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

The True Cost of Healthcare in the US

truecostofhealthcare.org

Post reply on HN
Print view View original

51–60 of 118 posts

Re: The True Cost of Healthcare in the US

#51

Post by jbooth »

thatswrong0 wrote: post #9
pstuart wrote: post #5

That's my doctor's site! The real takeaway (to me) is that single-payer health insurance would be the way to go.

I think it's a bit more complicated than that. It's easy to look at other countries and say, hey, that works there, therefore it will work here. But not all governments are created equal. If the government in the U.S. had a better track record, maybe it would be more palatable. But as is, I don't see single payer being the solution to our problems.

Other countries are pretty diverse with how they implement single-payer. Britain has NHS, Canada has private hospitals with government handling the insurance.

One thing in common: They all suck, yet are all much better than our system.

Re: The True Cost of Healthcare in the US

#52

Post by jbooth »

noahc wrote: post #49
cdavid wrote: post #37

Earlier quoted context omitted.

There is an easy way to refute your argument: what you're saying about 'socialization' also happened in most developed countries. At least in France, so-called 'social security' (which is about mandatory health insurance, and not pension as in the US) came in place just after WW 2, and without the US insanity in price inflation. Comparing with 1900 prices is a bit of nonsense given that there was little surgery at th…

He is comparing prices by putting it into 2013 dollars. It has nothing to do with availability. You can take a car, computer, or any other good that has a price and easily convert it back to 1865 or 1900 or whatever dollars and this helps understand the cost of things relative to today. This makes your two middle paragraphs irrelevant. If you want to just look at cancer here is a place to start: http://www.cancer.org…

Comparing medicine in 1900 and 1970 is just silly, full stop.

Regarding everything about 'government' vs 'free market'.. do you feel like you're in a free market healthcare system in America? I sure don't. I feel like I have no idea what's going on with medicine and the only difference between my insurance bureaucracy and a government bureaucracy is that the insurance company is actively trying to fuck me rather than just passively doing it.

I'm not saying big government bureaucracies are great -- they're terrible. Yet every other industrialized country's disaster of a bureaucracy is miles better than our private-public system. They have the same cost issues and also have cost inflation, but it's less inflation on a lower cost.

Re: The True Cost of Healthcare in the US

#53

Post by cdavid »

noahc wrote: post #49
cdavid wrote: post #37

Earlier quoted context omitted.

There is an easy way to refute your argument: what you're saying about 'socialization' also happened in most developed countries. At least in France, so-called 'social security' (which is about mandatory health insurance, and not pension as in the US) came in place just after WW 2, and without the US insanity in price inflation. Comparing with 1900 prices is a bit of nonsense given that there was little surgery at th…

He is comparing prices by putting it into 2013 dollars. It has nothing to do with availability. You can take a car, computer, or any other good that has a price and easily convert it back to 1865 or 1900 or whatever dollars and this helps understand the cost of things relative to today. This makes your two middle paragraphs irrelevant. If you want to just look at cancer here is a place to start: http://www.cancer.org…

The cost of cancer/dialysis/diabete is quite relevant since those things are inherently expensive today, and you won't be able to pay it from your pocket unless you are in the top few % income wise.

Regarding the 7 % costing 90 %, it does not surprise me much (the figure I heard in France was something like 10 % costing 60 %, but I don't pretend for their accuracy). You need to take into account that the 7 % are not uniformly distributed (age being an obvious factor). Also, in France at least, there is no such thing as Medicare/medicaid, so the mandatory health insurance costs can't easily be compared.

Regarding the prince thing: I don't understand the argument of putting things from year X in year Y in 2013 dollars for things that did not exist at that period X. If we discover in 50 years a definite cure against say cancer, getting the price in today's USD is meaningless (how much would someone like S. Jobs be willing to have paid for it ? Much more than anything related to inflation).

Re: The True Cost of Healthcare in the US

#54

Post by danielweber »

bdesimone wrote: post #45
danielweber wrote: post #18

Earlier quoted context omitted.

Richard Thaler just had this op-ed in the NYT on ways to reduce costs, talking some about tort reform: http://www.nytimes.com/2013/02/24/business/overcoming-obstac... ; I'm skeptical about tort reform as a panacea. However, lawsuits are incredibly expensive, and so doctors take steps that we would otherwise call economically unreasonable to avoid them. The amount of tort reform I think is really necessary is whatever…

It's not a panacea. It's a part of the very complicated system that is providing and paying for healthcare. How important are insurance premiums relative to other factors? It depends. But there are costs to having uncapped settlements, and lack of tort reform. Also, insurance premiums effect practices of different sizes differently. I personally think you can attribute the shift away from smaller private practice gro…

Most opposition to tort reform comes from the left, and fans of European-style health care also come from the left, so saying that we couldn't set up a European style because of the legal climate is intended to cause cognitive dissonance.

(I'm not advocating putting everyone into a government system run NHS-style system. Surely, though, me and a few thousand of my friends ought to be able to get together and attempt to emulate it if we wish.)

Re: The True Cost of Healthcare in the US

#55

Post by danielweber »

myko wrote: post #23
nirvana wrote: post #21

Back when he was alive, Milton Friedman did a study of the costs of health care in the US from 1900 to the 1970s. (I think the first study was in the 1970s, and it was updated in the 1990s) What he found was that the funding mechanism of health care over that time had shifted from patients paying out of pocket to government paying hospitals and government incentivized (by making it a tax write off for employers) and…

> now there are boards to decide who gets what care based on cost measures, rather than medical need. How is this different from insurance companies, or are those what you are referring to? I'm really confused by your statement.

Hardly anyone is really approving or denying care based on cost-effectiveness. Which is why costs are out of control.

Re: The True Cost of Healthcare in the US

#56

Post by rubyrescue »

skylan_q wrote: post #50
smutticus wrote: post #44

Earlier quoted context omitted.

>Whenever someone talks about the need for socialized medicine because "otherwise people would go bankrupt", remember it is the socialization of medicine that caused costs to rise to the point where people would go bankrupt. Because there are thousands of Canadians every year that go bankrupt because of health care costs. Your argument doesn't even begin to make sense.

Because there are thousands of Canadians every year that go bankrupt because of health care costs. Actually, there are. They go the US to get care that's not offered in Canada. The care here is about as good as former soviet bloc countries. If there was a chance that an illness such as cancer could kill me, I'd get out of Canada in a heartbeat and embrace poverty if it meant keeping my life.

It's just not true that large numbers of Canadians go to the US for healthcare. You need to supply evidence of this. The numbers are vanishingly small.

Re: The True Cost of Healthcare in the US

#57

Post by methehack »

huhsamovar wrote: post #14

I am one of the lucky few who has insurance provided by their employer. Unfortunately, if I am in a car accident and rack up $100,000 in bills, I am bankrupt.

Can you elaborate? Do you think your employer provided health insurance is related? If so, how?

Re: The True Cost of Healthcare in the US

#58

Post by Alex3917 »

adjwilli wrote: post #38
Alex3917 wrote: post #16

Earlier quoted context omitted.

"If he's right on 50% of his facts, it is disgusting how the system works." There were only a handful of actual statistics in there. The one thing he is wrong about though is that healthcare isn't "roughly 20% of the GDP", rather it's about 17.9%. The furthest out cms.gov gives yearly projections is to 2021, and even then healthcare is only supposed to be 19.6% of the GDP. And I think that might even include things l…

Isn't 17% roughly 20%? Or rather, isn't 17% roughly a fifth?

Only if you consider ~450 billion dollars to be a rounding error.

Re: The True Cost of Healthcare in the US

#59

Post by cobrausn »

smutticus wrote: post #44
nirvana wrote: post #21

Back when he was alive, Milton Friedman did a study of the costs of health care in the US from 1900 to the 1970s. (I think the first study was in the 1970s, and it was updated in the 1990s) What he found was that the funding mechanism of health care over that time had shifted from patients paying out of pocket to government paying hospitals and government incentivized (by making it a tax write off for employers) and…

>Whenever someone talks about the need for socialized medicine because "otherwise people would go bankrupt", remember it is the socialization of medicine that caused costs to rise to the point where people would go bankrupt. Because there are thousands of Canadians every year that go bankrupt because of health care costs. Your argument doesn't even begin to make sense.

Don't confuse an effective single-payer system for what we have or what 'Obamacare' (I hate that word) is giving us.

Re: The True Cost of Healthcare in the US

#60

Post by specialp »

zaidf wrote: post #10

We invited a dozen physicians for brunch this past weekend and they all had stories to share about how little they make per procedure compared to the amount the hospital makes. Example 1: A procedure costs $6,000 to be done at a hospital. It prices out patients paying out of pocket. The doctor realized that he himself gets about $700 from it. So the doctor reached out to another facility who agreed to do it for $1,80…

For example 1: The reason why the hospital charges so much is the fact that it gets stiffed for a lot of emergecy patients without insurance. Many hospitals are on the brink of bankruptcy especially in poorer areas. This does not always reflect in the huge disparity in prices people pay, but is a big factor. Hospitals try to offset their losses by charging paying customers more.

The real problems here especially with emergency care are that hospitals are forced to eat the cost of treating non insured patients, and that patients have no idea what something costs when they are there or if the people treating them will be covered by their insurance. Insurance companies spend a lot of time negotiating rates and making them somewhat uniform for them, but this is totally opaque to the patient. We need to make it more clear to the people being treated what things cost, and who is "in network". There have been times that I went to an emergency room "in network" and I was "balance billed" by nearly every doctor there due to them not being in network. What is a patient to do? Sit there with a book of providers and procedures?

Post reply on HN