4 ms·

I'm not a libertarian. I have no idea how you can possibly characterize the US's highly regulated health system as capitalist - could you explain?

maxxxxx 10y ago
In the US the quality of service is regulated but there are not many price regulations. Tell me, in what way would the US system have to change for medical providers to give clear pricing information? Be specific, don't use words like "capitalist" or "regulation".
- yummyfajitas 10y ago
  To start with, eliminate the massive subsidies for low deductible health insurance, and eliminate the regulations which mandate the provision of specific services. Then the high cost of low deductible health insurance will induce consumers to choose high-deductible plans, making them more price sensitive. As a non-libertarian, regulator friendly way to achieve this, you could also ban first dollar coverage.
  - maxxxxx 10y ago
    What you are pretty much saying is that first we need to put a lot more financial pain on patients so the high cost will force them to become more price sensitive. And somehow doctors and hospitals will then quote accurate prices?
    - yummyfajitas 10y ago
      Yes, doctors and hospitals will need to quote prices, otherwise consumers will take their business elsewhere. At least, that's what happens here in India. Are Americans somehow unable to do the same?
      - maxxxxx 10y ago
        You can't take your business elsewhere because there is nobody else who will give you a quote.
      - virmundi 10y ago
        We can't do that for many basic surgeries or medicines. Not because it's impossible, it's just that many hospitals and doctors don't know how much something costs [1, 2]. At the same time, for traumatic injuries, etc, you get shipped to the nearest hospital. You have no price negotiation power at that point. We should have a book value like shop rates for autos. 1 - http://frugalnurse.com/2016/08/doctors-dont-know-healthcare-costs/ http://frugalnurse.com/2016/08/doctors-dont-know-healthcare-... 2 - http://www.healthcareitnews.com/blog/doctor’s-don’t-know-or-care-about-cost-that’s-half-right http://www.healthcareitnews.com/blog/doctor’s-don’t-know-or-...
        yummyfajitas 10y ago
        Yet somehow, in India I can simply ask a price and be told one. Is Apollo Health just asking Shiva, and He refuses to answer outside the borders of India?
        virmundi 10y ago
        You never know, Garry, you never know [1]. Honestly it's silly boarding on stupid that we can't do that. I've heard various arguments. Most of them come down to a) doctors are sacrosanct, or b) it would cost too much money. 1 - https://www.youtube.com/watch?v=GcxNzPdp_2g https://www.youtube.com/watch?v=GcxNzPdp_2g
        kolinko 10y ago
        You can ask for a price, but perhaps there's a different reason for that than the one you provided?
    - awinter-py 10y ago
      A couple of misconceptions here I think: 1. You're saying higher deductible will increase the 'financial pain' to the consumer. Wrong -- what matters to consumer is cost for services + cost of insurance. 2. You're saying quoting accurate prices is the goal -- I think quoting prices at all is the goal. If consumers aren't moving to cheaper providers, prices will always go up. There are price controls built into insurance programs but they're not based on the real cost of providing a service so they can hurt quality. 3. You're saying 'financial pain' comes from high prices today. The real concern is that 0 price sensitivity increases the % of GDP allocated to health care to unsustainable levels. I can suffer pain today if it turns health cost growth from positive to negative.
  - kolinko 10y ago
    What kind of subsidies for low deductible health insurance are you talking about? (not from US, so I don't know)
    - yummyfajitas 10y ago
      The biggest is that employers can give you health insurance without paying taxes on it. There are a variety of Obamacare and other such rules which insist on low deductibles for certain categories of events. And of course, medicare/medicaid.

maxxxxx 10y ago

In the US the quality of service is regulated but there are not many price regulations. Tell me, in what way would the US system have to change for medical providers to give clear pricing information? Be specific, don't use words like "capitalist" or "regulation".

yummyfajitas 10y ago
To start with, eliminate the massive subsidies for low deductible health insurance, and eliminate the regulations which mandate the provision of specific services. Then the high cost of low deductible health insurance will induce consumers to choose high-deductible plans, making them more price sensitive. As a non-libertarian, regulator friendly way to achieve this, you could also ban first dollar coverage.
- maxxxxx 10y ago
  What you are pretty much saying is that first we need to put a lot more financial pain on patients so the high cost will force them to become more price sensitive. And somehow doctors and hospitals will then quote accurate prices?
  - yummyfajitas 10y ago
    Yes, doctors and hospitals will need to quote prices, otherwise consumers will take their business elsewhere. At least, that's what happens here in India. Are Americans somehow unable to do the same?
    - maxxxxx 10y ago
      You can't take your business elsewhere because there is nobody else who will give you a quote.
    - virmundi 10y ago
      We can't do that for many basic surgeries or medicines. Not because it's impossible, it's just that many hospitals and doctors don't know how much something costs [1, 2]. At the same time, for traumatic injuries, etc, you get shipped to the nearest hospital. You have no price negotiation power at that point. We should have a book value like shop rates for autos. 1 - http://frugalnurse.com/2016/08/doctors-dont-know-healthcare-costs/ http://frugalnurse.com/2016/08/doctors-dont-know-healthcare-... 2 - http://www.healthcareitnews.com/blog/doctor’s-don’t-know-or-care-about-cost-that’s-half-right http://www.healthcareitnews.com/blog/doctor’s-don’t-know-or-...
      - yummyfajitas 10y ago
        Yet somehow, in India I can simply ask a price and be told one. Is Apollo Health just asking Shiva, and He refuses to answer outside the borders of India?
        virmundi 10y ago
        You never know, Garry, you never know [1]. Honestly it's silly boarding on stupid that we can't do that. I've heard various arguments. Most of them come down to a) doctors are sacrosanct, or b) it would cost too much money. 1 - https://www.youtube.com/watch?v=GcxNzPdp_2g https://www.youtube.com/watch?v=GcxNzPdp_2g
        kolinko 10y ago
        You can ask for a price, but perhaps there's a different reason for that than the one you provided?
  - awinter-py 10y ago
    A couple of misconceptions here I think: 1. You're saying higher deductible will increase the 'financial pain' to the consumer. Wrong -- what matters to consumer is cost for services + cost of insurance. 2. You're saying quoting accurate prices is the goal -- I think quoting prices at all is the goal. If consumers aren't moving to cheaper providers, prices will always go up. There are price controls built into insurance programs but they're not based on the real cost of providing a service so they can hurt quality. 3. You're saying 'financial pain' comes from high prices today. The real concern is that 0 price sensitivity increases the % of GDP allocated to health care to unsustainable levels. I can suffer pain today if it turns health cost growth from positive to negative.
- kolinko 10y ago
  What kind of subsidies for low deductible health insurance are you talking about? (not from US, so I don't know)
  - yummyfajitas 10y ago
    The biggest is that employers can give you health insurance without paying taxes on it. There are a variety of Obamacare and other such rules which insist on low deductibles for certain categories of events. And of course, medicare/medicaid.