YC Research: Universal Healthcare • Hacker News Board

Re: YC Research: Universal Healthcare

#151

Post by beambot » Tue, Feb 07, 2017, 9:21 PM UTC

sbierwagen wrote: post #125

refurb wrote: post #46

Earlier quoted context omitted.

That's a vast over simplification of the issue and ignores issues around implementation. First off, Medicare Part D plans are run by private insurers and they certainly do negotiate on price. In fact, they tend to get better prices than commercial plans. Those savings are used to compete for Medicare dollars to cover those patients (i.e. savings are passed on to Medicare). Second, physician administered drugs are pai…

Medicare Part D plans are run by private insurers and they certainly do negotiate on price. Why is a third party negotiating for Medicare, rather than Medicare negotiating directly? Because they're smaller, and have less leverage. physician administered drugs are paid for at a rate that is the average of what private payers pay. Why is a third party negotiating for Medicare, rather than Medicare negotiating directly?…

What is preventing legislation that simply opens borders / trade for filling prescriptions?

Re: YC Research: Universal Healthcare

#152

Post by DanBC » Tue, Feb 07, 2017, 9:22 PM UTC

problems wrote: post #105

whb07 wrote: post #10

Unless you remove people out of the equation, universal healthcare will never work. There's no incentive for anyone to be efficient, more frugal, work harder, provide a better service in universal healthcare. Humans arent wired for this.

Yeah, there's definitely some things to consider here. Despite all the plusses of universal health care which others have already gone into - many people in Canada go to the US to get tests done faster because they can just pay for them, sometimes you're stuck waiting months. The US is also pretty much the world capital for a number of drug development and medical research areas simply because it's much more profitab…

I'm under the impression that Canada disallows private care. That doesn't have to be the case. You could have a system like the UK with both private and public care.

If you want to skip the queue you pay for it.

Re: YC Research: Universal Healthcare

#153

Post by HarryHirsch » Tue, Feb 07, 2017, 9:24 PM UTC

triangleman wrote: post #120

chicagobob wrote: post #40

Earlier quoted context omitted.

Only partially. Often at the time of consumption cost isn't something one can use to make decisions. But for those other times, sure it would help. Speaking of lack of info about pricing you might find this interesting: https://www.statnews.com/2017/02/06/health-insurance-high-de...

Great article. It's not just about pricing info, it's about the nationwide move to HDHP's and HSA's. Personally I'm pretty happy with my HSA, because now the list of things I can spend my healthcare dollar on is much longer: https://www.irs.gov/pub/irs-pdf/p502.pdf Lots of those things would not be covered by a traditional health insurance plan. But of course, it means we have chosen to forego health care and service…

we have chosen to forego health care and services in some cases

Only in America do you choose to forgo healthcare when you are at a conference and caught food poisoning because you aren't really sure if the hospital will take your health insurance. Where do I apply for my medal for saving the system some money?

Re: YC Research: Universal Healthcare

#154

Post by wvenable » Tue, Feb 07, 2017, 9:24 PM UTC

cookiecaper wrote: post #57

whb07 wrote: post #10

Unless you remove people out of the equation, universal healthcare will never work. There's no incentive for anyone to be efficient, more frugal, work harder, provide a better service in universal healthcare. Humans arent wired for this.

"Universal" means goverment-paid. It means that we have officially accepted that healthcare is so unfathomably impossible for a normal person to afford that the government has to inflate the cost out of existence. This is obviously not a sustainable or mature solution to the problem, but it's a band-aid that appears to relieve much of the burden involved for patients. I broke it out once and my net salary would be ab…

Because every doctors visit would cost money, people wouldn't get regular checkups and catch issues when they are cheap and easily dealt with. So now more pressure is put on that catastrophic medical insurance or government provided catastrophic health care.

That kind of system promotes poor and expensive health.

Re: YC Research: Universal Healthcare

#155

Post by Retric » Tue, Feb 07, 2017, 9:29 PM UTC

beambot wrote: post #151

sbierwagen wrote: post #125

Earlier quoted context omitted.

Medicare Part D plans are run by private insurers and they certainly do negotiate on price. Why is a third party negotiating for Medicare, rather than Medicare negotiating directly? Because they're smaller, and have less leverage. physician administered drugs are paid for at a rate that is the average of what private payers pay. Why is a third party negotiating for Medicare, rather than Medicare negotiating directly?…

What is preventing legislation that simply opens borders / trade for filling prescriptions?

Corruption. However, the line is generally described as: If companies can't discount per country then all countries end up paying high prices without discounts. However, if they can discount prices in some countries then that maximizes profits which increasing the customer base.

Re: YC Research: Universal Healthcare

#156

Post by jly » Tue, Feb 07, 2017, 9:29 PM UTC

HarryHirsch wrote: post #130

CaptSpify wrote: post #108

Earlier quoted context omitted.

> In the US you get to see the cost of care every time you have reason to see the physician I feel it's important to point out that you see the cost in the bill . There's no reliable way to see the cost beforehand.

What's seeing the expenses going to do, what mechanism is supposed to lower cost? When you need healthcare you need healthcare. No one goes to the physician for fun, elective procedures like breast enlargement or Lasik excepted.

Well, not all healthcare procedures are emergency. If I need something done, especially that which requires many separately-billable groups, the final cost can be extensive. Right now, it's very difficult to even estimate this cost in some cases. Using that data, timing can be better planned and in some cases, compared around for other similar options. The lack of transparency in pricing until you receive the bill is a big deal, in my opinion.

Re: YC Research: Universal Healthcare

#157

Post by DanBC » Tue, Feb 07, 2017, 9:29 PM UTC

alienjr wrote: post #54

CPLX wrote: post #12

Earlier quoted context omitted.

Somebody better tell all those non-humans in Western Europe about this.

Except for Switzerland, Western (not to speak about Eastern) Europe's universal healthcare means universal high taxes, universal low quality of treatment and universal access to waiting queues.

Waiting times are public information in England. You can verify what they are for most things.

Currently wait times are too long. This is because i) Social care has been chronically underfunded for many years ii) The NHS has been chronically underfunded for many years.

Here's the wait times for IAPT (short form talking therapy for mild to moderate mental health problems -- usually CBT).

http://www.content.digital.nhs.uk/catalogue/PUB22842/IAPT-mo...

> 87.8% waited less than 6 weeks and

> 98.3% waited less than 18 weeks to enter treatment

That's too long, and considerable pressure is being put on trusts to reduce those times.

There's a wealth of data just about IAPT here: http://content.digital.nhs.uk/iaptreports

Re: YC Research: Universal Healthcare

#158

Post by lkbm » Tue, Feb 07, 2017, 9:30 PM UTC

HarryHirsch wrote: post #130

CaptSpify wrote: post #108

Earlier quoted context omitted.

> In the US you get to see the cost of care every time you have reason to see the physician I feel it's important to point out that you see the cost in the bill . There's no reliable way to see the cost beforehand.

What's seeing the expenses going to do, what mechanism is supposed to lower cost? When you need healthcare you need healthcare. No one goes to the physician for fun, elective procedures like breast enlargement or Lasik excepted.

There are frequently multiple providers available, and they often have wildly different costs. Some insurers have experimented with incentivizing people to choose lower-cost providers with some success. If I could easily see that provider X was even 10% cheaper than provider Y, but has comparable ratings, I would probably go with X unless it's especially inconvenient, and I'm probably less price-sensitive than most people.

Re: YC Research: Universal Healthcare

#159

Post by lumberjack » Tue, Feb 07, 2017, 9:31 PM UTC

Universal healthcare is already much more cost effective than fully or semi-privitised health care.

Sorry, I forgot to pretend that all the other developed countries haven't figured out healthcare already.

Geez.

----------------

Oh and btw, when you have a universal healthcare system payed by taxes (none of that bullshit insurance crap that only ends up being costly regulation/financial bloat) you can have entire and fully private hospitals and health clinics where you can get service for cash, and surprise, surprise, it's ridiculously cheap because it has to compete with the effectively free public healthcare system.

Re: YC Research: Universal Healthcare

#160

Post by DanBC » Tue, Feb 07, 2017, 9:31 PM UTC

dragonwriter wrote: post #121

quickben wrote: post #107

Earlier quoted context omitted.

Interestingly enough, as a non American poster I find it amusing with the US posters having predominantly this type of selfish response. Every time healthcare is discussed on reddit, slashdot, etc, most of the people commenting on us healthcare debate it in the form of : "not with my hard earned money, you lazy commies, why don't you start working". What's interesting is that it isn't their fault. From the outside, t…

The amazing part is that Americans broken, non-universal, mostly-private but largely-public system spends more taxpayer money (per capita, for sure, but even as a share of GDP) than some countries that provide universal, mostly-to-entirely public, healthcare. So it's not even saving your tax money to avoid universal coverage.

Here's a cite for that:

http://visual.ons.gov.uk/how-does-uk-healthcare-spending-com...

> Despite less than half of the USA’s total healthcare expenditure coming from government expenditure or compulsory insurance schemes, it still spends more per person on these financing schemes than the UK- £3,111 in the USA in 2014, compared with £2,210 in the UK. In the USA spending on privately-funded healthcare is over five times more per person than in the UK.