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"because Flor has insurance including Medicare, he won’t have to pay the vast majority of it" Did they really use stuff that truly cost $1.1M on him, and did t

"because Flor has insurance including Medicare, he won’t have to pay the vast majority of it" Did they really use stuff that truly cost $1.1M on him, and did they need to? If they're charging some absurd amount for a room, maybe it's just a way of rationing at some level, not what is being consumed. I wish people would look at more what was spent in resources than what the dollar amount of the treatment was - if the patient didn't pay, then what matters to society is what was spent by society, not what number was written down as part of weird accounting. The article acknowledged "hospitals get paid only a portion of the amount they bill". It's not helpful or necessary to write anguished stuff based on your conviction that the accounting style is wrong. What matters is the effect on real people. On the other hand, if the reason that drug costs for instance were so high was because unnecessary drugs were used, or because they were wasted, or because the manufacturing of them was inefficient, that's a real problem and I wish that an article like this would focus on it, delve into it. Just...don't write stuff about how America is terrible because big numbers are scary. I can't tell if the article is meant to be pro or con universal coverage, or if the point is, America is terrible and always will be and universal coverage won't fix it. If the point is the latter, I think it's a cheap effort in support. If people take it seriously, it's very demotivational and makes me want to find a scapegoat for catharsis. Which for me, the default is adtech incentives these days.

Terretta 6y ago
At 400K hospitalizations per 30 days, and $1M per patient, that’s nominally $400B transfer of wealth per month from citizens (via patients, patients’ insurance, or taxpayers) to healthcare industry, with significant percentages extracted as income and profits at each step. Imagine if there were some way to cut out duplicative overhead and administrative costs from all these counter-parties and cut-outs...
- perl4ever 6y ago
  I think impugning or debating the legitimacy of the entire healthcare industry based on ignorance of the details is not productive. It disgusts me. Nearly everybody has a job in modern society that a random person on the street wouldn't understand, and yet too many people spend their time on the internet declaring most other people have "bullshit jobs". That is toxic bullshit. First the narrative was private insurance companies are useless, now it's the whole healthcare industry. You can't say that in fact $400B is being transferred, just because a number that big can be or is written down, and if it is, that it's inappropriate, without reference points and context. Anything that affects large numbers of people involves big numbers, so negative reactions to billions or trillions in and of themselves are useless or harmful.
  - TheDong 6y ago
    > Nearly everybody has a job in modern society that a random person on the street wouldn't understand That's true, but there's a very distinct difference between private insurance companies and other jobs I don't understand. Most of the time, if someone has a job I wasn't aware of, after it's explained to me I understand the reason it exists and it largely makes sense. In addition, most jobs don't have a readily available comparison of "And this other place doesn't have that job, instead does this, and it has these better results." In the case of private insurance, we have several examples of other countries that have socialized healthcare and have notably better outcomes. We have studies showing that our private insurance industry is flawed as implemented in america.
    - perl4ever 6y ago
      I wasn't defending private insurance companies, and I don't think they were mentioned in the article. The point I feel like making is that people have all the stock phrases and the same narrative about the US health care system when we aren't talking about the private insurance companies. When we aren't talking about people who are uncovered, abandoned by the government. Which makes me feel deceived, that people were making honest critiques in the first place lo these many years, rather than propagandizing against America because it's American. There are companies that are not-for-profit and part of public organizations, which are just like insurance companies but handle administration for Medicaid members. Are these useless, are these parasites? I don't believe hardly anyone who has an opinion on the system even knows such things exist. If they do have some purpose, in a public system, maybe popular criticism of insurance in general is too facile.
  - indemnity 6y ago
    You’re welcome to visit any other developed country where people don’t live in fear of getting sick and don’t treat massive bills as an inevitability, even after having insurance. Their health systems are as competent as those in the states, despite the fear mongering by your health industry of years-long wait times, queues, etc. So yeah, if the job we don’t understand results in massive underserving of your nation’s health needs, perhaps your disgust is misdirected.

Terretta 6y ago

At 400K hospitalizations per 30 days, and $1M per patient, that’s nominally $400B transfer of wealth per month from citizens (via patients, patients’ insurance, or taxpayers) to healthcare industry, with significant percentages extracted as income and profits at each step. Imagine if there were some way to cut out duplicative overhead and administrative costs from all these counter-parties and cut-outs...

perl4ever 6y ago
I think impugning or debating the legitimacy of the entire healthcare industry based on ignorance of the details is not productive. It disgusts me. Nearly everybody has a job in modern society that a random person on the street wouldn't understand, and yet too many people spend their time on the internet declaring most other people have "bullshit jobs". That is toxic bullshit. First the narrative was private insurance companies are useless, now it's the whole healthcare industry. You can't say that in fact $400B is being transferred, just because a number that big can be or is written down, and if it is, that it's inappropriate, without reference points and context. Anything that affects large numbers of people involves big numbers, so negative reactions to billions or trillions in and of themselves are useless or harmful.
- TheDong 6y ago
  > Nearly everybody has a job in modern society that a random person on the street wouldn't understand That's true, but there's a very distinct difference between private insurance companies and other jobs I don't understand. Most of the time, if someone has a job I wasn't aware of, after it's explained to me I understand the reason it exists and it largely makes sense. In addition, most jobs don't have a readily available comparison of "And this other place doesn't have that job, instead does this, and it has these better results." In the case of private insurance, we have several examples of other countries that have socialized healthcare and have notably better outcomes. We have studies showing that our private insurance industry is flawed as implemented in america.
  - perl4ever 6y ago
    I wasn't defending private insurance companies, and I don't think they were mentioned in the article. The point I feel like making is that people have all the stock phrases and the same narrative about the US health care system when we aren't talking about the private insurance companies. When we aren't talking about people who are uncovered, abandoned by the government. Which makes me feel deceived, that people were making honest critiques in the first place lo these many years, rather than propagandizing against America because it's American. There are companies that are not-for-profit and part of public organizations, which are just like insurance companies but handle administration for Medicaid members. Are these useless, are these parasites? I don't believe hardly anyone who has an opinion on the system even knows such things exist. If they do have some purpose, in a public system, maybe popular criticism of insurance in general is too facile.
- indemnity 6y ago
  You’re welcome to visit any other developed country where people don’t live in fear of getting sick and don’t treat massive bills as an inevitability, even after having insurance. Their health systems are as competent as those in the states, despite the fear mongering by your health industry of years-long wait times, queues, etc. So yeah, if the job we don’t understand results in massive underserving of your nation’s health needs, perhaps your disgust is misdirected.