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

The American Healthcare Conundrum

github.com

Post reply on HN
Print view View original

131–140 of 690 posts

Re: The American Healthcare Conundrum

#131

Post by hollerith »

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.

Not in iPhones!

Re: The American Healthcare Conundrum

#132

Post by WarmWash »

Firey take, but health insurers are not the problem they are made out to be. They're on your team and benefit from lower prices just as much as you do. They don't make any money either, don't argue with me, buy their stocks if you are so convinced and see how that goes over.

Health care providers carry immense blame. It's full of passionless people in it for the outsized paychecks, who once inside will just seek whatever local minimum to stay employed.

Re: The American Healthcare Conundrum

#133

Post by DangitBobby »

WarmWash wrote: post #132

Firey take, but health insurers are not the problem they are made out to be. They're on your team and benefit from lower prices just as much as you do. They don't make any money either, don't argue with me, buy their stocks if you are so convinced and see how that goes over. Health care providers carry immense blame. It's full of passionless people in it for the outsized paychecks, who once inside will just seek what…

They add an entire layer of make work and waste just for existing.

Re: The American Healthcare Conundrum

#134

Post by adgjlsfhk1 »

pixl97 wrote: post #77
glenstein wrote: post #52

Earlier quoted context omitted.

I will piggy back off of your comment because I was going to say a very similar thing. In my state, electric utilities are guaranteed a rate of return on investment of approximately 12%, if I remember correctly. And so there's a lot of incentive for build out and maintenance that's high in total dollar amount and high in volume of work done. In some ways it's the system working as designed but the "cap" can incentivi…

So you have an excessively built out electrical system... sounds like a win to me.

Absolutely not. The way to spend as much money as possible is to do intentionally inefficient repairs (e.g. last minute/reactive). The providers gain from grid unreliability since by causing problems, they get to justify spending money to "fix" them.

Re: The American Healthcare Conundrum

#135

Post by 0xbadcafebee »

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.

That's not why prices continue to increase. They can't just let prices skyrocket to pad their pockets. If they try, government regulators will block premium hikes, regular people will ditch them for cheaper competitors, and big businesses that pay premiums from cash will fire them for not keeping medical bills lower.

Re: The American Healthcare Conundrum

#137

Post by twoodfin »

ipsento606 wrote: post #85
nostrebored wrote: post #28

Earlier quoted context omitted.

ACA enshrined the worst parts of the American healthcare system for years to come. It is a politicized victory that is the best solution for no American citizens. Places I’ve been with fully privatized healthcare or single payer are both significantly better for consumers. Insurance companies have raised prices to restore profit, were briefly a mandatory expense, and will exist for years to come.

> ACA enshrined the worst parts of the American healthcare system for years to come before the ACA, insurers could deny coverage for pre-existing conditions people have forgotten how bad things used to be

Why is that inherently bad? Should I be able to buy fire insurance on pre-existing embers?

Re: The American Healthcare Conundrum

#138

Post by nradov »

Projectiboga wrote: post #55
nradov wrote: post #49

Earlier quoted context omitted.

That's true to an extent, and those minimal controls are why Medicare also wastes billions on paying fraudulent claims. https://relentlesshealthvalue.com/episode/ep502-how-some-pre...

Yes but the Medicare and Medicaid reimbursement rates are below breakeven so cash and insurance rates have to be above provider breakeven. The main cost frictions are administrative costs for billing on both the insurance and provider sides.

That's true to an extent, but some provider organizations manage to survive with patient populations that are almost entirely Medicare / Medicaid. Many provider organizations are just badly managed and haven't taken steps to optimize their finances through automation or participation in value-based care programs.

Re: The American Healthcare Conundrum

#139

Post by mothballed »

nradov wrote: post #109
mothballed wrote: post #48

Earlier quoted context omitted.

Price caps create shortages when they are the rate limiting factor, which is always the case when imposed on a free market whenever the cap is below the market price, so this is an extremely accurate statement when dealing with things like lightly regulated commodities. Whether they would be the rate limiting factor in health care remain to be seen, since health care is highly regulated with regulatory capture, licen…

You don't need to waste time with though experiments, you can just look around at various national healthcare systems. Wherever there are price caps, certain treatments have long queues or are simply not available at all. That's why affluent Canadians often come to the USA as medical tourists and pay cash for MRI scans or joint replacement surgery. Every system rations care somehow and price caps aren't necessarily t…

Are those market price caps, or are those caps on what the 'single payer' in a 'national healthcare system[s]' is willing to pay? I was under the impression that in these systems, the 'shortage' was created by the fact the single payer was not willing to pay the free market rate that would clear for these services, therefore there is an undersupply of services provided to the 'single payer', not that there was usually an actual market cap.

Typically in these countries you actually can get health care as long as you pay privately yourself and don't go through the 'single payer.' A price cap would mean that no matter how much you're willing to pay, you can't pay over the cap, which is much rarer than the presence of 'national healthcare systems' that merely won't pay over the supposed soft 'cap'.

Re: The American Healthcare Conundrum

#140

Post by twoodfin »

nradov wrote: post #109
mothballed wrote: post #48

Earlier quoted context omitted.

Price caps create shortages when they are the rate limiting factor, which is always the case when imposed on a free market whenever the cap is below the market price, so this is an extremely accurate statement when dealing with things like lightly regulated commodities. Whether they would be the rate limiting factor in health care remain to be seen, since health care is highly regulated with regulatory capture, licen…

You don't need to waste time with though experiments, you can just look around at various national healthcare systems. Wherever there are price caps, certain treatments have long queues or are simply not available at all. That's why affluent Canadians often come to the USA as medical tourists and pay cash for MRI scans or joint replacement surgery. Every system rations care somehow and price caps aren't necessarily t…

Indeed. The US has something around 4X the number of MRI scanners per capita compared to Canada. That’s an insane figure for what has become a baseline diagnostic tool.
Post reply on HN