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Your comment actually presents an idea that many choose to ignore, that healthcare is actually two markets in one. For routine primary care like regular checku
by ghobs91 8y ago
Your comment actually presents an idea that many choose to ignore, that healthcare is actually two markets in one.
For routine primary care like regular checkups or an appointment for some symptom bothering you, you absolutely are not under duress. You won't die because you took 5 minutes to choose a doctor on ZocDoc. With more transparency in costs of service, this could definitely become a market, ie "for $XX per month, get unlimited visits to our partner doctors' offices".
For emergency situations, surgeries, and things that require expensive ongoing care like cancer, you're correct in that you're under duress and can't really shop around. This is the market in which the usage of insurance makes sense, as it's a rare occurrence that would be catastrophic to pay for out of pocket for the majority of people.
I think we can do a great deal to lower cost of healthcare to Americans if we think of it in this two market approach, and handle each accordingly.
- rootusrootus 8y agoEven getting routine care, I've had 0% success gaining any transparency at all. Maybe it works for generic GP services, but for imaging or other testing, I've tried and completely failed. "Contact our billing department and they may be able to tell you" is the best answer I get. I'm ready to vote for forced transparency at all levels. I'm tired of this opaque negotiated pricing with insurance companies that manages to maximize my out-of-pocket costs.
- Sir_Vival 8y agoTransparency and high deductibles for everyone would instantly lower costs dramatically. I have to take testosterone, and you have two primary options. One is a gel that you rub on every day that's really hard to dose correctly due to absorbency issues, and the other is a weekly injection. I wasn't even offered the second option until I asked for it. The gel was $400 a month and the injection is around $20 a month. I generally hit my deductible a month or two in to the year for various reasons and the difference in copays isn't enough for me to care, generally. Medical insurance needs to be insurance again.
- eldavido 8y agoThe way I've usually seen this split is "emergent" vs. "non-emergent" (as in "emergency). You are correct that non-emergent care is a WAY bigger market than emergent. Most people completely ignore this. Chronic conditions like diabetes and Crohn's, end-of-life care (hospice, assisted living), dialysis, smoking cessation and weight loss, blood transfusions, most flavors of oncology (cancer treatment), knee replacements, etc. We need way more cost discipline in non-emergent situations. Changing the perception that all care is emergent might be the single biggest thing we could do to lower healthcare costs. It would let people see that there should indeed be a market in everything from X-rays to MRIs and we could finally have a sensible conversation about cost.
- Faark 8y agoA problem with this split is preventive care. You want to incentivize prevention, otherwise non-emergency issues can become way more costly emergencies. And just like that are both tied together, again...
- mcv 8y agoThat's why preventive care is almost universally covered in Netherland, despite the fact that many other things are not or partially covered. I can visit my physician any time for the smallest thing.