The Man Who Was Treated for $17,000 Less • Hacker News Board

Re: The Man Who Was Treated for $17,000 Less

#21

Post by amalag » Thu, Aug 22, 2013, 7:02 PM UTC

bmmayer1 wrote: post #14

JohnTHaller wrote: post #13

There are some interesting tidbits in the article, but it falls apart in the last paragraph when we see the true motive of the article: "Sadly, we are heading in the exact opposite direction. ObamaCare expands the role of the third party and practically eliminates the role—and the say—of the patient in the delivery of health care. Will they ever learn?" And then you see the writer's bumper at the end: "Dr. Singer pra…

So what? Is a medical surgeon not qualified to have an opinion on ObamaCare? Or are you suggesting he is not permitted to be against ObamaCare?

I think the Wall Street Journal (because of NewsCorp/Fox/Murdoch) would not give space to a pro-ObamaCare message on its article.

Re: The Man Who Was Treated for $17,000 Less

#22

Post by bmmayer1 » Thu, Aug 22, 2013, 7:03 PM UTC

jacobolus wrote: post #19

bmmayer1 wrote: post #14

Earlier quoted context omitted.

So what? Is a medical surgeon not qualified to have an opinion on ObamaCare? Or are you suggesting he is not permitted to be against ObamaCare?

You would be rightly skeptical of an athlete’s endorsement of a brand of shoes they are being paid to sponsor, even though a disinterested athlete would be well qualified to comment, as a professional. Similarly, in this case “paid for by the Koch brothers” is the most relevant part of his qualification here, not “surgeon”.

Just because he is allied with the Koch brothers doesn't mean he's wrong.

Re: The Man Who Was Treated for $17,000 Less

#23

Post by joshuahedlund » Thu, Aug 22, 2013, 7:04 PM UTC

bmmayer1 wrote: post #4

"Take the examples of Lasik eye surgery or cosmetic surgery. These services are not covered by insurance. Providers compete on the basis of quality, outcomes and price. And prices have continually dropped as quality and services have improved—unlike the rest of health care." Sadly, most people forget this. They think that healthcare is somehow immune from the laws of economics, that it is "special."

I like this argument, too, but the common response is that Lasik and cosmetic surgeries are elective - voluntary improvements to your body that are a sort of luxury that lend themselves to competition (shopping around, taking your time). By contrast, a lot of expensive medical procedures are much more critical and time-sensitive (you could say the demand is much less elastic), which makes it a lot harder for competition to work (though more price transparency might help!), especially if as another comment says[0], "You get taken to a hospital out of your control, and they're allowed to decide what services to provide and as well as the price they're going to charge you..."

[0]https://news.ycombinator.com/item?id=6258953

Re: The Man Who Was Treated for $17,000 Less

#24

Post by mc32 » Thu, Aug 22, 2013, 7:05 PM UTC

bmmayer1 wrote: post #4

"Take the examples of Lasik eye surgery or cosmetic surgery. These services are not covered by insurance. Providers compete on the basis of quality, outcomes and price. And prices have continually dropped as quality and services have improved—unlike the rest of health care." Sadly, most people forget this. They think that healthcare is somehow immune from the laws of economics, that it is "special."

Not sure the impact, economically, but...

Cosmetic and eye surgery, are for the most part, elective and the pool of potential clients pretty vast, depending on how it's marketed. Other surgeries/treatments are necessary (not as elastic) --it's not as if people would say, well, I have an extra $$$$$ so let me get a hip replacement. They are forced into having to (by the nature of the situation). I'm saying the economics are different, but that's not to say that scale should not apply to non-elective surgeries, but just that maybe to a lesser degree.

Re: The Man Who Was Treated for $17,000 Less

#25

Post by gwright » Thu, Aug 22, 2013, 7:07 PM UTC

JohnTHaller wrote: post #13

There are some interesting tidbits in the article, but it falls apart in the last paragraph when we see the true motive of the article: "Sadly, we are heading in the exact opposite direction. ObamaCare expands the role of the third party and practically eliminates the role—and the say—of the patient in the delivery of health care. Will they ever learn?" And then you see the writer's bumper at the end: "Dr. Singer pra…

You seem to be suggesting that the only valid opinions on any topic are those that originate from a person without any bias but who is somehow intimately informed about the topic.

Those people generally don't exist. The best we can hope for is some reasonable amount of transparency along with a variety of opinions.

Re: The Man Who Was Treated for $17,000 Less

#26

Post by jrockway » Thu, Aug 22, 2013, 7:08 PM UTC

bmmayer1 wrote: post #14

JohnTHaller wrote: post #13

There are some interesting tidbits in the article, but it falls apart in the last paragraph when we see the true motive of the article: "Sadly, we are heading in the exact opposite direction. ObamaCare expands the role of the third party and practically eliminates the role—and the say—of the patient in the delivery of health care. Will they ever learn?" And then you see the writer's bumper at the end: "Dr. Singer pra…

So what? Is a medical surgeon not qualified to have an opinion on ObamaCare? Or are you suggesting he is not permitted to be against ObamaCare?

People that disagree with me shouldn't be allowed to own a newspaper or write for one, especially if they disclose their affiliations at the bottom of the article.

Re: The Man Who Was Treated for $17,000 Less

#27

Post by cromwellian » Thu, Aug 22, 2013, 7:12 PM UTC

A month ago, I was traveling in Germany with my family and my daughter had an emergency, so I had to go to a German hospital in the middle of the night. Within 1 hour, they had given my daughter an ultrasound and two doses of medicine to treat her problem, the cost to me: $130 euro, and I didn't even use my health insurance (which does cover international emergencies)

3 years ago, I had a gallbladder attack in Shanghai. I didn't know what was happening at the time, it felt like a heart attack, like I was dying. Went to a Chinese hospital, they did an ultrasound, chest x-ray, CT scan, EKG, blood and urine tests within 2 hours, plus gave me morphine and antibiotics. The cost was on the order of $200.

I don't think the problems with the US healthcare system can be boiled down to capitalism vs socialism alone, it's much more nuanced than that.

Also, comparing a highly automated, elective procedure, that takes 1-2 people, and on an out-patient basis from a private office to something like a heart bypass or hernia surgery I think oversimplifies the situation.

If a doctor tells you that you need to have an MRI and a biopsy, how are you, an untrained "consumer" supposed to know a) whether or not it's really needed or excessive and b) how to shop around for it. c) if you can't afford it, and it's not an emergency, but it could save your life later, what then?

If someone gets routine upper GI endoscopies if they have a high genetic potential for esophageal cancer, and they can't afford these procedures, should they just wait until they are chocking from cancer and go to an emergency room so the state can pay for much more expensive late stage cancer treatments?

I'm all for comparison shopping, but there's still an element of right-to-healthcare for preventative care for those that can't afford it, and there's still the issue that people can't be expected to reason properly about risks and costs when their life is on the line. If a doctor prescribes a test, chances are, you'll want to do it out of fear alone of what might happen if you skip it.

Re: The Man Who Was Treated for $17,000 Less

#28

Post by bmmayer1 » Thu, Aug 22, 2013, 7:15 PM UTC

joshuahedlund wrote: post #23

bmmayer1 wrote: post #4

"Take the examples of Lasik eye surgery or cosmetic surgery. These services are not covered by insurance. Providers compete on the basis of quality, outcomes and price. And prices have continually dropped as quality and services have improved—unlike the rest of health care." Sadly, most people forget this. They think that healthcare is somehow immune from the laws of economics, that it is "special."

I like this argument, too, but the common response is that Lasik and cosmetic surgeries are elective - voluntary improvements to your body that are a sort of luxury that lend themselves to competition (shopping around, taking your time). By contrast, a lot of expensive medical procedures are much more critical and time-sensitive (you could say the demand is much less elastic), which makes it a lot harder for competit…

What the commenter suggested is exactly the situation right now: the hospital sets the prices as astronomically high as possible because they can get away with it, because the patients aren't paying it. Don't you think introducing patient choice into the equation would put some downward pressure on prices? And certainly if it puts any downward pressure on prices, it's a better situation than we have now.

Re: The Man Who Was Treated for $17,000 Less

#29

Post by JohnTHaller » Thu, Aug 22, 2013, 7:16 PM UTC

baddox wrote: post #17

JohnTHaller wrote: post #13

There are some interesting tidbits in the article, but it falls apart in the last paragraph when we see the true motive of the article: "Sadly, we are heading in the exact opposite direction. ObamaCare expands the role of the third party and practically eliminates the role—and the say—of the patient in the delivery of health care. Will they ever learn?" And then you see the writer's bumper at the end: "Dr. Singer pra…

So you're fine with the ideas presented in the article, until you realize that the author is associated with groups that tend to share those ideas? I don't understand.

His affiliation means his facts and actual investigation of the full story are suspect. His motivation is clear in that it was designed to be an anti-'ObamaCare' piece, which fits right in with the Wall Street Journal/Fox News/Murdoch's mission. Just as the facts and full story would be suspect in a pro-ObamaCare piece on MSNBC or Daily Kos.

Re: The Man Who Was Treated for $17,000 Less

#30

Post by rayiner » Thu, Aug 22, 2013, 7:16 PM UTC

So what do you do if you don't have $3,000 to pay for what can be a life-threatening operation (a hernia)? The Cato Institute answer, let the person die, is economically nonsensical. The economic value of that person's lost labor is almost certainly worth way more than $3,000.