6 ms·

American hospitals are just big ripoff machines. The whole nonsense with insurance negotiated, uninsured, in-network, out-of-network fees needa to go. Just post

American hospitals are just big ripoff machines. The whole nonsense with insurance negotiated, uninsured, in-network, out-of-network fees needa to go. Just post one price for a service for all. My girlfriend had a few surgeries over the last few years. The only conclusion I could draw from the bills was that a) they make up prices as they go b) they like to charge for things that never happened or put a several thousand percent markup on things They said that Obamacare was broken beyond repair. The same should be said for the current system and its billing practices.

Gibbon1 8y ago
I any other business tried to operate like hospitals do people would go to jail. Because what they do is fraud and extortion.
labster 8y ago
The current system is Obamacare, which is objectively terrible. It's just that the system before ACA was even worse. Until conservatives realize that there is no free market in health care without government intervention, guilds and cartels will continue.
- masonic 8y ago
  Obama/Pelosi/Reid could have implemented single-payer instead of Obamacare, but the latter makes their donors much more money.
  - labster 8y ago
    I remember 2008, and the path to 60 votes, and this was simply not true. Perhaps if Obama had started negotiating from single-payer, they maybe had would have gotten a public option. But a decade ago not enough democratic voters supported single-payer.
    - masonic 8y ago
      I remember 2008 Obama wasn't even President until 2009. It is true. The Democrats had a filibuster-proof 60-member caucus[0] in the Senate, full control of the House, and the Presidency. They didn't need (and didn't get) a single Republican vote. But as they delayed while busy loading the bill with even more disastrous spending (e.g. community pools, Risk Corridors, etc.), their Senate supermajority fell to 59. [0] https://www.senate.gov/legislative/LIS/roll_call_lists/roll_call_vote_cfm.cfm?congress=111&session=1&vote=00396 https://www.senate.gov/legislative/LIS/roll_call_lists/roll_...
      - pas 8y ago
        So, they had to cooperate, that is compromise, take more viewpoints into account! That the end result is worse (as in, it costs a lot more GDP wise) doesn't matter, as it wasn't important for the participants anyway. Conservatives wanted to emphasise the personal responsibility (and sweet, sweet personal freedom to not plan ahead), they got it.
      - labster 8y ago
        Caucuses are full of actual people who are worried about representing^W being reelected in vastly different districts. Party leadership can never rely on getting every vote; this is why whips were invented. In the case above, there was zero bipartisan cooperation past the original proposal, so the individual senators really mattered.
masonic 8y ago
Paying emergency/trauma patients get hit with the accumulated losses from all the trauma/emergency services they have to supply without compensation from the indigent and those here illegally. They have to accept everyone and treat them until stable. One MRSA or resistant-TB patient can ultimately cost them seven figures.
- maxxxxx 8y ago
  I want to see a detailed accounting of the money that floats around. I think the talk about having to compensate for other activities is just excuse.
- ericd 8y ago
  It's commonly trotted out that the non-paying ER patients force the higher list rate, and while it's a nice sob story cover that distracts from the outrageous audacity of the prices they charge, it just doesn't pass the sniff test. Want to know the daily rental rate for half of a shared room at Stanford's hospital? $17,000. That's not including any of the services, that's just for half of a tiny room. If there was a Four Seasons next to the hospital, it would be a small fraction of the price. That can subsidize a LOT of unpaid medical care. When you tack on the other care for a few days, it comes out to about $100k for a few days and maybe 24 hours of caretaker time during that time. I think the real reasons are much closer to the reason college tuitions are through the roof - a) there are far more "professional hospital administrators" now, drawing large salaries without a direct impact on quality of care, and b) relative price insensitivity by clientele, because they're either not paying for it themselves, or they're desperate for good medical care and are willing to pay any price at the time, and c) egregiously fancy expansions with fine woods everywhere in the lobby, marble, etc.
- pas 8y ago
  > those here illegally. How come they don't get a bill after treatment?
kamaal 8y ago
>>American hospitals are just big ripoff machines. Same here in India. For all the talk about Medical Tourism to India, it works only because Americans come here to India with Dollars, and $1 = 70 rupees. Your purchasing power suddenly increases by 70 times. For Indians in India. Its the same near US level rip off. Sometimes its also hard to not sympathize with the doctors. It takes the best years of your 20's and early 30's to get to be a good doctor, and its expensive to get all those degrees and training. So they charge whatever they have to, to not only recover all that money but also make a fortune worth profit along the way. A lot of time this is done through unethical means. Ordering tests the patient doesn't need(commissions with the labs), prolonging treatments to optimize for per visit costs, writing medication the patient doesn't need(again commissions with the pharmacy) etc etc. But yeah, I agree with you. Even In India, Most doctors I talk to want(ed) to go the US to settle there. Largely because of the apparently insanely high pay and perks. One person I talked in my extended family almost talked about it like it wasn't something they had to even think about. If you are a doctor you had to settle in the US. The profession is just too profitable in the USA, to not move to there.
- udkl 8y ago
  > and $1 = 70 rupees. Your purchasing power suddenly increases by 70 times. Don't want to be a snob, but $1 = 70 does not mean that the purchasing power of the dollar is 70 times. Purchasing power is related to the services and goods you can get. Eg: For $1, you can get a single nissan noodle bar in the US. For Rs70, you get around 7 maggi noodle bar's in India. In this case the purchasing power of the rupee is 8 times that of the USD.
- spdionis 8y ago
  Apologies in advance for not truly contributing to the discussion. > Same here in India. For all the talk about Medical Tourism to India, it works only because Americans come here to India with Dollars, and $1 = 70 rupees. Your purchasing power suddenly increases by 70 times. How is this logic?
  - eesmith 8y ago
    US$1 = JP¥110 = ISK 107, so the same logic says the purchasing power of a dollar in Japan and Iceland is even higher than in India.

Gibbon1 8y ago

I any other business tried to operate like hospitals do people would go to jail. Because what they do is fraud and extortion.

labster 8y ago

The current system is Obamacare, which is objectively terrible. It's just that the system before ACA was even worse. Until conservatives realize that there is no free market in health care without government intervention, guilds and cartels will continue.

masonic 8y ago
Obama/Pelosi/Reid could have implemented single-payer instead of Obamacare, but the latter makes their donors much more money.
- labster 8y ago
  I remember 2008, and the path to 60 votes, and this was simply not true. Perhaps if Obama had started negotiating from single-payer, they maybe had would have gotten a public option. But a decade ago not enough democratic voters supported single-payer.
  - masonic 8y ago
    I remember 2008 Obama wasn't even President until 2009. It is true. The Democrats had a filibuster-proof 60-member caucus[0] in the Senate, full control of the House, and the Presidency. They didn't need (and didn't get) a single Republican vote. But as they delayed while busy loading the bill with even more disastrous spending (e.g. community pools, Risk Corridors, etc.), their Senate supermajority fell to 59. [0] https://www.senate.gov/legislative/LIS/roll_call_lists/roll_call_vote_cfm.cfm?congress=111&session=1&vote=00396 https://www.senate.gov/legislative/LIS/roll_call_lists/roll_...
    - pas 8y ago
      So, they had to cooperate, that is compromise, take more viewpoints into account! That the end result is worse (as in, it costs a lot more GDP wise) doesn't matter, as it wasn't important for the participants anyway. Conservatives wanted to emphasise the personal responsibility (and sweet, sweet personal freedom to not plan ahead), they got it.
    - labster 8y ago
      Caucuses are full of actual people who are worried about representing^W being reelected in vastly different districts. Party leadership can never rely on getting every vote; this is why whips were invented. In the case above, there was zero bipartisan cooperation past the original proposal, so the individual senators really mattered.

masonic 8y ago

Paying emergency/trauma patients get hit with the accumulated losses from all the trauma/emergency services they have to supply without compensation from the indigent and those here illegally. They have to accept everyone and treat them until stable. One MRSA or resistant-TB patient can ultimately cost them seven figures.

maxxxxx 8y ago
I want to see a detailed accounting of the money that floats around. I think the talk about having to compensate for other activities is just excuse.
ericd 8y ago
It's commonly trotted out that the non-paying ER patients force the higher list rate, and while it's a nice sob story cover that distracts from the outrageous audacity of the prices they charge, it just doesn't pass the sniff test. Want to know the daily rental rate for half of a shared room at Stanford's hospital? $17,000. That's not including any of the services, that's just for half of a tiny room. If there was a Four Seasons next to the hospital, it would be a small fraction of the price. That can subsidize a LOT of unpaid medical care. When you tack on the other care for a few days, it comes out to about $100k for a few days and maybe 24 hours of caretaker time during that time. I think the real reasons are much closer to the reason college tuitions are through the roof - a) there are far more "professional hospital administrators" now, drawing large salaries without a direct impact on quality of care, and b) relative price insensitivity by clientele, because they're either not paying for it themselves, or they're desperate for good medical care and are willing to pay any price at the time, and c) egregiously fancy expansions with fine woods everywhere in the lobby, marble, etc.
pas 8y ago
> those here illegally. How come they don't get a bill after treatment?

kamaal 8y ago

>>American hospitals are just big ripoff machines. Same here in India. For all the talk about Medical Tourism to India, it works only because Americans come here to India with Dollars, and $1 = 70 rupees. Your purchasing power suddenly increases by 70 times. For Indians in India. Its the same near US level rip off. Sometimes its also hard to not sympathize with the doctors. It takes the best years of your 20's and early 30's to get to be a good doctor, and its expensive to get all those degrees and training. So they charge whatever they have to, to not only recover all that money but also make a fortune worth profit along the way. A lot of time this is done through unethical means. Ordering tests the patient doesn't need(commissions with the labs), prolonging treatments to optimize for per visit costs, writing medication the patient doesn't need(again commissions with the pharmacy) etc etc. But yeah, I agree with you. Even In India, Most doctors I talk to want(ed) to go the US to settle there. Largely because of the apparently insanely high pay and perks. One person I talked in my extended family almost talked about it like it wasn't something they had to even think about. If you are a doctor you had to settle in the US. The profession is just too profitable in the USA, to not move to there.

udkl 8y ago
> and $1 = 70 rupees. Your purchasing power suddenly increases by 70 times. Don't want to be a snob, but $1 = 70 does not mean that the purchasing power of the dollar is 70 times. Purchasing power is related to the services and goods you can get. Eg: For $1, you can get a single nissan noodle bar in the US. For Rs70, you get around 7 maggi noodle bar's in India. In this case the purchasing power of the rupee is 8 times that of the USD.
spdionis 8y ago
Apologies in advance for not truly contributing to the discussion. > Same here in India. For all the talk about Medical Tourism to India, it works only because Americans come here to India with Dollars, and $1 = 70 rupees. Your purchasing power suddenly increases by 70 times. How is this logic?
- eesmith 8y ago
  US$1 = JP¥110 = ISK 107, so the same logic says the purchasing power of a dollar in Japan and Iceland is even higher than in India.