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Health pricing is a weird fixed pricing with all sides in insurance companies, medical suppliers and doctors holding the cards to get the highest prices within
by drawkbox 8y ago
Health pricing is a weird fixed pricing with all sides in insurance companies, medical suppliers and doctors holding the cards to get the highest prices within the gamed rules with the consumer left out in the cold and each bill a random output that is rarely known beforehand.
Part of the problem is healthcare provided through work that skews pricing for large companies over individuals/small/medium businesses and entrepreneurs.
If we can't get healthcare removed from employers and have both a private and public option based on Medicare for all. We AT LEAST need legislation to bring in CLEAR pricing for insurance cost and non-insurance rates, similar to the CFPB mortgage Loan Estimate and Closing Disclosure that show all pricing clearly in one sheet of paper both the estimate and the final mortgage.
What other product do we buy that the price is not known until after the product/service is rendered? At least some idea of an estimate is even hard to get as each part of the medical pricing matrix scam (insurance companies, medical services/suppliers, doctors, pharmaceuticals) try to keep pricing shrouded to stick it to people wherever they can.
The consumer healthcare experience is horrible in the US healthcare system and employers being the insurance companies main customers is a major part of this problem but pricing can be helped with clear regulations and needs to be now.
- analog31 8y agoIn my view, understanding the flow of money in the health care system will be impossible until the system is wholly owned by the government. This may be the primary reason why health care in most civilized countries costs half of what it does here. Until then, everybody who's gouging us accuses everybody else of being the ones who are gouging us.
- ende 8y agoYou should consider the possibility that you have the direction of causality reversed there.
- sgift 8y agoConsidering ... done. Comparison with other countries says: Not reversed.
- andybak 8y agoTrying to parse your suggested reversal. Do you mean "health care in most civilized countries costs half of what it does here system is the reason it is government-owned in those places"? Leaving aside from the fact that very few countries have wholly-government owned health care - this formulation doesn't make sense. Or is it the line about gouging you are referring to? Can you explain a bit more clearly what your point is? I haven't woken up enough yet to decipher your comment.
- ende 8y agoCertainly, and I apologize if my brief wording wasn't clear. > This may be the primary reason why health care in most civilized countries costs half of what it does here. There is a common conception that simply adopting one of the many different systems used in these other countries would immediately solve the cost problems in US healthcare by way of single payer price negotiating, but the problem that addresses doesn't tell the whole story of high healthcare cost in the US. It's not just US healthcare costs that are abnormally high but healthcare consumption - due in part somewhat to the defensive posture of medicine towards a tort heavy society, but also because healthcare consumers in the US simply demand more healthcare than consumers in other countries; (call it the Super Size Me effect?) So it's not necessarily the case that any kind of single payer system is going to change that culture of consumption. The systems used in other countries are largely possible due to different levels and modes of consumption. Mind you, I generally support some kind of single payer system for the US (preferably modeled after some combination of elements from Canada, France and Australia). But I'm bothered by these panacea arguments when it doesn't seem at all clear that such statements of causality can be convincingly made.
- conanbatt 8y agoThe most frustrating issue with the Bernie Sanders single payer campaign is that they flat out lie saying that the reason why healthcare is expensive is because it is private. Healthcare hasnt been so expensive forever, it was actually very cheap decades ago, when it was still private. The efficiency issues are not public vs private. Its mostly regulatory burdens.
- furyg3 8y agoAs someone who lives in a country where the regulatory burdens are higher and healthcare is cheaper, you are very wrong.
- conanbatt 8y agoShare your country and I will be very much able to show you why the burden of regulation is worse in the us, at least in terms of price. And lets add one more thing: we can compare the US to itself, to 50 years ago, and show that 50 years ago healthcare was super cheap, and still private.
- scarface74 8y agoYes regulatory burdens like actually being forced to cover people with pre-existing conditions, not being able to drop people once they use thier insurance and not being able to exclude certain conditions....
- IncRnd 8y ago>> In my view, understanding the flow of money in the health care system will be impossible until the system is wholly owned by the government. To judge the correctness of your statement, just look at what has happened to other industries that the US Federal Government controls: costs rise, service times increase, quality suffers, accountability disappears, etc.
- lancewiggs 8y agoYou might want to compare the cost and service from VA to the private medical system. It’s not pretty for the private sector.
- dsfyu404ed 8y agoAgreed. I would have no problem with the Canadian government owning US healthcare since they already own and operate Canadian heath-care and do an ok job at it. Everything the US government owns seems to eventually slide toward being a lot like the DMV.
- nicoburns 8y agoThis seems to be because people in the US don't want to actually give their government control of anything. And thus anything that is government run seems to have clauses that allow private industries control things. The worst of both worlds!
- Moru 8y agoI don't think it's so much the goverment but the industry that tells the government what to do. You don't bite the hand that feed you.
- pjc50 8y agoIf Americans really believed in the superiority and effectiveness of the private system, they'd use it for their military. Troops should have a choice of Medevac service providers!
- 8y ago
- scarface74 8y agoAs far as prescription drug cost, even the part of the health care system that is government control - Medicare - prescription drug prices are whatever the company sets. When Bush signed the law making prescription drug coverage part of Medicare, part of the law was that the government could not negotiate prices.
- r00fus 8y agoI.e. Bush gimped any controls on drug costs.
- api_or_ipa 8y ago> until the system is wholly owned by the government The thing is that single payer healthcare systems in Canada and Europe aren't necessarily owned by the government. In Canada, each province's healthcare is run as a government owned insurance company, with the requirement that everyone have health insurance. Some provinces bill this out to each insured person on a sliding scale of income, with a cut off for the low income.
- dragonwriter 8y ago> This may be the primary reason why health care in most civilized countries costs half of what it does here. It's not, because other countries with mixed public/private systems don't have notably higher costs than the full- or primarily-public ones.
- cascom 8y agoI don’t disagree with your sentiment, but a major problem is that the US healthcare system’s function (or lack thereof) is based on price discrimination e.g. the list price for a doctor visit might be $150, the doctor gets reimbursed $15 for a Medicaid patient, $60 for a Medicare patient, $90 for privately insured patient, and a $135 for a cash pay patient. It’s a lot like college tuition - there is a sticker price - but very few student’s actually “pay” the sticker amount, or the same price for that matter At the end of the day the core problem is that price transparency and price discrimination are at odds with each other...people don’t like being told they have to pay more for something because of “who they are”
- Karishma1234 8y agoYes. The price discovery is near impossible when prices are not so upfront.
- AnthonyMouse 8y ago> I don’t disagree with your sentiment, but a major problem is that the US healthcare system’s function (or lack thereof) is based on price discrimination e.g. the list price for a doctor visit might be $150, the doctor gets reimbursed $15 for a Medicaid patient, $60 for a Medicare patient, $90 for privately insured patient, and a $135 for a cash pay patient. But all of this price discrimination is bad -- it's hurting everybody. Medicaid and Medicare patients paying less causes more doctors to not accept them. Privately insured and uninsured patients paying more imposes costs on working people and small businesses who have to subsidize a government program, not through taxes in proportion to their revenue or wealth, but through higher insurance premiums in proportion to their number of employees regardless of how much the employees make. Eliminating that sort of price discrimination would solve a significant portion of the problem by itself, by eliminating that cross-subsidy and requiring government benefits to be funded overly and by the people who can afford to pay rather than covertly through higher private insurance premiums on people who can't.
- the_mitsuhiko 8y agoI think the reason meds are expensive are completely different why doctors or hospitals are expensive in the states. While all of those things happen because the system has no desire to be cheap and free market forces do not happen they are all different and need to be fixed individually.
- deleted 8y ago[deleted]