Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

What I learned from reading a thousand emergency room bills

vox.com

Post reply on HN
Print view View original

321–330 of 592 posts

Re: What I learned from reading a thousand emergency room bills

#321

Post by brianpan »

ip26 wrote: post #289
heavyset_go wrote: post #66

Earlier quoted context omitted.

The history of private firefighting is a particularly dirty one. In the past, fire companies would show up and demand payment before putting out fires. If a payment couldn't be made, the company might negotiate the purchase of the burning property at a steep discount. Later, insurance companies hired brigades to only put out fires on insured properties. Fire companies might have fought or sabotaged one another in ord…

Why is this dirty? If you don't pay for fire protection, not even through taxes, why does anyone owe you incredibly hard & extremely dangerous labor saving your house? Firefighting is not a safe profession. (I certainly prefer publicly funded fire service)

It's not the payment that was specifically dirty, it's that privatized firefighting was a dirty job historically in America. Like competing companies brawling in the street on the way to a fire, dirty.

https://en.wikipedia.org/wiki/Broad_Street_Riot

Here is a comedian's take on it in podcast form: https://thedollop.net/wp/episode-138-dollop/

Re: What I learned from reading a thousand emergency room bills

#322

Post by fencepost »

ams6110 wrote: post #250
ncallaway wrote: post #219

Earlier quoted context omitted.

I don't believe that's true. What serious single payer proposals have been put forward that would eliminate private-pay, private insurance, or private care? I've never seen one. In fact, almost all "single payer" health systems that exist in other countries have private care and private insurance options. For example, such options are available in both the UK with the NHS and in Canada. I've never once spoken with an…

Bernie Sanders, for one, has advocated for the elimination of private health insurance by essentially putting everyone on Medicare.

Saying that Sanders is advocating the elimination of private health insurance because he favors Medicare for all is just as inaccurate a saying that anyone who advocates for improving public transit is trying to eliminate all privately owned vehicles.

I'm sure there are plenty of things to dislike about Sanders or anyone else whose political leanings tend toward things like publicly-funded healthcare coverage, it should be possible to come up with a few of them without blatant misrepresentation

Re: What I learned from reading a thousand emergency room bills

#324

Post by JshWright »

FireBeyond wrote: post #290
dv_dt wrote: post #199

Earlier quoted context omitted.

Ah, I understand that happens, but that's not what I was referring to. I was referring to private homeowners and insurance companies hiring firefighters. https://www.latimes.com/local/lanow/la-me-ln-private-firefig...

Companies like Rural/Metro, traditionally ambulance/EMS companies, have expanded into private fire, in those places (one notable city is Grants Pass, OR).

Rural/Metro is now American Medial Response (they were acquired and all the operations rebranded).

Re: What I learned from reading a thousand emergency room bills

#325

Post by heavyset_go »

ip26 wrote: post #289
heavyset_go wrote: post #66

Earlier quoted context omitted.

The history of private firefighting is a particularly dirty one. In the past, fire companies would show up and demand payment before putting out fires. If a payment couldn't be made, the company might negotiate the purchase of the burning property at a steep discount. Later, insurance companies hired brigades to only put out fires on insured properties. Fire companies might have fought or sabotaged one another in ord…

Why is this dirty? If you don't pay for fire protection, not even through taxes, why does anyone owe you incredibly hard & extremely dangerous labor saving your house? Firefighting is not a safe profession. (I certainly prefer publicly funded fire service)

>Why is this dirty?

Sabotage and physical fights broke out between fire companies while fires burned. That's a pretty gritty situation.

Allowing fire sales gives way to perverse incentives, like the profitability of arson and predatory pricing of fire fighting fees such that certain portion of victims will always have to sell their property at a discount.

Re: What I learned from reading a thousand emergency room bills

#326

Post by JshWright »

vkou wrote: post #192
mondo9000 wrote: post #118

Earlier quoted context omitted.

Meanwhile the EMTs make $12/hr :(

Where is all the money going? Does the ambulance have a solid-gold steering wheel?

Hahaha... No, the ambulance is a 10 year old Chevy 2500 w/ 150k miles...

Re: What I learned from reading a thousand emergency room bills

#327

Post by fencepost »

bluGill wrote: post #127
vec wrote: post #14

Exhibit A for why "free market healthcare" is an oxymoron. I have yet to hear a coherent explanation for how anyone can reasonably expect for price discovery to even pretend to function in a market where the consumers can't even guess the prices until after they've already purchased and frequently couldn't reasonably be expected to refuse service even if they did believe it was overpriced.

We do not have a free market. Most people get their health insurance from their employer - you cannot reasonably get insurance elsewhere (the same plan I have now for $100/month would cost over $1000/month, but I can't take that $1000/month to anyone else if I don't like my insurance so I accept it). This keeps me from taking a long leave of absence to live off my savings - until I quality for retirement (medicare).…

$1000/month is probably a heck of a plan or in a really expensive market if it's for a single person, and it's probably still decent for family coverage. If it was through the ACA Exchange it's probably also a Gold plan that when you look at maximum out of pocket costs simply loads up the premium rather than the OOP payments.

Re: What I learned from reading a thousand emergency room bills

#328

Post by maxxxxx »

sly010 wrote: post #251

This is outrageous because the regulation wouldn't even have to be complicated. In the EU there is a directive that you have the rights to know the retail prices of things before you make a purchase and in some countries, retailers have to honor the lowest posted price and we are talking about baguettes! I don't see why that same thing couldn't apply for healthcare. 1. ERs should publish prices in a public database.…

"1. ERs should publish prices in a public database. If a price is not published for an item/procedure, the customer can pay the lowest price she/he can find for the same procedure from an other provider. 2. The same price must be charged from everyone (regardless of insurance)."

this would bring a lot of sanity into the system.

Re: What I learned from reading a thousand emergency room bills

#329

Post by newyankee »

JaggedNZ wrote: post #263
newyankee wrote: post #168

Earlier quoted context omitted.

any idea how is it in NZ ?

Pretty much the same as Aus and UK, though I think some level of subsidised healthcare for visitors though surgery, etc. will be charged in full, and full coverage for permanent residents, where as Aus tends to charge full price for everything, I believe (still cheap compared to the states though). Doctors (GP) visit typically costs me around $40-50NZD, thats likely on the high side, Children are free / fully subsidi…

Even more transparency is a step up. Meaningful non anxiety inducing prices are all that is needed tbh.

Re: What I learned from reading a thousand emergency room bills

#330

Post by newyankee »

james_s_tayler wrote: post #188
newyankee wrote: post #168

Earlier quoted context omitted.

any idea how is it in NZ ?

It's fantastic here too. I had a scare recently and called the ambulance, was at the hospital pretty quickly, got an x-ray, stayed overnight, turned out not to be a serious thing but finally figured out what was causing it. No drama and no crazy $100,000 bills. Just healthcare of an acceptable quality when you need it. There is just no way that any perceived marginal improvement in the quality of care on an individua…

Indeed. I am surprised though because the income taxes in NZ seem to be lower than the quality of healthcare then. Wondering what the catch is.
Post reply on HN