4 ms·

> The problem really isn't the doctors but the structure of insurance and how people treat health care and health insurance similarly. The worst part is that hi

by mcny 9y ago

> The problem really isn't the doctors but the structure of insurance and how people treat health care and health insurance similarly. The worst part is that high costs aren't directly the fault of insurance companies but of government having driven the need for insurance. Health care used to be all cash, and people carried catastrophic health insurance policies only. We are moving back towards that. This isn't stating my preference, one way or the other, just the historical facts. > On the back end, there is the cost of lawsuits that also drives up prices systemically. Here's one example. A (probably not domesticated) cat scratched someone. They went to get shots. Waited a couple of hours and got the shot. Bill in the mail for about $8k. Somehow, I really doubt Humana paid their 80% which is $6,400 but of course the patient has to pay the 20%. I suspect what is happening is that Humana pays close to $0 and the patient picks up the whole tab of $1,600.

IncRnd 9y ago
> Here's one example. A (probably not domesticated) cat scratched someone. They went to get shots. Waited a couple of hours and got the shot. Bill in the mail for about $8k. Somehow, I really doubt Humana paid their 80% which is $6,400 but of course the patient has to pay the 20%. I suspect what is happening is that Humana pays close to $0 and the patient picks up the whole tab of $1,600. I totally get your point, but is that real example? http://health.costhelper.com/cat-scratch-disease.html http://health.costhelper.com/cat-scratch-disease.html Typical costs: - For patients covered by health insurance, out-of-pocket costs typically consist of doctor visit copays, prescription drug copays of $5-$50 or more, or coinsurance of 10%-50%. Cat scratch fever treatment typically is covered by health insurance. - For patients not covered by health insurance, cat scratch fever treatment typically costs less than $10 for over-the-counter pain relievers. For severe cases in which antibiotics are required, it typically costs from $30-$90 for oral antibiotics. For example, Drugstore.com charges about $30 for a two-week course of the generic antibiotic rifampin. It charges about $80 for a two-week course of the antibiotic ciprofloxacin. And it charges about $90 for a two-week course of the generic oral antibiotic azithromycin. - In the extremely rare cases in which serious complications occur and hospitalization is required, cat scratch fever treatment can cost tens of thousands of dollars. According to Medscape.com, the median hospitalization charge[1] for cat scratch disease is about $46,140.
- mcny 9y ago
  > I totally get your point, but is that real example? Yes, it actually happened. Overland Park, Kansas around July 2013 if I remember correctly. Also no fever. More like rabies and tetanus shots from what I heard. What if we could force all hospitals to disclose all financial transactions publicly? Would that help?
Pokepokalypse 9y ago
Okay, so on the catastrophic-only front: what about chronic issues, like diabetes, or depression, etc? Insurance pays for the initial crisis - but ongoing treatment comes solely out-of-pocket? Nobody can afford that. Especially with how drug prices have escalated. And in some of these chronic conditions, the end-stages become very costly. Insurance absorbs the early costs of regular care, which PREVENTS both chronic conditions, and these costly end-stages. (This is widely-accepted science, not insurance company marketing). So this catastrophic-only model simply is not tenable, will not work. Unless either these treatment prices come way, way, down. OR: we address the real source of the problem, which is that incomes have not come up to meet these niche costs which have inflated greatly, yet somehow avoided being measured and added to overall inflation statistics. ("hedonic adjustments", anyone?) Trump actually campaigned on lowering drug prices. Yet for all we've sacrificed to endure a Trump presidency, they've done absolutely nothing to address this problem. And they won't. I assure you. Therefore - the shitty-compromise solution must be: government pays. Because they're too cowardly to fix the problem any other way. Government pays until government can't. So they just borrow more. Not even "plain speaking" Trump has the balls to work these two problems. (Drug prices, and income stasis).

by mcny 9y ago

IncRnd 9y ago

> Here's one example. A (probably not domesticated) cat scratched someone. They went to get shots. Waited a couple of hours and got the shot. Bill in the mail for about $8k. Somehow, I really doubt Humana paid their 80% which is $6,400 but of course the patient has to pay the 20%. I suspect what is happening is that Humana pays close to $0 and the patient picks up the whole tab of $1,600. I totally get your point, but is that real example? http://health.costhelper.com/cat-scratch-disease.html http://health.costhelper.com/cat-scratch-disease.html Typical costs: - For patients covered by health insurance, out-of-pocket costs typically consist of doctor visit copays, prescription drug copays of $5-$50 or more, or coinsurance of 10%-50%. Cat scratch fever treatment typically is covered by health insurance. - For patients not covered by health insurance, cat scratch fever treatment typically costs less than $10 for over-the-counter pain relievers. For severe cases in which antibiotics are required, it typically costs from $30-$90 for oral antibiotics. For example, Drugstore.com charges about $30 for a two-week course of the generic antibiotic rifampin. It charges about $80 for a two-week course of the antibiotic ciprofloxacin. And it charges about $90 for a two-week course of the generic oral antibiotic azithromycin. - In the extremely rare cases in which serious complications occur and hospitalization is required, cat scratch fever treatment can cost tens of thousands of dollars. According to Medscape.com, the median hospitalization charge[1] for cat scratch disease is about $46,140.

mcny 9y ago
> I totally get your point, but is that real example? Yes, it actually happened. Overland Park, Kansas around July 2013 if I remember correctly. Also no fever. More like rabies and tetanus shots from what I heard. What if we could force all hospitals to disclose all financial transactions publicly? Would that help?

Pokepokalypse 9y ago

Okay, so on the catastrophic-only front: what about chronic issues, like diabetes, or depression, etc? Insurance pays for the initial crisis - but ongoing treatment comes solely out-of-pocket? Nobody can afford that. Especially with how drug prices have escalated. And in some of these chronic conditions, the end-stages become very costly. Insurance absorbs the early costs of regular care, which PREVENTS both chronic conditions, and these costly end-stages. (This is widely-accepted science, not insurance company marketing). So this catastrophic-only model simply is not tenable, will not work. Unless either these treatment prices come way, way, down. OR: we address the real source of the problem, which is that incomes have not come up to meet these niche costs which have inflated greatly, yet somehow avoided being measured and added to overall inflation statistics. ("hedonic adjustments", anyone?) Trump actually campaigned on lowering drug prices. Yet for all we've sacrificed to endure a Trump presidency, they've done absolutely nothing to address this problem. And they won't. I assure you. Therefore - the shitty-compromise solution must be: government pays. Because they're too cowardly to fix the problem any other way. Government pays until government can't. So they just borrow more. Not even "plain speaking" Trump has the balls to work these two problems. (Drug prices, and income stasis).