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Health insurers just published close to a trillion hospital prices

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Re: Health insurers just published close to a trillion hospital prices

#151

Post by bhupy »

JumpCrisscross wrote: post #119
PaulDavisThe1st wrote: post #112

Earlier quoted context omitted.

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…

> but ... this is actually the crux of the issue 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.

Not sure why you're getting downvoted, but this is exactly correct. Universal healthcare != public healthcare.

Re: Health insurers just published close to a trillion hospital prices

#152

Post by brightball »

e_i_pi_2 wrote: post #71
duffpkg wrote: post #70

I'm author of Hacking Healthcare for O'Reilly, 20 year health system executive, blah, blah. It's very easy for people to forget the scale of the US "health system", we are talking 1/5, maybe more, of the entire US economy. If US healthcare spending were a country, it would have the third largest GDP in the world. Accidents of history and the massive federal beauracracy created the crazy monster of ICD/CPT codes that…

Do you consider the amount that the US spends per capita on healthcare relative to other countries for the same standard of care a "failure" of the healthcare industry? Or is there some other reason healthcare "just costs more" here? Also wondering what you think a solution is - single-payer for better and simpler price negotiations, or some other approach? My main concern is if we're spending 20% of GDP on something…

I’ve heard a lot of complaints about Medicare/Medicaid. It does not inspire confidence in single payer.

Re: Health insurers just published close to a trillion hospital prices

#153

Post by medlazik »

a-user-you-like wrote: post #141
medlazik wrote: post #128

Earlier quoted context omitted.

Free market? Capitalism. I know we're on HN but, say the word? Capitalists take a cut. Shareholders of big pharma, insurance companies and hospitals are why healthcare in the US is expensive. Public sector not being monopolistic is why healthcare in the US is expensive. In France, social security reimburses about 70% of most costs. Cheap private insurance reimburses the rest. About 75% of public hospitals and not for…

Non free market? Communism. I know we’re on HN but, say the word? Of course the US market is highly regulated and so the market is not free to lower prices. Of course the AMA is a racket. Of course needs of certificate are abhorrent. Given the customer non—coerced access to his preferred provider, and not taking his money and slapping a bunch of regulations on him will of course lower prices and give him better care.…

That's right, communism. Social security in France is literally a communist system, founded by a communist minister. Hence why neoliberals want to destroy it.

Re: Health insurers just published close to a trillion hospital prices

#154

Post by bhupy »

ggrrhh_ta wrote: post #126
JumpCrisscross wrote: post #101

Earlier 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.)

Switzerland has very strictly and non-deniable obligatory minimum (very broad in coverage) insurance, with regulated yearly price adjustments and on top of that, publicly funded hospitals and clinics (mostly unprofitable but of high quality and offering treatments that would not be profitable for private hospitals) that issue their bills to the health insurances. And, to put the icing on the cake, there are treatment…

> Switzerland has very strictly and non-deniable obligatory minimum (very broad in coverage) insurance

So does the US: https://www.healthcare.gov/glossary/minimum-essential-covera...

> there are treatments and operations (e.g. congenital defects and invalidity-related) that are directly billed to the public social insurance (funded by salary deductions) to help health insurances reduce their risk.

> Switzerland's compulsory private health insurance is nothing comparable to other countries' private insurance. There is "additional private insurance" in Switzerland (covering alternative medicine treatments, access to single bed rooms in hospitals, etc.) which do operate as private insurances elsewhere.

You're mistaken, Switzerland has no centralized social insurance — it is fully privatized (for real medicine as well as alternative medicine), and is decentralized among its Cantons. It's just that the private Swiss insurers tend to be non-profits (same holds true for the US, e.g. Blue Cross, Kaiser, etc) and the for-profit insurers' profits are heavily capped/regulated (same holds true for the US).

Re: Health insurers just published close to a trillion hospital prices

#155

Post by dnissley »

e_i_pi_2 wrote: post #71
duffpkg wrote: post #70

I'm author of Hacking Healthcare for O'Reilly, 20 year health system executive, blah, blah. It's very easy for people to forget the scale of the US "health system", we are talking 1/5, maybe more, of the entire US economy. If US healthcare spending were a country, it would have the third largest GDP in the world. Accidents of history and the massive federal beauracracy created the crazy monster of ICD/CPT codes that…

Do you consider the amount that the US spends per capita on healthcare relative to other countries for the same standard of care a "failure" of the healthcare industry? Or is there some other reason healthcare "just costs more" here? Also wondering what you think a solution is - single-payer for better and simpler price negotiations, or some other approach? My main concern is if we're spending 20% of GDP on something…

Is it really the same standard of care? I would speculate that the standard of care in the US is at least marginally higher than many other developed countries based on my admittedly anecdotal experience, especially if you plug wait times for providers into the calculation (this seems to be the number one complaint that comes from people I've met that have immigrated to the US).

Re: Health insurers just published close to a trillion hospital prices

#156

Post by QuarterReptile »

paulmd wrote: post #76
ChrisLomont wrote: post #41

Earlier quoted context omitted.

Why that article points out the US spends $12k/capita on healthcare the singles out administrative costs at $1k/capita while ignoring all the other relevant factors is beyond me. They then use the misleading infant mortality stat, ignoring that the US considers vastly more babies viable than any other country, meaning we try to save infants that other countries write off, thus they count against the US when it fails,…

> The US pays about twice per nurse or doctor in the system, and part of that is because the US pays nearly twice for most skilled work. which is in turn because in the US an average GP comes out of medical school with $200k-300k of student debt that has to have interest serviced and paid off within some 10-20 year timespan. That cost ultimately ends up being borne by the patient and their insurance. unfortunately th…

>the US is very resistant to the idea of education reform in general,

I suspect almost all Americans are interested in education reform, but are split between two opposing directions: getting rid of nondischargeable, subsidized federal loans; or making the whole thing run on federal money.

Re: Health insurers just published close to a trillion hospital prices

#157

Post by simsla »

dnissley wrote: post #155
e_i_pi_2 wrote: post #71

Earlier quoted context omitted.

Do you consider the amount that the US spends per capita on healthcare relative to other countries for the same standard of care a "failure" of the healthcare industry? Or is there some other reason healthcare "just costs more" here? Also wondering what you think a solution is - single-payer for better and simpler price negotiations, or some other approach? My main concern is if we're spending 20% of GDP on something…

Is it really the same standard of care? I would speculate that the standard of care in the US is at least marginally higher than many other developed countries based on my admittedly anecdotal experience, especially if you plug wait times for providers into the calculation (this seems to be the number one complaint that comes from people I've met that have immigrated to the US).

If your outside experience was in the UK, I would tend to agree. Their healthcare is drastically underfunded.

In comparison to France, Germany, Belgium, the Netherlands, etc I would disagree.

Re: Health insurers just published close to a trillion hospital prices

#158

Post by haberman »

duffpkg wrote: post #99
linkdink wrote: post #77

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…

> Change from stainless steel hardware for doors and travel touch surfaces back to "brass/copper".

I have never heard of this. I had to Google it to even understand your meaning. It's eye-opening to learn that different metal surfaces have an effect on the spread of germs.

Re: Health insurers just published close to a trillion hospital prices

#160

Post by [deleted] »

narrator wrote: post #85
mskar wrote: post #63

Earlier quoted context omitted.

It's very expensive, carriers have an economic incentive to simplify it and this is still where they end up. There are a long tail of provider circumstances that the single-payer model will need to figure out. Some examples: * Small hospitals in low-density, underserved areas have to make up for underutilized equipment and personnel costs. They raise prices on unrelated, common procedures to break even (This is very…

What do you think about how Kaiser has handled the whole thing? The insurance company employing the doctors and just paying them a standard salary seems to create all the right incentives.

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