5 ms·

I am not surprised. Healthcare costs have been rising faster than inflation for several years. It's a difficult sell to increase budgets, so we have to resort t

I am not surprised. Healthcare costs have been rising faster than inflation for several years. It's a difficult sell to increase budgets, so we have to resort to these "invisible" cost cutting measures to try and stay afloat.

retrac 1y ago
> rising faster than inflation for several years Over here in Canada healthcare spending has been rising faster than general inflation more or less continuously since the 1960s. Seems to be generally true of many wealthy countries. More tech and therapies. And an ageing population. And probably other factors. https://commons.m.wikimedia.org/wiki/File:Health_care_cost_rise.svg https://commons.m.wikimedia.org/wiki/File:Health_care_cost_r...
- betaby 1y ago
  Salaries probably pay factor as well? Check the sunshine list, plenty of radiologists making 600k/year. That's literally 10x of the median salary.
  - thmsths 1y ago
    That does not explain everything. While you could make a reasonable case that doctors are overpaid in the US, the same budgetary crisis is happening all over Europe where salaries are much lower.
    - betaby 1y ago
      The crisis in France is clearly not on the same level that is in Quebec. It's not the only factor, but a serious one. As a continuation of it we have a heavily caped number of doctors what can be 'minted' every year. Same caps exist in the USA states.
      - genericacct 1y ago
        This also happens in Italy, there's a maximum number of people who can get into med school. However, even though some complain of being overworked, some others complain that increasing that maximum number will lead to unemployment. So apparently medical professionals can either be overworked or unemployed, there is no in between..
  - nicoburns 1y ago
    Perhaps in the US, but nobody is getting paid that in most public European systems. A quick google suggests that the absolute highest pay band for a doctor in the UK is ~£142k (~$190k USD). And there won't be many making that. See: https://www.worktheworld.co.uk/blog/highest-paying-medical-jobs https://www.worktheworld.co.uk/blog/highest-paying-medical-j...
  - couchridr 1y ago
    Sure but at least radiologists do something. What do hospital administrators do? Like a university a hospital has bureaucracy that grows.
  - zeagle 1y ago
    This cherrypicks a high billing specialty, doesn't appreciate an overhead of 25-40% for most physicians, and also overestimates the proportion of physician salaries in healthcare budgets (~15%). You could literally pay physicians half and not save that much. Also is that too high? I know a guy in his early 40s still finishing his 2nd radiology fellowship (4 years undergrad, 4 years med school, 5 years radiology, 1-2 years each fellowship = cost of his 20s/30s) to get a job... I find HN comments on healthcare compensation when it comes up funny because on the other hand compensation expectations in the tech gold mine here are justified. E.g. I take home less in CDN dollars than an L3 SE at google without benefits. I'm happy with what I do/get but there is a mismatch in rationalizing high compensation, markedly more years of university and training, and from my point providing a societal benefit.
- nradov 1y ago
  Another factor is Baumol's cost disease. While some aspects of healthcare have been automated, much of it still comes down to individual clinicians performing procedures on patients. https://a16z.com/solving-baumols-cost-disease-in-healthcare/ https://a16z.com/solving-baumols-cost-disease-in-healthcare/
- hungmung 1y ago
  Yeah hospital accounting is weird. I had family in the ER and one of their crappy meals was like $60, for basically just rice and canned vegetables on a tray. A single bandaid cost like $25 or something outrageous like that. This was pre-covid too. I'm sure that same meal is getting close to $100 by now.
- oldpersonintx2 1y ago
  [dead]
ajmurmann 1y ago
This will continue to happen as long as automation in health care is slower than in other sectors. It's due to Baumol's Cost Disease: https://en.m.wikipedia.org/wiki/Baumol_effect https://en.m.wikipedia.org/wiki/Baumol_effect The same is true for other sectors that struggle with automation like education.
- ToucanLoucan 1y ago
  So after every industry is fully automated and everyone has lost all their jobs, do we all just hold hands and walk into the sea together or...?
  - fragmede 1y ago
    The way I see it, you have three choices, the government, corporations, or billionaires. It's an oversimplification of power in this world today, but those are your choices. Which one of those do you pick to clothe and feed and house you, after the singularity happens?
    - crmd 1y ago
      Another potential alternative is healthy capitalism, where a large number healthcare providers are in competition with each other to provide the best service at the lowest cost. In this model a hospital, for example, would be forbidden to buy another hospital down the road, in the same way a doctor’s office would be forbidden to buy a second doctor’s office, because both cases reduce competition.
      - kelseyfrog 1y ago
        That would be government. Markets don't regulate themselves and monopoly is the natural equilibrium state of capitalism.
        crmd 1y ago
        No, it would be a mixed economy, where private individuals and businesses provide most of the goods and services, and the government plays a significant role in regulating the market. Monopolized markets are almost always evidence of regulatory failure.
Scarblac 1y ago
It's the baby boom. If level of care stays the same then at some point one third of the labour force is projected to have to work in healthcare, it's not possible.
- DANmode 1y ago
  It IS possible, just unlikely the industry will be able to command more interest than the sugar-mill → grave pathway that's been established.
e40 1y ago
In CA, USA. We got a 20% hike in healthcare prices for the renewal we just got this month. 20% is insane.
markx2 1y ago
It's not just costs. It is patient (and relatives) expectations. It is knowing that any perceived issue could result in litigation. It is that management may well have never 'worked the floor' so have no insight in to what happens. There may well just not be the time to do all the tasks that someone else had decided needed to be done.
- hulitu 1y ago
  > It's not just costs. It is profits. When someone is sick, or dying, we really need to make a huge profit, before it is too late. Porsches, Lamborghinis, Malibu houses cost money. You can't just sit there and let others do it, instead of you.
WalterBright 1y ago
Healthcare costs have risen faster than inflation since the 1960s, when the government got involved with providing "free" healthcare. Before then, costs tracked inflation. Health care costs that are not provided "free" by the government have fallen, such as lasik eye surgery.
- nradov 1y ago
  You seem to have the causality backwards. Prior to the 1960s, the healthcare system couldn't really do much. Most of the drugs, devices, and procedures were relatively cheap. After that the capabilities increased tremendously as did costs, and then government had to get involved to control costs and ensure patient access. (Although many of those government interventions ultimately had the opposite effect.)
  - WalterBright 1y ago
    Why did Lasik machines decrease in cost, while increasing in efficacy? Drugs were far cheaper before the 1962 FDA Amendments, after that was a massive increase in costs. See "Regulation of Pharmaceutical Innovation" by Sam Peltzman. https://www.amazon.com/Regulation-Pharmaceutical-Innovation-Amendments-Evaluative/dp/0844731285/ https://www.amazon.com/Regulation-Pharmaceutical-Innovation-... See also: How American Health Care Killed My Father https://www.theatlantic.com/magazine/archive/2009/09/how-american-health-care-killed-my-father/307617/ https://www.theatlantic.com/magazine/archive/2009/09/how-ame...
    - nradov 1y ago
      Drugs were cheaper back then because they were less safe and effective, and because the easy stuff had mostly already been found.
      - WalterBright 1y ago
        Before 1962, drugs were already regulated to be safe. 1962 brought about the requirement for effective, which enormously increased drug prices. It's all in the book I referenced.
huijzer 1y ago
To anyone here open minded enough to give it a shot, I encourage you to read The Real Anthony Fauci, or at least the first chapter. To people who feel resistance: what is the worst that can happen? If you after reading disagree then your brain will soon forget about it anyway so nothing is lost.
hulitu 1y ago
> so we have to resort to these "invisible" cost cutting measures to try and stay afloat. Yeah, this is the narative. In reality we only need increased profits.
immibis 1y ago
Most prices increase faster than inflation, interestingly enough.

retrac 1y ago

> rising faster than inflation for several years Over here in Canada healthcare spending has been rising faster than general inflation more or less continuously since the 1960s. Seems to be generally true of many wealthy countries. More tech and therapies. And an ageing population. And probably other factors. https://commons.m.wikimedia.org/wiki/File:Health_care_cost_rise.svg https://commons.m.wikimedia.org/wiki/File:Health_care_cost_r...

betaby 1y ago
Salaries probably pay factor as well? Check the sunshine list, plenty of radiologists making 600k/year. That's literally 10x of the median salary.
- thmsths 1y ago
  That does not explain everything. While you could make a reasonable case that doctors are overpaid in the US, the same budgetary crisis is happening all over Europe where salaries are much lower.
  - betaby 1y ago
    The crisis in France is clearly not on the same level that is in Quebec. It's not the only factor, but a serious one. As a continuation of it we have a heavily caped number of doctors what can be 'minted' every year. Same caps exist in the USA states.
    - genericacct 1y ago
      This also happens in Italy, there's a maximum number of people who can get into med school. However, even though some complain of being overworked, some others complain that increasing that maximum number will lead to unemployment. So apparently medical professionals can either be overworked or unemployed, there is no in between..
- nicoburns 1y ago
  Perhaps in the US, but nobody is getting paid that in most public European systems. A quick google suggests that the absolute highest pay band for a doctor in the UK is ~£142k (~$190k USD). And there won't be many making that. See: https://www.worktheworld.co.uk/blog/highest-paying-medical-jobs https://www.worktheworld.co.uk/blog/highest-paying-medical-j...
- couchridr 1y ago
  Sure but at least radiologists do something. What do hospital administrators do? Like a university a hospital has bureaucracy that grows.
- zeagle 1y ago
  This cherrypicks a high billing specialty, doesn't appreciate an overhead of 25-40% for most physicians, and also overestimates the proportion of physician salaries in healthcare budgets (~15%). You could literally pay physicians half and not save that much. Also is that too high? I know a guy in his early 40s still finishing his 2nd radiology fellowship (4 years undergrad, 4 years med school, 5 years radiology, 1-2 years each fellowship = cost of his 20s/30s) to get a job... I find HN comments on healthcare compensation when it comes up funny because on the other hand compensation expectations in the tech gold mine here are justified. E.g. I take home less in CDN dollars than an L3 SE at google without benefits. I'm happy with what I do/get but there is a mismatch in rationalizing high compensation, markedly more years of university and training, and from my point providing a societal benefit.
nradov 1y ago
Another factor is Baumol's cost disease. While some aspects of healthcare have been automated, much of it still comes down to individual clinicians performing procedures on patients. https://a16z.com/solving-baumols-cost-disease-in-healthcare/ https://a16z.com/solving-baumols-cost-disease-in-healthcare/
hungmung 1y ago
Yeah hospital accounting is weird. I had family in the ER and one of their crappy meals was like $60, for basically just rice and canned vegetables on a tray. A single bandaid cost like $25 or something outrageous like that. This was pre-covid too. I'm sure that same meal is getting close to $100 by now.
oldpersonintx2 1y ago
[dead]

ajmurmann 1y ago

This will continue to happen as long as automation in health care is slower than in other sectors. It's due to Baumol's Cost Disease: https://en.m.wikipedia.org/wiki/Baumol_effect https://en.m.wikipedia.org/wiki/Baumol_effect The same is true for other sectors that struggle with automation like education.

ToucanLoucan 1y ago
So after every industry is fully automated and everyone has lost all their jobs, do we all just hold hands and walk into the sea together or...?
- fragmede 1y ago
  The way I see it, you have three choices, the government, corporations, or billionaires. It's an oversimplification of power in this world today, but those are your choices. Which one of those do you pick to clothe and feed and house you, after the singularity happens?
  - crmd 1y ago
    Another potential alternative is healthy capitalism, where a large number healthcare providers are in competition with each other to provide the best service at the lowest cost. In this model a hospital, for example, would be forbidden to buy another hospital down the road, in the same way a doctor’s office would be forbidden to buy a second doctor’s office, because both cases reduce competition.
    - kelseyfrog 1y ago
      That would be government. Markets don't regulate themselves and monopoly is the natural equilibrium state of capitalism.
      - crmd 1y ago
        No, it would be a mixed economy, where private individuals and businesses provide most of the goods and services, and the government plays a significant role in regulating the market. Monopolized markets are almost always evidence of regulatory failure.

Scarblac 1y ago

It's the baby boom. If level of care stays the same then at some point one third of the labour force is projected to have to work in healthcare, it's not possible.

DANmode 1y ago
It IS possible, just unlikely the industry will be able to command more interest than the sugar-mill → grave pathway that's been established.

e40 1y ago

In CA, USA. We got a 20% hike in healthcare prices for the renewal we just got this month. 20% is insane.

markx2 1y ago

It's not just costs. It is patient (and relatives) expectations. It is knowing that any perceived issue could result in litigation. It is that management may well have never 'worked the floor' so have no insight in to what happens. There may well just not be the time to do all the tasks that someone else had decided needed to be done.

hulitu 1y ago
> It's not just costs. It is profits. When someone is sick, or dying, we really need to make a huge profit, before it is too late. Porsches, Lamborghinis, Malibu houses cost money. You can't just sit there and let others do it, instead of you.

WalterBright 1y ago

Healthcare costs have risen faster than inflation since the 1960s, when the government got involved with providing "free" healthcare. Before then, costs tracked inflation. Health care costs that are not provided "free" by the government have fallen, such as lasik eye surgery.

nradov 1y ago
You seem to have the causality backwards. Prior to the 1960s, the healthcare system couldn't really do much. Most of the drugs, devices, and procedures were relatively cheap. After that the capabilities increased tremendously as did costs, and then government had to get involved to control costs and ensure patient access. (Although many of those government interventions ultimately had the opposite effect.)
- WalterBright 1y ago
  Why did Lasik machines decrease in cost, while increasing in efficacy? Drugs were far cheaper before the 1962 FDA Amendments, after that was a massive increase in costs. See "Regulation of Pharmaceutical Innovation" by Sam Peltzman. https://www.amazon.com/Regulation-Pharmaceutical-Innovation-Amendments-Evaluative/dp/0844731285/ https://www.amazon.com/Regulation-Pharmaceutical-Innovation-... See also: How American Health Care Killed My Father https://www.theatlantic.com/magazine/archive/2009/09/how-american-health-care-killed-my-father/307617/ https://www.theatlantic.com/magazine/archive/2009/09/how-ame...
  - nradov 1y ago
    Drugs were cheaper back then because they were less safe and effective, and because the easy stuff had mostly already been found.
    - WalterBright 1y ago
      Before 1962, drugs were already regulated to be safe. 1962 brought about the requirement for effective, which enormously increased drug prices. It's all in the book I referenced.

huijzer 1y ago

To anyone here open minded enough to give it a shot, I encourage you to read The Real Anthony Fauci, or at least the first chapter. To people who feel resistance: what is the worst that can happen? If you after reading disagree then your brain will soon forget about it anyway so nothing is lost.

hulitu 1y ago

> so we have to resort to these "invisible" cost cutting measures to try and stay afloat. Yeah, this is the narative. In reality we only need increased profits.

immibis 1y ago

Most prices increase faster than inflation, interestingly enough.