It would be interesting to compare prices with countries with free government sponsored medical care. In NZ I know they work out the cost, and if you aren't a resident/citizen you have to pay the bill.
What I learned from reading a thousand emergency room bills
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Re: What I learned from reading a thousand emergency room bills
#72Reading this article and seeing all the startups sprouting in the field of health care and medicine tells me that there's still a lot more areas to innovate and disrupt in this industry. One big issue though are that lobbyists who wanted to keep prices high - to squeeze in as much profit as they can out of these. Drugs, Antibiotics, Procedures, Medical Professionals. I know it would be far-fetched to standardize and…
One way to disrupt the industry might be to have everyone be in one giant insurance pool, perhaps paid for via taxes, and then give everyone access to health care via some kind of non-profit entity. Sounds crazy, right? It worked well for my family and I during the many years I spent in Italy, which has health care costs that are something like half of what they are in the US in terms of GDP.
Yup, it's worked nearly all over the modern world, for years and years. The last thing I want in healthcare is more startup maniacs trying to "disrupt and innovate" when there is a clearly viable alternative.
Re: What I learned from reading a thousand emergency room bills
#73Earlier quoted context omitted.
Because, then the single payer, can say "your policies/prices don't work with our system", fix it, or we won't cover any patients, effectively shutting you down.
What is stopping insurance companies from doing that now? If you're paying for insurance, it's in your insurance company's best interest to pay low prices.
A recent episode of An Arm and a Leg podcast explains this pretty well (https://armandalegshow.com/why-health-insurance-actually-suc...). In many areas of the US, health networks are effectively local/regional monopolies and can pick and choose which insurance providers they accept. So there is effectively a "single seller" system for services that are in high demand.
Re: What I learned from reading a thousand emergency room bills
#74Earlier quoted context omitted.
I must admit I'm skeptical of the claim that "only government can negotiate a better price"... I think anyone that's worked on government systems knows that is not typically the case. Why wouldn't insurers argue for better prices now?
It works in 36 out of 37 modern OECD nations, with the US paying the most, and more than double all the other nations which have the government negotiate a better price. Even in our own VA system, their negotiated prices are lower for drugs than the Medicare part D program, barred from negotiating (and with large pieces managed by private companies). I think your skepticism should primarily be directed to wondering i…
> It works in 36 out of 37 modern OECD nations
The rest of the OECD has universal healthcare, but not necessarily fully public healthcare (the model vary considerably.)
Which just means that there are lots of good proven models that the US could adopt.
Re: What I learned from reading a thousand emergency room bills
#75Earlier quoted context omitted.
Exact same thing happened to my friend. He did all his research, and while he was under anesthesia a nurse assisted that was out of network. $5k out of pocket. He ended up getting it removed after some run around between insurance and the hospital.
Today is "don't believe the comments day" it seems. How is an unconscious person meant to be stop an "out of network" nurse assisting? Is there a tattoo that you can get?
I think OP meant he was able to get the extra $5k removed from the bill after the fact.... not the nurse removed from the operating room.
Re: What I learned from reading a thousand emergency room bills
#76Earlier quoted context omitted.
Exact same thing happened to my friend. He did all his research, and while he was under anesthesia a nurse assisted that was out of network. $5k out of pocket. He ended up getting it removed after some run around between insurance and the hospital.
Today is "don't believe the comments day" it seems. How is an unconscious person meant to be stop an "out of network" nurse assisting? Is there a tattoo that you can get?
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Re: What I learned from reading a thousand emergency room bills
#77It makes me sad that there are places in the world where people have to pay to go to an emergency doctor. I know it’s a political hot topic but all that aside doesn’t most people deep down inside think that every fellow human should have the right to free doctor?
Re: What I learned from reading a thousand emergency room bills
#78I'm not an advocate of government paid health care, but hospitals and medical providers should see that this train is coming and if they don't become more transparent it's going to be forced upon them. I don't have a problem with ER care being more expensive -- that isn't necessarily unreasonable when you are getting care in an expensive facility open 24x7, fitted out with equipment to handle any possible medical eme…
Doesn't have to be government _paid_, just regulated. Literally saying "you can't charge more than X for service Y". It isn't unprecedented either, see taxi tariffs in some areas.
Re: What I learned from reading a thousand emergency room bills
#79Earlier quoted context omitted.
The party responsible for payment (the government, in this case) can tell a billing party "I won't pay you more than ___ for that service, and if you don't like it, you can sue me" without taking on the same risk that an individual would. Lawsuits are a pretty inefficient, high-overhead way to bill out, so billing parties are incentivized to not raise accountants and auditors eyebrows.
I must admit I'm skeptical of the claim that "only government can negotiate a better price"... I think anyone that's worked on government systems knows that is not typically the case. Why wouldn't insurers argue for better prices now?
I'm getting into hand-wavey territory here, IANAprofessional in a related discipline, etc., and my personal leaning is towards socializing public services such as medicine already. So disclaimed...
I think "only (any large organization) can negotiate a better price" is a little misleading on the surface. On a macro level it should, in theory, be true, and should already be happening with private insurers; when I've looked at my own EOBs, they consistently will list a service, a coding, a billed price, an "allowed" price that is always much less than the billed price, and the amount paid (which predictably matches the "allowed" price). And yeah, when we're watching politicians pontificate, we end up having strong opinions about the total price of healthcare and its effect on the economy.
That said, does anyone _really_ make personal healthcare decisions based on the macro effect on the economy? I personally doubt it.
I posit that the vast majority of US citizens and residents wouldn't care if the annual healthcare spend changed by US$200 million, but any individual American cares A WHOLE LOT if you bill them personally for US$100,000 and their insurance doesn't cover it (or much of it).
It seems to me that a much better approach to this entire conversation is "let's drastically reduce the number of Americans forced into bankruptcy because they or their dependent got sick". My own inclination is that that'll require government intervention, because the incentives for a for-profit insurance company are to pay out as little as possible, but I'm open to anything that addresses that problem.
Re: What I learned from reading a thousand emergency room bills
#80I'm not an advocate of government paid health care, but hospitals and medical providers should see that this train is coming and if they don't become more transparent it's going to be forced upon them. I don't have a problem with ER care being more expensive -- that isn't necessarily unreasonable when you are getting care in an expensive facility open 24x7, fitted out with equipment to handle any possible medical eme…
I was not an advocate for gov't health care, but I am now for the same reason you stated. I have a high deductible plan, and have tried to get quotes in advance, but never can. I have been ripped off multiple times, despite trying to do my research, etc. My wife is a doctor, and at this point, I think single-payer is the least bad option.
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 to talk to our billing department, and they probably can't tell you anything until the doctor is finished."
I am now firmly in the single payer camp. Medicare for All, I guess. To the insurance companies and medical billing industry, and even doctors, I say: "Sorry, not sorry, when this train comes through try to remember you did it to yourself."