7 ms·

The number one thing the US needs to do is to mandate transparent pricing of all things medical. Wherever you look there is opaque pricing that's intentionally

The number one thing the US needs to do is to mandate transparent pricing of all things medical. Wherever you look there is opaque pricing that's intentionally hiding information from other market participants. No market can function without the participants having information.

lugg 8y ago
I'd like to see this for telecoms and the banking sector as well.
- mhb 8y ago
  What aspect of banking?
- Someone1234 8y ago
  Banking sector is legally required to be transparent. Specifically you should have received an "IMPORTANT DISCLOSURES" with information on them all like this: https://www.wellsfargo.com/credit-cards/propel/terms https://www.wellsfargo.com/credit-cards/propel/terms Telecom I completely agree though. Some of the fake fees they charge (that are worded to look like taxes/regulatory) is almost criminal.
  - lugg 8y ago
    That's not transparency. That is disclosing their prices in small print. I'm talking about removing hidden fees being passed around behind closed doors. Fees like what visa will charge your merchant and kick back to your bank. What other fees am I paying for indirectly without my knowledge? If I could see them maybe I could shop around for a bank that doesn't shaft merchants leading to a healthier economy and more jobs, you know, actual trickle down.
- deelowe 8y ago
  What's not transparent with banking? It's literally the most heavily regulated industry.
  - mschuster91 8y ago
    > What's not transparent with banking? From what I gather in the US issues are e.g. weird shit banks do when processing checks and other payments, e.g. reordering transactions to generate unneccessary overdraft fees. In Germany we for example long had the problem that ATMs of banks not in your network (e.g. when using a Deutsche Bank ATM with a Sparkasse card) were not required to show the fees associated with withdrawing cash. IIRC it needed EU regulation to finally fix this.
rangibaby 8y ago
Japan does this, the government decides the costs of all procedures and medicine, and user pays 30% + a couple of hundred bucks per month (more or less depending on your income). In general a trip to the doctor and medicine is $10-20. I paid $500 for a 4 night stay in hospital (appendicitis)
- ekianjo 8y ago
  Yeah, and the system is deeply in the red in Japan and everyone knows it. Seniors only pay for 10% of the cost and go way more to get medical care than salarymen, so there's no one to pay the bill in the end. It's not sustainable at all. You know that an injection of a typical cancer drug costs like 150 000 JPY and it's once every 2 weeks or so? And you have chronic conditions like Psoriasis or RA where biologic treatments cost more than 100 000 JPY per month/patient, and potentially for dozens of years as patients remain on treatment. This represents massive costs for the healthcare system. https://asia.nikkei.com/Economy/Chronic-deficits-plague-Japan-s-health-insurance-program https://asia.nikkei.com/Economy/Chronic-deficits-plague-Japa... > the government decides the costs of all procedures and medicine That's a simplification. There are rules for pricing. Drugs in Japan will typically be priced somewhere between EU pricing and US pricing because the PMDA benchmarks across different countries, so Japan drug prices can't be massively cheaper or something. Companies know that very well and on purpose do not let Japan get a first approval for any kind of major drug, as benchmarking vs EU/US will enable them to secure higher prices in Japan. There are whole teams working on optimizing the rollout of drugs worldwide just based on maximizing pricing strategies.
  - deleted 8y ago
    [deleted]
  - opencl 8y ago
    It really doesn't seem particularly deep in the red. 284 billion ¥ annual deficit for 32 million people, that would be covered entirely by raising everyone's premiums 750¥ (less than $7) per month.
    - 8y ago
Spooky23 8y ago
Rather than futz around with piecemeal regulation, we need to either make legal changes to return to pre-1971 views on anti-trust or socialize the whole process.
- noir_lord 8y ago
  I live in a country with socialised healthcare (UK/NHS) and while I like the NHS (I have two complex medical conditions that would largely make me uninsurable in the US) it has it's problems. As always it's the implementation not the concept, the NHS has been a political football for decades, The left wing party (Labour) get in and increase funding to offset the damage the Right wing party did (the Conservatives) by underfunding, then they swap back and forth. Even with all of it's problems it's a very efficient system at scale but it could be much better. For what it's worth out of 600 odd MP's (our version of Congress people) I'd maybe piss on two or three if they where on fire, the rest can burn.
  - munk-a 8y ago
    Sorry but this isn't a problem with socialized healthcare, this is a problem with education of people in general and voting knowledge and the election system. If a party that bankrupts a popular system keeps getting re-elected then something is wrong, _generally_ this can be attributed to the two party system of government that has become much more predominant in the western world and enables extremism by catering to single issue voters. To reword your statement, "My sandcastle building is going great except every once in a while this jerk comes over and kicks over my sandcastle, I guess there's a problem with my sandcastle" and the correct answer is that the problem is the jerk.
    - noir_lord 8y ago
      1000% agree but no idea what the solution is. We had a referendum on proportional representation vote and you should have seen the adverts from the against camp, it was depressingly expected though.
      - 8y ago
bluGill 8y ago
Your [large] employer benefits from the system and wants it to stay. You cannot get a better deal on health insurance on your own than through your employer. If you want to take a summer off the amount of money you would have to save up to pay for that is much higher. If you are thinking about changing jobs for more money you have to not only compare salaries, but also a complex benefit system that isn't really explained in the job offer. If you want to see transparent pricing get the employer out. Buy your insurance directly from whoever you want (or maybe from the agent you like). Of course it will take years for things to change after this, don't expect things overnight. Edit: as others have pointed out, it is the large companies who benefit at the expense of small companies and employees.
- maxxxxx 8y ago
  Yes, it's a f...ed up system that pretty much benefits everyone but the patient. Employers have control and providers and middlemen make boatloads of money.
- lotsofpulp 8y ago
  An employer benefits only if you are a big employer with an HR department that can afford to spend time on the BS paperwork. If you're a smaller employer, the overhead and costs are crushing. For smaller employers, it's better to just tell the employees to go to healthcare.gov and reimburse them for premiums they pay. Less paperwork, and employee gets to pay for health insurance with tax exemption.
- gumby 8y ago
  This was one of the many things misrepresented in the ACA debate. ACA, as intended, (and Medicare for all) put small business and startups on a more equal footing with the "big guys", but the "anti" campaign said "oh small business will suffer". Of course most small businesses can't afford to provide health insurance at all right now. And of course some lobbyist was able to put a stumbling block into the ACA: companies can't reimburse your ACA premiums (they can give you a raise but it's taxed).
- e40 8y ago
  As a small employer (< 50 people), I can tell you I hate that it is on me to find and provide insurance to my employees. It's only huge companies that want this system to remain.
zaroth 8y ago
I would go a step further. Pricing should be transparent and non-discriminatory. Discounts, bundling, rebates, or preferred pricing of any kind should be illegal in health care.

lugg 8y ago

I'd like to see this for telecoms and the banking sector as well.

mhb 8y ago
What aspect of banking?
Someone1234 8y ago
Banking sector is legally required to be transparent. Specifically you should have received an "IMPORTANT DISCLOSURES" with information on them all like this: https://www.wellsfargo.com/credit-cards/propel/terms https://www.wellsfargo.com/credit-cards/propel/terms Telecom I completely agree though. Some of the fake fees they charge (that are worded to look like taxes/regulatory) is almost criminal.
- lugg 8y ago
  That's not transparency. That is disclosing their prices in small print. I'm talking about removing hidden fees being passed around behind closed doors. Fees like what visa will charge your merchant and kick back to your bank. What other fees am I paying for indirectly without my knowledge? If I could see them maybe I could shop around for a bank that doesn't shaft merchants leading to a healthier economy and more jobs, you know, actual trickle down.
deelowe 8y ago
What's not transparent with banking? It's literally the most heavily regulated industry.
- mschuster91 8y ago
  > What's not transparent with banking? From what I gather in the US issues are e.g. weird shit banks do when processing checks and other payments, e.g. reordering transactions to generate unneccessary overdraft fees. In Germany we for example long had the problem that ATMs of banks not in your network (e.g. when using a Deutsche Bank ATM with a Sparkasse card) were not required to show the fees associated with withdrawing cash. IIRC it needed EU regulation to finally fix this.

rangibaby 8y ago

Japan does this, the government decides the costs of all procedures and medicine, and user pays 30% + a couple of hundred bucks per month (more or less depending on your income). In general a trip to the doctor and medicine is $10-20. I paid $500 for a 4 night stay in hospital (appendicitis)

ekianjo 8y ago
Yeah, and the system is deeply in the red in Japan and everyone knows it. Seniors only pay for 10% of the cost and go way more to get medical care than salarymen, so there's no one to pay the bill in the end. It's not sustainable at all. You know that an injection of a typical cancer drug costs like 150 000 JPY and it's once every 2 weeks or so? And you have chronic conditions like Psoriasis or RA where biologic treatments cost more than 100 000 JPY per month/patient, and potentially for dozens of years as patients remain on treatment. This represents massive costs for the healthcare system. https://asia.nikkei.com/Economy/Chronic-deficits-plague-Japan-s-health-insurance-program https://asia.nikkei.com/Economy/Chronic-deficits-plague-Japa... > the government decides the costs of all procedures and medicine That's a simplification. There are rules for pricing. Drugs in Japan will typically be priced somewhere between EU pricing and US pricing because the PMDA benchmarks across different countries, so Japan drug prices can't be massively cheaper or something. Companies know that very well and on purpose do not let Japan get a first approval for any kind of major drug, as benchmarking vs EU/US will enable them to secure higher prices in Japan. There are whole teams working on optimizing the rollout of drugs worldwide just based on maximizing pricing strategies.
- deleted 8y ago
  [deleted]
- opencl 8y ago
  It really doesn't seem particularly deep in the red. 284 billion ¥ annual deficit for 32 million people, that would be covered entirely by raising everyone's premiums 750¥ (less than $7) per month.
  - 8y ago

Spooky23 8y ago

Rather than futz around with piecemeal regulation, we need to either make legal changes to return to pre-1971 views on anti-trust or socialize the whole process.

noir_lord 8y ago
I live in a country with socialised healthcare (UK/NHS) and while I like the NHS (I have two complex medical conditions that would largely make me uninsurable in the US) it has it's problems. As always it's the implementation not the concept, the NHS has been a political football for decades, The left wing party (Labour) get in and increase funding to offset the damage the Right wing party did (the Conservatives) by underfunding, then they swap back and forth. Even with all of it's problems it's a very efficient system at scale but it could be much better. For what it's worth out of 600 odd MP's (our version of Congress people) I'd maybe piss on two or three if they where on fire, the rest can burn.
- munk-a 8y ago
  Sorry but this isn't a problem with socialized healthcare, this is a problem with education of people in general and voting knowledge and the election system. If a party that bankrupts a popular system keeps getting re-elected then something is wrong, _generally_ this can be attributed to the two party system of government that has become much more predominant in the western world and enables extremism by catering to single issue voters. To reword your statement, "My sandcastle building is going great except every once in a while this jerk comes over and kicks over my sandcastle, I guess there's a problem with my sandcastle" and the correct answer is that the problem is the jerk.
  - noir_lord 8y ago
    1000% agree but no idea what the solution is. We had a referendum on proportional representation vote and you should have seen the adverts from the against camp, it was depressingly expected though.
    - 8y ago

bluGill 8y ago

Your [large] employer benefits from the system and wants it to stay. You cannot get a better deal on health insurance on your own than through your employer. If you want to take a summer off the amount of money you would have to save up to pay for that is much higher. If you are thinking about changing jobs for more money you have to not only compare salaries, but also a complex benefit system that isn't really explained in the job offer. If you want to see transparent pricing get the employer out. Buy your insurance directly from whoever you want (or maybe from the agent you like). Of course it will take years for things to change after this, don't expect things overnight. Edit: as others have pointed out, it is the large companies who benefit at the expense of small companies and employees.

maxxxxx 8y ago
Yes, it's a f...ed up system that pretty much benefits everyone but the patient. Employers have control and providers and middlemen make boatloads of money.
lotsofpulp 8y ago
An employer benefits only if you are a big employer with an HR department that can afford to spend time on the BS paperwork. If you're a smaller employer, the overhead and costs are crushing. For smaller employers, it's better to just tell the employees to go to healthcare.gov and reimburse them for premiums they pay. Less paperwork, and employee gets to pay for health insurance with tax exemption.
gumby 8y ago
This was one of the many things misrepresented in the ACA debate. ACA, as intended, (and Medicare for all) put small business and startups on a more equal footing with the "big guys", but the "anti" campaign said "oh small business will suffer". Of course most small businesses can't afford to provide health insurance at all right now. And of course some lobbyist was able to put a stumbling block into the ACA: companies can't reimburse your ACA premiums (they can give you a raise but it's taxed).
e40 8y ago
As a small employer (< 50 people), I can tell you I hate that it is on me to find and provide insurance to my employees. It's only huge companies that want this system to remain.

zaroth 8y ago

I would go a step further. Pricing should be transparent and non-discriminatory. Discounts, bundling, rebates, or preferred pricing of any kind should be illegal in health care.