As Hospital Prices Soar, a Single Stitch Tops $500
nytimes.com
nytimes.com
If your kid is gushing blood, you call an ambulance to take them wherever they can get patched up the fastest. To expect someone to shop around until they find an equilibrium between supply and demand in that situation is ludicrous. It is absolutely the role of government to provide a safety net in these situations.
Source: I live in a first-world country and thus have universal health care.
You people have such a hard time with simple concepts, such as an ideologically disagreement on the role of government.
Your first world government did a good job of indoctrinating you.
Until then, best of luck with your trolling.
Emergency calls dispatched to competing ambulance/hospitals. Competing emergency dispatch services, say 911, 922, 933,... Customized emergency dispatch services - We'll have a life flight helicopter on call for only $99 a month! Plus any ideas from millions of people looking out for their best interests.
When it's less busy, the more affordable companies do most of the work - when it's busier, the more expensive ones fill in the service gap.
[1] http://jason-cochran.com/blog/when-gangs-of-thugs-put-out-yo...
Just as there's no communist utopia, there's no laissez-faire promised land.
“The care we give our patients? Priceless.
For everything else there is ChargeComplete.
Bill your patients for the things you do."
You could say the same thing about funeral services.
Yet it is a free market. And it works well. Because people buy plots ahead of time and negotiate services well in advance.
Nothing is stopping you from walking into an emergency room at your local hospital and negotiating a fair hourly or daily rate for care.
Well, nothing except them looking at you like you belong at a loony bin because why should anybody give a shit what things cost? Insurance pays for everything! Until it doesn't.
What a wonderful world we live in, where we don't need to worry about what something costs ... until your premium is thousands per month and you run to some halfwit politician to fix it. I would laugh, but I know many are crying right now, trying to make Obama's website work for them.
Well, except that when I die, my corpse only goes one place: the ground or the incinerator. And, as an added bonus, I get to choose that destination in advance. Oh, for the joys of only ever potentially needing emergency (or even urgent) care in a single location.
> Nothing is stopping you from walking into an emergency room at your local hospital and negotiating a fair hourly or daily rate for care.
I'm pretty sure that this is called insurance.
> until your premium is thousands per month and you run to some halfwit politician to fix it.
Or until you buy insurance on the open, free market and then have that insurance canceled for some obscure reason usually related to your suddenly becoming too expensive for your insurance carrier. Or knowing in advance that actually going to the doctor for that pain in your side will mark you as having a preexisting condition (even if the insurance doesn't pay for it and never even sees a bill) thus previously making you uninsurable or only able to receive coverage for a staggeringly high premium.
I could go on but I don't want to bore you with my real life tales of navigating our so-called health care system.
It's not as if the private insurance system that existed before Obama came to office was working especially well. While I agree that Obamacare's rollout has been a big mess, from the way some people talk you'd think insurers had never raised premiums or dropped people from coverage until last October. I'm guessing that a few years from now the bumps in rolling out Obamacare are going to be no more memorable than the bumps in rolling out Medicare ~50 years ago.
Yes, of course. By that point, they would have gotten used to the incompetence and stupidity, fully expecting it.
Based on your reply, I can surmise that you haven't even tried to use the system and sign up for a plan.
A few days later a $4K bill came through the mail :(
I'm appalled by the cost of health care in the US. For routine stuff the level of treatment and the expertise of doctors is not different than in Brazil, where I come from, but here I pay orders of magnitude more than I used to pay there. Health care here is so expensive that my wife said the other day that next year she's doing all her medical exams when she goes to Brazil.
What is the reason for such absurd prices in the US?
The kicker was that when I called the insurance company to ask about the cost they told me that it was unknowable in advance because they have rates negotiated with each hospital individually. When I asked if there was any way to estimate my out of pocket expense of if there was any cap they told me no.
So, there's literally no way to know what it's going to cost, at least with blue cross, because the rates are negotiated on a per facility basis and not public.
Not really a free market for sure.
"Administrative costs of running our health care system are astronomical...Duke University Hospital has 900 hospital beds and 1,300 billing clerks. The typical Canadian hospital has a handful of billing clerks."
On Reddit, where this stuff is discussed more, I just urge people if they can get away with it (they are conscious and can hide their wallet, for ex), to just give them a fake name. Almost $2k for a dab of skin glue? No! I don't care what complicated politico-economical factor lead to that. Free market, over-regulated market,expensive doctor's education loans, health insurance lobbyists, politicians, aliens, terrorists, gnomes. Doesn't matter. Putting that on the bill and sending to a parent is criminal. Fuck everything about it. Lie and cheat them and run away without feeling bad. They can say "oh but because people cheat it is so expensive", doesn't matter. They are stealing and screwing over the sick and disadvantaged, if you can turn right back and screw them, do it. Everybody for themselves.
I agree that's stupid, but that's how the system works for paying for medical care in the US. From the perspective of the hospital, it makes perfect sense.
The entire notion of hospitals being profit-making enterprises where people die when they can't afford to pay is literally absurd.
These hospital are almost exclusively non-profits. Measuring the profit margins of non-profits is folly. They funnel the excess money into salaries, marketing, equipment and expansion (often unnecessary).
The sucker without health insurance goes bankrupt trying to pay the full price.
Either way 'non-profit' venture in nearly all countries have been classic ways to avoid paying taxes. If you are rich, all you need to do is create a non-profit trust- Name it for religious, social or whatever charity. Once you do that you can thrown some peanuts towards a social cause and at the same time park millions worth wealth without paying taxes. Suddenly you can grow your wealth without paying taxes.
This is how it works in my country, India. You will see non-profit trusts, especially religious with billions in assets- Who don't pay a penny in taxes. They will occasionally have some religious festival and may be feed the poor on an auspicious day. While at the same time the trust grows fatter in assets and money everyday as they attract donations in billions, literally!!
It completely screws anyone not 'in the game'.
Luckily medical costs are generally reasonable here in Australia, but we still see crazily inflated housing prices due to residential property being treated like a stock.
Huge tax incentives are given to those 'investing' in property while 'buy to live' buyers like families get screwed.
Also, having your employer involved AT ALL with your medical insurance/bills is fucking insane.
I think the only real solution to the problem is to break both hospitals and universities into smaller pieces with more direct correlation between performed work and rewards. Right now gigantic organizations ("too big to fail") in hospitals and universities make it impossible for staff members to see how the money is spent. The smaller doctor offices can be more effective and offer lower prices to patients. Same goes to smaller schools. This is one of the examples where scale makes things worse, not better.
Of course, you also have to have shared facilities with expensive equipment. However, these facilities does not need to be a part of the hospitals/universities. For example, there are already 3rd party labs that provide services to hospitals and doctors. Same can be done for other procedures (e.g. MRI) and this can also help to use equipment more efficiently.
When you organize your startup, just give me 10% for the idea... ;)
It's sort of like if your boss asked you to something and offered to pay 200% of your costs. You'd certainly have an incentive to overstate them!
People can get broke by breaking their fingers.
In India, Allopathic System exist together with other 4 big system, namely Unani (Old Greek), Chinese, Ayurveda & Homeopath.
Yes, all practitioners have to register themselves to a certain extent with the medical board of India, but the system is not as highly centralized, and is more like professionals working mostly as practitioners, instead of hired workforce.
This can be ironically put as something similar to free market, since the prices are being defined by market forces.
The war over Polio, which India as per WHO has won, would not have been possible if polio vaccine drops were made free, and also their administration, for all people, including upper class.
http://en.wikipedia.org/wiki/Pulse_Polio
What I'm sure about is this that if I were to travel to US, to get hurt, and get such a bill, I would go bankrupt over night.
3000$ you can buy Tata Nano!
Also, its worth mentioning, that there is a creed of medical practitioners called "Pehelwaans" (word meaning=wrestler), which is one of the most autonomous individuals around. A stitch for comparison costs around 1$ from them. They appeared out of the sportpersons treating themselves in medieval India, and then making that into community business.
In simple words, compare Pehelwaans with Calculator, very few functions, cheap yet effective in daily life. Both PCs and Calculator exist in real world, same way, Allopathy has been adapted by people for serious stuff, while traditional fields stay prevalent for simple stuff.
Practically speaking, just google how India has become a medical tourism destination, and people from both lower income groups like in Africa, as well as from higher income group from US are coming here.
As of right now, in terms of skill of doctors, US still has the upper hand by far for rare diseases, and everything out of the ordinary. Which is good in one way, but seriously, I'm very disturbed by the fact that 500$ for a few stitches!
heck I could buy a high end phone for that much!
a) how much they're costing themselves in taxes b) so they could see how awesome we have it compared to others.
I should build this. I have the connections to make it happen. Hmm...
When I used to volunteer at the ER, I saw patients come in to pay some bills related to wheelchair rentals or crutches. Sometimes they had their prescriptions filled at the pharmacy, and they had to pay for that. But again, that's the extent of the bills that patients would see.
I once saw a guy come in via ambulance, screaming in pain. The paramedics rushed him in, and yelled to the staff that they needed a Resusc room immediately, since the guy had no detectable pulse or pressure, and she suspected he had a triple-A (I found out later that this was an abdominal aortic aneurysm.). The nurses fumbled to clear a room for them, but they eventually did. A quick ultrasound by the ER Dr. to confirm, and he was wheeled off to surgery.
That "bill" likely cost the taxpayers of Ontario upwards of $50k by my uninformed guess. Not sure if he survived or not, AAAs typically have extremely high mortality rates and have to be addressed within 30 minutes. In any case, I do appreciate the fact that him and his family don't have to worry about a thing, except getting better and appreciating life. However, I'm not sure what value it would provide for them to know the financial cost. shrug Something worth thinking about.
(Recounting this story makes me somewhat regret not continuing along the path to medical school. shrug Guess I have to contribute in a different way.)
I'll run the gauntlet. I'll take the devil's mark as a freeloader. Hunt me to the ends of the earth, credit machine. You'll never catch me on my motorcycle.
I was watching a show about venomous snake bites they charged this poor woman $80,000 for 100 bucks worth of anti-venom.
[1] Aga Khan University Hospital, Managed by AKDN, the 2nd largest NGO in the world (2nd only to the UN)
http://thehill.com/blogs/healthwatch/corporate-news/116745-h...
There have been some data sets released by CMS, but they're far from comprehensive.
"Forbes found 24 hospitals with more than 200 beds make 25 cents or more for every dollar of patient revenue they take in." http://thehill.com/blogs/healthwatch/corporate-news/116745-h... http://www.forbes.com/2010/08/30/profitable-hospitals-hca-he...
Bloomberg ran a lengthy story on how hospital consolidations are running up prices for all manner of procedures. http://www.bloomberg.com/news/2010-08-20/hospital-monopolies...
The New York Times is an international newspaper, it covers stories from all parts of the world. While they have a default America implied, yes, but why does this habit have to carry over to Hacker News?
Because HN submissions are generally expected to be titled the same as the page/article being submitted, and this policy seems to be enforced by moderators. But luckily, HN also shows what domain the submission links to, so what you see is
> As Hospital Prices Soar, a Single Stitch Tops $500 (nytimes.com)
from which you can determine that the article is most likely about American healthcare.
"Sure you can buy a hamburger for a dollar. But then you'd have to eat it." - local restaurant ad
Charging $2000 for a $200 service is the problem here, especially since that is not an informed market price, but an ultimatum set without a market negotiation or possibility for competition.
In most countries, including first world countries with medical facilities and doctor training comparable or better than USA, the full price would be $100 or less - disregarding who'd pay that bill (you, insurance or government), that is the full price charged by hospitals for such a service.
I'm not going to argue that the pricing is perfect; I am going to argue that there's a whole lot more behind that price than just overcharging. I've looked both my kids in the eyes while holding them still while being stitched up for one injury or another, thought thru a range of what-ifs, and had no problem paying the bill knowing there was more to it than just a little sewing. When both the doctor and urgent care clinic take one look at the injury and say "not here, she needs a hospital for this" and pass on billable treatment, there's a reason.
[1] - seems different cultures have different notions of what the term "hospital" entails. Methinks this confuses the discussion a great deal.