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

581–590 of 592 posts

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

#581

Post by taysic »

ip26 wrote: post #294
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.

Forget about obtuse billing, how is anyone expected to perform price discovery while unconscious (& being rushed to the hospital)?

You buy your insurance package ahead of time. Competition in the free market will cause ins providers to provide the best, most comprehensive plans.

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

#582

Post by taysic »

ttcbj wrote: post #248
rootusrootus wrote: post #80

Earlier quoted context omitted.

I find myself in the same boat. I've spent more from my HSA this year than I put into it (and I put in $6900) while I'm nowhere near hitting my deductible ($6K) because for whatever reason the insurance only thinks I've spent $2.7K. During this time I've tried to shop around, find the least expensive option (none of my medical needs this year have been urgent) and it's been impossible. Nobody can tell me. "You'd have…

For the record, this is exactly how I feel. They did it to themselves. I really believe in free markets, and I really see the downsides of gov't intervention, but my direct experience with this particular market says we'd be better off with the gov't.

Your current experience is of a highly regulated system with dwindling options and a lot of unintended consequences that weren’t thought through with the existing regulation - it is more similar to socialized care than the free market.

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

#583

Post by tgsovlerkhgsel »

pitaj wrote: post #246
tgsovlerkhgsel wrote: post #62

Want to do something about it? Regulate it. Like literally, have some government body write a table: 1 pill of 400 mg paracetamol ............ $0.50 1 pill of 800 mg paracetamol ............ $0.60 prescribing medicine (once per day) ..... $4.32 base fee for an ER visit .............. $200.00 5 minutes of work by an ER physician ... $27.43 etc. and impose that as the maximum price that can be charged. It's not going t…

Ah yes, price controls. This has never resulted in problems like shortages before.

Seems to work reasonably well in several European countries (I believe Switzerland has this, Germany at least partially also does).

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

#584

Post by tdsamardzhiev »

bogle wrote: post #470
tdsamardzhiev wrote: post #391

Earlier quoted context omitted.

To get an absence note for school/work? To make sure it's a common cold?

For a cold, just wait a week or two. There's nothing medicine can do for you anyway. If it's still there, then it's worth checking. Also, you shouldn't need a sick note unless you are off for more than a week (your legislative framework may vary).

Wait a week or two? That's what they told to my father in the military some 40 years ago. He's still fighting the consequences of that pneumonia.

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

#585

Post by kwhitefoot »

conanbatt wrote: post #518
kwhitefoot wrote: post #456

Earlier quoted context omitted.

Works in this context in several European countries. Switzerland for instance has compulsory insurance schemes where the prices are regulated and the insurer cannot refuse to insure.

I'd be surprised to hear of a case where price controls work, since it would go contrary to the core tenets of micro-economics. Do you have a link where I could read your source about this?

Just search the web. For instance DDG

https://duckduckgo.com/?q=Switzerland+compulsory+health+insu...

gives this as the first hit:

https://www.ch.ch/en/basic-health-insurance-services/

There is also this from a non-Swiss point of view:

https://www.expatica.com/ch/healthcare/healthcare-basics/hea...

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

#586

Post by Broken_Hippo »

ThomPete wrote: post #575
Broken_Hippo wrote: post #571

Earlier quoted context omitted.

*That's because you havne't considered how big the US is and you haven't considered that the US is mostly a land of immigrants not a land of people who lived their almost all their lives for several generations." I'm American. The first one is easy enough to consider. I can drive to Sweden in the same or less time than it would have taken me to get out of Indiana. I know it is big. I just don't see how that is an exc…

You are missing two important things here. Homogenous and small. These countries are homogenous which also means politically. You will be hard pressed to find any real fundamental political differences between parties in the scandinavian countries. They are all on the left side of Sanders. Furthermore, it matters quite a lot that you are dealing with a fairly limited population who all suffers from more or less the s…

Again, I don't see the size as anything but an excuse against it. Surely in the US, it would have to be adapted to different areas' populations. I'm not convinced Indiana is so much less homogenous than, say, Sweden. They are definitely not all on the left side of Sanders.

And again keep in mind the Scandinavian countries have budgets which means that you can't always get the treatment you want/need even if you had the money.

I don't know where you get this sort of information. I will never not be able to afford my medication. I broke my arm and got immediate, affordable treatment and had paid time off work even though my job was seasonal. In the US, with insurance, I would have struggled, not only with hospital bills, but with work. If you have an issue that they cannot treat in the country, you can travel outside of the country for treatment. Even if you are poor and have no money - the state does that. There are private hospitals and clinics around - if you have money, you can use them. They aren't always that much more expensive and the waiting period for non-emergency stuff is less.

The bottom line is that you are against a single payer system. That's fine, be honest, but please make sure your actual facts are facts instead of things people hear.

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

#587

Post by ThomPete »

Broken_Hippo wrote: post #586
ThomPete wrote: post #575

Earlier quoted context omitted.

You are missing two important things here. Homogenous and small. These countries are homogenous which also means politically. You will be hard pressed to find any real fundamental political differences between parties in the scandinavian countries. They are all on the left side of Sanders. Furthermore, it matters quite a lot that you are dealing with a fairly limited population who all suffers from more or less the s…

Again, I don't see the size as anything but an excuse against it. Surely in the US, it would have to be adapted to different areas' populations. I'm not convinced Indiana is so much less homogenous than, say, Sweden. They are definitely not all on the left side of Sanders. And again keep in mind the Scandinavian countries have budgets which means that you can't always get the treatment you want/need even if you had t…

You know nothing about me.

It sounds like you don't want to see the problem which makes it hard to have any discussion.

The size is a problem given that you would need to be able to offer consistent care across the nation this is exactly the kind of problems that single payer systems deal with. They are an actual problem in the scandinavian countries and these countries are small. Federal is federal.

I am not against a single-payer system. I grew up with one as I am Danish so I want a single-payer system. Especially as I have been having 2 melanomas and might likely get more and live in the US. I just wont work here and I won't be able to get the kind of care that I get now.

I know both systems pretty well that's where I get that information from I been living in both and experienced both.

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

#588

Post by bumby »

vec wrote: post #576
bumby wrote: post #564

Earlier quoted context omitted.

I see your point if the term profit is defined in a general sense, but with the exception of "corporations as people" caveat there's plenty of everyday examples where people are trying to maximize outcomes other than capital (sometimes at the expense of capital). I'm not sure that makes it any less of a free market

It does. There's no free market for soup kitchens for the homeless, for example. There exist entities who are willing to provide soup kitchen services below operating costs in perpetuity (i.e. charitably, for free). The price for services is kept artificially low ($0) by constant infusions of capital from outside the market (charitable donations), which prevents for-profit vendors who don't receive constant cash infu…

You illustrate the point well and maybe I'm just not well versed enough in the topic. You imply that a charity warps the free market by undercutting profit-motivated competitors but in the last statement you give the vendors the freedom of choice in regards to their customers. Is there any reason why this same freedom of choice can't be extended to people who choose a specific social outcome at the cost of less (or nil) profit? For example, are B-Corps fundamentally less "free market"? Or does the very nature of free market imply a profit maximizing function? As an example that comes to mind, I'm curious how not-for-profit and for-profit hospitals interact in a "free market" of healthcare in the United States.

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

#589

Post by conanbatt »

kwhitefoot wrote: post #585
conanbatt wrote: post #518

Earlier quoted context omitted.

I'd be surprised to hear of a case where price controls work, since it would go contrary to the core tenets of micro-economics. Do you have a link where I could read your source about this?

Just search the web. For instance DDG https://duckduckgo.com/?q=Switzerland+compulsory+health+insu... gives this as the first hit: https://www.ch.ch/en/basic-health-insurance-services/ There is also this from a non-Swiss point of view: https://www.expatica.com/ch/healthcare/healthcare-basics/hea...

At 450EU a month, i would not this a success of "price controls".

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

#590

Post by ncallaway »

conanbatt wrote: post #519
namdnay wrote: post #461

Earlier quoted context omitted.

No, the single payer portion doesn't have to compete with other plans. The other plans supplement the single payer insurance. E.g. single payer will cover everything up to a certain amount, and then you can buy a private plan to bring that amount higher, or maybe cover non-essential extras.

Ofc you can invent an infinite amount of models, and Sanders has not specified which one clearly yet afaik. In the case that Medicare is expanded and is optional, medicare will have the following fair challenges: it has to compete with other private insurances, which means is has to pay as much, and any administrative cost dissipates, in fact it gets worse, as providers still have to do multiple billing. If it has to…

> Sanders has not specified which one clearly yet afaik.

That's absolutely not true.

https://www.congress.gov/bill/115th-congress/senate-bill/180...

Post reply on HN