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

How to Charge $546 for Six Liters of Saltwater

nytimes.com

Post reply on HN
Print view View original

151–160 of 191 posts

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

#151

Post by dnautics »

moocowduckquack wrote: post #85
dnautics wrote: post #67

Earlier quoted context omitted.

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. "

You are severely misrepresenting that study as it is about the backgrounds of people who say they forgo healthcare on money grounds and pointing out that there are other factors other than whether someone can actually afford healthcare that affect whether people think they can afford healthcare. It also appears to not look at ethnicity at all in that study. It is basically saying that it isn't enough to make healthca…

forget ethnicity for a moment (there is a separate biological argument that is not sociological in nature), although we know what 'socio-economic' is a codeword for. The point is that posters above are saying things like "There is no discrimination in the public service." I can say for sure there is no way that is possible. If there were no discrimination, then there would be no reason why people are systematically avoiding the healthcare system. One ostensible goal of the French system is to rid itself of healthcare inequality. In that aspect it has failed. The numbers show that. And it doesn't matter that, maybe, the problem is 'education' or whatever, because that's still all a part of the state system.

I happen to believe the french system is better than the US system (as the US system is right now) but I don't personally believe that it is fundamentally the best system or in any way fundamentally better than a free market system (to include medical charities). But what I think is completely misguided is to think that the French system is absolutely equitable, infallible, or transposable to the US.

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

#152

Post by five18pm »

bpm140 wrote: post #135

I have two active kids and am reasonably active myself. We have probably received medical treatment a dozen times in the last year, a combination of walk-in clinics, personal physicians and emergency room visits, depending on the circumstances. During these visits, the staff have used equipment, given procedures and prescribed medication and have rarely, if ever, inquired about my thoughts on treatment. When my son j…

You are equating higher cost with better quality. There usually is a correlation, but with US healthcare's opaqueness with prices, I wouldn't make that correlation.

Leaving aside that, people do in fact make medical decisions based on cost. For example, for angioplasty there are two options - a medicated stent and a non-medicated, regular stent. The medicated stent is more expensive than the normal one. When it came to choosing one for my father, I chose a medicated one only because I was paying through insurance. But many of the patients out here in India don't have insurance. In that case there is a definite probability that a lower cost one will be chosen. Another example is dialysis. The frequency at which people perform dialysis is directly related to cost and affordability.

It is not always a given that patients would go for the absolute best.

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

#153

Post by lostlogin »

rdtsc wrote: post #110
twoodfin wrote: post #64

Earlier quoted context omitted.

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.

So how do you bring your child back after you ended up picking a cheaper bad doctor who kills your child. If you buy a bad TV you can return it and provide a bad review, so next time you shop from a better store. If you buy a car and it turns out to be a piece of shit, you just lost lots of money. It will take you years to recover and save for a better, but you still can. You can't get your life back, you can't get y…

Do you link the expense with the quality? If bad doctors are out there its not up to the consumer to stop them, this is what regulatory bodies are for. basic public safety. Cost (in most places I have been - mostly within Australia, New Zealand and the UK) has little to do with the quality of the care.

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

#154

Post by dylangs1030 »

dredmorbius wrote: post #145
tptacek wrote: post #116

Earlier quoted context omitted.

A bag of IV saline is a commodity. I would feel ripped off if I bought a bag of white flour and was charged $300 for it, too.

Mass-produced clothing is also a commodity. You're just convinced it's not.

No, that's wrong. Mass-produced clothing is the direct opposite of a commodity.

A commodity would be silk, or cotton - the raw fabric used as base materials. What you then do with those materials to increase their value directly changes them from commodities into products.

Put another way - gold is a commodity, as is silver. Jewelry, however, is not. It can't be a commodity if the material has been changed into a diversified form to increase its value - it has to be raw in order to be a commodity.

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

#155

Post by falsedan »

smokinn wrote: post #48
jes wrote: post #31

Earlier quoted context omitted.

With respect, what does capitalism mean to you? Lassiez-Faire or something different?

The current sense of the term in which I use it now is capital-maximizing. If you have money, if you're capitalistic, you should be investing in what can make you the most money, or, if you're bought in to a system, you should be extracting the most "value" from it as possible. I'm not using it as a political term, rather to describe our current, quarter-profit-maximization system driven by the stock market and publi…

Try 'mercantile' instead.

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

#156

Post by chris_j »

tonylemesmer wrote: post #150
CamperBob2 wrote: post #118

Earlier quoted context omitted.

Hint: if a half-dozen different people misinterpret your point, it's not them, it's you.

So many unnecessary arguments crop up on this forum because of selective, incomplete reading of comments and misinterpretation. If commenters took a minute to think about other potential meanings before going off on some misinformed rant it might make for a more productive debate. Then again pigs might one day fly.

What could nikatwork have changed about the original comment in order to make the intended meaning more clear here?

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

#157

Post by Inufu »

eco wrote: post #140
DanBC wrote: post #68

Earlier quoted context omitted.

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 communica…

The nearly ubiquitous cell phone contract sucks and the operators certainly try to make things confusing but if someone really does want a cheap cell phone and plan they can be had for quite cheap and at not much inconvenience. Drive down to Walmart and you can pick up a $30 cell phone and start using a prepaid plan that costs $30/mo. Most hospitals will not, however, tell you how much a procedure costs making shoppi…

$30/mo is nowhere near cheap - go check plans eg over here in Europe, where you can easily pay €7.50/mo or less, data plan included.

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

#158

Post by shalmanese »

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.

Many enterprise sales markets are as free as can be but you frequently see the exact equivalent of $500 bags of saline. The similarity in both cases is not the freedom of the market, it's that the purchaser and the consumer are not the same person.

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

#159

Post by ZeroGravitas »

jes wrote: post #57
nikatwork wrote: post #36

Many 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.

You probably were gouged when you bought that TV.

A record fine for a CRT price-fixing cartel that ran from 1996-2006:

http://www.bbc.co.uk/news/business-20608949

And an LCD price fixing cartel that ran at the same time:

http://www.bbc.co.uk/news/technology-20910299

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

#160

Post by jonknee »

prawn wrote: post #126

1. Does the industry need a few Mannings and Snowdens? 2. How much progress in the world is stifled by powerful incumbents blocking competition? Taxi lobbyists tackling Uber, car industry impeding mass transit in LA decades ago, etc?

The industry already got one actually, I coincidentally came across this yesterday:

http://www.bloomberg.com/news/2013-08-13/florida-pharmacists...

The TLDR is that an independent pharmacist treating AIDS patients got run out of business by price fixing competitors. He got the last laugh and sued on the behalf of the government and has so far collected $597M in awards (the government has collected over $3 billion).

The behavior of these (very large) firms was outrageous:

> For example, Abbott Laboratories (ABT) sold its antibiotic Vancomycin 1 GM FTV to customers for $4 a dose, according to a joint Justice Department and Ven-A-Care lawsuit. Abbott reported the cost to pricing publishers as $72.48 -- 18 times the actual amount, the lawsuit says.

This is likely going on for other types of drugs and then also in every other segment (medical devices/supplies being a biggy).

Post reply on HN