331–340 of 354 posts
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Reputation is pretty much worthless. Patient reviews are largely based on how nice the doctor seems (bedside manner) and have no correlation with actual clinical outcomes.
That's with today's system not the proposed system.
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FSAs are insane, conceptually. "Guess how much money you're spending in a year on healthcare! But beee caaareful: if you guess too high, YOU LOSE IT" I still used mine while I still had access to one, but it was grumpy-making and was usually almost more trouble than it was worth.
Unless you have an approved gym membership for which it can be used for ! With 30% discount !!
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Unless your a homeowner with a mortgage, then it's almost always better to itemize
Not so much anymore. The standard deduction for a married couple is now above 30k. It would take a large mortgage to pay that kind of interest in a single year. (Principle is not deductible; only interest)
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Pharmtech: "With your current insurance we can't sell you this medicine at any price. We're under an agreement." Me: "Okay, what if we don't go through insurance?" Pharmtech: "$45 for the prescription." Me: "That's a bit higher than last time." Pharmtech: performs some sort of incantation "Okay, $12." Me: "How did we go from not at any price to $12?" for those of you keeping score at home, the medicine was generic co…
Medicine not in formulary. Their clinical department decided it was not worth covering for $reasons. The Pharmacy, likely to be considered a preferred pharmacy, signed a contract to be bound by that company's clinical formulary for policyholders. $45 was probably cash price, the they can let it go for if they do their ordering through a pharmacy supply group. $12 may be a price with a discount program like GoodRx app…
- GoodRx was penalized $1.5m by the FTC 2/2023 [0] for sharing sensitive personal health information with third-party advertising companies (Facebook, Google, et al), without user consent. Then in 2024 it paid a $25m settlement arising from that action [1].
- GoodRx isn't subject to HIPAA, it can legally share "non-medical" information, i.e. your prescriptions, which often have a one-to-one (or one-to-few) correspondence to specific conditions. Hence, sidestepping HIPAA.
- its business model relies on collecting user data, which may be a concern for privacy-conscious individuals.
[0]: https://www.ftc.gov/news-events/news/press-releases/2023/02/...
[1]: https://www.hunton.com/privacy-and-information-security-law/...
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Here are the magic words in US Health Care: "What is the cash price?" It's usually less than you think and often worth avoiding the insurance company hassle. Then you can just get reimbursed with your FSA or HSA anyway.
>Here are the magic words in US Health Care: "What is the cash price?" I'm not so sure about that. Especially in a hospital setting. Many years ago, I was admitted to the hospital for several days as it was suspected (wrongly, but that's another issue with the perverse incentives in US "healthcare") that I had MRSA and the doctor wanted me on IV antibiotics while testing proceeded. I spent three days in the hospital,…
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Are clinicians any more competent than in other countries with similar levels of training? In Europe, UK, or here in Australia for example, the quality of public care seems to be competitive with the US, and the quality of private care here seems often even better. I've heard this "US healthcare is expensive but at least it's good" thing a few times, but never with any particular evidence, and from the few numbers I…
I didn't know American health care is known to be good. According to random lists I find it ranks pretty average. See numbeo it's 39 for Health Care Index https://www.numbeo.com/health-care/rankings_by_country.jsp
I've seen a lot of upcoding on my bills and it really aggravates me. It's fraud and the doctors should be happy that the insurance company is just reducing their payments instead of dropping them or trying to get them prosecuted. When someone loads their grocery bag full of cosmetics and razor blades, they get on the news and YouTube, but when a doctor systematically bills for services he didn't perform to the tune o…
> When someone loads their grocery bag full of cosmetics and razor blades, they get on the news and YouTube What does this part mean? I don't follow.
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And yet this has absolutely nothing to do with the claim that "Insurance companies hold tremendous leverage over care providers, up to and including the power to effectively put them out of business on a whim.", you're not even engaging with the argument at all.
It doesn't? All the money is going to them, and they're massively larger than the insurers, but it's the insurers with all the leverage? Why isn't more of the money going to the insurers then? https://nationalhealthspending.org/
There are 5 or 6 big insurance companies, maybe 2000 if we count all of the small ones and 400K medical practices. So even by this very simple money=leverage argument, each individual practice has far less money than the insurance company they are dealing with. So if more money = more leverage then these same numbers prove the opposite claim.
So its probably fair to say that the picture isn't as simple as money=leverage.
If a medical practice and an insurance company get into a dispute and one of them decides to not work together, the practice loses say 1/5th-1/10th of its customers, the insurance company loses 1/100000th of its revenue. I call that leverage.
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Standard of care for persistent symptoms compatible with acute bacterial rhinosinusitis for more than 10 days IS prescribing antibiotics.
Just asked my wife (ER doctor). She says it's 2 weeks for adults, 3 weeks for kids.
This sort of thing gets to two critical problems of the American system: 1. It is largely designed to make money, not actually help patients. So every step in the healthcare chain that can extract a bit of value will do so, largely to boost profits. 2. Insane complexity with limited transparency. How much will something cost? Hard to tell. Will it be covered? Who knows? On the opacity, I have one informative anecdote…
Flood insurance protects against the rare disaster where there's a flood.
Health insurance protects against the rare disaster where somebody's actually able to get healthcare.