And herein lies the true problem of medicine in America. We have the worst possible healthcare system. It is a privately run industry without any real competition. Almost anything would be better - either public healthcare or real competition. Instead, what we practice in America is an exercise in insanity played out on sick and injured.
How to Charge $546 for Six Liters of Saltwater
61–70 of 191 posts
Re: How to Charge $546 for Six Liters of Saltwater
#62There was a really, really good (depressing) article I'd read about a year or two ago talking about how group purchasing organizations worked to influence the costs of devices.
The example case was a guy who'd developed an auto-retracting needle, and was screwed out of business by some major manufacturers pressuring hospitals not to buy it.
Does anyone have a link to that article?
Re: How to Charge $546 for Six Liters of Saltwater
#63I keep getting that feeling that something must be done. Any suggestions HN readers?
What would happen if a hospital opened up that just had reasonable rates? It wouldn't make any deals with insurance companies other than to take payments. It posts all it's prices online and transparently for everyone to see. You can shop for treatments on their website. Could they make money this way?
Apparently, a bidding war. Fancy that. http://kfor.com/2013/07/08/okc-hospital-posting-surgery-pric...
Re: How to Charge $546 for Six Liters of Saltwater
#64Earlier quoted context omitted.
How do you explain other free markets that obviously deliver quality products at low prices? I don't feel gouged when I buy a television, a cell phone or lumber at Home Depot.
Well presumably you're not suffering from an ailment that requires immediate application of TV, Angry Birds or a 2x4 in those cases.
Emergency care has to be just a piece of the cost pie. People shop around for health care all the time, including for very expensive things like childbirth.
Re: How to Charge $546 for Six Liters of Saltwater
#65OT: It's truly a sad day when I have to check to make sure that I'm reading something in a news section and not the op/ed section of the grey lady.
Re: How to Charge $546 for Six Liters of Saltwater
#66Many in this thread are claiming that price fixing wouldn't occur in a "truly free" market. This is misty-eyed naivety. In a completely deregulated free market, it is even more in the hospitals' interest to form a price-fixing cartel. Any new player in the market trying to set reasonable market prices could be excluded through market pressure tactics (eg, tell distributors don't sell to them or our cartel will no lon…
How do you explain other free markets that obviously deliver quality products at low prices? I don't feel gouged when I buy a television, a cell phone or lumber at Home Depot.
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Re: How to Charge $546 for Six Liters of Saltwater
#67Earlier quoted context omitted.
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…
That is absolutely false. All French citizens and even foreigners enrolled in the "securite sociale" scheme have access to the same facilities, procedures and doctors. There is no discrimination in the public service. Any claims to the contrary are at best unfamiliarity with the subject if not deliberate misinformation.
http://eurpub.oxfordjournals.org/content/15/4/361.short
"The social inequalities in health have endured or even worsened comparatively throughout different social groups since the 1990s.... Health policies mainly promoting equal financial access to healthcare have little chance of abating health inequalities. "
Re: How to Charge $546 for Six Liters of Saltwater
#68Many in this thread are claiming that price fixing wouldn't occur in a "truly free" market. This is misty-eyed naivety. In a completely deregulated free market, it is even more in the hospitals' interest to form a price-fixing cartel. Any new player in the market trying to set reasonable market prices could be excluded through market pressure tactics (eg, tell distributors don't sell to them or our cartel will no lon…
How do you explain other free markets that obviously deliver quality products at low prices? I don't feel gouged when I buy a television, a cell phone or lumber at Home Depot.
Cell phones are a great example of the terrible results from supposedly free markets.
Plans are deliberately priced to be confusing to compare prices; plans are frequently updated to cause people to be stuck in win-optimal contracts; consumers are gouged on some items (see bizarre cost of sms in UK); and companies collude to defeat market mechanisms - see the use of area codes in auction bids as a method of communication when frequencies were auctioned off.
Re: How to Charge $546 for Six Liters of Saltwater
#69Earlier quoted context omitted.
Copy the health care system of any other rich country. They all get about the same results for half the price or less.
> Copy the health care system of any other rich country. This is easier said than done. The link between socialism, still a profane political philosophy, and municipal health care is too strong—the time it would take to switch it over is be on the order of election cycles, not years. Granted, we are already on that road, but it's going to be a long time before any mainstream politician embraces it.
The Boomers will die (of substandard health care) in another decade or so. That will change politics quite a bit.
Re: How to Charge $546 for Six Liters of Saltwater
#70Free market decisions will work when the patient has a choice. For example, when going for an outpatient visit to a doctors office that is scheduled in advance. One could argue that the patient has time to review their choices, call different providers and come to a decision.
This is not the case when the patient is being urgently hospitalized. They are typically rushed to the closest medical center and are subject to the prices it charges and it's providers charge. Given that they have no choice, whatever system it is that leads to these high prices is unlikely to change - if you are forced to buy something from me, why wouldn't i charge you as much as i feel like for it?
The government could get involved and force hospitals to adhere to a certain fee schedule - but why should for profit institutions have to adhere to this? In a truly capitalistic society they really shouldn't. The best ways to deal with this is to maximize insurance coverage, which is one goal of the affordable care act, and then to really use it as insurance and not to pay for every possible medical service a patient may require. Insurance companies will negotiate reasonable rates for hospitalizations. And if it's really being used as insurance and not to cover regular outpatient services, premiums would remain low as well.
So would there still be stories of the $4 Tylenol tablet dispensed in the hospital? Probably - but in the grand scheme of things, it wouldn't matter as much.