I find the name of the hospital highly ironic. After all, didn't the good Samaritan pay for the treatment and "hospitalization" of the victim?
One would expect a stay at the Good Samaritan Hospital to be free.
The anatomy of a ripoff
111–120 of 189 posts
Re: The anatomy of a ripoff
#112Earlier quoted context omitted.
"In the UK if you opt out of public healthcare you can't mix and match services beyond the GP level, this may change in the future." What do you mean by this? You can have pretty much any health service privately in the UK if you want to pay for it e.g. from BUPA: http://www.bupa.co.uk/
If you choose to get elective surgery for a condition rather than waiting in the queue for the NHS your room isn't covered by the Govt, your post-op prescriptions aren't covered, etc. If you do wait however they are covered. If you need corrective surgery afterwards to fix something that went wrong in the first op you normally aren't covered for that by the NHS either.
That's different from opting out, which would mean not paying for the NHS at all. This is buying additional coverage.
You can't opt out of the NHS in the UK, except by not paying taxes, which usually results in a spell in prison.
Re: The anatomy of a ripoff
#113Earlier quoted context omitted.
"In the UK if you opt out of public healthcare you can't mix and match services beyond the GP level, this may change in the future." What do you mean by this? You can have pretty much any health service privately in the UK if you want to pay for it e.g. from BUPA: http://www.bupa.co.uk/
If you choose to get elective surgery for a condition rather than waiting in the queue for the NHS your room isn't covered by the Govt, your post-op prescriptions aren't covered, etc. If you do wait however they are covered. If you need corrective surgery afterwards to fix something that went wrong in the first op you normally aren't covered for that by the NHS either.
For some reason none of that sounds particularly unreasonable to me - once you decide to opt out of the NHS then you have to accept that you are paying for all of the costs. Note that this view might be because I'm in the UK and have private health insurance - although everything major (accidents, childbirth) I've relied on the NHS.
While mixing and matching might seem sensible I suspect that the resulting administrative complexities might introduce the same kind of inefficiencies that the US system appears to suffer from.
Re: The anatomy of a ripoff
#114Earlier quoted context omitted.
> Medical care is the most highly regulated industry in the economy, and so nothing you see happening is going to bear very much resemblance to reality. This is a pretty big logical jump. I'm American, but have been living in the Netherlands for a while. Health care is probably more regulated here than in the US, yet in all of the ER visits I've experienced (myself or friends/family) I've never seen bills like that.…
I'm from Germany and you do realize that over here (don't know about the exact differences) privately-insured patients (who opted out off the 'mandatory' insurance scheme) basically pay a LOT more for any given medical service just so that patients covered under the mandatory insurance can get treated at all? It's like a giant (inefficient) money redistribution scheme, in all the worst ways imaginable. Regulation doe…
You forget to mention a few details: Younger privately insured patients actually generally pay less than their publicly insured counterparts (especially if they're male), since private insurance companies are allowed base premiums on risk (which grows with age). Private patients generally get better service, wait less and have access to more drugs and procedures. So yes, it's probably more expensive overall, but it's a voluntary decision and you get something in return.
Re: The anatomy of a ripoff
#115Earlier quoted context omitted.
Speaking as someone who doesn't know much about this stuff, your analogy reads more like, "the canal diverted the waterway, so tigers devoured the Pope". It may well be true, but you need to flesh it out more: explain how the new course flooded the tigers' habitat, forcing them to migrate to Rome.
The person you're responding to believes that if medical charges are vastly different between providers it must be due to evil government regulation, because after all in other sorts of stores we never see wildly varying prices for the same item and healthcare, where people have plenty of time to comparison shop (even if you're choking on turkey, you still have a few minutes to contact the various local hospitals and…
The person you're responding to believes that
The person he's talking to doesn't believe that putting a strawman argument into someone else's mouth is an honest debate tactic.
This question has nothing to do with ideology. As a matter of pure logic, regulation changes what the market is doing naturally; that's the whole point of the regulation.
This is a non-judgmental conclusion. One doesn't have to say that the market state was good or bad, or that the regulated state is good or bad. Simply that a regulated market differs from a free market. That's it.
Now, given that the system is highly regulated, it's clear that the regulators have screwed up.
However, this on its own doesn't tell us that the free market was good; it just tells us that the current regulatory regime is crap.
Re: The anatomy of a ripoff
#116The real scam perpetrated by hospitals and doctor's offices is rebilling. It works like this: 1) They send a bill with no information about the services performed. 2a) You waste your time tracking down what it was and then pay it. OR 2b) You pay the bill without wasting your time to verify. 3) They wait somewhere between a month and 6 months. 4) After receiving payment, they bill you again for the same services. 5a)…
Yes. There is extensive intentional fraud and corruption in the system, along with rampant profiteering that exists regardless of whether an entity has been granted "non-profit" status. (Non-profit doesn't mean you can't pay everyone on the board of directions millions in compensation.) Each time I've dealt with it (mostly helping relatives with their confusing bills) there's been double and triple billing, and billi…
You don’t even need there to be conscious corruption. If the system churns out incorrect bills through simple error (perhaps because the hospital never bothered to drag its accounting system out of the 1970s), and an overcharge is just as likely to be paid as a correct bill¹, then the bad system will stay in place without anyone twirling his mustache and sneering about his obscene profits.
¹Which is to say: Consumers in bad financial situations will dispute or default on overcharges, but they’ll do the same for correct bills. Insurance companies will occasionally dispute an overcharge, leading to six months of paperwork back and forth until they agree on what to pay, but they’ll put correct bills through the same wringer.
Re: The anatomy of a ripoff
#117Earlier quoted context omitted.
...when you measure things like life expectancy, Britons are as healthy as Americans. That gives you an idea of how much money is going down the tubes due to administrative inefficiency. It's hardly clear the money is going down the tubes due to administrative inefficiency. It might just be spent on unnecessary medicine, and costs might be higher in the US. According to one fairly decent source, administrative ineffi…
A couple things, first off, if costs are higher in the US, they shouldn't be, we're not living in a radically different reality in the UK. Market forces should be lowering those costs, but they're not, because the actual cost centers are completely insulated from any market whatsoever by the insurance system. RE: administrative inefficiency, from my limited experience (laying off teachers in local gov't back in 2004…
One of the reasons it costs less in the UK is because the NHS bargains the costs of drugs (and machinery etc) it buys down. This works partially because they can and do refuse to buy the drugs deemed too expensive. I don't have any statistics to back this up, but because the US system ends up spending as much as the pharmaceutical companies can possibly charge meaning they pay more for the same drugs. Somewhat of a perpetuating system, as the US pays more the pharmaceutical companies can handle the NHS bargaining the prices down some more. It's vaguely analogous to how the lesser paying medicare is subsidized by private insurance.
Re: The anatomy of a ripoff
#118Earlier quoted context omitted.
It depends on what you mean by "high deductible", but the Affordable Care Act specifically includes a circa-$6000 deductible option that would satisfy the individual mandate. See: http://www.kff.org/pullingittogether/What-Conservatives-Won-...
First dollar coverage of many things is mandated by the ACA. It's not clear yet which things (HHS and other agencies need to first "recommend" the required services), but first dollar coverage is mandated. http://www.healthcare.gov/law/resources/regulations/preventi... The fact that high deductible coverage may be possible for the non-"recommended" chunk of services is a good thing, however. (I say "may be possible"…
Currently, every plan I've come across also covers preventive care (immunizations, cancer screenings etc.), because insurance companies realize that this saves them money in the long run. The ACA just standardizes and regulates this. This is actually in the interest of the consumer, because every plan has to have a common set of preventive care services it has to provide for free, which makes plans much easier to compare.
Re: The anatomy of a ripoff
#119My wife is the manager of budget and reimbursement at a hospital, and from many conversations with her, I can imagine that this article is accurate. However, if I were writing this, I would have given greater emphasis to the effect that Medicare has on these problems. The article does mention that Medicare typically pays fees that are below actual cost for the procedures, and that hospitals must therefore increase ch…
Medical care is the most highly regulated industry in the economy... Uh huh. Talk to the (quite profitable) utility companies about that.
See, e.g., http://econlib.org/library/Enc/HealthCare.html
- - - - - Quote
Regulation and the Health Care Market
The health care industry is one of the most heavily regulated industries in the United States. These regulations stem from efforts to ensure quality, to facilitate the government’s role as purchaser of care, and to respond to provider efforts to increase the demand for their services. Hospitals and nursing homes are licensed by the state and must comply with quality and staffing requirements to maintain eligibility for participation in federal programs. Physicians and other health professionals are licensed by the states. Prescription drugs and medical devices are regulated by the Food and Drug Administration (see pharmaceuticals: economics and regulation). Some state governments require government permission before allowing a hospital or nursing home to be built or extensively changed. All of the above regulations restrict supply and raise the price of health care; interestingly, those who lobby for such regulations are medical providers, not consumers, presumably because they want to limit competition.
Some state governments limit the extent to which managed care plans may selectively contract with providers. All state governments have imposed laws governing the content of insurance packages and the factors that may be used to determine insurance rates. While these may enhance quality, they do impose costs that raise the price of health insurance and increase the number of uninsured. In testimony before the Joint Economic Committee of the Congress, one analyst reported the annual net cost of regulation in the health care industry to be $128 billion.10
Re: The anatomy of a ripoff
#120Every time I read about the US health-care system it amazes me more (in a negative way).
The point that I find worrying the most is, that it is impossible to figure out the costs before you get treatment. Also I am surprised, that there are no prenegotiated rates for treatment-procedures. The way it works in Germany is, that there is a catalog which contains all the standard procedures and a price that can be charged for the treatment/procedure, this system dates back to 1924. While "upselling" (doctors performing tests that are not necessary) is pretty common, prices are quite reasonable. Actually there are two catalogs, one for private insured patients and people without insurance (its almost impossible to be uninsured in Germany) and another one for public insured, the later one is based on a points system rather than prices and is supposed to be an administrative nightmare for doctors.