> we should also add that paying cash means you get the Medicare price.
Medicare doesn't pay enough. What if the doctor doesn't accept medicare?
Of course, reimbursement rates are hardly our only problem. We also use more expensive treatment options for the same conditions, give doctors (and thus patients) a level of flexibility unheard of elsewhere that allows to spend money on unnecessary medicine just to make a patient happy and have ridiculous administrative overhead costs.
You tell the working parents that they can deliver the baby in the shared room for no additional cost or upgrade to the private suite for $100k.
Not every new parent can afford the expense of birth. So the hospitals try and squeeze out as much as they can from every party to try and even it out.
As a high income earner, I'm specially vulnerable to this practice.
No judge or newspaper or activist has particular empathy that I got charged $200k for a delivery or $6k for an 2 mile ambulance ride.
I can afford to pay it so why am I being so picky about it?
It's such a regular occurrence that it does not make news anymore.
Much higher amounts make the news now:
https://www.theguardian.com/us-news/2018/jan/16/why-does-it-...
https://www.cbc.ca/news/canada/saskatoon/jennifer-huculak-ki...
> We overtrain docs and we’ve built hospitals that focus on private rooms instead of wards. Both of those hugely increase the labor cost and will take a long time to undo.
If I was a patient at a hospital, I would not be able to control this:
> We overtrain docs
That part is outside my control.
... but, I, as a patient at a hospital, would be able to control this:
> we’ve built hospitals that focus on private rooms instead of wards
Infact, some of hopitals in the U.S. do have ward deliveries - I believe Kaiser Permanente have shared rooms?
However, that is the rub - people are not explicitly requesting private rooms - hospitals just have them so they can charge as much as they can.
If you walk into a hospital, you cant ask to have a ward delivery. They take you to a private room by default - no questions asked. That's all they have.
Then the bill comes and the game begins - if the insurance company does not pay, the hospital will then come after you. They will put you on a payment plan.
If you can't make payments, they will sell you to collections. Some hospitals might settle for an upfront cash payment but then it cannot go through your insurance and you are out of money AND you did not meet your family deductible either.
If there was a choice to new parents between ward deliveries for $50k and private rooms for $150k, I know which one I would take.
I don't have that choice because my employer might not be offering care though Kaiser Permanente and the hospitals in network might only have private rooms.
So change employers because I prefer ward deliveries?
Thank you for pointing out where I can end up confusing a reader. I write occasionally. Example: https://www.quora.com/Do-all-citizens-have-a-right-to-afford...
Medicare's reimbursement rates could just as well be published by Gosplan. If you squint hard enough, they are almost an application of the Labor Theory of Value: There is an intrinsic value of everything determined by how much labor went into producing it. That, of course, leads to all sorts of fun stuff like seniors in Florida loading up on cosmetic surgery and ED medication on the backs of the younger generations.
The “price” is really just the unit cost. Companies seem to have no problem computing unit costs (and thus margins!), no gosplan-like apparatus is required for this beyond supply-chain management and accounting. The U.S. situation is complicated considerably by all the different parties involved which I guess is why this idea might work less well there.
Correspondingly I suppose the “true value” would be the value provided to the recipient of the procedure and society as a whole, and as you observe is much more subjective and probably best not even measured in dollars. I think “quality of life adjusted years” is a thing. The major problem is when the you and the state disagree on the value of a procedure and whether it justifies the costs...
Another way to look at it, “socialised medicine” is just health insurance collected by the state with full vertical integration; your insurer also runs the hospitals and provides the care. The upside is you’re covered, the downside is you don’t get to choose a plan.
I imagine that dollar-for-dollar a non-profit with the right incentives and oversight could out do the VC-backed leeches driving up prescription med prices.
These amounts are small enough where the U.S. government could pretty easily cover the expenditures. So by your logic, why do we need Silicon Valley venture capital? Why not just have the government pay for the R&D and make the results freely available to everyone?
Either the government is good at allocating capital for high-tech R&D or its not. Whether you're talking about medical tech or computer tech doesn't make a difference.
In theory, theory always beats practice. In practice, however...
Case in point: nearly every other developed country.
This sounds like a bit of an oversimplification.
If anything I ended up having issues at the few parts that _arent_ price controlled (eyecare in France is a pain, though I think mostly because supply of optometrists are limited)
Price control generates scarcity. Because bureaus can't have all the information about the market, it's impossible. The moment a bureau determinate a price you're generating an impact on the different areas without having the possibility to address it. The gov. is not the market, the gov can't be an omnipotent entity that knows everything, that's why they screw everything.
What a diversity of thinkers!
I lived in Canada for three years, and growing up in a fairly conservative area in the US, I was prepared for the worst - six-month wait times for life-saving procedures, etc. What I saw was more like Star Trek - people who needed medical care went to a clinic or hospital and got it, and they didn't have to worry about being bankrupted in the process.
After I moved back to the US, I got to see what it was like for most people - delaying or never getting critical procedures done, people with teeth rotting in their heads because they can't afford to go to the dentist, almost everyone 1 unexpected medical bill away from permanent financial ruin. Our system is objectively bad, and we deserve to feel bad for sticking with it.
You can cite all the market theory you want, but the US is a perfect empirical example of why those theories are wrong.
* Except for the tiny minority of the ultra-wealthy who can afford to pay any price for health care.
I'm not arguing for price controls on everything in general. I'm pointing out that _in this context_ price controls are a proven strategy and work and mean that people don't _die due to not affording their insulin_.
You can't just claim something which is demonstrably functional somewhere doesn't in fact work because your half baked theory trumps actual reality. This is why this sort of comment is downvoted.
What actual reality? Because there's price controls doesn't mean it works. It generates scarcity, always.
Go to SF, put all rentals to 100 dollars and see the effects of the price controls. They will be the same there and in China.
I am not surprised people who deny the fact of economic science is downvoting this.
Some of the middle men would have to get bent.
I will quote:
> The insured person pays the insurance premium for the basic plan up to 8% of their personal income. If a premium is higher than this, the government gives the insured person a cash subsidy to pay for any additional premium.
So, it's a basic insurance that doesn't cover everything. Also quoting:
> "Health insurance covers the costs of medical treatment and hospitalization of the insured. However, the insured person 'pays part of the cost of treatment' and 'For hospitalisation, one pays a contribution to room and service costs'."
As you can see, there's no 'free' but subsidizied basic healthcare treatments, but then you should pay everything.
When I originally read it, it seemed like the former, but given everyone’s responses it must be the latter.
Neither would violate the constitution. It's not that long a document and written reasonably clearly. If you disagree please cite the section.
I would gladly pay more to be seen sooner by a more qualified doctor. If I have to fly to another place to do that, I would.
Other counties pay less and have plenty of doctors per capita plus waste far less on middle men.