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I write about America’s health care system, and I got caught up in it

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Re: I write about America’s health care system, and I got caught up in it

#91

Post by nine_zeros »

agumonkey wrote: post #83
nine_zeros wrote: post #66

Earlier quoted context omitted.

I highly recommend healthcare in Asia. In most asian countries, healthcare is pure market driven. Aka, most people are uninsured so there is no insurance bureaucracy. No contracts, no lawsuits. The reputation of service and doctors matters. Appointments for this afternoon? No problem, you got it. American healthcare is what I would wish on my enemies.

All asian countries ? china ? japan ? india ? Any book about their systems ?

Systems and prices vary between countries. No idea if there's a book but my experience in Indonesia, India and Vietnam was stellar. Working with a medical facility was as simple as doing something in a mall.

If you are going from America, you can't go wrong in any major Asian country. India has the benefit of having English speaking doctors.

Re: I write about America’s health care system, and I got caught up in it

#92

Post by tragictrash »

convolvatron wrote: post #84
throwaway6734 wrote: post #64

Earlier quoted context omitted.

This is an overly paternalistic point of view that robs these people of their agency. They've spent their lives participating and interacting within the current political framework. Blaming all problems at the feet of "morally bankrupt leaders" is hyperbolic populist rhetoric to absolve personal responsibility.

sounds they they should have had a better investment strategy when they were working. some people.

Really hoping that's sarcasm

Re: I write about America’s health care system, and I got caught up in it

#93

Post by Auracle »

Auracle wrote: post #89
kemiller2002 wrote: post #38

Earlier quoted context omitted.

It's because a lot of times the doctors know it isn't going to work on the outset. A number of generics don't work exactly the same. You're punishing the patient and questioning the expert simply for the fact that the insurance company (or the government in the case of geriatrics) might save a few dollars.

It can also just be a matter of convenience. When I was first put on testosterone I was prescribed AndroGel, which is a gel you out on once daily. It costs $400 a month. Insurance gave a bit of hassle but with my test numbers they acquiesced. They shouldn’t have, though. Injections (what I’m on now) work better. They’re easier to maintain the correct dose, you don’t have to worry about getting it on your partner/kids…

As I was looking up current AndroGel prices I discovered there’s now a twice daily pill. That’s even more convenient than a gel!

Too bad it’s $1,000 a month. We’re all paying that so people can avoid sticking themselves with a needle.

Re: I write about America’s health care system, and I got caught up in it

#94

Post by civilized »

lotsofpulp wrote: post #85
civilized wrote: post #78

Earlier quoted context omitted.

Sort of. You get to initiate a fight with the insurer through an unaccountable arbiter. Insurer websites have lied to us in the past, claiming X was in network (zero cost!) and then sending us a denial resulting in a giant out of network bill for that exact X. Same service, same provider. Truly incompetent and evil system. Fills me with rage.

That is ridiculous. I have not had such blatant negligence / corruption happen to me yet.

The worst part is we only got this service because it was represented to us as free. It was a genetic test that was nice to have but not strictly necessary. We would not have gotten it if we'd known we would be billed $6k.

Now I feel like I will have to screenshot and archive every digital representation that is made to us about whether X will be covered and be prepared to initiate a lawsuit over it.

In the meantime we will simply not be paying the bill. I've been thinking about doing this for many other medical bills we receive as well. It's all so arbitrary and uncontrollable. I simply don't feel I have an obligation to pay a bill in a made-up amount for made-up reasons I have nothing to do with.

I am a very reliable bill payer and normally see it as a basic matter of personal responsibility, but this broke me.

Re: I write about America’s health care system, and I got caught up in it

#95

Post by nine_zeros »

coffeefirst wrote: post #88
nine_zeros wrote: post #37

Price aside, the biggest problem with American health care system is the administrative black hole at every stage. Wife was on some serious (and expensive) medical treatment. After many months, the medical provider was at the final stages of the treatment. As usual, the provider needs insurance approval for arcane codes that constitute that segment of the treatment. Get this, the medical provider applies for approval…

And to make matters worse, all this bureaucratic nonsense for coding, billing, authorization costs a stupidly large amount of money that gets baked back into the bills somewhere.

Oh yes, you get to pay $500/mo insurance premiums and $2000 deductible and lots of copays for the privilege of using this masochistic system.

Re: I write about America’s health care system, and I got caught up in it

#96

Post by lotsofpulp »

lil_dispaches wrote: post #54

Health Insurance is a political scam of epic proportions. There is no indemnity involved. It is not real insurance. You don't use insurance to pay a monthly bill, you have it for black swan events. Nor should insulin be 1000/mo, on paper or otherwise. The whole thing is performance politics to distract from the "insurance" companies running everything from medicine regulations to your kids playgrounds (so they don't…

> The whole thing is performance politics to distract from the "insurance" companies running everything from medicine regulations to your kids playgrounds (so they don't hurt themselves and need care).

This is also a consequence of our legal/tort system. At one of my business, a person claims to have stepped on a landscaping rock and damaged their ankle or knee or something. They took pictures of this roughly 2in x 2in x 2in rock in the parking lot, maybe a foot away from the curb that separated the landscaping rocks and the parking lot surface.

This lawsuit has been going on for 3 years now, and I can only assume $10k+ in lawyer time has been spent asking the employees if they saw a rock there and when they last checked the parking lot to see if it was clear of rocks, etc.

With the courts accepting cases like these, and businesses needing to protect themselves from cases like these, it is no wonder as a society, we end up wrapping ourselves in insurance. Specifically in this case, the person or family suing has been found to have a history of these types of lawsuits. And yet still, the case drags on.

Re: I write about America’s health care system, and I got caught up in it

#97

Post by refurb »

kemiller2002 wrote: post #38
refurb wrote: post #31

Earlier quoted context omitted.

Why is that broken? Even systems with universal healthcare have rules like this. Why use a $1000 per month branded drug unless you know the $5 per month generic drug doesn’t work?

It's because a lot of times the doctors know it isn't going to work on the outset. A number of generics don't work exactly the same. You're punishing the patient and questioning the expert simply for the fact that the insurance company (or the government in the case of geriatrics) might save a few dollars.

No, sorry “the doctor knows it won’t work” is complete BS.

We don’t spend 100x on a drug because a doctor “has a feeling”.

The insurance requirements are typically quite limited for 1st line failures. Doctor just needs to prescribe then 2 weeks later attest that it didn’t work.

Seems reasonable to save the healthcare system thousands of dollars when tens of dollars would do?

Re: I write about America’s health care system, and I got caught up in it

#98

Post by tiahura »

syki wrote: post #56
refurb wrote: post #31

Earlier quoted context omitted.

Why is that broken? Even systems with universal healthcare have rules like this. Why use a $1000 per month branded drug unless you know the $5 per month generic drug doesn’t work?

In all healthcare systems some form of rationing occurs since there aren’t enough resources to provide the best care to everyone. A system that rations care based on ability to pay or on wether or not your employer is generous is immoral. It is also immoral to profit off of denying someone care. Tough decisions have to be made and financially rewarding a company by denying care is despicable.

Right. The rationing should be based on ability to lobby, and the decisions should be made by politicians and agency bureaucrats.

Re: I write about America’s health care system, and I got caught up in it

#99

Post by throwaway6734 »

tragictrash wrote: post #74
throwaway6734 wrote: post #64

Earlier quoted context omitted.

This is an overly paternalistic point of view that robs these people of their agency. They've spent their lives participating and interacting within the current political framework. Blaming all problems at the feet of "morally bankrupt leaders" is hyperbolic populist rhetoric to absolve personal responsibility.

Sounds like the morally bankrupt trying to defend themselves.

What's your ideal healthcare situation and how do we get there from the current one?

Broad platitudes like "everyone should have access to healthcare" doesn't count

Re: I write about America’s health care system, and I got caught up in it

#100

Post by beerandt »

andi999 wrote: post #65
BobbyJo wrote: post #61

Earlier quoted context omitted.

> A system that rations care based on ability to pay... is immoral. You lost me there. What makes it immoral? Money is an asset allocation tool, so why is it morally wrong to use it for medicine the same way we do for food and housing? Genuine question. I have a hard time understanding what sets medicine apart from everything else when people think healthcare should be universally free, but not food, water, clothing,…

The demand price curve is different. If housing gets more expensive you could (although) difficult move into a smaller apartment, or different region. (Similiar with food up to a certain amount). This allows the market to find the best/right price by supply and demand. (I think this is called inelastic demand) If you have cancer though than basicall the market cannot find a price, and it would tend towards to: 'give…

Medical prices being inelastic (to the extent they are) has much more to do with medicare/medicaid/FDA regulations, govt & insurance allowable reimbursement rate lists, and costly govt requirements to even participate in a govt funded plan (like electronic medical records).

Proof? Services not typically covered, like plastic surgery or cosmetic dermatology. Clearly listed and even advertised prices for their services, openly discussed up front.

But if the govt reimbursement rate for an annual checkup is $x, why would anyone need to list that price up front, or have reason to ever charge any less?

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