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Have you ever actually tried to "shop around" for a serious, non-elective procedure like chemo or surgery? It's very difficult to get quotes, you can't easily c

Have you ever actually tried to "shop around" for a serious, non-elective procedure like chemo or surgery? It's very difficult to get quotes, you can't easily compare providers (there's no obviously corpus of "ratings" from other prior customers) and you're often limited to the 1-3 providers who are close enough to your home. That's not exactly a recipe for an effective market. Re your medicare proposal, are you suggesting that people who are diagnosed with cancer should get a cash check for the estimated value of the treatment? The incentive for fraud and graft in that kind of system would be incredible - lots of diagnoses are relatively subjective, and you'd be rewarding people for reporting every possible ailment they might be eligible for. If you're saying just give them their dollar average benefits, that pretty much defeats the whole purpose of having a risk pool.

Consultant32452 9y ago
>It's very difficult to get quotes It's very difficult to get quotes because no one is actually paying for it themselves. This would be solved immediately by empowering individual consumers. >you can't easily compare providers (there's no obviously corpus of "ratings" from other prior customers) This is because your insurance provider has chosen for you. Once again, this would be resolved by putting peoples' money back into their own hands. >If you're saying just give them their dollar average benefits, that pretty much defeats the whole purpose of having a risk pool. In my head I included still providing disaster coverage, but failed to type it. So that should alleviate your fears regarding things like getting cancer.
- tomkarlo 9y ago
  Can you point to an example where any of these three things have happened in the real world? "Still providing disaster coverage"... is pretty much all of what health insurance does for people over 65. The annual spend on preventative care is dwarfed by a single common incident (fall, flu, cancer) at that age.
  - Consultant32452 9y ago
    There's an urgent care place near me that I sometimes go to. They cater to a lot of people without insurance. The prices for all of their services are posted on a big menu board like you'd see at a fast food restaurant. Here's a citation that shows emergency care is only 2% of all healthcare. Of course, that's the entire healthcare market, not just elderly care. I'd be interested in any citations you could provide that shows that system-wide preventative care is dwarfed by the system-wide costs of major incidents for the elderly. http://www.politifact.com/truth-o-meter/statements/2013/oct/28/nick-gillespie/does-emergency-care-account-just-2-percent-all-hea/ http://www.politifact.com/truth-o-meter/statements/2013/oct/...
    - tomkarlo 9y ago
      You're confusing emergency care with non-elective care. Just because something isn't an ER visit doesn't mean you don't need to get treated for it immediately. E.g. the flu. > I'd be interested in any citations you could provide that shows that system-wide preventative care is dwarfed by the system-wide costs of major incidents for the elderly. 95% of healthcare spend is reactive, 5% is preventative[0] Medical spending in the last three years before death accounts for 13.4 percent of aggregate US medical spending.[1] And this ignores major treatments for people over 65 that occur more than 3 years before they die (and on average, people live 20+ years after they turn 65.) [0] http://www.newsweek.com/health-prevention-worth-money-86075 http://www.newsweek.com/health-prevention-worth-money-86075 [1] https://meps.ahrq.gov/data_files/publications/st429/stat429.pdf https://meps.ahrq.gov/data_files/publications/st429/stat429....
      - Consultant32452 9y ago
        Well, when you're setting the standard of being unable to negotiate or shop around for prices, you're definitely not talking about stuff like flu treatment. Sure, that might not be "elective" care, but it's not the type of care that stops you from making a couple phone calls to different providers. But more likely you know which provider is the "wal-mart" provider vs which is the "Macy's" provider.
fuzzybeard 9y ago
The industry isn't built to support market based solutions which is why providers couldn't give you a price even if you asked. That's what parent poster is trying to say. There just isn't pricing transparency so you can't get pricing. Where it's been shown to work is with smaller doctors offices for routine procedures like a flu shot. If you ask for a price and offer cash, they can work with customers on that.

Consultant32452 9y ago

>It's very difficult to get quotes It's very difficult to get quotes because no one is actually paying for it themselves. This would be solved immediately by empowering individual consumers. >you can't easily compare providers (there's no obviously corpus of "ratings" from other prior customers) This is because your insurance provider has chosen for you. Once again, this would be resolved by putting peoples' money back into their own hands. >If you're saying just give them their dollar average benefits, that pretty much defeats the whole purpose of having a risk pool. In my head I included still providing disaster coverage, but failed to type it. So that should alleviate your fears regarding things like getting cancer.

tomkarlo 9y ago
Can you point to an example where any of these three things have happened in the real world? "Still providing disaster coverage"... is pretty much all of what health insurance does for people over 65. The annual spend on preventative care is dwarfed by a single common incident (fall, flu, cancer) at that age.
- Consultant32452 9y ago
  There's an urgent care place near me that I sometimes go to. They cater to a lot of people without insurance. The prices for all of their services are posted on a big menu board like you'd see at a fast food restaurant. Here's a citation that shows emergency care is only 2% of all healthcare. Of course, that's the entire healthcare market, not just elderly care. I'd be interested in any citations you could provide that shows that system-wide preventative care is dwarfed by the system-wide costs of major incidents for the elderly. http://www.politifact.com/truth-o-meter/statements/2013/oct/28/nick-gillespie/does-emergency-care-account-just-2-percent-all-hea/ http://www.politifact.com/truth-o-meter/statements/2013/oct/...
  - tomkarlo 9y ago
    You're confusing emergency care with non-elective care. Just because something isn't an ER visit doesn't mean you don't need to get treated for it immediately. E.g. the flu. > I'd be interested in any citations you could provide that shows that system-wide preventative care is dwarfed by the system-wide costs of major incidents for the elderly. 95% of healthcare spend is reactive, 5% is preventative[0] Medical spending in the last three years before death accounts for 13.4 percent of aggregate US medical spending.[1] And this ignores major treatments for people over 65 that occur more than 3 years before they die (and on average, people live 20+ years after they turn 65.) [0] http://www.newsweek.com/health-prevention-worth-money-86075 http://www.newsweek.com/health-prevention-worth-money-86075 [1] https://meps.ahrq.gov/data_files/publications/st429/stat429.pdf https://meps.ahrq.gov/data_files/publications/st429/stat429....
    - Consultant32452 9y ago
      Well, when you're setting the standard of being unable to negotiate or shop around for prices, you're definitely not talking about stuff like flu treatment. Sure, that might not be "elective" care, but it's not the type of care that stops you from making a couple phone calls to different providers. But more likely you know which provider is the "wal-mart" provider vs which is the "Macy's" provider.

fuzzybeard 9y ago

The industry isn't built to support market based solutions which is why providers couldn't give you a price even if you asked. That's what parent poster is trying to say. There just isn't pricing transparency so you can't get pricing. Where it's been shown to work is with smaller doctors offices for routine procedures like a flu shot. If you ask for a price and offer cash, they can work with customers on that.