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

61–70 of 118 posts

Re: The True Cost of Healthcare in the US

#61

Post by danielweber »

rubyrescue wrote: post #56
skylan_q wrote: post #50

Earlier quoted context omitted.

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.

The numbers are vanishingly small

Well, compared to what?

The odds of having your private health insurance rescinded in the US is also very small -- but it's quite likely among people who suddenly rack up big health care costs.

Similarly, if you compare Canada-to-US medical tourists to the Canadian population, I'm sure it's amazingly tiny. But how does it compare to the people of means who have a medical procedure denied by the Canadian system?

(I don't fault Canada for denying care in some cases. Sometimes it's not worth it. But the Canadian system would be better if people were still allowed to top off the denied care with their own dollars and didn't need to leave the country to get it.)

Re: The True Cost of Healthcare in the US

#62

Post by wiremine »

Falling3 wrote: post #28
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…

Facts are more than just statistics. There were numerous statements about (what seems to be) gross, gross overcharging on everything from pens to surgical gowns to diagnostic equipment. There were the exorbitant salaries and let's not forget the chargemaster.

Exactly: that's the part I'd like to see a rebutted (if there is a rational rebuttal). The ad-hoc nature of their pricing model seems crazy.

Re: The True Cost of Healthcare in the US

#63

Post by pulledpork »

specialp wrote: post #60
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…

Do you have any links backing that statement up?

It sounds plausible but I'd love to verify it. I have no idea what % of people in the emergency room are uninsured and what % are not in an emergency setting.

Re: The True Cost of Healthcare in the US

#64

Post by andrewaylett »

elemeno wrote: post #47
cpeterso wrote: post #27

Do other countries have employer-funded health insurance? Why doesn't my employer pay for, say, my car insurance? This system discourages people from leaving a job to start their own business because private health insurance can be very expensive.

In the UK, it's not unusual for employers to offer private health insurance (or at least, it's pretty common for profesional jobs - I can't comment for other types of jobs!). From their point of view, it's comparatively inexpensive and the cost is probably easy recouped from their employees being able to get health problems dealt with faster than they might on the NHS so they're off work for less time. Edit - Given t…

I had private health insurance from a previous employer, and in my experience it was almost completely pointless. I'm not inclined to rate its provision as a substantial benefit for compensation purposes.

Re: The True Cost of Healthcare in the US

#65

Post by epmatsw »

pstuart wrote: post #22
thatswrong0 wrote: post #9

Earlier quoted context omitted.

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.

It doesn't solve everything but it should help to simplify matters greatly. What would help too is ubiquitous electronic records management, e.g., any records from a visit with one doctor should be usable by the patient at another doctor. Add to that cheaper testing and more AI / self-help and that should take it even further. Lastly, kill the corn lobby and get some real sense into people about how their diet and li…

Electronic Health Records are harder to implement than you'd expect. HIPAA sets really harsh penalties for violations that can occur much more easily if hospitals and doctors provide open access to other facilities. Organizations are also often reluctant to provide their data to other facilities because of a perception that it will lead to a loss of competitive advantage. Add to that the typical problems of cross-vendor interfacing between organizations.

That said, EHRs are definitely the way to go, and we'll see much more of them in the future. Once Stage 2 of Meaningful Use[1] kicks in, you'll see a bunch of hospitals scrambling to upgrade their IT infrastructure to make sure they continue to receive the bonus Medicare/Medicaid payouts they're receiving now.

1. http://www.healthit.gov/providers-professionals/meaningful-u...

Re: The True Cost of Healthcare in the US

#66

Post by zaidf »

specialp wrote: post #60
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…

The real problems here especially with emergency care are that hospitals are forced to eat the cost of treating non insured patients

That problem is not unique to hospitals and emergency centers. My father runs a private practice and he can't collect payment on a double digit percentage of patients. Yet, because he is a private practice, he gets compensated significantly less than a hospital for same procedures.

I am not convinced that the root cause of high hospital cost is to make up for patients that don't pay. It seems to be a circular argument given that a decent percentage of patients can't pay because the cost is so high.

Re: The True Cost of Healthcare in the US

#67

Post by Spooky23 »

specialp wrote: post #60
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…

That's also a symptom.

One root cause is that the Federal government (ie. Medicare) must get the best deal. If you give anyone else a better deal than Medicare, you are committing an act of fraud, and DoJ will go after you. This is known as a price floor.

Layer upon this the web of contractual arrangements surrounding different insurance providers, and you get to a place where you need to mark up the MSRP of a procedure to safely operate as a business.

The issue with poor areas having bankrupt hospitals is obviously complex. Hospitals are good for emergencies, really sick people and procedures. Not so good or profitable for primary care -- they are a lowest common denominator. You cannot afford to scale up quality outpatient medical practices if you are reliant on Medicaid to pay everything, and you can't operate small medical practices effectively and deal with all of the compliance activity that medicaid comes with.

Re: The True Cost of Healthcare in the US

#68

Post by epmatsw »

mokash wrote: post #48

Call me naive but why doesn't the US simply switch to a healthcare system similar to the UK's NHS? I live in Britain and I live happy knowing that if I get a scratch, I won't go bankrupt.

A significant portion of Americans don't trust their government to provide efficient services. In general, we'll trust other citizens and corporations to do a better job. On top of that, you have many people who are reasonably insured and don't have to worry about it, many people who don't want to pay for other people's healthcare, and many people who are scared of socialism. Once you combine those groups, you end up with a pretty significant chunk of the country that is opposed to single-payer for whatever reason.

That said, the US healthcare system's problems go much much deeper than just single-payer vs private-public.

Re: The True Cost of Healthcare in the US

#69

Post by bjelkeman-again »

danielweber wrote: post #61
rubyrescue wrote: post #56

Earlier quoted context omitted.

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.

The numbers are vanishingly small Well, compared to what? The odds of having your private health insurance rescinded in the US is also very small -- but it's quite likely among people who suddenly rack up big health care costs. Similarly, if you compare Canada-to-US medical tourists to the Canadian population, I'm sure it's amazingly tiny. But how does it compare to the people of means who have a medical procedure de…

When someone says you need to back up with numbers then it does seem a bit silly to ask for numbers as a counter argument. :)
Post reply on HN