6 ms·

If healthcare was really a capitalist endeavor then it wouldn't cost $5k for three stitches. Prices would be transparent, there would be a free market with comp

by jmckib 7y ago

If healthcare was really a capitalist endeavor then it wouldn't cost $5k for three stitches. Prices would be transparent, there would be a free market with competition, and healthcare wouldn't be linked to employment. You can thank regulations for all of those problems.

giantrobot 7y ago
What regulations are those exactly?
- gpm 7y ago
  The ones that let them not tell you how much they will charge you for a service until after they provide it, and then still demand payment (and have the government enforce that demand)? (I'm pretty sure that's not what the person you were replying to is going for - but it is a very problematic piece of the regulatory environment which is unique to hospitals)
- BurningFrog 7y ago
  Healthcare is probably the most regulated industry in the country. Nobody knows all the regulations, and asking for a list seems a bit clueless.
  - giantrobot 7y ago
    If you're going to claim specific problems are caused by regulations is not too much to ask which specific regulations cause specific problems. What's clueless is to use the word "regulations" like it's some incantation. Healthcare is heavily regulated because medical care is not usually something you can restitute after the fact. If you sell me a defective widget my life doesn't depend on I can get my money back or sue you to get it back. If a doctor sticks a defective medical widget in my body and I die, I can't really do much about it afterwards. I'd prefer that doctor's certifications have some sort of regulatory oversight. I'd also like medical widgets to be regulated so there's stringent QA and manufacturing process qualifications.
- mixmastamyk 7y ago
  The certificate of need is one regularly mentioned. The attachment of medical insurance to employment is another. If you don't already know at least a few of these, you're probably a student or not interested.
- WalterBright 7y ago
  One is you need a medical license to practice. To get a license, you need to be a graduate of an approved medical school. Slots in medical school are controlled by the AMA, which has a strong interest in limiting the number of doctors being minted, to keep doctor fees high. That's just one.
  - kevin_thibedeau 7y ago
    I know a trained foreign surgeon who switched to law after immigrating because of this red tape.
    - Melting_Harps 7y ago
      > I know a trained foreign surgeon who switched to law after immigrating because of this red tape. I had a few of my undergrad bio and chem labs with a Vietnamese doctor who came to the US, I always tried to be in his group whenever possible because he had the most insight into the Industry as a result of his transition. Apparently, because he was educated and practiced in Vietnam he was forced to have to repeat the entire process to enroll into Medical school. I'm not sure if was on loans or doing it on his own, but he must of have been determined to make it happen, because I'd probably do the same as your colleague if forced to do it all again. He was an older guy, I was 18 or 19 so anything over 25 was 'old' to me but I think he was in his 30s while we were in our 2nd year courses. With all of the polemics surrounding COVID19, I think the least we should do is take away the power of the AMA-like Institution to determine how many medical students can be enrolled into any program and make any necessary accommodations to ensure it happens. Making the current medical staff do the equivalent of an understaffed, under supplied death march has to make reason prevail regardless of our stance. Private and Public medicine is an issue to come back to, but being short staffed in a pandemic is suicidal--Italy recalling retired medical staff was alarming, but also highlighting that a Public Medical system is not yielding the panacea many suggest, either. And for anyone asking for a source on the AMA's practices look at his, I remember reading this in 2005 as I was in school, and being schooled and trained as if I wanted to take MCAT because of the looming shortages caused by retiring boomers, even though I had no interest in Medicine: https://usatoday30.usatoday.com/news/health/2005-03-02-doctor-shortage_x.htm https://usatoday30.usatoday.com/news/health/2005-03-02-docto...
monocasa 7y ago
Why wouldn't capital use the inability of people who are literally passed out and bleeding out on stretchers to price shop, to capital's advantage?
- dogma1138 7y ago
  Because someone would then do it for cheaper when medicine was a trade that’s how it used to be. And it’s somewhat how it’s still is in some fields of it primarily cosmetic, elective surgery (including LASIC and the likes) and dentistry. There are plenty of countries where the majority of the health care is provided by private firms even if the state picks up the bill or part of it including almost all countries with universal healthcare. The US is pretty much unique in costs and distribution of burden and it’s not because of the free market approach to healthcare. When 9 out of the 10 most profitable hospitals in US aren’t even private/for profit you can’t simply claim that the investment firm or HMO that owns the hospital tries to suck out as much profit as possible for their shareholders. P.S. I don’t agree that regulations are the problem anyone who thinks that you somehow would get better results with deregulating healthcare is likely very wrong, the entire system in the US is however broken and not because of simply campitalism.
  - perl4ever 7y ago
    "When 9 out of the 10 most profitable hospitals in US aren’t even private/for profit" How exactly do you measure the profit of a non-profit?
    - cosmie 7y ago
      The same as you measure the profit of any business. They're just referred to as net assets[1]. Non-profit is a misnomer - not for profit is a more apt phrase. While they can't operate with the intent of generating profit, they're perfectly allowed to actually generate profit from various activities. With the intention that the profits from that activity will be a revenue stream that funds loss-making activities elsewhere which support their nonprofit mission (such as issuing grants). Hence it's kept on the books as net assets. [1] https://smallbusiness.chron.com/non-profit-accounting-definitions-4157.html https://smallbusiness.chron.com/non-profit-accounting-defini...
WalterBright 7y ago
> If healthcare was really a capitalist endeavor then it wouldn't cost $5k for three stitches. Before the government got heavily involved in healthcare in the 1960s, healthcare was cheap. Edit: requested cite: https://www.thebalance.com/causes-of-rising-healthcare-costs-4064878 https://www.thebalance.com/causes-of-rising-healthcare-costs...
- PaulDavisThe1st 7y ago
  Citation required. Preferably with inflation adjusted dollars, compensation for expansion of treatment options, and the Reagan decision that ER departments are legally required to treat any patient. Feel free to make a moral case against Reagan's decision if you feel like it.
  - jacobsenscott 7y ago
    https://www.forbes.com/sites/chrisconover/2012/12/22/the-cost-of-health-care-1958-vs-2012/#3abf41c49106 https://www.forbes.com/sites/chrisconover/2012/12/22/the-cos...
    - gamblor956 7y ago
      This citation supports the point of the comment you are replying to. Healthcare was cheaper before Reagan interfered in the health care industry to artificially inflate costs to the financial benefit of his buddies.
  - WalterBright 7y ago
    I received 3 stitches in my face around 1987 from the emergency room. Cost was $289. I don't know why I remember the figure. Today that would be $658.08 according to the inflation calculator at https://www.usinflationcalculator.com/ https://www.usinflationcalculator.com/ I bought a 383 big block engine for my dodge, and a friend of mine was helping me move it into the garage. I tripped and fell on top of the block, making quite a gash in my eye socket. Lucky I missed my eye. Still have a scar! Sadly, the block turned out to have a crack in it and was not salvageable.

by jmckib 7y ago

giantrobot 7y ago

What regulations are those exactly?

gpm 7y ago
The ones that let them not tell you how much they will charge you for a service until after they provide it, and then still demand payment (and have the government enforce that demand)? (I'm pretty sure that's not what the person you were replying to is going for - but it is a very problematic piece of the regulatory environment which is unique to hospitals)
BurningFrog 7y ago
Healthcare is probably the most regulated industry in the country. Nobody knows all the regulations, and asking for a list seems a bit clueless.
- giantrobot 7y ago
  If you're going to claim specific problems are caused by regulations is not too much to ask which specific regulations cause specific problems. What's clueless is to use the word "regulations" like it's some incantation. Healthcare is heavily regulated because medical care is not usually something you can restitute after the fact. If you sell me a defective widget my life doesn't depend on I can get my money back or sue you to get it back. If a doctor sticks a defective medical widget in my body and I die, I can't really do much about it afterwards. I'd prefer that doctor's certifications have some sort of regulatory oversight. I'd also like medical widgets to be regulated so there's stringent QA and manufacturing process qualifications.
mixmastamyk 7y ago
The certificate of need is one regularly mentioned. The attachment of medical insurance to employment is another. If you don't already know at least a few of these, you're probably a student or not interested.
WalterBright 7y ago
One is you need a medical license to practice. To get a license, you need to be a graduate of an approved medical school. Slots in medical school are controlled by the AMA, which has a strong interest in limiting the number of doctors being minted, to keep doctor fees high. That's just one.
- kevin_thibedeau 7y ago
  I know a trained foreign surgeon who switched to law after immigrating because of this red tape.
  - Melting_Harps 7y ago
    > I know a trained foreign surgeon who switched to law after immigrating because of this red tape. I had a few of my undergrad bio and chem labs with a Vietnamese doctor who came to the US, I always tried to be in his group whenever possible because he had the most insight into the Industry as a result of his transition. Apparently, because he was educated and practiced in Vietnam he was forced to have to repeat the entire process to enroll into Medical school. I'm not sure if was on loans or doing it on his own, but he must of have been determined to make it happen, because I'd probably do the same as your colleague if forced to do it all again. He was an older guy, I was 18 or 19 so anything over 25 was 'old' to me but I think he was in his 30s while we were in our 2nd year courses. With all of the polemics surrounding COVID19, I think the least we should do is take away the power of the AMA-like Institution to determine how many medical students can be enrolled into any program and make any necessary accommodations to ensure it happens. Making the current medical staff do the equivalent of an understaffed, under supplied death march has to make reason prevail regardless of our stance. Private and Public medicine is an issue to come back to, but being short staffed in a pandemic is suicidal--Italy recalling retired medical staff was alarming, but also highlighting that a Public Medical system is not yielding the panacea many suggest, either. And for anyone asking for a source on the AMA's practices look at his, I remember reading this in 2005 as I was in school, and being schooled and trained as if I wanted to take MCAT because of the looming shortages caused by retiring boomers, even though I had no interest in Medicine: https://usatoday30.usatoday.com/news/health/2005-03-02-doctor-shortage_x.htm https://usatoday30.usatoday.com/news/health/2005-03-02-docto...

monocasa 7y ago

Why wouldn't capital use the inability of people who are literally passed out and bleeding out on stretchers to price shop, to capital's advantage?

dogma1138 7y ago
Because someone would then do it for cheaper when medicine was a trade that’s how it used to be. And it’s somewhat how it’s still is in some fields of it primarily cosmetic, elective surgery (including LASIC and the likes) and dentistry. There are plenty of countries where the majority of the health care is provided by private firms even if the state picks up the bill or part of it including almost all countries with universal healthcare. The US is pretty much unique in costs and distribution of burden and it’s not because of the free market approach to healthcare. When 9 out of the 10 most profitable hospitals in US aren’t even private/for profit you can’t simply claim that the investment firm or HMO that owns the hospital tries to suck out as much profit as possible for their shareholders. P.S. I don’t agree that regulations are the problem anyone who thinks that you somehow would get better results with deregulating healthcare is likely very wrong, the entire system in the US is however broken and not because of simply campitalism.
- perl4ever 7y ago
  "When 9 out of the 10 most profitable hospitals in US aren’t even private/for profit" How exactly do you measure the profit of a non-profit?
  - cosmie 7y ago
    The same as you measure the profit of any business. They're just referred to as net assets[1]. Non-profit is a misnomer - not for profit is a more apt phrase. While they can't operate with the intent of generating profit, they're perfectly allowed to actually generate profit from various activities. With the intention that the profits from that activity will be a revenue stream that funds loss-making activities elsewhere which support their nonprofit mission (such as issuing grants). Hence it's kept on the books as net assets. [1] https://smallbusiness.chron.com/non-profit-accounting-definitions-4157.html https://smallbusiness.chron.com/non-profit-accounting-defini...

WalterBright 7y ago

> If healthcare was really a capitalist endeavor then it wouldn't cost $5k for three stitches. Before the government got heavily involved in healthcare in the 1960s, healthcare was cheap. Edit: requested cite: https://www.thebalance.com/causes-of-rising-healthcare-costs-4064878 https://www.thebalance.com/causes-of-rising-healthcare-costs...

PaulDavisThe1st 7y ago
Citation required. Preferably with inflation adjusted dollars, compensation for expansion of treatment options, and the Reagan decision that ER departments are legally required to treat any patient. Feel free to make a moral case against Reagan's decision if you feel like it.
- jacobsenscott 7y ago
  https://www.forbes.com/sites/chrisconover/2012/12/22/the-cost-of-health-care-1958-vs-2012/#3abf41c49106 https://www.forbes.com/sites/chrisconover/2012/12/22/the-cos...
  - gamblor956 7y ago
    This citation supports the point of the comment you are replying to. Healthcare was cheaper before Reagan interfered in the health care industry to artificially inflate costs to the financial benefit of his buddies.
- WalterBright 7y ago
  I received 3 stitches in my face around 1987 from the emergency room. Cost was $289. I don't know why I remember the figure. Today that would be $658.08 according to the inflation calculator at https://www.usinflationcalculator.com/ https://www.usinflationcalculator.com/ I bought a 383 big block engine for my dodge, and a friend of mine was helping me move it into the garage. I tripped and fell on top of the block, making quite a gash in my eye socket. Lucky I missed my eye. Still have a scar! Sadly, the block turned out to have a crack in it and was not salvageable.