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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 dependin
by 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 agoYeah, 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 agoIt 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.
- ekianjo 8y agoYour calculation is wrong. That's a deficit for a single year. There is a lot more deficit coming from multiple years piling up. Plus, the article clearly mentions: > The relatively low incomes of those covered by government insurance make it difficult to raise premiums The ones who benefit the most from large healtchare payments have close to no income (retired people), so they can't bear any cost at all basically. This means massively increasing premiums for a minority of the population.
- deleted 8y ago[deleted]
- dv_dt 8y agohttps://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita https://en.wikipedia.org/wiki/List_of_countries_by_total_hea... Per capita healthcare costs in Japan are still less than half of the costs of the US. Because of the age heavy demographics in Japan, that should be more difficult to handle than the US.
- Someone1234 8y agoIn terms of setting prices, that's what Medicare is largely. The government sets the prices. That's why in the US there has been a large push for "Medicare for all" (with Medicare Advantage plans covering above the basic coverage).
- maxxxxx 8y agoI bet the US could save boatloads of money if they abolished Medicaid, VA and other programs and instead went to Medicare for all as base coverage. Then you can add private insurance on top of that if you want more extensive coverage.
- merpnderp 8y agoNot the worst idea. We have already boxed ourselves into the worst type of socialized medicine, we might as well try to fix it.
- dv_dt 8y agoVA costs for drugs are lower than Medicare because the VA is allowed to negotiate drug prices, while Medicare is not. Part of the Medicare for all bill should change that.
- refurb 8y agoThe VA prices are less a negotiation and more of “the law says you have to give me at least a 24% discount”.
- dv_dt 8y agoConsidering that other first world nations pay half or less per capita for healthcare, and have government bodies setting allowed prices for drugs, then perhaps this is a big clue to affordable healthcare in the US.
- maxxxxx 8y agoI would already be happy if the prices just were transparent. That should be an issue that should appeal to most reasonable people.
- HarryHirsch 8y agoHow would price transparency work for emergencies that require hospital treatment? It's routine emergencies like appendicitis, psychiatric crises requiring a few days of inpatient treatment, even broken limbs. Those are the real cost-drivers, and if you've ever had a child or spouse with any of these you know that this isn't like picking a clinic for butt enlargement or LASIK.
- maxxxxx 8y agoIf you can't know upfront then publish the cost after the treatment. In addition publish the negotiated rates for all insurances. It's not that hard.
- Loughla 8y agoI 100% agree with this. I can get transparent pricing only AFTER treatments/stays, and only AFTER multiple phone calls and in-person visits to billing and administration. We recently did this for my spouse who had to have surgery that ended up not being covered by insurance due to it being classified as 'elective'. It was 100% NOT elective, and I decided to dig. After almost a full year (and being sent to collections for non-payment as I refused to pay until I had an itemized bill) I received a bill that was actually itemized. The surgeon/staff coded the surgery as the wrong procedure. But because there is never, ever a bill that lays out what you're paying for, I was never presented with an opportunity to question charges. Luckily I have a position that allows that much flexibility, but not everyone is that lucky.
- HarryHirsch 8y agoBut because there is never, ever a bill that lays out what you're paying for, I was never presented with an opportunity to question charges. The opportunity to question charges arises when you get your day in court. But, as you have discovered, the collection agency won't ever try to get a judgement in court because they full well know that the charges on the bill are bogus and the judge will throw the whole thing out if they pull up in front of one. That's how it works.
- nickjj 8y ago> In general a trip to the doctor and medicine is $10-20. I paid $500 for a 4 night stay in hospital (appendicitis) But you need to factor in your monthly costs into the equation. If you never experience a severe illness or accident then you're paying $3,020 ($250/month?) a year to see a doctor once for a routine checkup, or ~30k for 10 years, or nearly ~100k for 30 years.
- throwaway4job 8y agoOnce again, a "very smart" hn commenter doesn't understand the concepts of risk or insurance. Quelle surprise.
- jjoonathan 8y agoLow out-of-pocket is an advantage in and of itself. The total cost calculations that show the US system to be twice do include taxes spent on health care, naturally.
- GuinansEyebrows 8y agosimilar to the netherlands, where the government mandates pricing and coverage options and private insurers compete within those guidelines. basically everyone over a certain income threshold pays about a hundred euros out of pocket per month, with almost no cop-pays to speak of (including doctor visits and perscriptions). people in the netherlands are healthy and have easy access to affordable healthcare, and the big insurers still operate within a competitive system. it's not my personal favorite but it seems to work well for most people.