6 ms·

When I'm hungry, I'm still able to visit multiple restaurants/ stores to compare prices. But when I'm having a heart attack, do I really have the option to shop

When I'm hungry, I'm still able to visit multiple restaurants/ stores to compare prices. But when I'm having a heart attack, do I really have the option to shop around?

fennecfoxen 9y ago
1. What percentage of your health issues are "emergency, heart attack RIGHT NOW"-class issues? What percentage of health care spending overall are these issues? 2. Have you or someone you know in the United States ever "shopped around" or otherwise prepared in advance for an emergency through the provision of, say, catastrophic health care insurance, which promises to pay for emergency room visits? (Employer coverage can count here.) To the extent that (1) is a small number, this question is a non sequitor. To the extent that (2) is large, even that small number is further mitigated. There are lots of arguments about why it might be better to structure health care as a centrally-planned activity instead of a market-based activity. This isn't one of the good ones.
- dagw 9y ago
  1. What percentage of your health issues are "emergency, heart attack RIGHT NOW"-class issues? If just you're counting all issues it's obviously quite few. If you're weighting by potential costs then it's very high. Basically the more expensive and necessary a procedure is the less chance you have to shop around. If I was to break down the costs of all medical procedures I've had over the past 30 years I'd say that almost all of it would be taken up by a single series of emergency surgeries.
- crusso 9y ago
  If outrageous healthcare costs were only kicking in for life-or-death emergencies then you might have a point. Healthcare costs across the board - except in unregulated, uninsured spheres like plastic surgery, lasik, etc. - are extraordinarily high.
  - tertius 9y ago
    The point he's making is that it's only unfeasible to negotiate when you need treatment this minute. Therefore a free market system is feasible for everything else. Not that it's what we currently have as you point out.
    - mattkrause 9y ago
      Even there though.... Do you think (or the average person) knows enough to shop around? This stuff is complicated! I'm not sure I could make a rational decision between treatments that have different prices, but also different likelihoods of success, side effect profiles, and all that. This is even more complicated when you're paying for a diagnosis too, rather than just a treatment. Lasik and plastic surgery are interesting because they're essentially commodities and the patient can easily evaluate the results themselves.
      - tertius 9y ago
        > Do you think (or the average person) knows enough to shop around? Do I think that education surrounding general health has diminished. I feel very strongly about this. There should not be as large of a chasm between my knowledge or ability to diagnose (i.e. is something serious enough to go to the doctor for) and the knowledge of a doctor/PA etc. But yes, the average person deals with market economics every day and they're certainly smart enough to make decisions there. > Lasik and plastic surgery So are office visits, annuals, screenings, minor procedures (think stitches to Tonsillectomy). I.e. the bulk of medical service.
- NoGravitas 9y ago
  Even for non-emergency care, it's not feasible to shop around in the US healthcare market. Doctors don't know prices. Typically, front-office staff won't know prices until they've talked to your insurance company. It's probably not possible to get prices from your insurance company except in the context of a very specific claim, which can only come from the doctor's office or hospital's office staff. A small difference in coding for the same issue/procedure can result in huge cost differences. It might be possible to shop around for prices on particular surgical procedures (eg), but only after you've paid an unpredictable amount for diagnosis. And you may have to pay twice for diagnosis to make this possible.
  - maxerickson 9y ago
    I believe their point was in the abstract. In a system where it is feasible to shop around, people will tend to do so and it will put downward pressure on prices. Maybe the thing to do is to start treating insurance-hospital networks that do not disclose pricing as collusion. It certainly makes no sense to me that our system has individual patients having adversarial dealings with 2 huge institutions every time they need care.
- Avshalom 9y ago
  >>1. What percentage of your health issues are "emergency, heart attack RIGHT NOW"-class issues? What percentage of health care spending overall are these issues? 100%, in theory at least. See I'm vaguely poor--18421 before taxes last year, currently about 5000 before taxes this year--which means I can't afford to go see a doctor because "I'm not sure but I think this is more than a sprain", "that's weird this lymph node has just swollen to thrice it's normal size over night" or "hmm this is definitely infected"[1]. In fact anything that isn't 0-copay, which isn't much because I can't afford swanky insurance, is basically out of reach. ALSO because I'm 31 and spent my adult life insurance-less I have almost literally no idea how to even get myself care if I could afford it (I mean what do you just throw a dart at a phone book? walk into a hospital and keep asking nurses questions?) As a result any[2] health care I receive is going to be a result of some one else calling an ambulance for me. Which will leave me in exactly no state to be comparison shopping. [1]true stories [2]well I did manage to get on some anti depressents and counseling last year by crying at the good people at my student health center for an hour or so, only after some one pointed out that generics for chronic conditions are covered by my insurance (a fact which does not actually appear in the policy packet but is only mentioned in small print on a PDF comparing the different plans) and the first month of counseling being covered by my student activity fees.
deleted 9y ago
[deleted]

When I'm hungry, I'm still able to visit multiple restaurants/ stores to compare prices. But when I'm having a heart attack, do I really have the option to shop around?

fennecfoxen 9y ago

1. What percentage of your health issues are "emergency, heart attack RIGHT NOW"-class issues? What percentage of health care spending overall are these issues? 2. Have you or someone you know in the United States ever "shopped around" or otherwise prepared in advance for an emergency through the provision of, say, catastrophic health care insurance, which promises to pay for emergency room visits? (Employer coverage can count here.) To the extent that (1) is a small number, this question is a non sequitor. To the extent that (2) is large, even that small number is further mitigated. There are lots of arguments about why it might be better to structure health care as a centrally-planned activity instead of a market-based activity. This isn't one of the good ones.

dagw 9y ago
1. What percentage of your health issues are "emergency, heart attack RIGHT NOW"-class issues? If just you're counting all issues it's obviously quite few. If you're weighting by potential costs then it's very high. Basically the more expensive and necessary a procedure is the less chance you have to shop around. If I was to break down the costs of all medical procedures I've had over the past 30 years I'd say that almost all of it would be taken up by a single series of emergency surgeries.
crusso 9y ago
If outrageous healthcare costs were only kicking in for life-or-death emergencies then you might have a point. Healthcare costs across the board - except in unregulated, uninsured spheres like plastic surgery, lasik, etc. - are extraordinarily high.
- tertius 9y ago
  The point he's making is that it's only unfeasible to negotiate when you need treatment this minute. Therefore a free market system is feasible for everything else. Not that it's what we currently have as you point out.
  - mattkrause 9y ago
    Even there though.... Do you think (or the average person) knows enough to shop around? This stuff is complicated! I'm not sure I could make a rational decision between treatments that have different prices, but also different likelihoods of success, side effect profiles, and all that. This is even more complicated when you're paying for a diagnosis too, rather than just a treatment. Lasik and plastic surgery are interesting because they're essentially commodities and the patient can easily evaluate the results themselves.
    - tertius 9y ago
      > Do you think (or the average person) knows enough to shop around? Do I think that education surrounding general health has diminished. I feel very strongly about this. There should not be as large of a chasm between my knowledge or ability to diagnose (i.e. is something serious enough to go to the doctor for) and the knowledge of a doctor/PA etc. But yes, the average person deals with market economics every day and they're certainly smart enough to make decisions there. > Lasik and plastic surgery So are office visits, annuals, screenings, minor procedures (think stitches to Tonsillectomy). I.e. the bulk of medical service.
NoGravitas 9y ago
Even for non-emergency care, it's not feasible to shop around in the US healthcare market. Doctors don't know prices. Typically, front-office staff won't know prices until they've talked to your insurance company. It's probably not possible to get prices from your insurance company except in the context of a very specific claim, which can only come from the doctor's office or hospital's office staff. A small difference in coding for the same issue/procedure can result in huge cost differences. It might be possible to shop around for prices on particular surgical procedures (eg), but only after you've paid an unpredictable amount for diagnosis. And you may have to pay twice for diagnosis to make this possible.
- maxerickson 9y ago
  I believe their point was in the abstract. In a system where it is feasible to shop around, people will tend to do so and it will put downward pressure on prices. Maybe the thing to do is to start treating insurance-hospital networks that do not disclose pricing as collusion. It certainly makes no sense to me that our system has individual patients having adversarial dealings with 2 huge institutions every time they need care.
Avshalom 9y ago
>>1. What percentage of your health issues are "emergency, heart attack RIGHT NOW"-class issues? What percentage of health care spending overall are these issues? 100%, in theory at least. See I'm vaguely poor--18421 before taxes last year, currently about 5000 before taxes this year--which means I can't afford to go see a doctor because "I'm not sure but I think this is more than a sprain", "that's weird this lymph node has just swollen to thrice it's normal size over night" or "hmm this is definitely infected"[1]. In fact anything that isn't 0-copay, which isn't much because I can't afford swanky insurance, is basically out of reach. ALSO because I'm 31 and spent my adult life insurance-less I have almost literally no idea how to even get myself care if I could afford it (I mean what do you just throw a dart at a phone book? walk into a hospital and keep asking nurses questions?) As a result any[2] health care I receive is going to be a result of some one else calling an ambulance for me. Which will leave me in exactly no state to be comparison shopping. [1]true stories [2]well I did manage to get on some anti depressents and counseling last year by crying at the good people at my student health center for an hour or so, only after some one pointed out that generics for chronic conditions are covered by my insurance (a fact which does not actually appear in the policy packet but is only mentioned in small print on a PDF comparing the different plans) and the first month of counseling being covered by my student activity fees.

deleted 9y ago

[deleted]