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This will ensure the death of the private healthcare system. It won't happen overnight, but eventually the private/hybrid healthcare system will have no redeemi

by mtgx 8y ago

This will ensure the death of the private healthcare system. It won't happen overnight, but eventually the private/hybrid healthcare system will have no redeeming qualities other than to extract as much profit as possible out of anyone's health issues. That's when no one will support it anymore (except the politicians taking bribes to support it).

Analemma_ 8y ago
Why the downvotes? He's right. The thing about insurance is that the only reason it works is because of imperfect information about the future. The more accurately people can be priced, the more pointless private health insurance becomes: the expensive patients (pre-existing conditions, or just people with bad luck) will get accurately priced and have impossible premiums and won't bother, and the cheap patients will realize they probably don't need it, take a gamble and also not bother. Microtargeted health insurance will be its own undoing.
- mindcrime 8y ago
  It sounds like you're doing something that most people do, despite it being incorrect. That is, conflating "health care" and "health insurance". Everybody has gotten so conditioned to the idea that "health insurance" pays for everything health related, that we all seem to take this for granted. But it doesn't have to be so. I believe that our goal should be to reduce the cost of health care so that most of it can be afforded without insurance - with insurance then returned to its role as a hedge against the more extreme/unlikely events.
  - poulsbohemian 8y ago
    >Everybody has gotten so conditioned to the idea that "health insurance" pays for everything health related, that we all seem to take this for granted. But it doesn't have to be so. Try this experiment. Walk into your doctor's office and ask what a procedure would cost. Ask the doctor, the receptionist, the billing clerk - ask everyone. No one will be able to give you an answer. That's why they are conflated. Fix that (very ripe for disruption) problem and you'll fix health care. PS: I agree with you, it should generally be affordable without insurance.
    - mindcrime 8y ago
      Try this experiment. Walk into your doctor's office and ask what a procedure would cost. Ask the doctor, the receptionist, the billing clerk - ask everyone. No one will be able to give you an answer. That's why they are conflated. Fix that (very ripe for disruption) problem and you'll fix health care. Agreed.
    - jsoc815 8y ago
      > Try this experiment. ...ask everyone. No one will be able to give you an answer. Funny you say this. A friend just went through this. Not even the insurance company could say. The calls to everyone got so ridiculous that I had to construct lawyerly questions so that people couldn't default to weaselly answers. The provider billing staff seemed to feel put upon that they were being asked to coordinate w/the insurer to figure out patient out of pocket cost would be. And in the end they still couldn't figure it out.
      - poulsbohemian 8y ago
        Here's what gets to me as well... providers love to talk about how little they get reimbursed from medicare and from many insurers. But, for example, I'm not going to have a surgery that I would really like to have (and that a doctor agreed I should have) because nobody can tell me what the cost would be. The 15 minute appointment with the doctor who recommended it to me was $700 out of pocket - so I'm unlikely to return if that's the kind of bill I get hit with for having a cup of coffee with them. So, I'd like to believe that at some point, given the current environment in which people are paying for insurance but can't afford to go to the doctor, that we'll see providers realize they are losing out on revenue opportunities by not actually serving their customers.
        jsoc815 8y ago
        >I'm not going to have a surgery... because nobody can tell me what the cost would be. Exactly this! I thought having my friend appeal to the provider's interest in being paid might spur them to figure it out. Surprise! It didn't. Even when explicitly mentioning that the point of asking for this information was to ensure that (s)he had the $$ to pay them, the provider('s billing team) still balked at being asked to figure out out of pocket cost(s). When (s)he threatened to cancel the procedure, they just said "Fine." (s)He tried w/another provider, who was a little more diligent in trying to figure things out, but the best that they could do was figure out that the insurance company would approve the procedure, and what some of the involved parties were billing. Mind you, (s)he was actually dealing with the hospital where the procedure was to be performed. But of course, since all of the people involved are not hospital staff, they "can't" figure out everything. It's all ridiculous and the result of bad policy and planning. On a separate note, I once noticed a billing error. When I called the insurance company to ask if they had any standards/definition for what constitutes delivery of a particular service/procedure, the rep said, "No. We just look at the amount charged and pay if it makes sense."
mindcrime 8y ago
This will ensure the death of the private healthcare system. We don't have a private health-care system, and haven't for a very long time. The government and big corporations[1] are so deeply entwined into the current system that it barely approaches anything that could be called "private". [1]: Corporations are a legal fiction which depend on the State for their existence.
poulsbohemian 8y ago
> will have no redeeming qualities other than to extract as much profit as possible out of anyone's health issues. We're already at this point, but I don't see why you think that will be the death of the private healthcare system, see: >politicians taking bribes to support it

by mtgx 8y ago

Analemma_ 8y ago

Why the downvotes? He's right. The thing about insurance is that the only reason it works is because of imperfect information about the future. The more accurately people can be priced, the more pointless private health insurance becomes: the expensive patients (pre-existing conditions, or just people with bad luck) will get accurately priced and have impossible premiums and won't bother, and the cheap patients will realize they probably don't need it, take a gamble and also not bother. Microtargeted health insurance will be its own undoing.

mindcrime 8y ago
It sounds like you're doing something that most people do, despite it being incorrect. That is, conflating "health care" and "health insurance". Everybody has gotten so conditioned to the idea that "health insurance" pays for everything health related, that we all seem to take this for granted. But it doesn't have to be so. I believe that our goal should be to reduce the cost of health care so that most of it can be afforded without insurance - with insurance then returned to its role as a hedge against the more extreme/unlikely events.
- poulsbohemian 8y ago
  >Everybody has gotten so conditioned to the idea that "health insurance" pays for everything health related, that we all seem to take this for granted. But it doesn't have to be so. Try this experiment. Walk into your doctor's office and ask what a procedure would cost. Ask the doctor, the receptionist, the billing clerk - ask everyone. No one will be able to give you an answer. That's why they are conflated. Fix that (very ripe for disruption) problem and you'll fix health care. PS: I agree with you, it should generally be affordable without insurance.
  - mindcrime 8y ago
    Try this experiment. Walk into your doctor's office and ask what a procedure would cost. Ask the doctor, the receptionist, the billing clerk - ask everyone. No one will be able to give you an answer. That's why they are conflated. Fix that (very ripe for disruption) problem and you'll fix health care. Agreed.
  - jsoc815 8y ago
    > Try this experiment. ...ask everyone. No one will be able to give you an answer. Funny you say this. A friend just went through this. Not even the insurance company could say. The calls to everyone got so ridiculous that I had to construct lawyerly questions so that people couldn't default to weaselly answers. The provider billing staff seemed to feel put upon that they were being asked to coordinate w/the insurer to figure out patient out of pocket cost would be. And in the end they still couldn't figure it out.
    - poulsbohemian 8y ago
      Here's what gets to me as well... providers love to talk about how little they get reimbursed from medicare and from many insurers. But, for example, I'm not going to have a surgery that I would really like to have (and that a doctor agreed I should have) because nobody can tell me what the cost would be. The 15 minute appointment with the doctor who recommended it to me was $700 out of pocket - so I'm unlikely to return if that's the kind of bill I get hit with for having a cup of coffee with them. So, I'd like to believe that at some point, given the current environment in which people are paying for insurance but can't afford to go to the doctor, that we'll see providers realize they are losing out on revenue opportunities by not actually serving their customers.
      - jsoc815 8y ago
        >I'm not going to have a surgery... because nobody can tell me what the cost would be. Exactly this! I thought having my friend appeal to the provider's interest in being paid might spur them to figure it out. Surprise! It didn't. Even when explicitly mentioning that the point of asking for this information was to ensure that (s)he had the $$ to pay them, the provider('s billing team) still balked at being asked to figure out out of pocket cost(s). When (s)he threatened to cancel the procedure, they just said "Fine." (s)He tried w/another provider, who was a little more diligent in trying to figure things out, but the best that they could do was figure out that the insurance company would approve the procedure, and what some of the involved parties were billing. Mind you, (s)he was actually dealing with the hospital where the procedure was to be performed. But of course, since all of the people involved are not hospital staff, they "can't" figure out everything. It's all ridiculous and the result of bad policy and planning. On a separate note, I once noticed a billing error. When I called the insurance company to ask if they had any standards/definition for what constitutes delivery of a particular service/procedure, the rep said, "No. We just look at the amount charged and pay if it makes sense."

mindcrime 8y ago

This will ensure the death of the private healthcare system. We don't have a private health-care system, and haven't for a very long time. The government and big corporations[1] are so deeply entwined into the current system that it barely approaches anything that could be called "private". [1]: Corporations are a legal fiction which depend on the State for their existence.

poulsbohemian 8y ago

> will have no redeeming qualities other than to extract as much profit as possible out of anyone's health issues. We're already at this point, but I don't see why you think that will be the death of the private healthcare system, see: >politicians taking bribes to support it