Congress is set to ban most surprise medical bills • Hacker News Board

Re: Congress is set to ban most surprise medical bills

#201

Post by uoaei » Mon, Dec 21, 2020, 6:37 PM UTC

gregario wrote: post #192

kstrauser wrote: post #168

Earlier quoted context omitted.

I've that this before, but I like my markets free as in GPL, not free as in BSD. That is, I want the markets themselves to be free, even if that means that participants in the market have limitations put on them to keep them from capturing the market, forming monopolies, etc.

It's the regulations / limitations you are proposing that make it possible/likely that a monopoly will form. See Milton Friedman on this. There's basically no example of a monopoly forming outside of government regulation.

That's because there's basically no example of advanced economies that are not regulated by government. It's not the regulation that makes monopolies happen, it is that regulations only exist in markets which could support monopolies.

Re: Congress is set to ban most surprise medical bills

#202

Post by Moodles » Mon, Dec 21, 2020, 6:37 PM UTC

As an immigrant coming to America, honestly the most shocking and surprising thing (apart from the state of homeless in San Francisco being tolerated as normal) is the medical care expenses. How on Earth is it that I can walk into a doctor's office or hospital to get medical treatment and have no idea how much it's going to cost? $10? $100? $1000? Who knows. I had an ear infection once, went to the doctor who looked at it for a minute and said "give it a few days". I assumed this would cost maybe $20 or something? Nope. $400. There's just no way of even knowing. In no other industry would you buy something without knowing the price ahead of time. With medical care it's even more screwed up because, well, it's your health? You're generally more desperate for services now, so it's not like shopping around for clothes or something.

Re: Congress is set to ban most surprise medical bills

#203

Post by stevebmark » Mon, Dec 21, 2020, 6:38 PM UTC

cdjk wrote: post #19

jsperson wrote: post #13

That it takes such effort to pass a bill like this - 80% public approval, banning a clearly predatory practice, has turned me from a pure free market thinking into a believer in single payer healthcare. The free market just doesn't work when there is very little elasticity in consumption. I've been on the receiving end of a $15K air ambulance bill (thankfully covered by insurance) as well as the out of network specia…

The existing health insurance industry is far from free market. Try getting a price for a procedure or visit beforehand. Compare that to dental insurance. I’m always shocked when I get a treatment plant after 5 minutes that outlines exactly what the dentist needs to do, how much insurance will pay, and how much I will need to pay. Of course the set of possible treatments for dental work is a lot smaller, but it seems…

How is that not a "free market"? Private, corrupt back room business deals dictate the prices that screw over patients. It's entirely determined by the private market. That sounds like a free market to me.

Re: Congress is set to ban most surprise medical bills

#204

Post by mcshicks » Mon, Dec 21, 2020, 6:39 PM UTC

kevinofe wrote: post #147

mcshicks wrote: post #29

California has such a law already. I went to an ER at the beginning of the year for a minor fracture and had a "contract physician". I was pleasantly surprised when the bill was exactly my er visit copay. I had an equally unpleasant experience several years ago that cost me thousands of dollars. https://dmhc.ca.gov/Portals/0/HealthCareInCalifornia/FactShe...

The CA law is kind of BS. My partner went to see doc, they ran a few tests, told her it would probably be covered by insurance and then we got a bill for $1700. They said it wasn't "surprise" bill because it wasn't out of network. I told them "it is a surprise to us!" From then on, we always ask the cost of every single test/procedure. (In fairness to the hospital, they did give us a $50/month, interest free payment…

Yeah I agree the name is misleading and it doesn't cover all situations. My specific situation both times was ER rooms with out of network doctors, but I agree that there can be many other situations where the law is not that helpful. My personal opinion is those would be better managed by a single payer system like they have in many other countries. I haven't looked at the federal law close enough to know if it covers cases other than out of network doctors.

Re: Congress is set to ban most surprise medical bills

#205

Post by leetcrew » Mon, Dec 21, 2020, 6:39 PM UTC

hodgesrm wrote: post #132

kayodelycaon wrote: post #9

> Some private-equity firms have turned this kind of billing into a robust business model, buying emergency room doctor groups and moving the providers out of network so they could bill larger fees. If this doesn’t describe evil, I don’t know what else would.

It's hard to see how anyone could extol the virtues of a "free market system" where behavior like this exists. It is pervasive in American health care. Just search for "orphan drugs" if you are insufficiently outraged. [1] [1] https://www.washingtonpost.com/news/wonk/wp/2017/12/18/this-...

the orphan drug issue is a result of pharmaceuticals being very much not a free market. consider how absurd it is that you can jack up the price for a product you don't even have a patent for by several thousand percent and still have it be uneconomic for anyone to undercut you. to me, this implies more of an issue with the overall regulatory environment than individual profit-seeking behavior.

Re: Congress is set to ban most surprise medical bills

#206

Post by 2Gkashmiri » Mon, Dec 21, 2020, 6:39 PM UTC

silentsea90 wrote: post #141

2Gkashmiri wrote: post #43

In India you have these government run hospitals. Entry is essentially free and so is the emergency / opd treatment. For procedures they charge peanuts compared to private sector. The only thing, there is a waiting list and hygeine is not always a priority. There is an AIIMS hospital in Delhi and I had the misfortune of taking a relative there for treating surgical infection. It was brutal. We got in line around 9 am…

Public services in India, especially ones interacting with people en masse are terrible. No recourse but to go to private hospitals.

they are terrible because they are too less. other than that i would rather get treated in a government run hospital because they employ only the most capable of doctors, senior and otherwise. the problem isnt in the doctors. its infrastructure.

i think people got my comment wrong way. i am very much in support of these hospitals. just that i want them to be in every major district rather than being restricted to major cities. its not like these places would remain empty

Re: Congress is set to ban most surprise medical bills

#207

Post by EvanAnderson » Mon, Dec 21, 2020, 6:40 PM UTC

mrlala wrote: post #164

HenryKissinger wrote: post #7

Earlier quoted context omitted.

"‘As I was being eaten, I was thinking about my insurance’: Woman who lost face in bear attack on why she’s voting for Bernie Sanders" https://www.independent.co.uk/news/world/americas/us-electio...

How any of you snakes on here can downvote this is beyond me. I mean, I know who you are. People who have a great job and don't really have to worry about insurance. Or maybe at a university where insurance is probably covered well. So f everyone else, right? I am self employed so I have to worry about paying all this shit myself; 11k family deductible with 40% co-insurance for $1200. Every time my young kids have ha…

I found, being self-employed for a long time, that hardly anybody inside or outside the medical establishment understands how much health insurance costs for the self-employed (and what little you actually get for it). My first thoughts re: anything health-related are always costs. The treatment one receives from medical provider when they ask about costs is really degrading, too. (Try asking what a procedure for your _child_ will cost-- you really get treated badly for that.)

Re: Congress is set to ban most surprise medical bills

#208

Post by Moodles » Mon, Dec 21, 2020, 6:40 PM UTC

jsperson wrote: post #13

That it takes such effort to pass a bill like this - 80% public approval, banning a clearly predatory practice, has turned me from a pure free market thinking into a believer in single payer healthcare. The free market just doesn't work when there is very little elasticity in consumption. I've been on the receiving end of a $15K air ambulance bill (thankfully covered by insurance) as well as the out of network specia…

As an immigrant coming to America, honestly the most shocking and surprising thing (apart from the state of homeless in San Francisco being tolerated as normal) is the medical care expenses. How on Earth is it that I can walk into a doctor's office or hospital to get medical treatment and have no idea how much it's going to cost? $10? $100? $1000? Who knows. I had an ear infection once, went to the doctor who looked at it for a minute and said "give it a few days". I assumed this would cost maybe $20 or something? Nope. $400. There's just no way of even knowing. In no other industry would you buy something without knowing the price ahead of time. With medical care it's even more screwed up because, well, it's your health? You're generally more desperate for services now, so it's not like shopping around for clothes or something.

Re: Congress is set to ban most surprise medical bills

#209

Post by [deleted] » Mon, Dec 21, 2020, 6:41 PM UTC

iaw wrote: post #100

jsperson wrote: post #13

That it takes such effort to pass a bill like this - 80% public approval, banning a clearly predatory practice, has turned me from a pure free market thinking into a believer in single payer healthcare. The free market just doesn't work when there is very little elasticity in consumption. I've been on the receiving end of a $15K air ambulance bill (thankfully covered by insurance) as well as the out of network specia…

> has turned me from a pure free market thinking into a believer in single payer healthcare The current trend in 'free-market economics' is to call captured markets free and then argue for the relatively lax regulation. Most markets are not free markets and the healthcare definitely isn't. There's very little true choice, participants are typically under duress when seeking expensive services, and prices are hidden.…

[deleted]

Re: Congress is set to ban most surprise medical bills

#210

Post by thowawayyy » Mon, Dec 21, 2020, 6:41 PM UTC

mindslight wrote: post #181

thowawayyy wrote: post #170

Earlier quoted context omitted.

How is that solving the car crash situation?

The same way you don't get super gouged when choosing a restaurant while hangry - non-urgent shoppers keep prices down across the board, even for urgent participants. I'm not saying this makes for some total solution - just reacting to rejection of the market dynamic having any worth. It's foolish to cast aside entire paradigms of approaches because they don't fully solve every corner case. (The dual would be to ask…

I didn't mean to suggest that there shouldn't be the option to freely chose alternative treatment options under a free market model, in cases where you're not happy with what a single payer model would cover.

Rather my point was that when you need urgent or critical medical care there should be a baseline assurance of a solution to your predicament as you may not be in a position to shop around.

Your analogy with restaurants is not a good one, since you are unlikely to be in a situation where you're about to starve to death, and the only restaurant in town has 3 Michelin stars, grocery stores don't exist, and passers-by are not qualified to give you food :)