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How to Charge $546 for Six Liters of Saltwater

nytimes.com

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Re: How to Charge $546 for Six Liters of Saltwater

#21

Post by thrownaway2424 »

dopamean wrote: post #15
DanielBMarkham wrote: post #11

It's always in the seller's interest to create a complex and opaque system of pricing, especially when the buyer doesn't even pay for the services. This is why free markets aren't the answer to everything. It's free and open markets that drive efficiency out of any process. The problem here is one of incentives. If I promise to pay you for mowing your neighbor's lawn, and he rarely reviews what you're doing and I rar…

> This is why free markets aren't the answer to everything. Perhaps I've misunderstood you here but in my opinion the way healthcare works is sort of the opposite of a free market and if a free marketplace for health services were allowed to exist then things like $500 bags of saline solution wouldn't exist.

It is not possible to have a "free market" in health care because the "customers" are often on the brink of death, or not even conscious.

Re: How to Charge $546 for Six Liters of Saltwater

#22

Post by thrownaway2424 »

dude3 wrote: post #20

I think there are 2 big factors that always seem to be missing from these investigations. The high costs offsets individuals who don't pay for their healthcare. Keep in mind that the hospital must treat anybody who walks in the door and they frequently do not get reimbursed by the government. Also keep in mind that the solution must be perfect when it physically cannot be. Because if there is a .0001 percent chance o…

(U.S.) states where malpractice damages are limited do not have lower health care costs.

Re: How to Charge $546 for Six Liters of Saltwater

#23

Post by [deleted] »

thrownaway2424 wrote: post #22
dude3 wrote: post #20

I think there are 2 big factors that always seem to be missing from these investigations. The high costs offsets individuals who don't pay for their healthcare. Keep in mind that the hospital must treat anybody who walks in the door and they frequently do not get reimbursed by the government. Also keep in mind that the solution must be perfect when it physically cannot be. Because if there is a .0001 percent chance o…

(U.S.) states where malpractice damages are limited do not have lower health care costs.

[deleted]

Re: How to Charge $546 for Six Liters of Saltwater

#24

Post by brohee »

dnautics wrote: post #10
w1ntermute wrote: post #9

Earlier quoted context omitted.

I'm not sure why the overall size of the population is relevant here. If it works for countries with populations of 5 million (Norway), 63 million (UK), 82 million (Germany), and 126 million (Japan), I think it's completely reasonable to at least try it in a country of 319 million.

Ethnic homogeneity is also an issue. If you think that an arab living in france gets the same quality of healthcare as a european french person at the same poverty level, you're kidding yourself. Not that the US doesn't have these problems. Ultimately, different ethnicities get different diseases, too, so the bureaucrats in charge of deciding what gets covered and to what extent are basically institutionalizing racia…

As someone that spent quite a bit of time in French hospitals visiting relatives recently, I have no reason whatsoever to think access to care is limited in anyway whether on ethnic or socioeconomic background... Do you care to cite some sources?

Re: How to Charge $546 for Six Liters of Saltwater

#25

Post by carbocation »

yalogin wrote: post #19

So this is by design isn't it? The fact that insurance covers everything and the hospitals do not have to eat up any costs begs for this to happen. If the majority of customers (patients) pay out of their pocket then the hospitals would be incetivized to make themselves attractive to patients. Else why the hell do they care? In fact they mark up prices multiple times to offset any unforeseen costs of eating up costs…

Serious question: why do you think that hospitals don't have to eat costs?

It's a loaded question in the sense that I've been at various hospitals and they always talk about their budget shortfall which is in part due to non-reimbursed care provided to those who cannot pay and/or have no insurance. But it's also not a loaded question in the sense that I want to understand why people would think hospitals don't eat costs.

Re: How to Charge $546 for Six Liters of Saltwater

#26

Post by elstevo »

Not to defend the costs or the state of the system, but the justification for the prices of medications in hospitals usually includes the time of the nurses, pharmacists, and techs that make the whole administration process happen safely.

Also, hospitals will bill whatever amount they can get reimbursed. Most insurance companies have contracts with hospitals where they only get a fraction of the billed amount. The rest is written off by the hospital. Uninsured patients can usually work out payment plans for lower amounts as well. That said, healthcare in the US is still pretty damn expensive.

Re: How to Charge $546 for Six Liters of Saltwater

#27

Post by coenhyde »

The problem with having healthcare under private enterprise is that these healthcare providers do not operate under the free market conditions we assume they do.

There is no "perfect information" allowing consumers to choose the cheapest price. As the article points out the pricing structure is very opaque. Not to mention the "consumers" want the best product regardless of cost, after all we are talking about their lives here.

Given the lack of free market conditions operating on these healthcare providers it is only logical that they would behave like the extortion rackets they are.

Re: How to Charge $546 for Six Liters of Saltwater

#28

Post by chasing »

csense wrote: post #3
kumarski wrote: post #2

I keep getting that feeling that something must be done. Any suggestions HN readers?

Turn healthcare into a government bureaucracy. Because that's an effective way to combat waste, inefficiency, and overcharging

Whelp, the private sector sure seems to be fuckin' it up, so maybe it's time we give the government a shot.

Re: How to Charge $546 for Six Liters of Saltwater

#29

Post by smokinn »

refurb wrote: post #16

One of the big reasons for this problem is Medicare. The reimbursement that Medicare offers is often far less than it costs the hospital. Why does Medicare not cover the cost of a procedure? Usually because it did cover it in the past (to the point of generosity) and providers reacted by shifting their services to maximize the profits. A good example is the infusion of drugs. Medicare pays ASP+4% (just cut from +6% d…

Sounds like the problem isn't actually medicare, sounds more like it's adding a capitalistic, profit-maximizing middleman into the system.

Re: How to Charge $546 for Six Liters of Saltwater

#30

Post by acheron »

chasing wrote: post #28
csense wrote: post #3

Earlier quoted context omitted.

Turn healthcare into a government bureaucracy. Because that's an effective way to combat waste, inefficiency, and overcharging

Whelp, the private sector sure seems to be fuckin' it up, so maybe it's time we give the government a shot.

Which private sector is that? Because our current healthcare system is nowhere near "private".
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