91–100 of 104 posts
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In no way is this a free market. Not even close. There are so many market distortions that prevent a healthy market place from operating. If you recall, the ACA act was supposed to help solve many of these problems by making it more affordable. It appears to have exacerbated it.
I don't think there is any evidence it exacerbated it.
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An interesting story I heard on the radio: A father got a call from his daughter that she went to the emergency room, because she had a vitamin C pill stuck in her throat and she was scared. In NY, they are required to give an estimate of costs, and estimated $1600 for the exam and the can of ginger ale they gave her to drink so she could swallow it. Fast forward a few weeks, and they got the bill. They ended up char…
> if these had been available OTC or if doctors could operate out of pharmacies and prescribe something on the spot, it would have been so, so much cheaper. Just a tip for future cases, a lot of those pharmacies have small clinic in them staffed by a nurse practitioner. They can prescribe most things in most states. If it happens again, you can probably take her and her discharge paperwork and have the nurse write ou…
Nothing happened after that.
I've rarely gotten an accurate medical bill (vastly inflating the time I was seen by the doctor is the most common mistake), and if it's inaccurate I just don't pay.
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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 "
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The US seems to have invented (or at least normalized) medi-begging - the process of posting to gofundme-type sites to help pay medical debt. The very existence of 'medial fundraising' as a thing should be the damning indicator that we need some form of single-payer across the board. Hundreds of thousands of people publicly begging for help with medical bills should be a national embarrassment.
We do a good job ignoring the economic issues of our neighbors, until it impacts our house. Overall, people are pretty vocal about wanting a living wage, affordable healthcare, affordable education, housing, etc. yet we seem to constantly move in the opposite direction. IMO - our political machine has become too dysfunctional and no longer serves the people, or even make meaningful incremental progress. It's quite a…
So yes, they say they want a living wage, but get really really really upset if you suggest that means the guy scanning your groceries makes as much as they do.
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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 heal…
My point is -- almost none of those things should have exorbitantly high prices, because they don't actually cost that much.
Do urgent care centers actually use an exorbitant amount of resources to provide health care services? They do not. Does getting any MRI actually consume thousands of dollars of resources, even counting labor? It does not.
To me, the main reason we still have not had meaningful healthcare reform in this country is that Americans have seen the made up numbers on those ridiculous works of fiction called "medical bills" and "statements of benefits" for long enough, that they think they are real. They are not.
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…
An interesting story I heard on the radio: A father got a call from his daughter that she went to the emergency room, because she had a vitamin C pill stuck in her throat and she was scared. In NY, they are required to give an estimate of costs, and estimated $1600 for the exam and the can of ginger ale they gave her to drink so she could swallow it. Fast forward a few weeks, and they got the bill. They ended up char…
This makes no sense. Insurance companies NEVER pay more than they are asked to pay. It's half the reason why medical billing is such a royal pain. A doctor or pharmacy knows they've left money on the table if they get exactly what they ask for from the insurance company.
And there's no way that increasing the coinsurance for the patient (co-pays are fixed dollar amounts so there's no "bumping it up") does anything for the insurance company. If your coinsurance is 20%, the insurance company is still paying paying 80% whether that's 80% of the $2200 or the $3500. Even if the person had an HDHP plan and was paying all of that out of pocket, all the insurance company raising the the cost from 2200 to 3500 would have done was move the patient $1300 closer to their deductible and out of pocket limits and make it more likely the insurance company is paying out more money in the future.
More likely is that the ER billed $3500 and the insurance's allowed amount was $2200.
Earlier quoted context omitted.
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 heal…
Notice, you're not complaining about employees using too many health services, you're complaining about you and your employees getting massively overcharged for the (let's be honest, relatively few) healthcare services they get. My point is -- almost none of those things should have exorbitantly high prices, because they don't actually cost that much. Do urgent care centers actually use an exorbitant amount of resour…
Earlier quoted context omitted.
An interesting story I heard on the radio: A father got a call from his daughter that she went to the emergency room, because she had a vitamin C pill stuck in her throat and she was scared. In NY, they are required to give an estimate of costs, and estimated $1600 for the exam and the can of ginger ale they gave her to drink so she could swallow it. Fast forward a few weeks, and they got the bill. They ended up char…
>Fast forward a few weeks, and they got the bill. They ended up charging his insurance $2,200, and the insurance company valued the trip at $3,500 (presumably to bump up his co-pay? not sure). This makes no sense. Insurance companies NEVER pay more than they are asked to pay. It's half the reason why medical billing is such a royal pain. A doctor or pharmacy knows they've left money on the table if they get exactly w…
It's possible that the (clearly upset) father on the phone had the story mixed up, but I'm not sure that NY law would allow an estimate for a medical bill to end up being billed at more than double the original estimate. Hell, in my state car repairs can't exceed 10% of the original estimate without approval from the customer. Either way it shakes out, if the story is real the state commissioners are going to have fun with it.