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The Man Who Was Treated for $17,000 Less

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Re: The Man Who Was Treated for $17,000 Less

#91

Post by ahallock »

specialist wrote: post #73
cromwellian wrote: post #27

A month ago, I was traveling in Germany with my family and my daughter had an emergency, so I had to go to a German hospital in the middle of the night. Within 1 hour, they had given my daughter an ultrasound and two doses of medicine to treat her problem, the cost to me: $130 euro, and I didn't even use my health insurance (which does cover international emergencies) 3 years ago, I had a gallbladder attack in Shangh…

...capitalism vs socialism alone, it's much more nuanced than that. Profiteering. Seems pretty simple to me. I'm exhausted by the -ism debates and mythical free markets. To me, it's about the incentives. So I support a single payer using the capitation model, reward wellness vs treating disease. With ACA (Obamacare), I hope that we're on our way towards single payer in the USA. Meanwhile, I'm impressed with improveme…

The free markets are mythical because they're not allowed to happen. Single payer is a horrible idea. Why would you trust a centralized agency (which can be bribed and corrupted so easily) with such an essential service? The government purchasing healthcare from outside organizations is bound to be overrun with special interests and obscene contracts (like we see with the military). I want to be able to vote with my wallet; I don't want a single entity, especially one that can levy taxes and borrow massive amounts of money from the Fed, to have a monopoly. The State will then just choose winners and losers, make certain activities illegal so we can't test alternatives, etc. I just don't see how that can end well.

Re: The Man Who Was Treated for $17,000 Less

#92

Post by felideon »

JPKab wrote: post #72
cromwellian wrote: post #27

A month ago, I was traveling in Germany with my family and my daughter had an emergency, so I had to go to a German hospital in the middle of the night. Within 1 hour, they had given my daughter an ultrasound and two doses of medicine to treat her problem, the cost to me: $130 euro, and I didn't even use my health insurance (which does cover international emergencies) 3 years ago, I had a gallbladder attack in Shangh…

I used to be on a High Deductible Health Plan, which is designed to be just like the author suggests: only for catastrophes. For anything else, you use a Health Savings Account (a tax free account you put money into) and use it to just pay cash prices. IT WAS HORRIBLE. The concept of course, is great. But the problem is one of chicken and egg. Because the entire system is set up for 3rd party payment, NOBODY, and I m…

Is it possible to pay cash prices without an HSA? I'm under the impression that if you have health insurance (high deductible or not) you are required to use it.

The one time I asked for a cash price for a shot at a hospital, it was pretty quick for the receptionist to give it to me. (Incidentally, $150 cash vs. the $300 bill that came in the mail later, since I used my insurance. For a shot of Rhogam.)

Re: The Man Who Was Treated for $17,000 Less

#93

Post by specialist »

ahallock wrote: post #91
specialist wrote: post #73

Earlier quoted context omitted.

...capitalism vs socialism alone, it's much more nuanced than that. Profiteering. Seems pretty simple to me. I'm exhausted by the -ism debates and mythical free markets. To me, it's about the incentives. So I support a single payer using the capitation model, reward wellness vs treating disease. With ACA (Obamacare), I hope that we're on our way towards single payer in the USA. Meanwhile, I'm impressed with improveme…

The free markets are mythical because they're not allowed to happen. Single payer is a horrible idea. Why would you trust a centralized agency (which can be bribed and corrupted so easily) with such an essential service? The government purchasing healthcare from outside organizations is bound to be overrun with special interests and obscene contracts (like we see with the military). I want to be able to vote with my…

Please provide an example of a free market.

Why do the existing single payer systems outperform the USA's private health plan system, measured in both cost per capita and life expectancy?

Re: The Man Who Was Treated for $17,000 Less

#94

Post by specialist »

refurb wrote: post #79
specialist wrote: post #73

Earlier quoted context omitted.

...capitalism vs socialism alone, it's much more nuanced than that. Profiteering. Seems pretty simple to me. I'm exhausted by the -ism debates and mythical free markets. To me, it's about the incentives. So I support a single payer using the capitation model, reward wellness vs treating disease. With ACA (Obamacare), I hope that we're on our way towards single payer in the USA. Meanwhile, I'm impressed with improveme…

Profiteering is too simplistic of explanation. If you read up on the various regulations and how they create incentives for hospitals to do this, it makes more sense. And you have to be careful with the regulations you institute. A LOT of the current problems with the US healthcare system are due to gov't regulations. If you want to see an example, just google "average selling price ASP" and see the utter mess that r…

So fewer regulations will lower healthcare costs in the USA?

Re: The Man Who Was Treated for $17,000 Less

#95

Post by venomsnake »

plock wrote: post #84
roc wrote: post #67

Earlier quoted context omitted.

The real point to them being elective luxuries is that the would-be consumer can actually walk away entirely. You needn't get lazik from anyone . The same can't be said of many/most medical procedures. You can't research the market and just skip getting a knee replacement altogether, the way you could with lazik. To say nothing of more serious problems.

The consumer also can't entirely walk away from the food market. That doesn't make food prices go out of control.

According to USDA in 2011 15% of US households suffered from food insecurity - for them they are already out of control.

And there are the other couple of billion people on the planet that cannot afford a dollar per day for a meal.

Re: The Man Who Was Treated for $17,000 Less

#96

Post by EvanAnderson »

felideon wrote: post #92
JPKab wrote: post #72

Earlier quoted context omitted.

I used to be on a High Deductible Health Plan, which is designed to be just like the author suggests: only for catastrophes. For anything else, you use a Health Savings Account (a tax free account you put money into) and use it to just pay cash prices. IT WAS HORRIBLE. The concept of course, is great. But the problem is one of chicken and egg. Because the entire system is set up for 3rd party payment, NOBODY, and I m…

Is it possible to pay cash prices without an HSA? I'm under the impression that if you have health insurance (high deductible or not) you are required to use it. The one time I asked for a cash price for a shot at a hospital, it was pretty quick for the receptionist to give it to me. (Incidentally, $150 cash vs. the $300 bill that came in the mail later, since I used my insurance. For a shot of Rhogam.)

That depends. Some providers are contractually bound (and in some jurisdictions laws also apply) into "preferred provider contracts" that require the provider to bill your insurance and disallow them from taking cash.

Re: The Man Who Was Treated for $17,000 Less

#97

Post by cromwellian »

ahallock wrote: post #91
specialist wrote: post #73

Earlier quoted context omitted.

...capitalism vs socialism alone, it's much more nuanced than that. Profiteering. Seems pretty simple to me. I'm exhausted by the -ism debates and mythical free markets. To me, it's about the incentives. So I support a single payer using the capitation model, reward wellness vs treating disease. With ACA (Obamacare), I hope that we're on our way towards single payer in the USA. Meanwhile, I'm impressed with improveme…

The free markets are mythical because they're not allowed to happen. Single payer is a horrible idea. Why would you trust a centralized agency (which can be bribed and corrupted so easily) with such an essential service? The government purchasing healthcare from outside organizations is bound to be overrun with special interests and obscene contracts (like we see with the military). I want to be able to vote with my…

single-payer != single provider. Single Payer systems are insurance, they don't provide service, they doll out cash.

The only function of an insurance company is to pool funds and distribute them. In theory, overhead should be very low and there's not much to innovate on except to figure out the best ways to deny coverage or detect fraud.

Re: The Man Who Was Treated for $17,000 Less

#98

Post by rkangel »

The system in the UK, while not perfect, is actually pretty damn good. It's a national pass-time to be rude about the NHS, but when Obamacare was in the press* we all suddenly remembered how good we've got it.

There are all sorts of criticisms one can level at the US Health "system" (as well as the UK NHS), but it fundamentally has to come down to efficient use of resources. In the UK, we pay money to the NHS (via tax) and the NHS spends it on our healthcare, in the form of people's wages and equipment costs etc. Internally, the NHS is set up to get the best healthcare result overall for the entire country, with the money it has.

In the US, there's an extra party - the insurance company. You pay your money to them, and then they pay some of that to the hospitals etc. for your healthcare. The key is some of - they're a business, with costs to pay, and profits to extract. You're making less efficient use of the money overall.

Capitalism, when used properly, is a great way of getting efficiency. For consumer goods lower costs means lower prices so more sales, so more money. Capitalism working perfectly, so the consumer is paying as little as possible. But the insurance companies aren't incentivised to produce efficient healthcare, the very opposite. They're not evil (mostly), that's just how the market is.

* Possibly still my favourite quote from any newspaper ever, was a sadly ill-informed "Investor's Business Daily" trying to be rude about the NHS, saying "if Stephen Hawking were British, he's be dead". Stephen Hawking IS British (I've seen him in Cambridge), and has been well cared for by the NHS to live to the ripe old age of 70 - very rare for someone with Motor Neurone Disease.

Re: The Man Who Was Treated for $17,000 Less

#99

Post by usefulcat »

felideon wrote: post #92
JPKab wrote: post #72

Earlier quoted context omitted.

I used to be on a High Deductible Health Plan, which is designed to be just like the author suggests: only for catastrophes. For anything else, you use a Health Savings Account (a tax free account you put money into) and use it to just pay cash prices. IT WAS HORRIBLE. The concept of course, is great. But the problem is one of chicken and egg. Because the entire system is set up for 3rd party payment, NOBODY, and I m…

Is it possible to pay cash prices without an HSA? I'm under the impression that if you have health insurance (high deductible or not) you are required to use it. The one time I asked for a cash price for a shot at a hospital, it was pretty quick for the receptionist to give it to me. (Incidentally, $150 cash vs. the $300 bill that came in the mail later, since I used my insurance. For a shot of Rhogam.)

I could certainly be wrong, but I'm not aware of any requirement to always use insurance. However, if you pay for treatment out of pocket wouldn't you still need to involve your insurance company somehow in order for your payment to be counted towards your deductible?

Re: The Man Who Was Treated for $17,000 Less

#100

Post by Mindless2112 »

BrandonY wrote: post #42
flagnog wrote: post #32

Earlier quoted context omitted.

Here's a better idea: require all hospitals and Dr offices to publish fee schedules in a centralized location, allowing the customer to price-shop procedures. Then there would be downward pressure on prices, and you could plan in advance of elective procedures.

Operator, I'm having a heart attack! Please direct me to the nearest centralized location of the fee schedule, so that I might begin studying my options.

There's no reason you couldn't compare costs before an emergency occurs. Not that you'd know off the top of your head which hospital is cheapest for any given procedure when you need it, but you could get a good general idea.
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