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Couldn't agree more. Ultra cheap options is exactly what healthcare needs. 95% of medical issues don't require expensive equipment or highly trained practitione

by darawk 9y ago

Couldn't agree more. Ultra cheap options is exactly what healthcare needs. 95% of medical issues don't require expensive equipment or highly trained practitioners to treat. Your broken bone doesn't require the very latest X-ray machine - the one from 20 years ago will do fine. The nurse practitioner can handle your UTI. You don't need someone who went through residency for that. There is so much cost to be saved all over the system if we could break some of these anti-competitive thickets. Walmart is an excellent choice for doing that sort of thing.

freehunter 9y ago
I agree, cheaper health care is what we need, and hospitals can cut back on some unneeded expenses to make that happen... but my fear is we'll just see more low-cost low-benefit healthcare plans instead. I'd work with an older x-ray machine if it meant a little cheaper price. I wouldn't, however, buy a healthcare plan than didn't include x-rays just because it was cheaper.
- darawk 9y ago
  Well, the hope is your plan would cover what is required to treat a given condition. I.e. if you have a simple broken bone, you get the cheap x-ray. If you have a complex fracture that requires fine resolution, they cover the brand new fancy x-ray. The problem right now is: Your doctor prescribes the fancy x-ray as a catch-all, for everything that requires an x-ray. The insurance company then gets billed for "x-ray", which the doctor said was necessary. There is no incentive pressure for you to choose the cheap one, because you're not paying. The doctor doesn't care because they're not paying. And the insurance company gets screwed - but they're a business, so what do they do? Raise rates for everyone, and pass it on down the line.
  - deleted 9y ago
    [deleted]
  - nitrogen 9y ago
    Someone commented but was downvoted (apparently because they work for an insurance company?), and they deleted their comment. I think it's informative enough to quote here for history: > Actually, in many cases, we slap an authorization requirement on the fancy imagining or deny the claim for a lack of medical necessity. (Source: I work for an insurance company) You want to improve healthcare? Fix drug prices, fix the adversarial model between insurers and providers and do whatever you have to to get patients more facetime with clinicians. Connect and coordinate care - especially post discharge. Worry about things outside of medicine like food or social isolation or financial health.
    - darawk 9y ago
      I think that's true when they can tell the difference. But a lot of times, the doctor is just "go get an MRI, and hey, why don't you go to the place in our building". The price will be 3x higher than the place down the street, but the patient doesn't know that or care. Now, some insurers do indeed have strict in-network requirements, where they approve each place and how it provides care, and that can be a reasonable solution to this problem, but patients hate it, so many of them don't do it, and instead absorb this cost. > You want to improve healthcare? Fix drug prices, fix the adversarial model between insurers and providers What does 'fix drug prices' mean though? And why would 'fixing the adversarial model between insurers and providers' help things? In every other setting, adversarial models push costs down. These seem more like aspirations than solutions.

by darawk 9y ago

freehunter 9y ago

I agree, cheaper health care is what we need, and hospitals can cut back on some unneeded expenses to make that happen... but my fear is we'll just see more low-cost low-benefit healthcare plans instead. I'd work with an older x-ray machine if it meant a little cheaper price. I wouldn't, however, buy a healthcare plan than didn't include x-rays just because it was cheaper.

darawk 9y ago
Well, the hope is your plan would cover what is required to treat a given condition. I.e. if you have a simple broken bone, you get the cheap x-ray. If you have a complex fracture that requires fine resolution, they cover the brand new fancy x-ray. The problem right now is: Your doctor prescribes the fancy x-ray as a catch-all, for everything that requires an x-ray. The insurance company then gets billed for "x-ray", which the doctor said was necessary. There is no incentive pressure for you to choose the cheap one, because you're not paying. The doctor doesn't care because they're not paying. And the insurance company gets screwed - but they're a business, so what do they do? Raise rates for everyone, and pass it on down the line.
- deleted 9y ago
  [deleted]
- nitrogen 9y ago
  Someone commented but was downvoted (apparently because they work for an insurance company?), and they deleted their comment. I think it's informative enough to quote here for history: > Actually, in many cases, we slap an authorization requirement on the fancy imagining or deny the claim for a lack of medical necessity. (Source: I work for an insurance company) You want to improve healthcare? Fix drug prices, fix the adversarial model between insurers and providers and do whatever you have to to get patients more facetime with clinicians. Connect and coordinate care - especially post discharge. Worry about things outside of medicine like food or social isolation or financial health.
  - darawk 9y ago
    I think that's true when they can tell the difference. But a lot of times, the doctor is just "go get an MRI, and hey, why don't you go to the place in our building". The price will be 3x higher than the place down the street, but the patient doesn't know that or care. Now, some insurers do indeed have strict in-network requirements, where they approve each place and how it provides care, and that can be a reasonable solution to this problem, but patients hate it, so many of them don't do it, and instead absorb this cost. > You want to improve healthcare? Fix drug prices, fix the adversarial model between insurers and providers What does 'fix drug prices' mean though? And why would 'fixing the adversarial model between insurers and providers' help things? In every other setting, adversarial models push costs down. These seem more like aspirations than solutions.