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Health care is turning into a consumer product

economist.com

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Re: Health care is turning into a consumer product

#241

Post by FowlSoft2013 »

avgDev wrote: post #155

I don't know how any American can accept the pile of trash that the US healthcare is. The only good thing is that in some cases you will get state of the art care, this is "rare" and may not result in better outcomes. 1. The cost is insane. It doesn't matter how much money you have, if you stay long term in a hospital your bill will be insane and more than an average cost of a house. 2. Single ER visit? 10 different…

The problem from my point of view is conflating ongoing healthcare with catastrophic coverage. Outpatient care should absolutely be a free market (prescriptions, lab tests, specialist visits etc.). Catastrophic incidents/diagnoses should be a simple lump sum payout (Cancer, Hear Attack, Stroke, etc.).

Alternative options I've seen being offered for ongoing healthcare is Direct Primary Care where essentially you pay a membership fee to have unlimited access to a primary care physician.

I think the root of the problem is subsidization and the patch work of legislation that gets piled on year after year to "fix" the issue. The entire price function is completely out of wack and as long as the patient is stuck between the provider, insurance carrier, and government debating who has to pay, they will lose.

Re: Health care is turning into a consumer product

#242

Post by knubie »

UglyToad wrote: post #116
mrsuprawsm wrote: post #35

This seems more like a symptom of the wildly broken American health-care system than anything else. In countries with a more functioning healthcare system, disruption of the status quo (especially by VC-funded private companies seeking a large payday) is neither necessary or desirable, slow iterative improvements are the name of the game. Furthermore, the US spends far more per capita than every other country on heal…

To add to this, the absurdity of the 'healthcare' system in the US is made even more apparent as a non-US citizen buying health insurance for (long-term) international travel. Firstly (loosely regulated) insurance is an absolutely stupid way to provide healthcare. Pre-existing conditions? Maybe you just don't deserve to live, either way we're witholding life-saving care from you because our tables say so. Need to cla…

The American health insurance industry is anything but "loosely regulated."

Re: Health care is turning into a consumer product

#243

Post by wombatpm »

dqpb wrote: post #108
pjc50 wrote: post #54

Earlier quoted context omitted.

The problem is that "market" is a really bad fit for meeting healthcare needs, and doubly so when it's intermediated by insurers. People get the amount of healthcare they can afford from their discretionary budget and work their insurers for - not the amount they need. So they may get "more" (or at least more expensive) care than they need, or less. Note that many of the European systems are semi-private, so you reta…

In my book, it’s a big red flag when a market is intermediated by anyone. The whole point of markets is to crowd source decision making, so if you remove the crowd, then what is it that you actually have left?

Rent seeking oligarchs?

Re: Health care is turning into a consumer product

#244

Post by bell-cot »

At least in my mind, "consumer product" quite clearly implies that the price is advertised, or at least easily found. And it does not change during the transaction.

Which is definitely not the case in American health care - unless you have "For the Top 1%" health insurance, or are buying at the bottom end (a bottle of aspirin, maybe an eye exam or dental cleaning).

Re: Health care is turning into a consumer product

#245

Post by hamter »

majormajor wrote: post #234
cntainer wrote: post #44

It's interesting to see that "Health care consumes 18% of GDP in America" compared to ~10% in most developed countries. In my (non-american) opinion part of that difference comes from the fact that healthcare is already a consumer product in the US. Maybe not entirely, but much more than in Europe, where universal healthcare sponsored by the state is the norm. Another point is that US healthcare is considered the mos…

It's not all bad to spend more - consider the extra hospital capacity that so far has helped absorb COVID shock impacts better than neighboring Canada. Hopefully we don't hit the limit of that, even, though. https://www.bloomberg.com/news/articles/2022-01-06/hospital-... US health outcomes also aren't so bad for those who have affordable access to the system , as I understand it. But the spending is something to keep…

idk canada has 806 covid deaths per 1M and usa has 2573, it's not exactly screaming 'success story' to me.

Re: Health care is turning into a consumer product

#246

Post by majormajor »

dr_orpheus wrote: post #222
cntainer wrote: post #44

It's interesting to see that "Health care consumes 18% of GDP in America" compared to ~10% in most developed countries. In my (non-american) opinion part of that difference comes from the fact that healthcare is already a consumer product in the US. Maybe not entirely, but much more than in Europe, where universal healthcare sponsored by the state is the norm. Another point is that US healthcare is considered the mos…

> Well, I guess it is more efficient if the expected outcome is a larger profit for different private companies and middlemen and not the well-being of the rest of the population. My favorite example of this is when I had to get an MRI. The lab imaging said it would be $800 if they billed it through insurance, or it would be $600 to just pay for it directly out of pocket. So the cost of having to deal with my insuran…

This is always extra annoying because it might be a false savings to pay cash there. Let's say your MRI says you need a $5500 procedure, and your plan's deductible is $3000, 90% coverage after, and out of pocket max is $6000, and there's nothing else you've spent on the plan this year.

Pay $800 for MRI with insurance, you'll then pay $2200 for the procedure to hit the deductible + 10% of the remaining $3300, so $2530 total for the procedure. $3330 total for the year between the two things.

Pay $600 cash for MRI, you'll then pay $3000 for the procedure to hit the deductible, and 10% of the remaining $2000, so $3200 total for the procedure. Now you've paid $3800 total, so you've spent $470 more despite the MRI being "cheaper"!

If you have other expenses so your out of pocket max comes into play, that difference approaches the full $600.

Re: Health care is turning into a consumer product

#247

Post by jimt1234 »

The current healthcare system in the US is just as bad for service providers as it is for service recipients, maybe even worse.

My girlfriend has worked with children with special needs for around 20 years, mostly children with autism. A few years ago, the field began migrating from almost entirely state-funded to funding from private insurance (California, not sure about other states). The problems with private insurance funding began almost immediately and couldn't be clearer. Under the state-funded program that existed for decades, her company met monthly with the state funding agency, discussed individual cases, and got funded. Easy, efficient. With private insurance, well, the best way to describe it is that her small company had to hire a full-time person just to manage the billing/funding with the insurance companies. And this is not a do-nothing position. This position is responsible for much of the company's revenue, which is inherently important. Also, understanding all the different processes/procedures/BS of each insurance company is highly skilled. That might sound ridiculous, but it's totally true. I hear the stories about fighting with insurance companies, trying to get paid for services rendered months prior. Quick example: one private insurance company (a big one, you've heard of them) only accepts payment requests via fax. Yes, fax. But it gets better. The fax line is only "active" during regular business hours, and the line is almost always busy, because as you might expect, other companies are trying to get paid, too.

Re: Health care is turning into a consumer product

#248

Post by pydry »

DrBazza wrote: post #211
pydry wrote: post #180

Earlier quoted context omitted.

>In principle, you're correct. In practice ... It sounds like you are disputing empirical evidence as well as standard economic theory regarding monopsonies. >The UK public might "adore" the NHS, but they have a pretty poor understanding of how it is funded. Not really. It's mostly funded with taxation. They are not so aware of the corruption going on underneath with taxpayer money. >If the government kept funding th…

> It sounds like you are disputing empirical evidence as well as standard economic theory regarding monopsonies. When there are multiple sellers of generic drugs , you're correct. When there is one seller of a non-generic, life saving drug with no alternative, the NHS is going to pay whatever the one seller, which by definition is a monopoly, is going to charge. [1] > What is even the point of that sentence? That we…

>When there are multiple sellers of generic drugs, you're correct. When there is one seller of a non-generic, life saving drug with no alternative, the NHS is going to pay whatever the one seller, which by definition is a monopoly, is going to charge.

This is incorrect. If the price is too high they refuse, depriving the company of all income. This has been done for certain cancer drugs.

Even if they dont refuse their pricing power lets them beat down prices.

>That we cannot keep increasing NHS funding exponentially

It's barely even increasing in line with inflation.

>Some people seem to find that fact hard

They really dont.

>Both parties campaigned for the NHS in the 1940s.

This is provably false. The tories wanted an insurance based system rather than the system we have modeled on the soviet union.

I think Im gonna leave this discussion here. We clearly dont live in the same plane of reality.

Re: Health care is turning into a consumer product

#249

Post by BorisEm »

rkk3 wrote: post #158
avgDev wrote: post #155

I don't know how any American can accept the pile of trash that the US healthcare is. The only good thing is that in some cases you will get state of the art care, this is "rare" and may not result in better outcomes. 1. The cost is insane. It doesn't matter how much money you have, if you stay long term in a hospital your bill will be insane and more than an average cost of a house. 2. Single ER visit? 10 different…

> the pile of trash that the US healthcare is There are significant problems but whose Vaccine did you take for Covid-19? Pfizer (Us), Moderna (US), Johnson and Johnson (US)...

2 of the 3 vaccines you mention were not fully developed in the US despite what you insinuate.

Johnson and Johnson was developed by Janssen which is based in the Netherlands and Belgium [1].

And as others have pointed out, Pfizer was developed by BioNTech in Germany [2].

[1] https://en.wikipedia.org/wiki/Janssen_COVID-19_vaccine

[2] https://en.wikipedia.org/wiki/Pfizer%E2%80%93BioNTech_COVID-...

Re: Health care is turning into a consumer product

#250

Post by bendbro »

buu700 wrote: post #235
mumblemumble wrote: post #189

Earlier quoted context omitted.

One thing to note about US healthcare is that it seems almost deliberately engineered to not be a market. I've never received significant health care in another country, so I can't say how the US system differs from others with any expertise. But I can say how US health care differs from just about anything else I spend money on: 1. I don't really get to shop for health insurance providers. My employer picks one, may…

A lot of this was covered by the Libertarian Party's position on healthcare reform in the last election, which I thought was interesting: https://www.foxnews.com/politics/jo-jorgensen-big-idea-marke... There are probably ways that we could combine aspects of greater and lesser privatization to achieve the best of both worlds. I have some thoughts that I've been mulling around for a while: 1. Expand the government to…

> New regulation to ban copays and set a mandatory floor on deductibles (say, $10k)

I like everything here except this. Won't a significant amount of healthcare (grouped by specialization, hospital, etc) still be funded by insurance and be outside the reach of market forces?

I am also curious whether there are barriers to producers of medicine, healthcare supply, etc from disrupting existing overpriced producers.

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