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

The Amish health care system

slatestarcodex.com

Post reply on HN
Print view View original

61–70 of 327 posts

Re: The Amish health care system

#61

Post by notyourday »

FearNotDaniel wrote: post #56
notyourday wrote: post #49

Earlier quoted context omitted.

> ...the Amish are honorable customers. This separates them from insurance companies, who are constantly trying to scam providers however they can. Much of the increase in health care costs is “administrative expenses”, and much of these administrative expenses is hiring an army of lawyers, clerks, and billing professionals to thwart insurance companies’ attempts to cheat their way out of paying. If you are an honora…

> If they’re healthier, why is their life expectancy lower? Possibly they are less interested in prolonging life than we are. R&D write: > Amish people are more willing to stop interventions earlier and resist invasive therapies than the general population because, while they long for healing, they also have a profound respect for God’s will. This means taking modest steps toward healing sick bodies, giving preferenc…

"little", "slightly" and "less" is significantly under-emphasizing how gigantic is the gap between what an average ( even average poor ) person living in Lancaster expects in terms of healthcare and an Amish family living around Lancaster expects in term of healthcare.

Re: The Amish health care system

#62

Post by nsxwolf »

GuiA wrote: post #21
daenz wrote: post #14

>How do the Amish keep costs so low? R&D (plus a few other sources) identify some key strategies. >...the Amish are honorable customers. This separates them from insurance companies, who are constantly trying to scam providers however they can. Much of the increase in health care costs is “administrative expenses”, and much of these administrative expenses is hiring an army of lawyers, clerks, and billing professiona…

> Imagine how many social problems would disappear if people had more integrity and stronger morals. Literally every aspect of life would improve. Granted, everyone in the world is suddenly moral and of utmost integrity and everyone gets used to this new reality. The economic upside in lying/cheating is now so high that a few minutes later the world is back to exactly what it was, except for the first few persons to…

I think the public school system has the Catholic Church beat in that regard, if you categorize it as a single organization.

Re: The Amish health care system

#63

Post by SamReidHughes »

jpab wrote: post #54
bluejekyll wrote: post #12

“ The Amish have had a life expectancy in the low 70s since colonial times, when the rest of us were dying at 40 or 50. Since then, Amish life expectancy has stayed the same, and English life expectancy has improved to the high 70s.”

I found that curious. Why were the Amish living so much longer than others in colonial times?

Less exposure to disease.

Re: The Amish health care system

#64

Post by robocat »

hateMyIdeas wrote: post #26
refurb wrote: post #9

Earlier quoted context omitted.

That's what some universal systems already do. I was reading up on Singapore. There is a baseline of insurance for hospital stays, but it's in a ward with 6 other patients in the same room. If you want something better (and there are tiers), you pay more. You can buy insurance policies that pay for the more comfortable stay.

That's not how insurance works, expensive insurance has a lower max out of pocket. What you are talking about is that rich people don't need insurance at all. They just pay out of pocket.

That is how health insurance works in New Zealand.

If you want private health insurance for say $50 a month[1], then insurance gives access to procedures more quickly and the rooms are much nicer than the public health care system. It may give access to rare but expensive procedures.

If you don’t want insurance, then the default is the public healthcare system, which is paid for by taxes. You will usually be in a ward with other patients. You pay small amounts on use (to prevent abuse, and even those amounts are reduced to nearly free if you are poor). The level of care is reasonable, but can be slow for non-urgent elective surgery, and extremely expensive procedures are not available. The public healthcare system handles ongoing chronic conditions much better than a private system could.

[1] You can see a quote from https://www.southerncross.co.nz/ if you give your age, gender and tick whether you smoke. Note that Southern Cross is a nonprofit co-op, most premiums get returned to members (on average, less an approx 10% administrative overhead).

Re: The Amish health care system

#65

Post by markdown »

prime_factor wrote: post #15
markdown wrote: post #13

Earlier quoted context omitted.

The same in Fiji. We have universal health care, but anyone is of course free to forego that and pay (or use their private insurance) for a private room rather than a ward, or just go to a private hospital instead. I don't understand the debate about this in the US. It's as if the rich assume that things will change for the worse for them if universal health care is enacted.

What about middle class people who can't afford private care but fear that the socialized healthcare system will be of worse quality than what they currently have?

Perhaps they should be taught about capitalism.

If there is demand for private healthcare affordable to the middle class, the demand will be met with supply.

And if that fails, they should be taught about democracy.

That if it turns out that socialised healthcare doesn't work for most Americans most of the time, then the country can revert to the system it currently has.

Re: The Amish health care system

#66

Post by TheCoelacanth »

nsxwolf wrote: post #62
GuiA wrote: post #21

Earlier quoted context omitted.

> Imagine how many social problems would disappear if people had more integrity and stronger morals. Literally every aspect of life would improve. Granted, everyone in the world is suddenly moral and of utmost integrity and everyone gets used to this new reality. The economic upside in lying/cheating is now so high that a few minutes later the world is back to exactly what it was, except for the first few persons to…

I think the public school system has the Catholic Church beat in that regard, if you categorize it as a single organization.

"The public school system" is not an organization. It is thousands of organizations.

Re: The Amish health care system

#67

Post by maxerickson »

foolinaround wrote: post #57

one major reason why our health insurance is high is because of its wide scope. When you take car insurance, it does not pay for oil changes, tire repair etc, since these are considered regular maintenance. If you don't do this, then your car will fall apart faster and again, you are on your own... Not a straight analogy, but if we make people pay on their own for regular visits, mandate tha they must visit a doctor…

Regular office visits don't cost much to provide.

They are sort of like paying to fix chips in windshields, if you want an analogy.

(The actual billed cost for those sorts of visits is ~$100, which doesn't add up very fast compared to ER visits or any sort of complex care)

Re: The Amish health care system

#68

Post by specialist »

jay_kyburz wrote: post #44
daenz wrote: post #14

>How do the Amish keep costs so low? R&D (plus a few other sources) identify some key strategies. >...the Amish are honorable customers. This separates them from insurance companies, who are constantly trying to scam providers however they can. Much of the increase in health care costs is “administrative expenses”, and much of these administrative expenses is hiring an army of lawyers, clerks, and billing professiona…

No, what we should do is build our systems so that human nature is taken into consideration. There will always be good and bad people. Medical pricing should be simple, upfront and direct. It should not require lots of clerks and "billing professionals" It shouldn't required armies of expensive lawyers to settle disputes. Whether the bill was not paid by the customer, or the doctor failed to deliver what the customer…

Yup. I first learned this from Donald Norman's Design of Everyday Things. Try to apply that heuristic to all my efforts.

Re: The Amish health care system

#69

Post by paulryanrogers »

lqet wrote: post #25
daenz wrote: post #14

>How do the Amish keep costs so low? R&D (plus a few other sources) identify some key strategies. >...the Amish are honorable customers. This separates them from insurance companies, who are constantly trying to scam providers however they can. Much of the increase in health care costs is “administrative expenses”, and much of these administrative expenses is hiring an army of lawyers, clerks, and billing professiona…

> [Nobel laureate Steven Weinberg] once said, "Religion is an insult to human dignity. With or without it, you’d have good people doing good things and evil people doing bad things, but for good people to do bad things, it takes religion.” To which Freeman Dyson remarked, “Weinberg’s statement is true as far as it goes, but it is not the whole truth. To make it the whole truth, we must add an additional clause: ‘And…

> And for bad people to do good things – that takes religion.

Clever retort. But even if proven true somehow is it the religion that made the bad do good or agreed upon ethics with consequences for those who broke them? Must it include belief in some unprovable future consequence?

Re: The Amish health care system

#70

Post by specialist »

daenz wrote: post #14

>How do the Amish keep costs so low? R&D (plus a few other sources) identify some key strategies. >...the Amish are honorable customers. This separates them from insurance companies, who are constantly trying to scam providers however they can. Much of the increase in health care costs is “administrative expenses”, and much of these administrative expenses is hiring an army of lawyers, clerks, and billing professiona…

Who are the scammer's in this thesis?
Post reply on HN