Earlier quoted context omitted.
In your opinion, what would be the lowest hanging fruit that could be changed to have the largest positive impact?
People are rarely satisfied with this answer but its demonstrably true and was proven time and time again at the facilities ClearHealth managed. 1) Feverent, almost religious, adherence to hand washing. 2) No neck ties or dangly sleves whatsoever in buildings that house patients. 3) Change from stainless steel hardware for doors and travel touch surfaces back to "brass/copper". Those are simple, virtually free, thing…
Health insurers just published close to a trillion hospital prices
111–120 of 549 posts
Re: Health insurers just published close to a trillion hospital prices
#112Earlier quoted context omitted.
I don't think that disproves a general trend that increased socialization in healthcare costs leads to better outcomes and less per-capita spending. Also FWIW France and Switzerland both have universal healthcare, under different systems where France splits payments 3 ways and covers more with the govt[1], and Switzerland seems to have a system like the ACA in the US where it's compulsory, but they also set caps on t…
> France and Switzerland both have universal healthcare You said private healthcare/insurance were to blame. Switzerland has private health insurance. Universal healthcare is a separate goal post. For what it’s worth, I’m unclear its comprehensive iteration is compatible with America’s immigration model. (It absolutely is for life-saving measures.)
> You said private healthcare/insurance were to blame. Switzerland has private health insurance.
Private business in all western countries operates within the regulations and laws that cover them. The health insurance industry in Switzerland operates under a very different set of regulations and laws than the same industry in the USA. If you want to blame the OP for not being more explicit - "private healthcare/insurance and the regulatory framework are to blame" - then fine, but ... this is actually the crux of the issue.
Re: Health insurers just published close to a trillion hospital prices
#113Unrelated: “dolt” vs “doIt” is one of my standard font competence tests
Re: Health insurers just published close to a trillion hospital prices
#114Earlier quoted context omitted.
It would appear us SQLite zealots have encountered the final boss. Petabytes uncompressed would be tricky if you need to slice those columns. SQLite caps out at ~281 terabytes of storage before it can't track any additional pages. None of this is to say you couldn't partition the data across a lot of SQLite instances in varying ways. I will probably take a shot at it this weekend. Looking to see just how unlimited my…
> It would appear us SQLite zealots have encountered the final boss. That's cute. :) There isn't much value in feeding it all into a conventional RDBMS. OLAPs and columnar stores are what is needed here. But first it will need a great deal of grooming and ETL work.
Re: Health insurers just published close to a trillion hospital prices
#115Earlier quoted context omitted.
My understanding (not an expert by any means) is that we basically have two tiers of negotiation - the fed. govt. has way more leverage but also some amount of corruption that goes into pricing, then afterwards individual hospitals and "networks" of providers will negotiate with the insurer - sometimes after the procedure has already happened - to figure out the final price. The end result is that you might end up wi…
> To make it worse we also have laws preventing healthcare providers from providing prices upfront, out of a fear that people will forego necessary care they can't afford. What are these laws? This seems so backwards - I know personally I have put off medical care in my past because I had high deductible insurance, and no guarantee that the bill I'd get wouldn't wipe me out, and no way to price shop. Paralysis of unk…
Re: Health insurers just published close to a trillion hospital prices
#116Re: Health insurers just published close to a trillion hospital prices
#117- these prices, as negotiated between insurers and providers, were already well known inside the industry. so much so that many procedures could be declined coverage well in advance of a customer ever needing one. this insider knowledge formed the core of many earnings reports for insurers and hospitals alike,
- Disclosure is meaningless if the customer has no alternative. most health services that bankrupt are emergency medicine, and as such youll pay anything to save your own life. thrusting a stack of price sheets at a faceless national healthcare monopoly and demanding a fair price is a laughable if not sad idea. Healthcare is not something capitalism is equipped to competently support.
- hospitals have zero incentive to work with you on any price for any service, and no federal state or local law will compel them to do so by virtue of a combination of bureaucratic deadlock and regulatory capture. is it, for them, more profitable to sell your arbitrary debt to a credit collection agency? shove you into a debt counseling service they get kickbacks from? work a long and grueling payment plan through their own financial services division to bolster quarterly profit long-term in a recession? or just ignore your pleas entirely? what they charge is not up for debate by you.
Re: Health insurers just published close to a trillion hospital prices
#118Earlier quoted context omitted.
I don't think that disproves a general trend that increased socialization in healthcare costs leads to better outcomes and less per-capita spending. Also FWIW France and Switzerland both have universal healthcare, under different systems where France splits payments 3 ways and covers more with the govt[1], and Switzerland seems to have a system like the ACA in the US where it's compulsory, but they also set caps on t…
It's not just Switzerland and France; the Netherlands also has a private-only health insurance system. It's also very difficult to draw decisive conclusions since, across countries, there are hundreds of confounding variables — it's not just public vs private, but it's also which regulations exist in each country, whether it's employer-sponsored vs individual, general willingness to pay, etc. You're correct that Swit…
> Medicare Advantage Plans are another way to get your Medicare Part A and Part B coverage. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by Medicare-approved private companies that must follow rules set by Medicare. (emphasis added)
Those rules are, IIUC, substantively different than the ones that cover the non-medicare private insurance industry, and as a result I'm not sure what any of the (true) facts that you've quoted really mean in the context of the questions being asked here.
Also, from reading up about MA, it would seem that MA is operating on the "HMO" (health maintainance organization) model that started to be touted in the 1990s. AFAIK, the HMO model has not done much to contain consts in the broader US private health insurance world. It would be interesting to know if it is specifically the combination of the HMO model and Medicare rules that has allowed MA to apparently work better than OM.
Re: Health insurers just published close to a trillion hospital prices
#119Earlier quoted context omitted.
> France and Switzerland both have universal healthcare You said private healthcare/insurance were to blame. Switzerland has private health insurance. Universal healthcare is a separate goal post. For what it’s worth, I’m unclear its comprehensive iteration is compatible with America’s immigration model. (It absolutely is for life-saving measures.)
What aspect of America's immigration model do you think intersects with this? > You said private healthcare/insurance were to blame. Switzerland has private health insurance. Private business in all western countries operates within the regulations and laws that cover them. The health insurance industry in Switzerland operates under a very different set of regulations and laws than the same industry in the USA. If yo…
I'm not sure it is. Universal healthcare is orthogonal to private health insurance. That's the lesson of Switzerland's example. I don't believe this is commonly known or accepted in American politics. Instead, any attempt at reform is pitched and vilified as an attempt to end private health insurance and healthcare.
Re: Health insurers just published close to a trillion hospital prices
#120Earlier quoted context omitted.
In your opinion, what would be the lowest hanging fruit that could be changed to have the largest positive impact?
People are rarely satisfied with this answer but its demonstrably true and was proven time and time again at the facilities ClearHealth managed. 1) Feverent, almost religious, adherence to hand washing. 2) No neck ties or dangly sleves whatsoever in buildings that house patients. 3) Change from stainless steel hardware for doors and travel touch surfaces back to "brass/copper". Those are simple, virtually free, thing…
Because of the pandemic I started encountering doors that have a shoe pull, where you can use your foot to open the door instead of having to touch the handle. I really hope these catch on, but they are still quite rare.