151–160 of 339 posts
Anecdata: I just had a very mild infection a month ago, but it went to my heart so I went to the ER (thinking they'd give me antibiotics and send me on my way). They wanted to monitor me for 2 days so admitted me. I know I have the right to refuse (and very nearly did), but wanted to make sure my heart was all right. Long story short, they gave me nothing more than aspirin for that stint, did an echo and an EKG, and…
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"I wish stitches were done on a fee for service model like shooting lasers into people's eyes is."
That was still a FFS model. The difference is whether the procedure is typically covered by insurance.
Somehow everybody in this system claims they're not the ones making bank on this swindling. The doctors say they're underpaid. The hospital admin says they're underpaid. The insurance companies say they're barely covering their payouts. So who is lying?
No one is lying. The system is filled with massive inefficiencies. 1) Insurance companies don’t pay sticker prices. They pay negotiated rates. At the same time, hospitals have to pick up a lot of ER costs that are never covered. They might be making money but reasonable amounts at best (also that’s probably not true either considering how many hospitals are shutting down in the US). 2) The negotiated rates insurance…
Meanwhile, in developing countries, it's not that hard to find a decently qualified doctor running his own small clinic with couple of nurses in a busy street. And to the next level, there is always a small 20-bed hospital around with 3-4 doctors and a bunch of nurses. And options keeps increasing in size and cost from small to the big hospitals like you typically see in the US. Almost 95% of primary healthcare are met by these small-mid level operations and people go to the big hospitals only for complicated surgeries and intensive care.
In this example of just 6 stitches, it probably would have been administered by a nurse in a 20-bed hospital for fraction of the cost of a big hospital.
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The stitches are expensive mostly because of many regulatory factors that restrict the supply of medical services and drive costs up, with the "free market" component being in how much they can charge the patients. It's the worst of both worlds in the US.
We have more "regulatory factors" in Europe, and much cheaper treatment... Like 1/40 or so as much in this case...
The American culture is one of rugged individualist pioneering cowboys who won't be told what to do, even if you're warning them that if they take another step they'll fall off a cliff.
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Cool story. So what you're saying is there is an horrendous creeping bueaucracy cost here. Funny, because that's exactly what free market proponents argue is the cause of inefficiency in publicly managed healthcare systems, and the reason to move towards models based on the US system. Someone is lying.
> Someone is lying. It’s you, to yourself. What we have is not by any stretch of the imagination a free market solution. It’s insane amounts of paper pushers created by the government. The whole insurance system we have is an impractical mess designed to fail. The free market would never have designed something so customer unfriendly, people would have gone elsewhere had competing solutions been allowed to exist. In…
I'd be interested in how the free market develops that solution. At the very least, regulation would be involved. And we all know how adept the free market is at getting around regulation.
Anyway. I'm off to go lie to myself some more. Cheers.
I always find interesting to read these stories because nowhere else but the US can you make over 300k USD a year as a senior engineer of some kind. In Europe, 200k EUR is already ridiculous, and most countries take away half your salary in taxes anyway so... Would you rather make 300k and pay 4k for the occasional ER visit or make 50k after tax and pay 100 for the occasional ER visit? I suppose this comment will get…
So the system works well for me at least, but I know it is much much worse for others
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Just my 2 cents. I live and work in Germany and am insured in one of the many public insurances. My monthly contribution is 350 Euro, my employer has to pay 350 Euro per month, too. Hence, I am paying approx. 7500 Euro for my insurance per year. Assuming I work 35 years plus some inflation, then I will pay over 300.000 Euro for my insurance. This excludes contribution before 25 (where my parents paid for me) and my c…
You think that's all it costs? According to wikipedia, German health care is 77% government-funded.
But dont worry, there are insurances for that, too. The good ones cost you another 300-400 Euro per year. This makes another 30.000-50.000 Euro on top of what I already pay.
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The US's non-paying contingent doesn't need to be any different from any other countries in order to cause the problem. The issue is that the uninsured subsidize the non-payers alone. This is radically different from countries with universal health care where the costs are spread among the entire tax-paying population. As for why the US spends more than any other country: it's due to an overabundance of caution among…
Do you have numbers for that? Even the comfortably insured in the US have to pay a fee when they visit a doctor, typically around $35 for GP and $100 or more for a specialist.
Most of the time I restrict myself from this kind of comments, but here is what experience is typically like in Russia. You are sick or even probably sick, like biten by tick and worry about it is infectious. You go to the neatest hospital, local ER, register yourself (no documents needed). Any time of day. You get triaged immediately, if your situation is not life-threatening, there is a queue. Waiting times are any…
"The state-provided health care is free" Today I learned that doctors and nurses in Russia work for nothing. No? So where does the money to pay them come from?
> Every time someone talks about free this or that in the Nordic countries an American will pop his head up and yell "It's paid for with your taxes" without fail.