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The American Healthcare Conundrum

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Re: The American Healthcare Conundrum

#121

Post by programmertote »

qwertyuiop_ wrote: post #98

Its called American Medical Association racket.

Agreed. As a spouse of a specialist doctor in the US, average folks don't include doctors when they blame the exorbitant prices of the US healthcare. Sure, big pharma, insurance companies, hospital admins and everyone in between play a part in this big profit-making machine.

But doctors (a lot of them, not all) are complicit in this healthcare complex. American Medical Association is one of the top lobbying groups in D.C. They gate-keep the production of US doctors artificially low by making the candidates go through longer years of education (4 years of college before another 4 years of med school is an overkill for most doctors) compared to other developed nations, resulting in high compensations for doctors AND longer wait-time for patients (due to doctor shortage). They also put up regulation barriers and it requires a lot of certification and exams to become a doctor, so whoever becomes a doctor has the best interest to keep the system (status quo) going.

Average US doctor gets paid a lot more than their counterparts in other developed nations.

Re: The American Healthcare Conundrum

#122

Post by nradov »

nomilk wrote: post #99

I recently travelled to Vietnam for dental work, it's really shocking how easy to it to shop around when dentists actually publish their price lists online for easy comparison/perusal. In my native country, dentists rarely if ever publish prices online, and it's hard to get prices over the phone. If hospitals could be forced to publish price lists, it would be game changing, allowing patients to shop and compare qual…

Hospitals are forced to publish price lists (charge master).

https://www.cms.gov/priorities/key-initiatives/hospital-pric...

But at a consumer level it's still quite difficult to predict what your total out-of-pocket expense will be for the same course of treatment at two different facilities.

Re: The American Healthcare Conundrum

#123

Post by mwwaters »

nradov wrote: post #31
cogman10 wrote: post #17

Earlier quoted context omitted.

This seems like we need similar price caps for healthcare providers, medical equipment providers, pharmaceuticals, etc. Done just in isolation for 1 part of the healthcare industry results in this obvious bad effect. Removing the rule wouldn't help things.

Price caps always and everywhere cause shortages, including long queues for certain types of care. This may be acceptable but we need to understand the trade-offs when making any changes.

Electric utilities face price caps and there are not electricity shortages.

It depends on the level of market failure, but there are not a ton of hospitals to choose from regardless.

Re: The American Healthcare Conundrum

#124

Post by bawana »

Does anyone here remember how health care was delivered before medicare and medicaid was enacted in 1965? It was not pretty. Prices were low then because it was all private pay and charity. Why do you think so many hospitals are named after saints? The church made a significant contribution to running healthcare. But when the govt got involved in 1965, the MBAs started salivating. Now we have a system that is built around govt style procurement that we cannot afford. As our population ages, as salaries continue to remain flat, we will have hard choices to make.

Re: The American Healthcare Conundrum

#125

Post by Aurornis »

rayiner wrote: post #96
graemep wrote: post #60

> The US spends ~$14,570 per person on healthcare. Japan spends ~$5,790 and has the highest life expectancy in the OECD. That gap is roughly $3 trillion per year. The difference in life expectancy will be influenced by multiple factors and may have more to do with diet and lifestyle than with healthcare. Japan also spends less per capita than the UK, France or Germany. The US spends a lot more than any of those so th…

I suspect you would see the exact same trend comparing Japan and the U.S. in transit, education, and many other services. The U.S. spends more per capita to get less.

The US is a wealthier country and wages are higher here than Japan.

The median equivalised household disposable income of a US household is over twice that of a household in Japan.

This is one of many reasons why it’s so misleading to compare prices across countries in a vacuum. All of the people doing the work for those education, transportation, and other services and all of their inputs aren’t going to work for Japan-equivalent pay when they’re living in the United States.

Re: The American Healthcare Conundrum

#126

Post by nradov »

programmertote wrote: post #121
qwertyuiop_ wrote: post #98

Its called American Medical Association racket.

Agreed. As a spouse of a specialist doctor in the US, average folks don't include doctors when they blame the exorbitant prices of the US healthcare. Sure, big pharma, insurance companies, hospital admins and everyone in between play a part in this big profit-making machine. But doctors (a lot of them, not all) are complicit in this healthcare complex. American Medical Association is one of the top lobbying groups in…

The AMA may cause some problems but you can't reasonably blame them for this one. They are not a regulatory or accreditation body. State medical boards control provider certification. Some universities have combined BS / MD programs that cut education time down to 6 years.

Re: The American Healthcare Conundrum

#127

Post by 0xbadcafebee »

bawana wrote: post #124

Does anyone here remember how health care was delivered before medicare and medicaid was enacted in 1965? It was not pretty. Prices were low then because it was all private pay and charity. Why do you think so many hospitals are named after saints? The church made a significant contribution to running healthcare. But when the govt got involved in 1965, the MBAs started salivating. Now we have a system that is built a…

Or we could adopt universal healthcare like every other developed nation, pay less, and have a healthier nation?

Re: The American Healthcare Conundrum

#128

Post by airstrike »

timtim51251 wrote: post #7

Lots of people are saying nonsense here. The actual reason commercial insurers pay more is that's the only way to can make more profits. Because of Obamacare requiring 80% of the money they collect to be spent, the insurance companies just get to keep 20%. So insurance companies spend more so they can collect higher premiums. That's how they make more money. Several doctor friends have told me this as well.

This would only hold empirically if prior to the ACA, commercial insurers did not pay more.

Re: The American Healthcare Conundrum

#130

Post by nradov »

mwwaters wrote: post #123
nradov wrote: post #31

Earlier quoted context omitted.

Price caps always and everywhere cause shortages, including long queues for certain types of care. This may be acceptable but we need to understand the trade-offs when making any changes.

Electric utilities face price caps and there are not electricity shortages. It depends on the level of market failure, but there are not a ton of hospitals to choose from regardless.

There are electricity shortages.

https://fortune.com/2025/11/10/nvidia-hometown-santa-clara-c...

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