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Banks and hospitals are cashing in when patients can't pay for health care

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Re: Banks and hospitals are cashing in when patients can't pay for health care

#81

Post by jewayne »

iso1631 wrote: post #36
Mezzie wrote: post #25

Earlier quoted context omitted.

In addition to people mentioning the information asymmetry, healthcare demand is also inelastic and not substitutable. I have MS. If I sub out my treatment, I increase my odds of losing the ability to ever walk again. Likewise, if I have a relapse and end up in the hospital, I need steroids immediately.

Healthcare demand seems to be boosted by the profit motive. The healthcare industry has an incentive to increase healthcare usage - by oversubscribing unneeded drugs and procedures and through constant daytime adverts about "talk to your GP about thing which has a list of side effects longer than the commercial break "

In the US we actually use quite a bit less healthcare than some other places in the developed world (Japan, for example). Which is what you would expect, that our high prices would reduce the consumption of healthcare. We in the USA have come to believe, as a society, that healthcare is exorbitantly expensive. But it's not actually exorbitantly expensive to provide healthcare, we just pay exorbitantly high prices. Which actually helps convince us that healthcare is, by nature, exorbitantly expensive.

Re: Banks and hospitals are cashing in when patients can't pay for health care

#82

Post by Mezzie »

iso1631 wrote: post #74
Mezzie wrote: post #47

Earlier quoted context omitted.

Yeah, this is definitely part of the reason for the cost, but overall healthcare is pretty inelastic. (Ads for meds are so odd: I spent a couple of years in Canada and they don't do that there and it was bizarre coming back to the US and hearing them.) Another reason for this is that Americans are so litigious: tests are ordered because otherwise the patient can sue. Which in turn is the case because the only way to…

In the UK we have medical malpractice too (and far to much of it), but we also define what tests are expected. My understanding is the people defining those tests aren't incentivised to overtest (by companies trying to sell the tests) or undertest (through fear of being sued).

Yeah, I imagine having some sort of central authority (NHS) against which even private practitioners can compare themselves helps here. American healthcare is just chaos. I guess the closest thing here would be Medicaid/Medicare but even those are administered through private companies with variances in what is covered.

Also there's probably less resorting to suing in the UK since people whose doctors mess up can get the resulting problems treated. In the US, if a doctor fucks up and you need more treatment, it can bankrupt you and the only way to recoup the costs is to sue.

Re: Banks and hospitals are cashing in when patients can't pay for health care

#84

Post by secabeen »

The biggest challenge is just the entrenched interests. If we reduced US health care expenditures just to the median level of developed countries, we would spend ~$1 trillion/yr less than today. That's a lot of people laid off, who will fight tooth and nail to keep their jobs active.

Re: Banks and hospitals are cashing in when patients can't pay for health care

#85

Post by aksss »

elzbardico wrote: post #7

What is incredibly amazing is how much health care costs in the US. Government expenditures Per Capita are over twice of the nations like Canada, UK, Australia, and Japan. And most of this for medicare, for which only a fraction of the population is eligible. And yet, this is not enough, and people need private health insurance. Then you look at the prices of common medications, and most of them (mind you, a lot of t…

> looks like the invisible hand of markets is not working here

Holy crap - Fan or no fan, the "invisible hand" isn't a factor in that environment. Healthcare is highly regulated, the market for drugs (for instance) highly rigged by federal reimbursement commitments, the third-party payer system obscures all costs from the consumer rendering them incapable of making informed choices. If you wanted the market to sort out health care, you'd need to get rid of state-level 'certificates of need' to introduce competition on the supply-side, actually achieve price transparency for consumers to avoid price fixing, and massively overhaul medicate part D to bring costs for drugs down. This is in addition to allowing insurance markets to cross state lines.

Total facepalm when I hear people say, "look at healthcare - guess the free market doesn't work". Nobody needs to argue that it should be a total free and open market devoid of regulation - that's a dumb retort, but to not understand how regulation has served to facilitate self-dealing, instituted market barriers, and create a money-go-round, is equally as daft.

Re: Banks and hospitals are cashing in when patients can't pay for health care

#86

Post by aksss »

jewayne wrote: post #81
iso1631 wrote: post #36

Earlier quoted context omitted.

Healthcare demand seems to be boosted by the profit motive. The healthcare industry has an incentive to increase healthcare usage - by oversubscribing unneeded drugs and procedures and through constant daytime adverts about "talk to your GP about thing which has a list of side effects longer than the commercial break "

In the US we actually use quite a bit less healthcare than some other places in the developed world (Japan, for example). Which is what you would expect, that our high prices would reduce the consumption of healthcare. We in the USA have come to believe, as a society, that healthcare is exorbitantly expensive . But it's not actually exorbitantly expensive to provide healthcare, we just pay exorbitantly high prices. W…

I can tell you from sitting in meetings with insurance brokers that people (employees) consume healthcare with very little regard for price. ER and urgent care usage is too high, MRI's vary in price in the same city by 400%, but there is no price discrimination going on for the consumer because they just pay a copay or less (if they've hit their deductible) - it's "free". You say we actually use quite a bit less healthcare, but I'm not sure who "we" is. "We" make dumb decisions about healthcare - preferring UC clinics to preventative healthcare and sanitation, we overpay because we can't price shop services, we don't know the actual costs of what we're consuming and so make very dumb decisions, and sorry, that opaqueness is by design. It's a fantastic money machine.

Re: Banks and hospitals are cashing in when patients can't pay for health care

#87

Post by blue039 »

willcipriano wrote: post #9
elzbardico wrote: post #7

What is incredibly amazing is how much health care costs in the US. Government expenditures Per Capita are over twice of the nations like Canada, UK, Australia, and Japan. And most of this for medicare, for which only a fraction of the population is eligible. And yet, this is not enough, and people need private health insurance. Then you look at the prices of common medications, and most of them (mind you, a lot of t…

Medicine is the most regulated and subsidized industry in the US. This is theft by regulatory capture[0]. Globalism is magically not applied to medicine, simply stopping being protectionist on prescription drugs would save consumers billions of dollars a year, it's easy, it's obvious and no politician will ever do it. [0] https://en.m.wikipedia.org/wiki/Regulatory_capture

You're also forgetting that medicine is cheap everywhere else because US citizens pay 99.9% of the bill.

Every new medicine, every name brand medicine, every generic is paid at an exorbitant rate in the US which allows companies to provide cheaper medications to other countries. Every new surgery, every new technique, literally every part of the medical process is subsidized IN FULL by Americans.

Put it simply - if the US decided collectively we will not pay any more than cost for generic medication the entire world's healthcare system would collapse overnight. Most of the west would no longer be able to socialize their healthcare. 3rd world nations would likely halve their life expectancy. This is why, in my opinion, the US will never be able to do a medicare-for-all type situation. It's already unaffordable on the current tax basis strictly to take care of Americans. The unmentionable cost of subsidizing literally the entire planet's medical system through paying insane prices for everything makes it unaffordable even in some fever dream scenario.

When you're getting your cheap healthcare and free medicines take the time to thank your nearest American. They are dying so that you can afford to live. Your insulin is only cheap/free because some poor sap in America is paying quite literally 1400x your cost. The taxes other countries pay into their medical system pales in comparison to the amount of money Americans pour into their healthcare to keep it cheap everywhere else. There is simply no comparison to how badly Americans get bent over.

Re: Banks and hospitals are cashing in when patients can't pay for health care

#88

Post by theGnuMe »

mgkimsal wrote: post #68
theGnuMe wrote: post #42

Earlier quoted context omitted.

ACA increases the subscriber pool. The main issue now is the high deductibles which causes folks to ration care. Otherwise your premiums are scaled based on income. You also do get some primary care visits included and a few other things. That's so you catch things earlier before they get expensive. What the ACA really does though, is reduce the financial impact of a catastrophic event. So you are covered and out of…

Assuming that 10 or 100k of services is 'in network'. The only plan I can remotely afford now offers no functionality in any 'out of network' facility. The columns are all just 'n/a'.

Sure but that's ok.

If you cannot get equivalent care nearby "in network" then you can go out of network and get covered. They won't like it and it can take negotiation but you have that option. All emergency care for example operates this way.

This is why the ACA stuff uses your zip code to offer plans. Remember most of these are State and Federal partnerships with private companies. The companies are just offering up their "networks". You and the State are paying the premiums.. One way to think about it is that the state is paying the employer portion.

This is way better than how it use to be...

Re: Banks and hospitals are cashing in when patients can't pay for health care

#89

Post by antisthenes »

klyrs wrote: post #41
antisthenes wrote: post #22

If you have obscene hospital bills, just don't pay them. Worst case scenario, you will get sued and have a lien put on your house.This still doesn't obligate you to pay. You can just let inflation eat away at the bill for years on end. People need to hit these profiteering practices right in the wallet. I'll take bad credit over actual bankruptcy any day.

> You can just let inflation eat away at the bill for years on end. Can we really? Wouldn't that require that our income tracks inflation? Because that's not true for perhaps most people in the US. Only executive-level income is beating inflation. I think the option most available is to die poor and have your pitiful assets distributed to your creditors.

It's still way better to die poor than to live AND die poor.

At least if you don't pay the medical bills, you'll have a little bit more money while you live, making it less miserable.

Re: Banks and hospitals are cashing in when patients can't pay for health care

#90

Post by ars »

cvccvroomvroom wrote: post #17

Anecdotal example: I was in a coffee shop in Redding CA. There was a lady with a nasal infusion pump tube in her nose. I struck up a conversation with her. It turns out she had Stage IV cancer and was about to go before a bankruptcy magistrate to fight to keep her clothes, housing, and vehicle. Her creditors were the doctors and hospitals who were going after her while she was still alive.

Why didn't she qualify for all the free (subsidized) insurance options offered by the ACA?
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