2 ms·

You completely and totally missed the point.

pwnstigator 17y ago
You made an inappropriate analogy. There are no inherent costs to the consumer in eating fine foods. There are enormous inherent costs to medical care. Most patients want to be treated with minimal pain, risk, and time lost, so they can get back to their regular lives. Their incentive is already, in virtually all cases, in the cost-minimizing direction.
- yummyfajitas 17y ago
  This has been shown empirically to be false. Patients will consume medicine with no health benefits if it is free, but not if they must pay for it. http://www.rand.org/health/projects/hie/ http://www.rand.org/health/projects/hie/
  - mattmaroon 17y ago
    You did not miss the point.
- mattmaroon 17y ago
  It's not inappropriate. The point is that when people perceive something as free, they intrinsically opt for the most expensive option. They also will get costly tests and procedures that have at best an extremely remote chance of being useful. The whole reason tort reform, which the original author did mention, is needed is because doctors know this and then prescribe expensive, unneeded tests simply to cover their asses. Between that perverse incentive (which he did address) and the patient's lack of fiscal accountability, enough people have an MRI done every time they sneeze to have a huge impact on health care prices. When insurance companies instituted even very small patient copays on non-generics, usage rates of generics skyrocketed. Just having to pay $5 more (for a product that actually costs hundreds more, but is chemically identical) aligned people with their economic incentives and caused a massive shift in consumer behavior. Brand name pharma companies fought back by giving vouchers to doctors to pass out to patients that covered their co-pays. Brand name medicine market share went right back up. Insurance companies have no effective way to combat vouchers and are forced instead to raise health care rates. Also you're just plain wrong because you're applying rational thought to people who are in a panicked state. When someone has a health problem, they'll do anything and everything to fix it. We all value our own lives as effectively worth infinite dollars, which makes any treatment rational from our perspective. Society, on the other hand, cannot afford to be so generous.
abstractbill 17y ago
In that case, so did I. You compared free high-end foods to free healthcare, which frankly just seems bizarre. Nobody wants to use healthcare. Even when I lived in the UK, and I could have visited the doctor for free every single day if I had chosen to, I did not. Neither did I ever hear of anyone ever doing that or anything close to it. Having lived in both the US and the UK, I haven't changed my habits. I visit the doctor when I feel I really need to. The only difference is that in the US, an insurance bureaucrat then sends me a letter telling me they're not paying up because <insert random excuse here>.
- pwnstigator 17y ago
  And in the US, you get the privilege of paying for the paper on which the denial letter was printed... and, to make it better, the bureaucrat's salary. If you buy private health insurance, you're literally paying the salary of the asshole who pores over people's medical records looking for reasons to deny care (e.g. undisclosed insomnia prescription from 1982 as a "pre-existing condition").
  - mrshoe 17y ago
    Just to play devil's advocate, here's a mind bender for you: we should be grateful to that asshole. The insurance company is paying his salary because it costs them less than would the care that he manages to deny. If he didn't exist, the insurance company's costs would increase. This means that insurance premiums would have to increase. Whether you buy your insurance directly, or it's deducted from your paycheck, or your employer pays for it in full, that increased cost of insurance premiums would trickle down to you in the end.
    - pwnstigator 17y ago
      Just to play devil's advocate, here's a mind bender for you: we should be grateful to that asshole. Until you or I get cancer, that is. Last I checked, the probability of you and I having at least one life-threatening health problem in the next 100 years was pretty close to 1.0. What's actually happening, regarding that asshole, is that you're paying 95% premiums for 85% care. It gets worse than that, because the 15% being shaved off is at the high-cost end, which is precisely where you need your insurance.

You made an inappropriate analogy. There are no inherent costs to the consumer in eating fine foods. There are enormous inherent costs to medical care. Most patients want to be treated with minimal pain, risk, and time lost, so they can get back to their regular lives. Their incentive is already, in virtually all cases, in the cost-minimizing direction.

yummyfajitas 17y ago
This has been shown empirically to be false. Patients will consume medicine with no health benefits if it is free, but not if they must pay for it. http://www.rand.org/health/projects/hie/ http://www.rand.org/health/projects/hie/
- mattmaroon 17y ago
  You did not miss the point.
mattmaroon 17y ago
It's not inappropriate. The point is that when people perceive something as free, they intrinsically opt for the most expensive option. They also will get costly tests and procedures that have at best an extremely remote chance of being useful. The whole reason tort reform, which the original author did mention, is needed is because doctors know this and then prescribe expensive, unneeded tests simply to cover their asses. Between that perverse incentive (which he did address) and the patient's lack of fiscal accountability, enough people have an MRI done every time they sneeze to have a huge impact on health care prices. When insurance companies instituted even very small patient copays on non-generics, usage rates of generics skyrocketed. Just having to pay $5 more (for a product that actually costs hundreds more, but is chemically identical) aligned people with their economic incentives and caused a massive shift in consumer behavior. Brand name pharma companies fought back by giving vouchers to doctors to pass out to patients that covered their co-pays. Brand name medicine market share went right back up. Insurance companies have no effective way to combat vouchers and are forced instead to raise health care rates. Also you're just plain wrong because you're applying rational thought to people who are in a panicked state. When someone has a health problem, they'll do anything and everything to fix it. We all value our own lives as effectively worth infinite dollars, which makes any treatment rational from our perspective. Society, on the other hand, cannot afford to be so generous.

abstractbill 17y ago

In that case, so did I. You compared free high-end foods to free healthcare, which frankly just seems bizarre. Nobody wants to use healthcare. Even when I lived in the UK, and I could have visited the doctor for free every single day if I had chosen to, I did not. Neither did I ever hear of anyone ever doing that or anything close to it. Having lived in both the US and the UK, I haven't changed my habits. I visit the doctor when I feel I really need to. The only difference is that in the US, an insurance bureaucrat then sends me a letter telling me they're not paying up because <insert random excuse here>.

pwnstigator 17y ago
And in the US, you get the privilege of paying for the paper on which the denial letter was printed... and, to make it better, the bureaucrat's salary. If you buy private health insurance, you're literally paying the salary of the asshole who pores over people's medical records looking for reasons to deny care (e.g. undisclosed insomnia prescription from 1982 as a "pre-existing condition").
- mrshoe 17y ago
  Just to play devil's advocate, here's a mind bender for you: we should be grateful to that asshole. The insurance company is paying his salary because it costs them less than would the care that he manages to deny. If he didn't exist, the insurance company's costs would increase. This means that insurance premiums would have to increase. Whether you buy your insurance directly, or it's deducted from your paycheck, or your employer pays for it in full, that increased cost of insurance premiums would trickle down to you in the end.
  - pwnstigator 17y ago
    Just to play devil's advocate, here's a mind bender for you: we should be grateful to that asshole. Until you or I get cancer, that is. Last I checked, the probability of you and I having at least one life-threatening health problem in the next 100 years was pretty close to 1.0. What's actually happening, regarding that asshole, is that you're paying 95% premiums for 85% care. It gets worse than that, because the 15% being shaved off is at the high-cost end, which is precisely where you need your insurance.