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

30% of All Rural Hospitals in the US Are at Risk of Closing [pdf]

ruralhospitals.chqpr.org

Post reply on HN
Print view View original

51–60 of 163 posts

Re: 30% of All Rural Hospitals in the US Are at Risk of Closing [pdf]

#51

Post by sidr »

justrealist wrote: post #18
explaininjs wrote: post #8

Earlier quoted context omitted.

Is there any country with a medical system that people don't complain about? For instance is there anyone in the world that would agree: "Gee, my healthcare is so cheap, it's surprising that it covers everything I want it to without me needing to go out of my way to justify my treatment options and I have so many medical professionals available to me at a moments notice!"

I don't mean to start a flame war, but the most positive things I've heard are from Indian colleagues/friends who are used to paying cash for very affordable service back in India. No insurance or national coverage, just low overhead and high skill.

Those colleagues were very wealthy by Indian standards to begin with and have only increased their purchasing power by being abroad. India does in fact have free care at government facilities and they are certainly not "low overhead and high skill". I'd pick rural American healthcare over rural Indian healthcare 10 times out of 10.

Re: 30% of All Rural Hospitals in the US Are at Risk of Closing [pdf]

#52

Post by cheeseomlit »

jorblumesea wrote: post #9

Can we please just implement some level of universal healthcare. The fact that healthcare is tied directly to payers, who fight over how to much to pay, is ridiculous. Imagine your local hospital shutting down because the hospital charged $50 for aspirin but the insurer wanted $40.

If you take an industry cornered by an entrenched cartel and then socialize it as-is you are only cementing their control over it even further, making a healthy competitive market impossible. Prices are criminally exorbitant now, what makes you think they'll go down when the government is the one paying them? If history is anything to go by the effect will be the opposite

Re: 30% of All Rural Hospitals in the US Are at Risk of Closing [pdf]

#53

Post by toomuchtodo »

lookdangerous wrote: post #34
toomuchtodo wrote: post #32

Earlier quoted context omitted.

Government payer reimbursements must go up, but cost controls are necessary as well to drive out a profit motive. Yes, I'm aware that the limited quota on residency slots is also a problem that needs solving for. https://www.commonwealthfund.org/publications/fund-reports/2... https://www.commonwealthfund.org/publications/explainer/2019... https://www.politico.com/agenda/story/2017/10/25/doctors-sal... https://www.vox…

What about menu prices and the ability to comparison shop?

I think there is mixed evidence this is beneficial vs fixed prices. I'm not outright against the idea, but there has to be robust pricing and metadata available so you can be a high information consumer when shopping for non emergency services.

https://www.healthaffairs.org/doi/10.1377/hlthaff.2016.1471

https://www.ncbi.nlm.nih.gov/books/NBK53921/

Re: 30% of All Rural Hospitals in the US Are at Risk of Closing [pdf]

#54

Post by hospitalJail »

jorblumesea wrote: post #9

Can we please just implement some level of universal healthcare. The fact that healthcare is tied directly to payers, who fight over how to much to pay, is ridiculous. Imagine your local hospital shutting down because the hospital charged $50 for aspirin but the insurer wanted $40.

The problem with US healthcare isnt the payer, its the supply of workers/red tape.

Physicians are clearly the worst with their complete control through the ACGME/AMA, but pharmacists were a huge lobbyist in 2008 when it mattered. The various owners, hospitals, pharma manufacturing, pharmacies, all make sure they keep the red tape strong and the medicaid + medicare payments coming.

Re: 30% of All Rural Hospitals in the US Are at Risk of Closing [pdf]

#55

Post by dilyevsky »

jbm wrote: post #21
jeron wrote: post #7

There was a Reddit post that these rulers[0] were $80 from a medical supplier when they could be purchased for $6 on eBay, which is an easy explanation why healthcare here is ridiculously priced [0]: https://imgur.com/a/BSPRh

Um, wasn't that 100 for 80 dollars? That's how I read the imgur link.

In the original post[0] it was $6 for 100 pack too. And someone pointed out that msrp is $70 so it’s not that bad and ebay was probably either a scam or surplus. Most things on reddit is bs for votes or straight up astroturfing.

[0] https://old.reddit.com/r/pics/comments/1jiczi/i_work_in_a_ho...

Re: 30% of All Rural Hospitals in the US Are at Risk of Closing [pdf]

#56

Post by jeffbee »

I'm not 100% sure about the conclusion, in which we force private insurers to cover the cost for rural services. I suggest there is a middle ground where rural life is reformed slightly to become economically sustainable. Rural America is in many ways ridiculously expensive to serve, and not just for health care. Consolidating populations into compact towns that have several thousand people fixes a lot of those cost issues, and it also goes a long way toward preventing the need for the hospitals in the first place, which for rural ER departments comes from car crash injuries.

Re: 30% of All Rural Hospitals in the US Are at Risk of Closing [pdf]

#57

Post by AvocadoPanic »

ethanbond wrote: post #17
explaininjs wrote: post #8

Earlier quoted context omitted.

Is there any country with a medical system that people don't complain about? For instance is there anyone in the world that would agree: "Gee, my healthcare is so cheap, it's surprising that it covers everything I want it to without me needing to go out of my way to justify my treatment options and I have so many medical professionals available to me at a moments notice!"

The NHS is one of the most beloved institutions on the planet AFAICT. Of course everyone would prefer if everything were better all the time, but complaints about the US system and clearly not on the same plane as those about UK’s.

Unless you're reading news items about no ambulances or beds, being left on trollies in corridors, waiting lists for procedures lack of available GP appointments. Before covid not as a result.

Re: 30% of All Rural Hospitals in the US Are at Risk of Closing [pdf]

#59

Post by HEmanZ »

People here seem to go straight to politics on US healthcare, but does anyone ever stop to consider that this really is a complicated problem?

I’ll look at two political extremes:

- in a pure-market healthcare situation, these hospitals likely wouldn’t exist in the first place. Health services would be worse than they are now in rural areas, to the point that many probably wouldn’t have “real” health services at all because there’s not enough of a market to support it. You can say “well that’s my choice to live somewhere I can’t pay for healthcare” and that’s a different discussion, but free market wouldn’t get good healthcare in rural places.

- you could have a single payer system, at which point providing good healthcare to rural areas would be a “net drain” on everyone else. Basically people in dense areas would be subsidizing people in rural areas REGARDLESS of those people’s incomes or wealth (this is a similar problem to many ex-urbs in America where we basically subsidize the infrastructure of rich people who live there).

Neither of these seems to work out well, and I worry neither I politically sustainable. It doesn’t strike me as an easy problem…

Re: 30% of All Rural Hospitals in the US Are at Risk of Closing [pdf]

#60

Post by Eisenstein »

justrealist wrote: post #18
explaininjs wrote: post #8

Earlier quoted context omitted.

Is there any country with a medical system that people don't complain about? For instance is there anyone in the world that would agree: "Gee, my healthcare is so cheap, it's surprising that it covers everything I want it to without me needing to go out of my way to justify my treatment options and I have so many medical professionals available to me at a moments notice!"

I don't mean to start a flame war, but the most positive things I've heard are from Indian colleagues/friends who are used to paying cash for very affordable service back in India. No insurance or national coverage, just low overhead and high skill.

How much does it cost to do chemo in India? Dialysis? Kidney transplant? get an MRI for a head injury?
Post reply on HN