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

Post-apocalyptic life in American health care

metarationality.com

Post reply on HN
Print view View original

101–110 of 189 posts

Re: Post-apocalyptic life in American health care

#101

Post by jimberlage »

AnthonyMouse wrote: post #94
flatline wrote: post #62

Earlier quoted context omitted.

The government is mostly just there to manage contracts, the actual work would be done by the same doctors that are doing it today. You would just pare n profit-seeking entities down to one principally administrative entity. If you wish to pay for your own medical procedures out of pocket there will be nothing stopping you. That is not to say this does not have problems. Insurance is anti-competitive on top of that.…

> You would just pare n profit-seeking entities down to one principally administrative entity. If you wish to pay for your own medical procedures out of pocket there will be nothing stopping you. Nothing except that it creates a monopoly and a monoculture. There are many procedures you may not be able to afford out of pocket, so the only way to get them is to choose a provider that covers it. If there is only one pro…

This is a really thoughtful and useful comment! Worth calling your representative about. I love the observation that price transparency starts with providers, I so rarely hear that mentioned.

Re: Post-apocalyptic life in American health care

#102

Post by op00to »

colechristensen wrote: post #48
andutu wrote: post #19

My boyfriend woke up one day to find out they couldn't pee. After a few ER visits and an MRI, they determined he had Stage 2 bladder cancer. However, because they had the audacity to seek immediate medical treatment for a life threatening health issue, they have now been saddled with thousands of dollars in medical debt. I had to personally dip into my earnings from my Big Tech internship to help pay some of it off.…

Why with single payer would there not still be instances of treatment being denied? >rather than deal with faceless automata at health insurance companies Would this not be replaced with faceless automata in government? Just look at how the VA is run and complains about it. Looking at that I have exactly zero confidence in the government being able to run things better than the shit show at the insurance companies. B…

The denials would not be based in a profit motive in a single payer solution.

Re: Post-apocalyptic life in American health care

#104

Post by op00to »

jmye wrote: post #6
BeefDinnerPurge wrote: post #2

I'd be great with a baseline medicare for all system publicly funded across the board with the option to pay more for privately funded better options. Not going to get that, or anything close to that, are we? I give up America, you get the health care you're willing to prioritize. Not my problem any more. That said, going out of network if you can and going to the places with the cases if you can are the only real cu…

Medicare for all is not a panacea and would cause dramatic breaks in care in other places. The fragmented private model sucks, but the belief that single-payer would fix much of anything is faulty. Reform should happen, but it shouldn’t be based on a bumper sticker, and it should be thoughtful about the vast differences between SF, NYC, West Texas and Southern South Dakota. “Fixing” things for people in major cities…

You provide no examples of your statement. I say Medicare for all is a panacea and will cause no breaks in care.

That was easy.

Re: Post-apocalyptic life in American health care

#105

Post by op00to »

jmye wrote: post #67
fzeroracer wrote: post #22

Earlier quoted context omitted.

Rural healthcare is being crippled in part due to state politicians posturing for political clout. Major reforms like medicare for all shouldn't be held back because they're not perfect, because otherwise we're going to continue having the same problems we've been having where compromised half-assed bills make the system overall worse.

I’m not saying we shouldn’t reform - I’m saying we should be careful about what that reform is, and what its goals are. I would generally suggest that CMMI and provider groups is/are more heavily involved than big city voters who know very little about a very, very complicated issue. Lastly, rural healthcare is in trouble because reimbursements are bad (especially Medicare reimbursements), FFS (fee-for-service) is a…

Why is it Medicare’s problem to fix that educated people choose not to live in certain places?

Re: Post-apocalyptic life in American health care

#106

Post by addicted »

andutu wrote: post #19

My boyfriend woke up one day to find out they couldn't pee. After a few ER visits and an MRI, they determined he had Stage 2 bladder cancer. However, because they had the audacity to seek immediate medical treatment for a life threatening health issue, they have now been saddled with thousands of dollars in medical debt. I had to personally dip into my earnings from my Big Tech internship to help pay some of it off.…

> They pay little, but there was an instance where one of their physicians had to appeal to insurance to get a scan done (thankfully the insurance acquiesced). It doesn't make sense and all this debate around single payer healthcare is just obfuscation and distraction from investigating actual solutions.

Single payer is literally a complete solution to the problem you’re mentioning before.

So why is it obfuscation and distraction? Especially when single payer systems in Europe have proven to have better outcomes at a fraction of the cost?

I find the thought process here fascinating. Single Payer, which is actually delivering results in nearly every other developed country is an “obfuscation” and we need to find “actual solutions”. Doing what every other country that doesn’t seem to have the problem in question is not an “actual solution”. No, we must invent one out of thin air or it doesn’t count.

This seems like a Not Invented Here syndrome taken to its extreme.

Re: Post-apocalyptic life in American health care

#107

Post by addicted »

riffraff wrote: post #91
JoshGG wrote: post #43

Great article but the author is missing the fact that this is all designed on purpose. The insurance system is designed around a consistent strategy called “don’t pay out”. The USA spends more GDP on healthcare than any country on earth and the insurance companies are immensely profitable. Every company involved is making money off the status quo and wants to maintain the current system. when a patient comes along wh…

It was somewhat surprising to see the author come up with "we need standardized interfaces between actors" rather than "we solve this with public healthcare for everyone". But to be fair, you can easily get lost in bureaucracy in public healthcare too, and private health insurance exists in countries with public health too.

Just switching to a public healthcare, or more likely, a public payer system won’t magically solve the problem. There’s a lot of work that needs to be done to ensure it works well.

The difference is that there is evidence from other countries that a public payer system allows for a better medical system to be built on top of it. There’s no evidence that America’s system of patchwork and arbitrary payments by different vested interests each trying to offload their expense onto some other entity allows for a decent system.

Re: Post-apocalyptic life in American health care

#108

Post by badpun »

ars wrote: post #70
secabeen wrote: post #68

Earlier quoted context omitted.

Is this the Kaiser Permanente model? I think it's a fairly good model, but they do pay pretty mid-level on Physician salary. It's not a place you can clear $500k+.

> but they do pay pretty mid-level on Physician salary. It's not a place you can clear $500k+. That's the goal!! Very high doctor pay is the number 1 cause of skyrocketing medical expenses. The model should be coupled with them opening a lower cost university and training 10 times as many medical people as we do today. Along with better supply lowering prices, it also means a Doctor could have normal working hours, s…

> That's the goal!! Very high doctor pay is the number 1 cause of skyrocketing medical expenses.

Exactly! I can't think of any other country where doctors routinely make 15-20x minimum wage, and people become doctors predominantly to make a lot of money. In most countries, doctors make very good money, but not 15-20x minimum wage good. In Western Europe, for example, it's more of 5-8x minimum wage.

Re: Post-apocalyptic life in American health care

#109

Post by thallium205 »

JoshGG wrote: post #43

Great article but the author is missing the fact that this is all designed on purpose. The insurance system is designed around a consistent strategy called “don’t pay out”. The USA spends more GDP on healthcare than any country on earth and the insurance companies are immensely profitable. Every company involved is making money off the status quo and wants to maintain the current system. when a patient comes along wh…

Health insurance profits are capped by government. They aren’t immensely profitable in the strictest sense of the word. That’s why they had to refund premiums during COVID.

Re: Post-apocalyptic life in American health care

#110

Post by [deleted] »

andutu wrote: post #19

My boyfriend woke up one day to find out they couldn't pee. After a few ER visits and an MRI, they determined he had Stage 2 bladder cancer. However, because they had the audacity to seek immediate medical treatment for a life threatening health issue, they have now been saddled with thousands of dollars in medical debt. I had to personally dip into my earnings from my Big Tech internship to help pay some of it off.…

[deleted]
Post reply on HN