Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Health insurers just published close to a trillion hospital prices

dolthub.com

Post reply on HN
Print view View original

391–400 of 549 posts

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

#391

Post by weberer »

planetsprite wrote: post #215
ChrisLomont wrote: post #39

Earlier quoted context omitted.

> to justify the unethical system that allows millions to die unnecessarily Which people are those millions? The system saves millions of lives that would have died in generations past. How do you factor that into your claim?

I'm comparing the number of preventable deaths in the US vs countries with similar GDP/capita https://www.oecd-ilibrary.org/sites/3b4fdbf2-en/index.html?i... The US has a mortality rate due to preventable causes comparable to Poland/Slovakia despite having nearly a 4x higher GDP per capita. Even poorer countries with better systems do far better w.r.t preventable mortality. This amounts to an extra 100,000 deaths per…

Those countries have lower obesity rates.

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

#392

Post by trashtester »

cycomanic wrote: post #376
chii wrote: post #253

Earlier quoted context omitted.

But looking from another perspective - if healthcare is 20% of GDP, an awful amount of people are therefore paid directly due to this "waste". Any improvement in efficiency would mean those people lose out on jobs. A new use for them must be found, or there will be massive unemployment (at least, short-medium term).

There was a quote by an opposition politician in Germany to the argument that Germany should buy the Eurofighter (which had huge cost overruns etc.) because it creates jobs. Loosely translated: "We can also build a pyramid for Helmut Kohl [chancellor at the time] if the goal is to create jobs".

The defence industry is treated like that in every country. Part of the reason why a country wants to retain some military industry domestically, is to ensure production capacity during a security crisis (kind of like for agriculture). It's not just "jobs", but "jobs" with that particular skillset.

For instance, Germany is producing the Leopard 2. They may export most of them during peacetime, but should they need to, they could start pumping out those tanks for the Bundeswehr instead. Furthermore, with the skills available domestically, it would take much less time to repurpose VW/BMW/Audi factories to also produce weapons.

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

#393

Post by Bayart »

coredog64 wrote: post #84
e_i_pi_2 wrote: post #80

My current assumption is that private healthcare/insurance is to blame, because countries without that or with less generally have better outcomes at less cost. Looking for evidence to the contrary

As two quick examples, both Switzerland and France have private healthcare providers and insurers. I think that’s enough to falsify your assumption :)

Private healthcare in France is supplementary to public healthcare and mostly abides by regulations dictating what can be reimbursed by the social security system, there's quite a bit of price control. It only gets wild in niche products (say very fancy dental implants).

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

#394

Post by chii »

cuteboy19 wrote: post #343
seandoe wrote: post #307

Earlier quoted context omitted.

Not sure why you're getting down voted so bad. It's a valid point. I recognize that there is waste and inefficiency in the system, but I can guarantee that any effort to "streamline" or cut "waste" will inevitably hurt everyday people... Even outside of job cuts.

If keeping existing inefficiency protects jobs, perhaps introducing new inefficiency creates jobs? But that would mean that we should force people to do wasteful things in order to stimulate the economy! Thankfully the economist bastiat solved this absurdity in 1850. https://en.m.wikipedia.org/wiki/Parable_of_the_broken_window

> we should force people to do wasteful things in order to stimulate the economy!

you laugh, but this is exactly what the US gov't does, esp. with military budget allocation. Why do you think all sorts of military products are split into different pieces for manufacturing, separated into different states? It certainly doesn't help efficiency.

I'm not saying that healthcare shouldn't be improved via efficiency increases - it needs improving! But let's not kumbaya and ignore the plight of those whose livelihood would be disrupted (and not of their own fault).

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

#395

Post by heavyset_go »

JamesBarney wrote: post #317
groby_b wrote: post #194

Earlier quoted context omitted.

That 90% number is plain not true. Please cite any source for that. The costs for obese folk are on average 90%-100% higher than for non-obese folk, but that's not 90% of total spending. (See e.g. https://pubmed.ncbi.nlm.nih.gov/33470881/ ) Total cost approaches 20% of spending: https://www.hsph.harvard.edu/obesity-prevention-source/obesi...

I wonder though how much this drives up the cost. Because obesity also drives down lifespan, and age has a huge impact on healthcare expenditures.

Obesity, like smoking, is one of those morbidities that lower lifetime healthcare costs significantly, as most costs are incurred in old age, as you saisd. Obesity, smoking, etc can kill before reaching an age where people start incurring high costs.

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

#396

Post by taneq »

chii wrote: post #253
seaourfreed wrote: post #246

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).

But looking from another perspective - if healthcare is 20% of GDP, an awful amount of people are therefore paid directly due to this "waste". Any improvement in efficiency would mean those people lose out on jobs. A new use for them must be found, or there will be massive unemployment (at least, short-medium term).

Or maybe it would mean that more people actually receive quality care? In AU, at least, our waiting periods for pretty much everything are ridiculous.

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

#397

Post by Bayart »

stevage wrote: post #241
bhupy wrote: post #105

Earlier quoted context omitted.

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.

It's the mutuelle. The way healthcare works here, the essential medical stuff is reimbursed by the universal healthcare system (sécurité sociale), and the rest is out of pocket. The mutuelle covers the part that's normally for you to pay, which can be quite significant for dentistry and glasses. My employer currently gives me a mutuelle that's decent to start with, and I chose to pay a 15€/month premium for increased coverage.

For example I just got a 900€ dentist bill recently. By default the sécurité sociale would just reimburse 300€ of it, for the essential care as well as a standard deductible on dental crowns. With my current mutuelle there's only 3€ left for me to pay.

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

#398

Post by heavyset_go »

dominotw wrote: post #213
groby_b wrote: post #194

Earlier quoted context omitted.

That 90% number is plain not true. Please cite any source for that. The costs for obese folk are on average 90%-100% higher than for non-obese folk, but that's not 90% of total spending. (See e.g. https://pubmed.ncbi.nlm.nih.gov/33470881/ ) Total cost approaches 20% of spending: https://www.hsph.harvard.edu/obesity-prevention-source/obesi...

I was using obesity as a standin for metabolic syndrome to compare populations. Not sure if measure how many ppl have 'metabolic syndrome. https://www.nhlbi.nih.gov/health/metabolic-syndrome metabolic disease = all things that can be fixed by lifestyle modifications ( unless you are too far gone, ie). see my reply here: https://news.ycombinator.com/item?id=32744868

Metabolic syndrome is often a side effect of medication or symptom of other diseases that can't be fixed with lifestyle modifications alone.

For example, there are a lot of people on psychiatric medications that can cause metabolic syndrome as a primary side effect.

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

#399

Post by Der_Einzige »

3pt14159 wrote: post #372
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…

I understand you're the relative expert here, but even so I must disagree with your general thrust. I've been hospitalized in four different countries. The least sane was America. The sanest was a private hospital in England, but the public hospital in England was fine too. My home country of Canada is sane, reliable, and reliably slow and mediocre bordering on subpar. Cyprus lacked toilet seats, but at least the foo…

You're coping. Americans are responsible for about half of the world's medical research.

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

#400

Post by ohgodplsno »

randomdata wrote: post #337
multiplegeorges wrote: post #303

Earlier quoted context omitted.

Much of the current failures are due to conservative provincial governments (looking at you, Ontario...) purposely underfunding before and into the pandemic. We are now reaping what they have sown. This is a classic "underfund to prove the system doesn't work thus we must privatize it!" move.

It seems a bit strange to call out the Conservatives specifically. Ontario has been purposefully underfunding healthcare for decades upon decades, with most of the damage done decades ago. Peterson (Liberal) forced practitioners to operate under fixed rates defined by the province, which even lead to a doctors strike. Rae (NDP) eliminated 8,000 acute care beds. Harris (PC) eliminated another 6,000 beds. Governments o…

Conservatives hate that their money is taken away to fund poor people and take money away from their rich friends, and it brings them to defund healthcare, liberals hate that it creates a natural monopoly and their inability to see a functioning society work without private hospitals brings them to defund healthcare
Post reply on HN