Congress is set to ban most surprise medical bills • Hacker News Board

Re: Congress is set to ban most surprise medical bills

#421

Post by roenxi » Tue, Dec 22, 2020, 8:23 PM UTC

8note wrote: post #403

roenxi wrote: post #320

Earlier quoted context omitted.

In 2013, 64% of health spending was paid for by the government [0]. The non-profit hospitals share of total hospital capacity has remained relatively stable (about 70%) for decades [0]. The regulation section of Wikipedia is a litany of anti-free-market policies [0]. You can argue that free market principles fail in healthcare, and I will happily disagree and we can all have a cheerful time. But the US hasn't tried a…

People arguing for socialized medicine are arguing for bringing down the absurd costs, by virtue of having a very strong negotiating position and economies of scale. Canada's single payer system is an example of that. In a free market, employment status would still be related to your healthcare, eg. through credit checks to see if you're moral enough to get surgery. Theres no reason companies would stop providing hea…

> a very strong negotiating position and economies of scale

Pretty sure that the US Federal government is the most indebted entity on the planet, and they'd be subject to exactly the same forces that have currently made them upregulate the cost of healthcare.

There is no reason to think they'd use a good bargaining position to bring down costs - the US Federal government is the most cost insensitive entity in history. And a free market is totally capable of finding economies of scale if it is cheaper.

Re: Congress is set to ban most surprise medical bills

#422

Post by mattnewton » Tue, Dec 22, 2020, 8:42 PM UTC

sershe wrote: post #418

mattnewton wrote: post #411

Earlier quoted context omitted.

> Right, so your city should operate an emergency room funded mostly by taxpayers, and then just charge a fixed deductible (e.g. $1000) for emergency care, which isn't enough to induce bankruptcy in general but is enough to deter people from using it in place of primary care This is just a public option that covers little and without the bargaining power on price a state has versus a city, right? Why wouldn't the sam…

The latter is probably not causal - poor Americans have no money for either insurance or dental care, whereas non-poor would pay for retail dental anyway, but they also mostly have insurance.

The end result is still broken for nearly a quarter of americans and could be fixed with state sponsored care. That dental care is tolerated to be this way is not a good argument for free markets in healthcare working, to me at least.

Re: Congress is set to ban most surprise medical bills

#423

Post by dang » Wed, Dec 23, 2020, 12:59 AM UTC

curiousgal wrote: post #21

lordnacho wrote: post #11

> Surprise bills happen when an out-of-network provider is unexpectedly involved in a patient’s care. Patients go to a hospital that accepts their insurance, for example, but get treated there by an emergency room physician who doesn’t. Such doctors often bill those patients for large fees, far higher than what health plans typically pay. How do courts uphold this? You go to a restaurant, they say you can buy the tas…

It's just appalling to see a nation as smart, rich and well accomplished as the U.S. being straight up retarded when it comes to healthcare.

Nationalistic flamebait is not allowed here, regardless of country. You've posted like this before, too (https://news.ycombinator.com/item?id=25016561) — that's not ok on this site, so please don't do it again. We're trying to avoid the tedious, nasty flamewars this kind of thing leads to.

https://news.ycombinator.com/newsguidelines.html

Re: Congress is set to ban most surprise medical bills

#424

Post by Moodles » Wed, Dec 23, 2020, 1:56 AM UTC

henrikschroder wrote: post #319

Moodles wrote: post #202

As an immigrant coming to America, honestly the most shocking and surprising thing (apart from the state of homeless in San Francisco being tolerated as normal) is the medical care expenses. How on Earth is it that I can walk into a doctor's office or hospital to get medical treatment and have no idea how much it's going to cost? $10? $100? $1000? Who knows. I had an ear infection once, went to the doctor who looked…

It's pretty tragic that there are so many people like you and me, immigrants who have experienced several different healthcare systems, and we can all testify that the US system sucks on every level compared to other systems. And yet, there's a huge amount of Americans who have only ever lived in the US, who are certain the US system is the best in the world, and who believe all the scary stories that are designed to…

I wouldn't say it sucks on every level. The actual quality of care is usually good.

Re: Congress is set to ban most surprise medical bills

#425

Post by Moodles » Wed, Dec 23, 2020, 1:56 AM UTC

93po wrote: post #351

Moodles wrote: post #208

Earlier quoted context omitted.

As an immigrant coming to America, honestly the most shocking and surprising thing (apart from the state of homeless in San Francisco being tolerated as normal) is the medical care expenses. How on Earth is it that I can walk into a doctor's office or hospital to get medical treatment and have no idea how much it's going to cost? $10? $100? $1000? Who knows. I had an ear infection once, went to the doctor who looked…

It's safe to assume talking to a doctor is a minimum of $400. Any labs or testing, another $400. Surgery starts in the thousands. Life saving care is the same cost as a house.

It's not though. Sometimes a simple visit is like $20 or even free.

Re: Congress is set to ban most surprise medical bills

#426

Post by 93po » Wed, Dec 23, 2020, 5:29 AM UTC

Moodles wrote: post #425

93po wrote: post #351

Earlier quoted context omitted.

It's safe to assume talking to a doctor is a minimum of $400. Any labs or testing, another $400. Surgery starts in the thousands. Life saving care is the same cost as a house.

It's not though. Sometimes a simple visit is like $20 or even free.

If you have insurance that doesn't have a deductible or it's preventative care, sure. I'm talking paying cash or insurance with high deductible

Re: Congress is set to ban most surprise medical bills

#427

Post by rudnevr » Wed, Dec 23, 2020, 4:07 PM UTC

newen wrote: post #383

cogman10 wrote: post #199

Earlier quoted context omitted.

Yup! And what will you do about it anyways? Like "Oh, you need xyz, it will cost $1000" Ok. Now that I know that, what am I supposed to do? Shop around? What if I'm in the emergency room, what then? Are they supposed to give me a price menu for every single drug or treatment they need to perform against me? "Hey, we'll do CPR, but that'll will be $100, please sign here so we can save your life". The ala cart method s…

For some perspective, I’m pretty sure there are a lot of non-Americans reading this thread amazed at just how comical current US thinking around healthcare has become.

Absolutely. By the way, in most cases you don't have to bill it at all, because the actual cost is negligible.

Re: Congress is set to ban most surprise medical bills

#428

Post by kristopolous » Thu, Dec 24, 2020, 2:38 AM UTC

conanbatt wrote: post #406

8note wrote: post #402

Earlier quoted context omitted.

Having capital is power though, so by that logic, having capitalists in a free market causes market failures

Power is being used very loosely here. The power to use violence is very difference to the "power" you get from producing something that is so good that gives you a lot of leverage. The best way to beat a company that has market power is with other companies that fight in the same space or around it. And if there is one last man standing to reap profits from the victory, its again not necessarily bad. Market monopoli…

Nonsense. The absolutely last thing a company wants to do is compete. They avoid competition at all costs.

The first instinct is to buy, then shut it down, then smother it out with sheer capital, then retreat either up or downmarket.

That's why when you go in to the supermarket to look at commodities, they're often owned by either 1 or 2 companies that are mutually invested in each other.

You see a bunch of brands, but the capital ownership structure is almost entirely consolidated. Better products get dragged to court by existing players who try to shut them down or legislatives get greased palms for new regulations ("protected" terms).

In instances where this can't happen there's cartel systems which is why the dominant grocery store changes city by city.

The Austrian model of how humans work is dead wrong, how markets work is dead wrong, how capital flows is dead wrong, they're just wrong wrong wrong.

That's why they never use any examples and only have theoretical exercises, because there's absolutely zero evidence for their claims. Any observation of reality would show they're incorrect in a multitude of ways at every step.

That's why when you look at economics texts before the classical liberalism hubris, it is full of actual historical events, actual earnings and economic history to use as evidence and it's why the Chicago quacks had to tear those parts out, because their ideas don't work when you look at reality. If you look at evidence, their theories don't agree with it. They know this and that's why they don't use anything more than broad non-specific folksy anecdotal stories, because narrative fiction is the closest thing to reality they can get.

Re: Congress is set to ban most surprise medical bills

#429

Post by golergka » Thu, Dec 24, 2020, 9:42 AM UTC

iaw wrote: post #100

jsperson wrote: post #13

That it takes such effort to pass a bill like this - 80% public approval, banning a clearly predatory practice, has turned me from a pure free market thinking into a believer in single payer healthcare. The free market just doesn't work when there is very little elasticity in consumption. I've been on the receiving end of a $15K air ambulance bill (thankfully covered by insurance) as well as the out of network specia…

> has turned me from a pure free market thinking into a believer in single payer healthcare The current trend in 'free-market economics' is to call captured markets free and then argue for the relatively lax regulation. Most markets are not free markets and the healthcare definitely isn't. There's very little true choice, participants are typically under duress when seeking expensive services, and prices are hidden.…

> participants are typically under duress when seeking expensive services

I'm not from US and don't have personal experience with american health system, but that would only be true if you start shopping for medical insurance when you already have broken your leg.

If you behave as a responsible adult and choose a hospital to register to, or an insurance provider to take care of you, beforehand, how are you under any kind of duress?

Re: Congress is set to ban most surprise medical bills

#430

Post by nickpp » Thu, Dec 24, 2020, 9:57 AM UTC

kaibee wrote: post #312

gregario wrote: post #192

Earlier quoted context omitted.

It's the regulations / limitations you are proposing that make it possible/likely that a monopoly will form. See Milton Friedman on this. There's basically no example of a monopoly forming outside of government regulation.

> There's basically no example of a monopoly forming outside of government regulation. Facebook has a monopoly on the social network.

TikTok, Twitter, LinkedIn and pretty much every forum and IM network.