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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

#401
post #335

Earlier quoted context omitted.

Walk around the supermarket that you drive to, hopefully not being maimed or maiming someone else on the way. A ludicrous expenditure of energy to avoid physical activity so that you can buy products to help alleviate the symptoms of the energy expenditure and laziness. Can’t walk, or bike, or take the non-existent public transit. That’s for sure.

I don't think driving is merely to avoid physical expenditure. Driving is a result of rural and suburban living as well as poor urban planning. Lots more people would walk or bike if it was reasonably feasible.

I suspect it's a bit of a chicken/egg problem (based on my opservations from visiting the US). Even in suburban areas there seems to be roads everywhere, often very hard to cross without a car.

Where I live in Europe, the expectation is that the kids will walk or take the bike to school. 95% of the paths they need to travel is covered by walkways (usually separated from the roads, and in many cases with dedicated bike lanes). Everywhere the kids need to cross, there are crosswalks, and every morning before school a team of parents is organized to safeguard these crosswalks.

Meanwhile, driving is slowed down significantly by the efforts above. The roads are underfunded and lines tend to form around the school (some parents still do drive their kids, up to about half when the weather is really bad). But with parents blocking the crosswalk every time a kid is near, bottlenecks do form. Basically, if you're in a car, you're treated as a 2nd rate citizen. :)

Oh, and I suppose one benefit of all this walking is that hospital bills go down. Mostly because of the exercise, but also to some extent due reduction in air polution (which is helped further by most of the remaining cars being electric, most of which, ironically, are of a certain American brand).

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

#402

Earlier quoted context omitted.

Social insurance is covered by AHV/SVA/IV (funded by salary deductions and cover congenital defects, invalidity, some rehabilitation therapies and other non profitable coverage) and of course healthcare is not fully privatized as you say: private insurances are private, offering highly regulated compulsory insurance and can offer less regulated additional insurance. Some hospitals/clinics/health and elderly centers (…

I guess that you don't know that, for example, if you get operated of a congenital defect in Switzerland, the bill goes to the SVA instead of to your private insurance (and so on for specific cases) I am not conflating anything, you have a superficial understanding that makes you think it is privatized. If you dig into the spending public & private and the actual details you would see that Switzerland is not privatiz…

But that’s the same as the US. If you are born with a disability you can get social security insurance (SSI) payments that can also qualify for public (Medicaid) insurance.

https://www.cbpp.org/research/social-security/ssi-a-lifeline...

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

#403
post #326

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NASA’s budget for 2022 is about $24 billion or roughly $145-$150 per working person. Perhaps a lot of money depending on what you think should be prioritized. personally I think it’s hard to argue that they aren’t delivering something of high value to humanity, especially recently with the success of the JWST. And maybe very especially compared to other agencies.

NASA is wasting the bulk of their funding in an obsolete launch system. Over the he past 50 years they have held back any economical progress in access to space. https://www.washingtonpost.com/business/nasas-artemis-rocket...

> NASA is wasting the bulk of their funding

SLS is expensive, but it's nowhere close to the bulk of NASA's funding. It's about 10%.

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

#404

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. You also haven't given even a hint of proof for this alleged trend. Maybe there is a trend, but let's look at some serious data before we just assume it's an obvious fact.

Google healthcare cost per capita vs life expectancy. Last time I checked, Canada, for example, spent 1/3rd less than the USA and Canadians lived a few years longer. IIRC, of the "universal coverage" systems, Switzerland's ACA-like system had the highest per capita, but still less than USA's system. Much has changed these last few years. eg Our life expectancy in the USA has fallen.

Life expectancy is a terrible measure for quality of healthcare. It ignore so many other factors. The only way it could be a suitable measure if you assumed every human in every country was the same except for the healthcare they receive. It's pretty clear they aren't - lifestyle, smoking rates, alcohol and drug abuse, accidents, suicides, genetics.

You’re far better to look at things like “survival after cancer diagnosis” where the US has some of the world’s best outcomes.

https://www.healio.com/news/hematology-oncology/20180131/us-...

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

#405
post #258

Earlier quoted context omitted.

(ND)JSON is simpler because people actually follow the spec, unlike with CSV.

People violate the JSON spec all the time. And following the CSV spec is much easier than following the JSON spec. And there's only like three edge cases.

> And there's only like three edge cases.

Unless you involve MS Excel or, worse, MS Excel on macOS. OTOH, pitfalls are: UTF-8 BOM, comma vs semicolon, single vs double quote, multiline cell content and escaping, escaping in general...

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

#406
post #231

Earlier quoted context omitted.

After you criticized the comment as only “sounding enlightening” I was eager to hear your thoughts. Unfortunately I think your comment is even less enlightening. I mean, not all healthcare problems are caused by lifestyle. So clearly healthcare is a base layer - there is no situation where it wouldn’t exist.

I'll concede that the comment was vague and relied too heavily on a shared intuition. Though I will admit, the reward became well played dry comedy throughout your sibling comments. So I'll break down my reasoning a bit. It requires a full blog post to get out, so please forgive the abridged version. Healthcare is a catch all for all the other problems of society. The top costly conditions in the US are (in order of…

Yes, most governments do not allow pricing according to ricks; but, whether insurance will take that risk group and insure them does in fact act as pricing according to risk. An example is diabetes. As if you are not with an elite insurance carrier via elite high income job you have actually not having insurance and dying from diabetes due not being able to afford insulin shots.

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

#407
post #284

Earlier quoted context omitted.

> In fact, of the countries that usually make up the global leaders in health/medical innovators, all but 1 (the UK) engage in price controls ( https://immigrantinvest.com/insider/the-best-healthcare-coun ...), and the UK's NHS is suffering from a rationing crisis, and (ironically) a cost crisis. The UK's difficulty lie in their leadership and political issues and in the economic consequences of Brexit. I'm not sure…

The NHS's difficulty lies in the simple fact that it is understaffed ( https://www.express.co.uk/life-style/health/1633058/general-... ) and the staff are underpaid ( https://www.bbc.com/news/newsbeat-62290577 ) — leading to unprecedented wait times. This is because the "list prices" that the NHS pays for GP, nurses, and services are not subject to market forces, they are set by the government. The government is curr…

> The NHS's difficulty lies in the simple fact that it is understaffed and underpaid — leading to unprecedented wait times. This is because the "list prices" that the NHS pays for GP, nurses, and services are not subject to market forces, they are set by the government. The government is currently failing to address the supply loss with little political will to increase list prices.

And the US's problem is that the list prices it pays for GPs, nurses, and services are subject to market forces and thus are too high. The government is currently failing to address the service provision loss with little political will to decrease list prices (even though they would propagate through to consumers as decreased costs).

It seems to me that there's no getting around the need for good governance here. And that lack of it is no excuse for not governing at all.

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

#408

Earlier quoted context omitted.

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

There's no point pretending you know what people's motivations are. Conservatives I've read/heard seem to generally want similar outcomes, but disagree drastically on the methods.

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

#409
post #364

Earlier quoted context omitted.

Actual founders are maybe 0.1% of the HN reader base. Most everyone else are tech workers not looking to disrupt anything.

I'm mostly interested why the USA suddenly becomes pro-worker when it comes to this expensive and inefficient healthcare system they have. I swear you could be talking to the most hardline GOP guy who wouldn't spit on a trade unionist if they were on fire ... but if you mention, say, single-payer healthcare they'll start weeping for the all the workers in hospitals' billing departments and in health insurance compani…

No, they're worried that single-payer would increase healthcare costs and/or decrease quality. They might be wrong, but that's not why they'd be worried.

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

#410
post #89

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…

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…

> e invest many times per capita what other countries put into basic medical research

This is a big thing. I'm in the UK, where healthcare is very socialised, but I very much appreciate the fact that the US invests in making and productionising the next generation of healthcare, which we can then buy in bulk at a discount.

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