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Correct. The problem is that a simple system like that is similar to car insurance, it only helps you pay for catastrophe. The reason US health insurance is so
by SapphireSun 14y ago
Correct. The problem is that a simple system like that is similar to car insurance, it only helps you pay for catastrophe. The reason US health insurance is so expensive is because we tried to institute a health plan via insurance that tries to do things like address chronic conditions and preventative care. There are many problems with that, but the point is that India has only solved the easy problem. We are in the midst of solving the hard problem: How do we equitably manage the healthcare of the entire nation that gives the rich and poor alike quality health care.
That said, we aren't doing it right at the moment since it's taking us about 16% GDP to do it when other countries have managed to do much better financially with better overall outcomes.
Price consciousness is a marginally good thing in health care. If people are going to get treated for the sniffles, they can easily price discriminate. The real problem is that price transparency, for all the expensive things in health care, doesn't actually help. You can only price discriminate when you understand what you're buying. When you don't understand, price becomes a signal of quality, and people don't compromise with their health like they would with cars. They also are paying with other people's money. In fact, some case studies have found that price transparency causes the lower price guys to simply raise their prices to compete with the higher price guys regardless of quality because patients don't care about price except to the degree it signals quality.
- yummyfajitas 14y agoHow do we equitably manage the healthcare of the entire nation that gives the rich and poor alike quality health care. (Assuming "we" means India, though I don't live there anymore.) Fix corruption, the licensing system, the protectionism, etc, so that they become wealthier. Make the rest of the economy as capitalistic as the medical system. It's hard to fix anything with a GDP/capita < 1 lac/year. The real problem is that price transparency, for all the expensive things in health care, doesn't actually help. You can only price discriminate when you understand what you're buying. (I think now you are talking about the US.) Strangely, when Indians pay out of their own pocket (in whole or in part), they routinely price shop. Is price shopping a weird skill that Indians have but Americans don't? I suspect not, given that my uninsured mother routinely does it.
- SapphireSun 14y agoSorry! I was talking about the US, which is the system I sort of kind of barely understand. Other than what the GP said, I don't know much about India. I was just addressing the sentiment that India's insurance scheme should be transplanted here and that it would fix a lot of things.
- SapphireSun 14y ago(I am only addressing the US). Price shopping happens when the payer is directly affected by the costs (note: you mentioned your mother is uninsured) and when you can evaluate the quality (or don't care). It's actually very difficult to evaluate who's good and who isn't because a) statistics aren't often released (because hospitals and doctors block them) and b) the statistics can be difficult to interpret (a good doctor with bad stats can just have a sicker overall population). A big problem was that the data capture to adjust for these factors wasn't there (records were frequently kept on paper and billing codes barely correspond to reality). A big problem has been simply that even when the data was there, it is incredibly expensive to aggregate and report it. In the US, we are attempting to fix some of these things. Medicare has implemented Quality Metrics and the requirement that doctors implement electronic medical record systems that measure some of the easier things to measure (patient counseled about managing diabetes, summary slip issued at end of visit, et cetera). Hopefully, price transparency plus a modern statistical reporting system will result in price shopping being viable in the next decade (of course the patient must be willing to discriminate).
- btilly 14y agoThe reason US health insurance is so expensive is because we tried to institute a health plan via insurance that tries to do things like address chronic conditions and preventative care. False. Every other developed country has solved this problem while paying less - in most cases substantially less - than the USA. This while, according to a variety of statistics, getting better health outcomes. There are a lot of reasons why medicine costs so much in the USA, but the factor that you identified is more of a convenient excuse than "the reason".
- SapphireSun 14y agoOh I don't disagree with you. I meant that the reason "insurance" costs so much is because we tried to shoehorn other countries' systems into an insurance scheme. Indian insurance is much closer to what actual insurance is like, so it's much cheaper.