13 ms·

The difference here is not that we don't do surgeries efficiently, but that we are subject to the effects of regulatory capture, which stops any kind of price c

The difference here is not that we don't do surgeries efficiently, but that we are subject to the effects of regulatory capture, which stops any kind of price competition in its tracks and leads to $300 bags of saline.

notyourday 8y ago
I most am most likely going to need an ACL surgery in a couple of months so we will see how it goes. So far I found out that pretty much every "X is difficult" is a gospel peddled by lazy. This is my first relatively major incident so I'm running pretty blind -- I'm approaching it as I approach needing to do something in business. Instead of going to the ER ($2,500), I went to a walk in medical center ($120), got seen by an emergency medicine doc. I got a $120 (ER) brace for free in that clinic -- it is probably one of 100 in NYC, open 7 days a week from 8 am to midnight -- i did not go to their other one which is 24x7 Instead of spending $800 on X-ray at the ER, I spent $40 and got results on a CD within 10 minutes at the same walk in clinic. My MRI was not $2800 but $600 because instead of doing it in a hospital I did it at the radiology center. Both the doc at the walk in clinic and the surgeons said "You can do it in the hospital but it would cost a lot more and take a lot longer. Go to Lenox Hill Radiology -- they have about fifty locations in the city and you would be able to get it done today oh and your results will be emailed to us". My two visits to orthopedic surgeons ( there were two different doctors working at the same office ) specializing in sports medicine ( fixing athletes ) cost me $260 ( first visit ) and $120 ( follow up ) -- same two surgeons looked at me and the second visit included a second set of X-rays ( not extra cost ). My one on one PT specializing in sports rehab is costing me $100/h rather than unknown amount. I have a hunch simply because I let my fingers do the Googling my ACL surgery wont cost me $50k even though I won't be leaving NYC to do it. What is that magic thing that I did? Googled "Sports medicine surgeons" and sent emails to the email addresses. I also googled "Physical therapy near me" and emailed all of them, getting the prices and asking if they had any experience with rehabbing athletes -- I read reviews of the ones that did not respond after -- none of them had good reviews. The ones that did respond had very decent prices, used tech and were on the ball oh and they had stellar reviews. But I guess that is hard. Edit: Cute. Bring on the downvotes. That's the crux of the problem. Personal responsibility is "hard" so no wonder those who tend to outsource it get fleeced. When HN re-enables my posting ability I will respond to the individual questions/positions.
- 8ytecoder 8y ago
  What's the incentive for me to save all that money when my insurance pays for it anyway and my company pays for my insurance? Insurance is supposed to do this job - negotiate prices ...etc., but, people are so attached to their doctors that insurance usually caves giving hospitals a much higher bargaining power.
  - notyourday 8y ago
    High Deductible Plan. Takes care of big ass expenses, steep cost in the beginning.
    - ams6110 8y ago
      It's a start, but imperfect because most people with a high deductible plan will also have a health savings account (HSA). The HSA may even be required, not sure. The problem with HSAs is that although it's "your" money, it can only be spent on qualified health expenses. So there's a reduced incentive to spend carefully, because you can't use the money for anything else.
      - leetcrew 8y ago
        if you end up with "too much" money in your HSA, can't you just reduce the amount of money that goes into it? obviously you can't just go buy a car with the money, but to me it seems like there is a strong incentive not to overspend from your HSA if you control how much of your paycheck goes into it.
        ams6110 8y ago
        Yes but I always contribute the max to get the most tax reduction. I like paying taxes less than I like paying doctors.
        leetcrew 8y ago
        have you already maxed out your company 401k and IRA contributions?
atonse 8y ago
Yup and organizations like the AMA that artificially keep the numbers of graduating doctors down to create a shortage and drive up prices.

notyourday 8y ago

I most am most likely going to need an ACL surgery in a couple of months so we will see how it goes. So far I found out that pretty much every "X is difficult" is a gospel peddled by lazy. This is my first relatively major incident so I'm running pretty blind -- I'm approaching it as I approach needing to do something in business. Instead of going to the ER ($2,500), I went to a walk in medical center ($120), got seen by an emergency medicine doc. I got a $120 (ER) brace for free in that clinic -- it is probably one of 100 in NYC, open 7 days a week from 8 am to midnight -- i did not go to their other one which is 24x7 Instead of spending $800 on X-ray at the ER, I spent $40 and got results on a CD within 10 minutes at the same walk in clinic. My MRI was not $2800 but $600 because instead of doing it in a hospital I did it at the radiology center. Both the doc at the walk in clinic and the surgeons said "You can do it in the hospital but it would cost a lot more and take a lot longer. Go to Lenox Hill Radiology -- they have about fifty locations in the city and you would be able to get it done today oh and your results will be emailed to us". My two visits to orthopedic surgeons ( there were two different doctors working at the same office ) specializing in sports medicine ( fixing athletes ) cost me $260 ( first visit ) and $120 ( follow up ) -- same two surgeons looked at me and the second visit included a second set of X-rays ( not extra cost ). My one on one PT specializing in sports rehab is costing me $100/h rather than unknown amount. I have a hunch simply because I let my fingers do the Googling my ACL surgery wont cost me $50k even though I won't be leaving NYC to do it. What is that magic thing that I did? Googled "Sports medicine surgeons" and sent emails to the email addresses. I also googled "Physical therapy near me" and emailed all of them, getting the prices and asking if they had any experience with rehabbing athletes -- I read reviews of the ones that did not respond after -- none of them had good reviews. The ones that did respond had very decent prices, used tech and were on the ball oh and they had stellar reviews. But I guess that is hard. Edit: Cute. Bring on the downvotes. That's the crux of the problem. Personal responsibility is "hard" so no wonder those who tend to outsource it get fleeced. When HN re-enables my posting ability I will respond to the individual questions/positions.

8ytecoder 8y ago
What's the incentive for me to save all that money when my insurance pays for it anyway and my company pays for my insurance? Insurance is supposed to do this job - negotiate prices ...etc., but, people are so attached to their doctors that insurance usually caves giving hospitals a much higher bargaining power.
- notyourday 8y ago
  High Deductible Plan. Takes care of big ass expenses, steep cost in the beginning.
  - ams6110 8y ago
    It's a start, but imperfect because most people with a high deductible plan will also have a health savings account (HSA). The HSA may even be required, not sure. The problem with HSAs is that although it's "your" money, it can only be spent on qualified health expenses. So there's a reduced incentive to spend carefully, because you can't use the money for anything else.
    - leetcrew 8y ago
      if you end up with "too much" money in your HSA, can't you just reduce the amount of money that goes into it? obviously you can't just go buy a car with the money, but to me it seems like there is a strong incentive not to overspend from your HSA if you control how much of your paycheck goes into it.
      - ams6110 8y ago
        Yes but I always contribute the max to get the most tax reduction. I like paying taxes less than I like paying doctors.
        leetcrew 8y ago
        have you already maxed out your company 401k and IRA contributions?

atonse 8y ago

Yup and organizations like the AMA that artificially keep the numbers of graduating doctors down to create a shortage and drive up prices.