411–420 of 592 posts
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Where is all the money going? Does the ambulance have a solid-gold steering wheel?
Most people don't/can't pay their hospital bills.
If this is true, the system is completely broken.
If it's not true, then the system is completely broken, but in a different way.
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> But the hospital doesn't know if the birth is going to be uncomplicated until it actually happens. If the hospital gives out only a projected price... The hospital can totally give a realistic, projected price: It can know what the probability of a complicated birth will be, and it is also able to amortize that over all the uncomplicated births. There's no sane public-policy reason it should be structured like a re…
If it's a projected price, then the original commenter is still screwed if the birth becomes complicated. It's still a slot machine. Furthermore, it would incentivize sketchy practices like setting a lower base price than competitors but aggressively discovering (or manufacturing) complications so that the average price is considerably higher than the base price.
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> Which is to say don't propose something until you understand the unintended side effects. You can get your desired result but while making everything worse. I think the American experiment in trying to provide market health care has demonstrated that you can, in fact, have a 'free' market for healthcare, while making almost everything about that healthcare worse.
The american way is not a free market. The employer tax break on health insurance is a significant manipulation.
Your vision benefits enjoy similar tax breaks, but I've yet to see an optometrist try to bill someone without benefits $800 for a vision exam, or $4,000 for a pair of glasses.
Its not the tax break. It's something else.
Last year my 1 year old baby had an accident in Germany. She fell off of a bed. I took her to an ER and after the examination I paid approx. 100€ = ~100usd. I assume in USA I would have paid 10kUSD or more..
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"Don't let The Perfect be the enemy of The Good." We are overspending on the quality of health care we get today. Further there is a lot of fear mongering about socialized medicine. I've experienced medicine in both the UK and the US. I can tell you, there isn't a difference in quality. Further, when I got a cold and went in, wait time wasn't 6 hours or whatever other BS people claim. Wait time was ~10 minutes. In fa…
I've had different experiences from you. My experience in the UK was wait 90 minutes in a waiting room and when it was finally close to my turn I was told I could only see a nurse and she wasn't allowed to proscribe any medicine so if I wanted to see a doctor I should go down the street to the private doctor. This was in London near Soho. In Japan the first time I went to a doctor it was for stomach pain. He gave me…
The decision to go to a doctor is a financial one in the US, sometimes superceding a health one. Our life expectancy is dropping as well. It’s a broken system and adding more of what is broken about it won’t work, if the goal is for society to be healthy.
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Most people don't/can't pay their hospital bills.
Most? Like, over 50%? If this is true, the system is completely broken. If it's not true, then the system is completely broken, but in a different way.
Of course, it's absurd that all 3 out of 4 paths require you to take extra, often really painful steps (collection + bankruptcy, maintaining insurance, or long drawn-out negotiation) just to pay a reasonable price for something that is 100% non-optional and most countries provide for much-closer-to-free. But that's kinda what happens when the system is broken
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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).…
> We do not have a free market. Most people get their health insurance from their employer - you cannot reasonably get insurance elsewhere What you are describing are in fact the freest parts of the health insurance market. Employers, quite rationally and of their own free will, choose to offer health insurance as a benefit because it attracts and retains talent better than other similarly priced incentives. The fact…
What is worse is that poorer people in the individual market can’t even get a tax break for buying health insurance (not until it becomes 10 percent of their income and they decide to itemize). In contrast, employers buy health insurance for their employees tax free. This literally screws poor people in service jobs by making them actually pay much more for health insurance (even including what the employer would pay).
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Gee, that sure does sound like a private dispute between you and your employer to me. If you want to opt out of your company's health care plan then you're more than welcome to go attempt to negotiate with your manager about raising your salary by the amount of their health care contribution. Best of luck to you.
Such an agreement would likely be illegal under federal law, creating the risk for regulatory and civil sanctions for the employer.
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Legislation requiring up-front presented costs to be honored and any additional procedures/costs to be cleared with patient consent as they happen (or a consent waiver obtained from the patient with a promised limit or incentive such as overall discount) might be an improvement. Or it may increase costs for the worse. Who knows.
Careful there though. If a surgeon is operating on cancer and discovers that the tumor is much larger than expected the operation will take longer - be more expensive - or the surgeon does the operation as planned and then charges even more for the second surgery to remove the rest. Or maybe all operations are estimated as the worst case and so you end up with no more clue about what you will pay than today - in some…
No reason we can't have something similar that in US health care as far as I'm aware, at least for the happy path where the patient is lucid and in a reasonable state of mind up front. But then again, why do we have to worry about this when plenty of countries have a basically-zero-fee system in place?
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That assumes that the desire for health care is unbounded like other consumables. In reality most healthy individuals want a limited amount of care, sick individuals want the least amount of care required to return them to health - and there are fundamental limits on the amount of care that can be provided to those who are beyond the help of current technology. As such you would expect a finite level of demand from t…
No, the demand for healthcare is basically infinite. I got a cold yesterday with a crazy bad sore throat, I thought of maybe popping into the doctor. But it turns out to be just a regular cold. My mother would have 100% gone to the doctor. The clinics here in Canada are chock full of kids with the flu and people coming in 'because'. Maybe that's beneficial due to the risk 'it could be something bad'. Or maybe the eco…