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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

#241

Post by stevage »

bhupy wrote: post #105
e_i_pi_2 wrote: post #98

Earlier 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…

When I worked in France, I had health insurance through my employer. I never really understood what it was, and fortunately never needed to use it.

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

#242

Post by seaourfreed »

xyzzy123 wrote: post #198
duffpkg wrote: post #89

Earlier quoted context omitted.

Healthcare is such a base layer of the economy, I find comparisons to be extraordinaly difficult between countries. On the most basic level our pathway to becoming a healthcare provider of all sorts is dramatically more expensive and limited than other countries, what healthcare providers are paid is dramatically more than other countries, we invest many times per capita what other countries put into basic medical re…

It's a confusopoly! They're most obvious with "basic" products like energy and comms - in theory what is delivered is mostly undifferentiated kWh or GB but through the magic of "confusing plans", marketers have succeeded in making comparisons very difficult for regular people. (You can do it, but you need OCD, a year of billing data and a spreadsheet - which greatly exceeds the cognitive effort most people will inves…

...because the healthcare corporations get congress to sell out citizens. $3.5 BILLION flow through lobbyists every year (all industries). Healthcare being a huge part of that. Congress sells out US citizens & corporations fuel it

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

#243

Post by _dw7s »

gwright wrote: post #122
medlazik wrote: post #103

Earlier quoted context omitted.

As with everything it touches, it's the intrinsic failure of capitalism (ofc success for the capitalists / bourgeoisie). It's the amount of capitalism that defines prices. In every other country the more healthcare is a public matter, the cheaper it is for the people.

Healthcare in the US is definitely not driven by the free market. It is probably one of the most regulated industries. Whatever disfunction you want to call out in US healthcare it is going to be difficult to pin that on the free market.

> Healthcare in the US is definitely not driven by the free market.

You're conflating 'capitalism' with 'free market'. You can have either without the other and OP was calling out 'capitalism' specifically.

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

#244

Post by ilaksh »

RhodesianHunter wrote: post #6

Anyone else get the feeling this is malicious compliance on behalf of the insurance companies? "Oh, they're going to force us to publish our prices are they? Well we'll publish so much data it'll take a herculean effort to make it readable to anyone that doesn't work in data engineering"

Of course it is.

The problem is that the health care costs situation results in many deaths and very severe economic consequences for much of the country.

Until lying, cheating, and scheming, and screwing over the public have consequences like prison time, you can expect executives to do everything possible to avoid complying with the spirit of laws like this.

There probably was an effort to create a more useful and sanely worded law that would provide a uniform format for rules that could reduce dataset sizes by a factor of 100, but was killed by the healthcare industry because it would require some implementation costs on their end and make the data files actually useful.

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

#245

Post by stackbutterflow »

TedDoesntTalk wrote: post #200
Barrin92 wrote: post #129

Earlier quoted context omitted.

beyond Europe as well. Singapore which has exceptionally low healthcare spending (5.9% of GDP) heavily controls prices and purchases down to individual equipment in hospitals.

Singapore has a population of 5.6 million. USA has a population of 330 million. How would you control prices and purchases at that level?

According to this website [0] there are 30 states with a population of less than 6 millions. Why can't they each operate like Singapore?

[0] https://worldpopulationreview.com/states

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

#246

Post by seaourfreed »

USA Healthcare is 19.5% of GDP. Canada + Australia + UK + (a few similar countries) average 10.5% of GDP.

The USA healthcare price gouges via run away prices. Healthcare corporations corrupting congress is the fuel that forces this on people (and breaks a free market).

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

#247

Post by stevage »

sl-dolt wrote: post #32

I'm the author. A question I have is: how did so many prices ever get negotiated in the first place? What kind of systems are in place to do this kind of micro-negotiation?

And I, as an Australian citizen, am wondering why we don't have this mess. Afaik in our system, each insurer just has one flat price for how much they cover of each procedure. And each provider has a flat price for how much the procedure costs. No individual negotiations between providers and insurers.

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

#248

Post by nradov »

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…

The US is (exaggerating a bit) a nation of obese, sedentary substance abusers. We are sicker on average than other developed countries and thus have a higher demand for healthcare.

We might be able to eke out some minor improvements by tweaking the payment model and eliminating some waste. Those things are worth doing, but they won't fix the fundamental problem. The US won't get healthcare spending down to Japan's levels until Americans start acting like Japanese.

There are some other key factors as well. A large fraction of healthcare spending goes toward treating elderly patients with serious chronic conditions in their last few years of life. Some countries explicitly deny care to such patients because they don't think it's justified on a QALY basis, but Americans seem uncomfortable with rationing on that basis.

And some aspects of the US healthcare system are top notch. For many types of cancers we have the world's best 5-year survival rates. There is a thriving medical tourism business where patients from countries with socialized medicine such as Canada come here to receive rapid treatment instead of waiting for years for something like a hip replacement.

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

#249

Post by Spooky23 »

stackbutterflow wrote: post #245
TedDoesntTalk wrote: post #200

Earlier quoted context omitted.

Singapore has a population of 5.6 million. USA has a population of 330 million. How would you control prices and purchases at that level?

According to this website [0] there are 30 states with a population of less than 6 millions. Why can't they each operate like Singapore? [0] https://worldpopulationreview.com/states

The problem is that states are like accidents of history and are fairly arbitrary.

You need this with lots of stuff. “Vice” states are adjacent to more prudish states. Think New Hampshire, Delaware, Pennsylvania, South Carolina.

In the case of healthcare, states tend to push costs to somewhere else. As in send the sick person to NYC.

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

#250

Post by javajosh »

wefarrell wrote: post #225
javajosh wrote: post #173

This is unacceptable. Perhaps it meets the letter of the law, but certainly not the spirit. This doesn't begin to make healthcare anything like a "free market". It's dishonest in the same way a restaurant might be forced to release a nutritional analysis of their food, and so they release a molecule-by-molecule description. Despicable.

You assume that they’re being intentionally nebulous but in actuality it really is that complicated.

I said precisely what I meant: they've failed to meet the spirit, if not the letter, of the law. Whether or not it's intentional is beside the point.
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