The Doctor Is In. Co-Pay? $40,000 | Hacker News Reader

The Doctor Is In. Co-Pay? $40,000

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20 pointschmars15 comments

> For five-figure annual fees, boutique medical services offer the wealthiest Americans the chance to cut the line and receive the best treatment.

Whether this buys you the best treatment is highly contestable and, I think, unlikely. It would probably buy you the most treatment, which is not necessarily what you want.

On the other hand, the long wait time to see physicians is a real concern, and it is advantageous to be seen sooner rather than later for essentially every condition. I think the moral hazard lies in the fact that you can buy access to earlier care, rather than with the fact that you can buy access to "top" physicians.

These are empirical questions which can/should be studied.

As someone who lives in a country with socialized medicine, (Canada), the discussion of hospitals removing "normal" (shared) rooms to replace them with more-profitable private rooms is disturbing.

Here, private rooms have become the standard that all new hospitals are built to. Not only are patients generally happier, but they drastically reduct the spread of germs between patients in hospitals. When my kids were born, (they're quite young - <6 years old), my wife had a private room. When my son was hospitalized for a couple of months last fall, he had a private room, with a couch-ish thing that I could sleep on. We didn't pay extra for these, the were the only options at the hospitals we were at. These are not special, private, hospitals in any way, they're just renovated and/or built within the past decade.

It seems like the profit-based healthcare system south of the border is keeping patients in shared rooms, which are nearly a generation out of date here.

Can you explain your first sentence? What is the discussion surrounding shared vs. private rooms?

If it's anything like Europe, doctors and hospitals get to charge extra (not covered by the state medical insurance) if the patient is in a private room. Plus the private room itself costs extra too.

It has different names depending on the country.

PS. private medical insurance may cover the private room thing. Also, doctors are effectively incentivized to give private room patients preferential treatment. So it is one source of inequality in Europe's health services.

In the article there's a whole section about how hospitals are removing non-private, (aka "normal"), rooms, to replace them with more-profitable private rooms that patients pay for out-of-pocket, (and, since they're not insurance companies, can't negotiate better rates).

Many hospitals house patients in shared rooms with two (or more) beds separated by a sliding curtain. It's cheaper, and is otherwise basically all downside, as jbeales says.

> “They’re taking him to a local hospital,” Mr. Battelle’s wife, Michelle, told Dr. Shlain as the boy rode in an ambulance to a nearby emergency room in Marin County. “No, they’re not,” Dr. Shlain instructed them. “You don’t want that leg set by an E.R. doc at a local medical center. You want it set by the head of orthopedics at a hospital in the city.”

So, tying up an ambulance for a couple hours because they "too good" for an ER (which would be completely capable of dealing with a broken leg)?

Yeah, setting a leg bone isn't normally a challenging or delicate procedure. I feel like either there were complications we don't know about or Dr. Shlain was bullshitting them to justify his bill.

> He sees no reason that the medical world should not respond to consumer demand like any other player in the service economy. “Whenever I bump into a bleeding-heart liberal, which I am, I mention that schools, housing and food are all tiered systems,” he said. “But health care is an island of socialism in a system of tiered capitalism? Tell me how that works.”

I can't decide if this is the "two wrongs make a right" fallacy or the "whataboutism" fallacy.

https://en.wikipedia.org/wiki/Two_wrongs_make_a_right - https://en.wikipedia.org/wiki/Whataboutism

I just love how seemingly everyone involved in this is like "Wow this is so much, I mean I can't believe money gets you this, but I have the money/have been given the money so I guess we should do it" like this somehow manifested out of the thin air and everybody was just going along with it. Horseshit.

At some point, someone sat down with a few other people and proposed "Hey what if we charge rich entitled people insane fees so they never need to wait among the proletariat for medical care, you know, the ONE TIME in life when everyone is more or less equal" and they went along with it and now it's a business. Because apparently, when you're wealthy, the best thing you can find to do with your money is demonstrate to everyone else (or at the very least shield your delicate eyes from the suffering of) those less fortunate.

Crap like this really makes me look forward to capitalisms inevitable collapse.

This, until it is your child who is waiting with a broken leg and crying with pain.

This is the moment where theoretical political ideas go down the drain and you pull your gold credit card.

I guess my theory is take more of that persons money via taxation and make the hospital work faster and better for everyone, not just his lucky offspring.

This has never worked in the history of humanity, except maybe in some remote tribes.

The closest was communism and French Revolution, which failed, among others, the idea of equality.

And that makes it okay?

No it does not make it ok, as the fact that my wife is seriously ill, that my parents have to worry about money for their treatemenrs, and like many other things.

It is just reality.

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