That actually sounds like the high deductible plan is functioning as it should though. Causing consumers to price-shop and avoid price-gouging providers.
Last year, I paid $4000 more than my $6500 out of pocket maximum, because I had a heart procedure and the heart rehab following the procedure was an exception to the out of pocket maximum, a fact I discovered only after incurring the costs. You see, if you clearly follow the asterisk and the footnote references in the policy, then it's very clear that these expenses would not have been covered.
Funny! Pointed too.
Getting the best dealz runs in basic conflict with needing to stay alive.
This is why markets do not work well for primary care. They can work well higher up the chain where life basics are not really in play.
Health care is an inelastic good, we need it. So this is a market (much like having a military) that really benefits from the government stepping in and making things sane.
The reality is you need an M.D. to make a reasonable evaluation. This is why at an HMO we have primary care physicians. Or in any other country, GPs. They decide if you need specialized care. However, how am I supposed to pick one of them? It's Russian nesting doctors.
It's probably the most complicated thing we have to deal with in our non-professional lives.
With a bank, Bank of America has terrible service - so I just don't use them, with a doctor though... what if I'm paying a premium price but receiving substandard care, given how complex human bodies are most illnesses compound over time and only in very select circumstances could you get a doctor to come in post defacto look at an X-Ray and say "This doctor was terrible, that's totally a tumor" maybe the real issue is that a tingling in your finger tips when you sit down that you asked your doctor about went unnoticed and twelve years later your heart gave out over totally preventable causes.
Seriously though in general managers have worked in and around technical people before, and their role in the process is to evaluate qualitatively. Are they a good communicator? Do they seem like awful people? They use feedback from the engineers to estimate if they're good engineers. I don't have a deep bench of M.D.s to lean on to figure this stuff out.
Same way you would pick anything else? I shopped around for my GP and changed several.
Some factors were: years of experience, user feedback, spoken languages, any red flags for the whole practice, how they respond to my concerns and questions in conversation, etc.
Also I think it's not really fair to take full lifetime costs into consideration at once. As you get older you'll be looking at those much more expensive treatments and covered by expensive insurance but the insurance tends to be of a higher quality when it comes to reducing sudden costs - I am more concerned about younger people who generally have terrible insurance and may get hit with 4 months of 20k physio due to a sudden injury but generally have low "normal" costs.
Let users watch a series of videos and choose what kind of risk and benefit they tolerate/want and how much they’re willing to spend.
It’s morbid, but we do such assessments constantly. Do I come to a complete stop and waste a few seconds and ml of gas, or roll through it and be really careful about it?
The difference in your "every day" scenarios is recoverability. Your actual health put at risk means you die, unrecoverably.
Then there is always people not being able to spend. So they just die?
A poll on that policy would be instructive.
Obviously the advanced directive solution is largely irrelevant in a 100% coverage/public system. The insurer then makes those decisions for you. But for as long as you have a system with uninsured, there’s value in having decisions made in advance as a “just in case”.
In simpler times, a city able to provide clean water was a city of note. Worthy destination. This has been true for ages.
Flint fucked for how long now?
Our national priorities are insane! Bat shit wrong and health care, food, water, housing are all right at the top of reform agendas for damn good reason.
We can do better, and we need to.
The uninsured are uninsured because they are unable to spend. Put whatever the fuck anyone wants on that paper and it does not matter one lick.
Might as well write, "yeah, let me die, k?"
Frankly, there is zero value in the idea, and a lot of harm potential in the norms being changed for the worse: "but they consented..."
Anyone who wants to make a directive can do so today. Expecting people to do it because our system is fucked makes zero sense.
It is long past time we get our priorities in order so conversations like this are laughable, not morbid.
I always wonder if you libertarians are doing a bit, because it sure seems like it.
It’s a solution to the problem of “I continued to choose to live in an environment without health insurance, how do I handle the situation of not being in a position to negotiate?”
This extreme libretarianism stuff is pure BS, health care services in an emergency cannot exist as a free market.
As for those uninsured that just broke their ____ and are not in a position to start calling around, having pre-negotiated rates for the best pricing against all hospitals within a reasonable time’s transport would save a pile of cash. There’s no shortage of hospitals or excess capacity in the US.
The UK has periodically had a back and forth on whether the outcome ratio numbers which are collected for internal statistical measures should be published.
ie should we make it easy to get a number that says 4.6 for Mr Able, 5.2 for Ms Awesome and 3.8 for Mr Good?
At one extreme the reality may be that Mr Good isn't good and his numbers are low because he's a bad surgeon, he makes a lot of mistakes, his technique is not what it should be, he's using an approach that's outdated... that's a real problem, and maybe "patient choice" is a fix where colleagues may be reluctant to say "Fire Mr Good" because he's a good guy, he's not _terrible_ at his job, but yeah they would not themselves choose to be treated by him.
At the other extreme the reality may be that Mr Good is the only guy who'll take patients that Ms Awesome thinks are too high risk. She thinks it's better to say "No", he thinks if they seek medicine he should do his part. Maybe they're obese, or they won't stop smoking, or they won't stop doing the sport that's wrecking their body. And Ms Awesome is right that Mr Good's patients are higher risk, but that's not because he's doing a bad job, he's playing what was dealt.
Every time patients are asked to rate the quality of the care, they consistently rate simple feel-good care like massages, chiropractice, or just therapy as very good, but saved-your-lfe-operations get rated very badly, because the experience and recovery is often miserable. You live, but you don't feel good, so you rate the quality of the care after how you feel, even though you ought to rate it Five-star, A++++, would transplant a failed heart again!
So the rational person abandons subjective ratings and look at objective ratings, what's the medical outcome for a provider? Sure, that's better, but the quality of the outcome is incredibly dependent on the quality of the patients! It's a well-known fact that a positive attitude helps immensely with recovery, how do you measure that? How do you integrate that with an outcome measurement?
On the other hand, if a provider is charging too much, they shouldn't be included in the plan in the first place, as they're simply a bad option.
The principle idea is that because they have to pay some, they'll be more sensitive to pricing and more willing to shop for an affordable provider, which is exactly the efficiency argument.
And in this particular case I agree, even. Though the fact that this has to be done by individuals (who are sick!) sort of makes a hash of the moral notions of "the market" being the solution here. We're buying efficiency at the cost of individual grief, and that has value too.