which brings with it a slew of health problems. This accounts for an additional $147 b…

Colonoscopies in the US cost about $2,500 out-of-pocket, even with insurance. Most other countries are under $1,000 for the same procedure.

$1,000 sounds high. I just had one this morning in Russia at a very nice modern private clinic. The entire thing including anesthesiologist was under $75 completely out of pocket. It was amazing to me compared to my experience with healthcare in the US (I'm an American) - they gave us a price up front.