The healthcare market is taxing reproduction out of existence • Hacker News Board

Re: The healthcare market is taxing reproduction out of existence

#151

Post by vkou » Mon, Dec 01, 2025, 11:47 PM UTC

peter422 wrote: post #85

vkou wrote: post #62

Earlier quoted context omitted.

Expenses are definitely higher, and doctors and hospital CEOs and med school CEOs do drive nicer cars and have bigger summer dachas, but I can't say the same about quality. Six month waits for a specialist, every PCP and shrink you'd want to visit not taking on new patients, ER wait times comparable with other developed nations, worse overall outcomes... Maybe the top 0.5% is getting better care, but I really wouldn'…

See what the wait times are for the specialists in other countries, if they even exist! The US is also the 3rd biggest country in the world. It’s very hard to solve these things are such a massive scale.

> See what the wait times are for the specialists in other countries, if they even exist!

I assure you, they exist, I have been to them, and the wait times were about as long.

> It’s very hard to solve these things are such a massive scale.

That's goalpost-shifting nonsense that doesn't justify the outrageous cost of healthcare. And most of these problems become easier to solve with a higher population and density and larger economy, because you have way more slack in the system, and you have way more economies of scale that you can put to work.

I'm also not complaining about healthcare in the middle of Alaska, 50 miles from a highway (or deep in the poverty belt). I'm talking about overpriced, underachieving care in wealthy metro areas.

Re: The healthcare market is taxing reproduction out of existence

#152

Post by jeeeb » Mon, Dec 01, 2025, 11:50 PM UTC

digi59404 wrote: post #142

jopsen wrote: post #131

An American PPO with a $10 co-pay is pretty awesome. The only downside is that it's too easy to get a procedure you don't need :) I've tried tellings doctors in Denmark I wanted X, Y, Z test and getting told, nah, the outcome wouldn't change your treatment so we don't want to order those tests. Generally, healthcare is decent, but no doubt a good PPO plan does not compare :) Public health care seems more like HMO, yo…

That second paragraph is what scares me the most about pure public healthcare options. The following isn’t to compare/contrast systems.. it’s just a viewpoint. My cardiologist went “tests look fine, heart looks fine, there’s no reason for you to take colchicine. No clue why you have issues, everything is fine. Just take this brand new beta blocker to manage your heart rate.” Meanwhile, there’s no answer why my heart…

At least in the systems I’ve experienced (Australia and Japan). You can just go to another doctor.

There’s no “insurance networks” and no visitation limits. You can go to _any_ doctor nationwide.

I’d be curious to know where you had that experience and what the limits are on finding a different doctor ..

Re: The healthcare market is taxing reproduction out of existence

#153

Post by sokoloff » Mon, Dec 01, 2025, 11:51 PM UTC

izacus wrote: post #130

toast0 wrote: post #79

Earlier quoted context omitted.

Claiming $200/month for a phone makes one wonder which numbers are valid. I'm not saying everyone needs to make a $100 phone last 5 years and use a $15/month plan, but I'm not even sure how I would get to $200/month in phone bill, even including financing an iPhone 17 Pro Max.

[flagged]

It’s also what critical thinkers do when evaluating “what percentage full of shit do I think this author is?”

If a glaring innumeracy or terrible estimate is in the article, why did the author include that? What was their angle? Does that make me trust the rest of the article more or less?

Re: The healthcare market is taxing reproduction out of existence

#154

Post by rimbo789 » Mon, Dec 01, 2025, 11:54 PM UTC

hypeatei wrote: post #120

estimator7292 wrote: post #72

Earlier quoted context omitted.

How come other countries have better healthcare at lower real costs? Basically every developed nation has better healthcare outcomes than the US. All other nations have cheaper healthcare. America is not special, we've just brainwashed our less-observant citizens into believing that solutions the entire rest of the world uses will never and can never work here. There's nothing special about our population or economy…

When I went to Canada, I talked to someone who said the Canadian government will subsidize trips to the US for certain treatments because it's not available at all in Canada or has insane waiting times. It's one data point, I know, but generally I think it's true that quality and availability of care in the US is much better.

I’m a Canadian and I’ve worked in health care.

This is only done for very specialized treatments where the province (they run the health care delivery) doesn’t have the treatment and/or the American resource is closer than a Canadian treatment location.

For example Nova Scotia will send some complex paediatric cases to Boston. They could send them to Toronto, but Boston is closer. Same with Manitoba but they use Minneapolis.

Canada is only 40m people and almost half that is in one province. The smaller provinces simply don’t have the population to justify having every possibly medical bell and whistle.

Point is when province sends Canadians for US treatment is isn’t actually about better quality as not all provinces have the same in house capacity and often the next largest city with such capacity is an American city.

Re: The healthcare market is taxing reproduction out of existence

#155

Post by kirth_gersen » Mon, Dec 01, 2025, 11:54 PM UTC

ErroneousBosh wrote: post #147

losvedir wrote: post #29

Hmm, counting the insurance premiums 100% towards the birth of the child is a bit misleading. Presumably, you'd be paying those even if you didn't have the child. That said, the cost of health insurance for a family is pretty outrageous. My premiums are along the same lines as the ones here (although less noticeable since they're paid by my employer).

Why do you need to get insurance for your child to be born anyway? Isn't the hospital already insured? Isn't that kind of janky?

In America, you basically need insurance to act as a larger stronger party in the negotiation of prices with the hospital on your behalf. Without the bargaining power of the insurance company the prices you'd pay can be significantly inflated. So paying for the insurance is the slightly lesser of two evils. Supposedly. From your question it seems perhaps you live somewhere with a saner system in place. I'm envious.

Re: The healthcare market is taxing reproduction out of existence

#156

Post by avgDev » Mon, Dec 01, 2025, 11:56 PM UTC

BeetleB wrote: post #121

losvedir wrote: post #29

Hmm, counting the insurance premiums 100% towards the birth of the child is a bit misleading. Presumably, you'd be paying those even if you didn't have the child. That said, the cost of health insurance for a family is pretty outrageous. My premiums are along the same lines as the ones here (although less noticeable since they're paid by my employer).

> Hmm, counting the insurance premiums 100% towards the birth of the child is a bit misleading. I see your point, but do you not think that if you're a family of 4, having to pay $40K before insurance kicks in is ridiculously expensive, and out of reach for most Americans? I'd wager that most self employed folks in the US almost never benefit from insurance (except for things covered by Obamacare which come nowhere n…

The problem is the healthcare cost is insane. You will go through $40k after a good injury that may need a major surgery or few smaller surgeries. Average cost for hip replacement is $40k.

I've had a sports hernia and the bill was about $30k.

Re: The healthcare market is taxing reproduction out of existence

#157

Post by evanelias » Mon, Dec 01, 2025, 11:56 PM UTC

Aaronontheweb wrote: post #42

losvedir wrote: post #29

Hmm, counting the insurance premiums 100% towards the birth of the child is a bit misleading. Presumably, you'd be paying those even if you didn't have the child. That said, the cost of health insurance for a family is pretty outrageous. My premiums are along the same lines as the ones here (although less noticeable since they're paid by my employer).

I only keep this plan because we're planning on having children, so yes, it's included in the pricing decision.

That doesn't make sense to me. Are you saying your health insurance premiums would be $0 if you weren't planning on having children?

Re: The healthcare market is taxing reproduction out of existence

#158

Post by gishh » Mon, Dec 01, 2025, 11:58 PM UTC

BeetleB wrote: post #121

losvedir wrote: post #29

Hmm, counting the insurance premiums 100% towards the birth of the child is a bit misleading. Presumably, you'd be paying those even if you didn't have the child. That said, the cost of health insurance for a family is pretty outrageous. My premiums are along the same lines as the ones here (although less noticeable since they're paid by my employer).

> Hmm, counting the insurance premiums 100% towards the birth of the child is a bit misleading. I see your point, but do you not think that if you're a family of 4, having to pay $40K before insurance kicks in is ridiculously expensive, and out of reach for most Americans? I'd wager that most self employed folks in the US almost never benefit from insurance (except for things covered by Obamacare which come nowhere n…

I am a male breast cancer survivor. I had a mammogram the other week. $620.

No, nobody benefits from insurance in America. Well, nobody ill.

Re: The healthcare market is taxing reproduction out of existence

#159

Post by jay_kyburz » Mon, Dec 01, 2025, 11:58 PM UTC

venturecruelty wrote: post #139

celeritascelery wrote: post #132

Earlier quoted context omitted.

Most medical care is not an immediate emergency. If I could compare MRI prices and it would impact how much I pay (either as an insurance copay or out of pocket) I would absolutely do that. But I have no opportunity to do that so there is not price feedback like there is in a market.

Sorry, this is simply not true. Every 1-3 years, I get a simple diagnostic procedure to make sure I don't get cancer. Without it, I'm at a very real risk of developing cancer that would quickly kill me. There is no universe in which it doesn't cost around $10,000. None. It is simply impossible for me to get out of paying that. My options are: 1. Use insurance, and hopefully it's covered. 2. Pay out of pocket. 3. Skip…

I wonder if you could pay a few air fairs and have the procedure done overseas and still come out ahead?

Re: The healthcare market is taxing reproduction out of existence

#160

Post by kirth_gersen » Mon, Dec 01, 2025, 11:59 PM UTC

toast0 wrote: post #79

mhb wrote: post #44

Earlier quoted context omitted.

Also not a big impact on the message, but $200/mo for a phone is a bit disingenuous.

Claiming $200/month for a phone makes one wonder which numbers are valid. I'm not saying everyone needs to make a $100 phone last 5 years and use a $15/month plan, but I'm not even sure how I would get to $200/month in phone bill, even including financing an iPhone 17 Pro Max.

$200 doesn't seem that crazy if they are buying several phone lines. I assume he pays at the least his wife as well, so that's two. If they have home internet bundled in as well, that would easily explain that figure. All to say, AT&T. He may also have a home phone line for a fax machine. It is perhaps a bit disingenuous to bundle it all together, but it also isn't the main point of the article.