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

The World’s Cheapest Hospital Has to Get Even Cheaper

bloomberg.com

Post reply on HN
Print view View original

121–130 of 202 posts

Re: The World’s Cheapest Hospital Has to Get Even Cheaper

#121

Post by danielharan »

thatoneuser wrote: post #99
jrochkind1 wrote: post #47

He succesfully performed a complicated surgery for $10K that would cost $200K in the US. And India still can't afford to pay those prices. The problem is obviously not that THIS guy is not working efficiently. It's that the distribution of wealth under our planetary economic system is deeply unfair.

Idk if I'd agree that it's "unfair" because that implies there's some natural balance we've disrupted, when in reality wealth is largely the result of labor and ingenuity. If a group of people gets together and creates wealth for themselves and their offspring, is it unfair that they are wealthier than the rest of the population? That kind of thinking at some level is fundamentally unfair itself - if you go collect a…

"that implies there's some natural balance we've disrupted"

There's a whole history of colonialism to contend with. What was once nearly a quarter of world GDP in 1700 dropped to less than 5% in 250 years. The whole country was deindustrialized.

It's a lot easier to actualize our potential in some places. I don't think it's demonizing me to admit that if I was born a woman in Sub-Saharan Africa, or in a war zone, I wouldn't have been able to build wealth like I have.

Re: The World’s Cheapest Hospital Has to Get Even Cheaper

#122

Post by benmaraschino »

Scoundreller wrote: post #39
Frondo wrote: post #34

Earlier quoted context omitted.

I had my gallbladder removed in a emergency surgery over a decade ago. It happened on a Wednesday night. I had excruciating pain, enough to nearly black out -- and a friend took me to an emergency room, where they did an ekg, ultrasound, put me on a morphine drip and operated the next day. Once the pain set in, I was in no position to do research for a variety of reasons. I'm not sure what kind of shopping around cou…

Isn’t the solution an advanced care directive? Where you make decisions in advance of something happening, just in case you end up in a situation where you can’t decide yourself? E.g. no extraordinary measures or no CPR, or, get me into one of these nursing homes and not this one. Even in public health care countries, there’s plenty of decisions that are a good idea to make in advance. I don’t see why they can’t be s…

Comparison shopping arguably isn’t the intended purpose of advance care directives—which, FYI, can only go into force if the person is legally incapitated, and being in pain, however extreme, is a grey area as I’m sure you could make the case that decision-making capacity still exists. There’s also the issue of having the agent available when such an event happens, and having them be in possession of the directive.

Anyway, even then, it’s infeasible to enumerate all the possible decisions in advance—not only is it impossible to know what your costs will be ahead of time, there’s a lot of variation in cost. There isn’t going to be a single hospital in your region that’ll have the cheapest prices across the board, so it’s not as simple as “send me to the cheapest hospital”.

Re: The World’s Cheapest Hospital Has to Get Even Cheaper

#123

Post by PorterDuff »

rb808 wrote: post #30

$2k for major surgery, nice! Last time I went to ER it was $2k for the doctor's assistant to ask a few questions and put a band aid on.

Hah. $2k. Cheap.

Me = goto ER for absurdly high BP and heart palpitations, which I've never had before. Quick hook up to ekg, watch BP, learn about PVCs, get kicked out after an hour or so as BP lowers somewhat. All in the hallway, no real admission. Admittedly not necessary looking back but you do what you have to.

Cost? $10k for the ER. $1500 for the doctor. Next cost? $4k for the ER if I'm poor Next cost? $350 of co-pay once I dug out my insurance card, God knows what Blue Cross pays. Broken system? I think so.

Re: The World’s Cheapest Hospital Has to Get Even Cheaper

#124

Post by dredmorbius »

aznpwnzor wrote: post #119
thatoneuser wrote: post #99

Earlier quoted context omitted.

Idk if I'd agree that it's "unfair" because that implies there's some natural balance we've disrupted, when in reality wealth is largely the result of labor and ingenuity. If a group of people gets together and creates wealth for themselves and their offspring, is it unfair that they are wealthier than the rest of the population? That kind of thinking at some level is fundamentally unfair itself - if you go collect a…

> in reality wealth is largely the result of labor and ingenuity many would argue that in reality wealth is largely the result of capital

Or rents and political aspects of wealth.

"Wealth, as Mr Hobbes says, is power."

-- Adam Smith

Re: The World’s Cheapest Hospital Has to Get Even Cheaper

#125

Post by dredmorbius »

notyourday wrote: post #86
superhuzza wrote: post #21

Earlier quoted context omitted.

What happens when someone has an emergency like a stroke or heart attack? Not a lot of time to email all the local hospitals. What happens when the patient is unconscious? What happens if their condition can only be treated by a certain facility or medication? But yes, surely people are only getting screwed over the healthcare system because they are lazy . /s

That's the only time when one cannot get quotes. Depending on a location ( ave/st in NYC and a time of day ) the ambulance would take one to a specific emergency room in a specific hospital chain. But again, that's not where most of medical services "waste" is occurring.

Most medical expense is care of chronic conditions and end-of-life care. Not elective procedures.

https://www.qualityhealth.com/health-lifestyle-articles/10-m...

Re: The World’s Cheapest Hospital Has to Get Even Cheaper

#126

Post by npmn »

naruvimama wrote: post #114
steve19 wrote: post #74

Earlier quoted context omitted.

I am not saying you should not be proud of Indian progress, but I suspect the experiences of a businessman in a big city in India are vastly different to a low caste woman with TB in rural India. A friend of mine is a nurse who did social work in rural India. What she told me about the local hospitals was horrifying, not just the condition of the hospital and how patients with infectious diseases were sleeping on the…

The use of the word "low caste" is in quite mean considering "poor" would be more appropriate. Just as Black or Native American would be a poor substitute for poor american. Or Roma/Eskimo/Greenlander/Sami for Europe Especially considering that the current prime minister and president of India are from so called backward communities. India has come a long way in social development and using the "caste card" is quite…

It is not out of taste. Caste System(Jati System) though weakened still alive and kicking in India. (Dalits) Lowest caste layer in India is still subjugated to things like Cow vigilantism, Honour killing, Social boycott, Caste clashes and discrimination in various/all forms of life. It is interesting to note that Dalits are almost always on the receiving end of these issues.

Giving example of the Prime Minister/President is equivalent to saying since Barack Obama is the president of US, black discrimination.

PS: I belong to the so called Lower Caste in India and I have myself experienced instances of subtle/blatant discrimination. Thankfully haven't experienced anything serious yet, maybe because I became an Software Engineer and now live in a major city, thanks to the affirmative actions adopted by India, but poorer strata of lower caste living in tier-3 cities/villages face a lot of cases of discrimination even today.

While India has a long way in social development, it still has a long to go. This narrative of bashing Europeans/Outsiders/Pakistanis for anything negative has to stop. Jati System has been in practise for thousands of years now.

Re: The World’s Cheapest Hospital Has to Get Even Cheaper

#127

Post by sgjohnson »

udba wrote: post #52
rb808 wrote: post #35

Earlier quoted context omitted.

Actually it wasn't a critically urgent problem but needed doctors attention. If someone wants an idea for an app or website - a way to lookup local ERs by price would be great.

> If someone wants an idea for an app or website - a way to lookup local ERs by price would be great. > lookup local ERs by price Incredible. It's absurd that an idea like this is a reasonable suggestion.

Why? It’s the free market approach. After all, healthcare is just a service.

Re: The World’s Cheapest Hospital Has to Get Even Cheaper

#128

Post by BucketSort »

drewblaisdell wrote: post #116
thatoneuser wrote: post #99

Earlier quoted context omitted.

Idk if I'd agree that it's "unfair" because that implies there's some natural balance we've disrupted, when in reality wealth is largely the result of labor and ingenuity. If a group of people gets together and creates wealth for themselves and their offspring, is it unfair that they are wealthier than the rest of the population? That kind of thinking at some level is fundamentally unfair itself - if you go collect a…

> in reality wealth is largely the result of labor and ingenuity The greatest trick the devil ever pulled was convincing people that this is true.

Trick of the wealthy. It's the only thing that keeps people from revolting against this madness. Donald Trump's fortune is largely the result of labor and ingenuity, right? This warped perspective is going to be the death of us.

Re: The World’s Cheapest Hospital Has to Get Even Cheaper

#129

Post by erikpukinskis »

thatoneuser wrote: post #99
jrochkind1 wrote: post #47

He succesfully performed a complicated surgery for $10K that would cost $200K in the US. And India still can't afford to pay those prices. The problem is obviously not that THIS guy is not working efficiently. It's that the distribution of wealth under our planetary economic system is deeply unfair.

Idk if I'd agree that it's "unfair" because that implies there's some natural balance we've disrupted, when in reality wealth is largely the result of labor and ingenuity. If a group of people gets together and creates wealth for themselves and their offspring, is it unfair that they are wealthier than the rest of the population? That kind of thinking at some level is fundamentally unfair itself - if you go collect a…

> wealth is largely the result of labor and ingenuity

Does that assertion come from a study, or is it just a guess?

My guess would be that wealth comes primarily from war and genocide, but I admit I haven't looked at the economic theories.

Re: The World’s Cheapest Hospital Has to Get Even Cheaper

#130

Post by notyourday »

superhuzza wrote: post #21
notyourday wrote: post #9

Earlier quoted context omitted.

I most am most likely going to need an ACL surgery in a couple of months so we will see how it goes. So far I found out that pretty much every "X is difficult" is a gospel peddled by lazy. This is my first relatively major incident so I'm running pretty blind -- I'm approaching it as I approach needing to do something in business. Instead of going to the ER ($2,500), I went to a walk in medical center ($120), got see…

What happens when someone has an emergency like a stroke or heart attack? Not a lot of time to email all the local hospitals. What happens when the patient is unconscious? What happens if their condition can only be treated by a certain facility or medication? But yes, surely people are only getting screwed over the healthcare system because they are lazy . /s

> What happens when someone has an emergency like a stroke or heart attack? Not a lot of time to email all the local hospitals. What happens when the patient is unconscious? What happens if their condition can only be treated by a certain facility or medication?

This is not a rocket science: when one sees a complex problem one does not attempt to solve the entire problem using an full rewrite -- instead one breaks out it into pieces and solves one piece at a time. If the piece is too big to solve that piece is broken down into pieces and those individual pieces are solved.

It is debugging of the problem 101.

> What happens when someone has an emergency like a stroke or heart attack?

Call 911.

Have a toothache? Don't call 911. Call a dentist. In fact, call several dentists. It is, of course, possible to call 911 and have an ambulance take one to an emergency room because of a toothache ( this was a case told to me by a friend who is currently doing an ER rotation. He swore he was not pulling my leg ).

> What happens if their condition can only be treated by a certain facility or medication?

It is unlikely that a common condition can be treated by a single facility.

> or medication?

If we are to optimize the costs of overspending by not selecting cheaper alternatives where we can there would be more money to spend on the expensive "it can be only done here" or "it can only be done using this medication".

Post reply on HN