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Fat Ogre posted:Notice how I said they should have to post their prices upfront. It could allow comparison shopping before hand. Or once you're stable being transferred to a lower cost place. You are NOT going to comparison shop when your brain is hemorrhaging or some dickheel runs you over in his car. Posting prices will change NOTHING except the elective market, while the majority of emergency health care is dispensed price-blind. You need it; you get it; you figure out how to pay the extortion fees later.
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May 10, 2014 15:44
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anonumos posted:You are NOT going to comparison shop when your brain is hemorrhaging or some dickheel runs you over in his car. Posting prices will change NOTHING except the elective market, while the majority of emergency health care is dispensed price-blind. You need it; you get it; you figure out how to pay the extortion fees later. Yeah because all medical services are emergency related  I have a wife and three kids and have had to call an ambulance ZERO times in my life. Yet interestingly enough have utilized and paid for a wide range of services that were I able to comparison shop would have been useful.
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May 10, 2014 15:56
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Wow, well then I guess nobody in the world has emergencies, it's all in our imaginations. That's good to hear!
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May 10, 2014 16:05
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Axe Master posted:Wow, well then I guess nobody in the world has emergencies, it's all in our imaginations. That's good to hear! The entire idea is being hand waved away because of emergencies which is stupid as poo poo.
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May 10, 2014 16:09
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anonumos posted:You are NOT going to comparison shop when your brain is hemorrhaging or some dickheel runs you over in his car. Posting prices will change NOTHING except the elective market, while the majority of emergency health care is dispensed price-blind. You need it; you get it; you figure out how to pay the extortion fees later. Possibly relevant, from Politifact of all places. quote:We easily found the source of the statistic -- a calculation publicized by the American College of Emergency Physicians. Obviously, this is a group with a dog in the fight, but the calculation they made was pretty straightforward and is based on federal data. One study finds a higher estimate. quote:The study -- by Michael Lee and Brian Zink of Brown University’s Warren Alpert Medical School and Jeremiah Schuur of Harvard Medical School -- used data from the Centers for Disease Control and Prevention’s National Hospital Ambulatory Medical Care Survey, which tallied approximately 130 million ER visits, a much higher number than the Medical Expenditure Panel Survey, which counted 49 million visits. Based in part on this discrepancy, the authors said the actual percentage may range anywhere from 4.9 percent to 10 percent, rather than 2 percent. So let's say emergency services are between 4.9% and 10% of healthcare costs and a proportionate share of admissions. It seems like most care is non-emergency.
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May 10, 2014 16:09
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I find it hilarious that people use the word  medical rationing as if the term hasn't existed for a billion years in medicine under the term TRIAGE.There is no excuse for the US to not have a better system of healthcare. We pay more, as a nation, for fewer covered citizens, fewer covered procedures, and worse outcomes. The ACA, for all its protections, really only entrenches a system of high-premium/high-deductible insurance that really does jack-poo poo for the average citizen. It is a staggering ethical failure for healthcare to be a for-profit industry. Hopefully Vermont will get their poo poo together so I can move for decent insurance without having to ex-patriate.
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May 10, 2014 16:10
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wateroverfire posted:Possibly relevant, from Politifact of all places. Also many emergency room visits aren't because you're critical. You fall and bust your leg, knowing how much they cost for a broken limb could be something you know beforehand. Or a burn, or a cut or allergic reaction etc. I've been in the emergency room with my kids numerous times and none of them were so dire that an extra 10 minute drive to a cheaper place would have been a life or death decision. This is especially relevant when you're having to wait for triage or just to be processed after being seen. Siting in an emergency room waiting for three hours gives plenty of time to shop.
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May 10, 2014 16:19
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menino posted:The demand for the service is too erratic and immediate for pricing signals to make a difference. This is like health care markets 099 Not entirely. Having co-pays tied directly to actual costs would do something, and would be a good idea under any system in my opinion. Really most things arn't a trip to the ER.
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May 10, 2014 17:31
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Fat Ogre posted:I have a wife and three kids and have had to call an ambulance ZERO times in my life. Oh well okay then problem solved.
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May 10, 2014 18:19
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VitalSigns posted:Oh well okay then problem solved. Keep dodging what is being said because you're angry. Please explain why posting prices for people to see, wouldn't be beneficial for most healthcare situations 
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May 10, 2014 18:44
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Fat Ogre posted:Keep dodging what is being said because you're angry. I literally brought up a common example of where it would do nothing, and you handwaved it away with "I've never needed an ambulance, why can't everyone be a good planner like me?" Seriously I want to know what happens when I'm found unconscious, do the paramedics check out the decision tree tattooed on my back (maybe in henna so it can be updated constantly)? I'd bring up expensive conditions like cancer treatment as another argument for UHC, because comparison shopping is not going to help you choose between one bill you can't afford and another bill you can't afford...but a person in that situation should take responsibility and avoid cancer like you have right? Are you Rob Portman? You are, aren't you. 
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May 10, 2014 18:53
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But it's actually not comparatively common. And it has parallels to a whole bunch of other industries which deal with emergencies (plumbers, car repair) and respond to price signals just fine. So it's really a bad argument against posting prices and using prices as one peice of the puzzle.
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May 10, 2014 18:57
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asdf32 posted:But it's actually not comparatively common. Medical bills are the largest cause of bankruptcies in the United States, so I'm going to have to ask you to show your work and tell me where there's all this affordable health care out there that nobody knows about because hospitals don't post price lists. Plumbing and car repair aren't life-or-death situations where you get the work done or you die. You can get an estimate for a car repair and decline it if you can't afford it. One of my friends whose minimum wage job doesn't give him insurance was up all night with a stomach ache, and it was so bad in the morning that he went to the ER and got moved up to the front of the line when he was eventually writhing on the floor of the ER--turned out he had a serious infection and was in hospital for a weak with an IV of antibiotics, serious painkillers, and emerged with an $80k bill that he will never be able to pay and will trash his credit. There was literally no way to know what care he needed when he walked in the door, but it's a good thing he didn't wait another day because the doctors told him that he may well have died had he done so. But no, I'm sure while doubled over in pain, once he got his diagnosis he should have called around to other hospitals in the area, maybe driven around and paid several doctors to each diagnose him and give him an estimate. This "personal responsibility" nonsense is a crap feel-good measure that will do nothing to help those most hosed over by our health care system, but give Just World bullshitters cover to wag their fingers at the poor and lecture them for not being good conscientious shoppers like them. "I've never needed an ambulance" Indeed. It's crap like all his suggestions are crap. "High unemployment in a recession. Pound pavements, get your resume out there, and we'll have it licked in no time!" "The law field crashed while you were in school? All those graduates should get another $40k in loans and get an engineering degree, problem solved!" "Medical bills bankrupting people: shop smarter!" "Not enough chairs in musical chairs? Play harder, losers!" These are systemic problems, but conservatives like you and Fat Ogre prefer to imagine that if the poor can just be a little thriftier and get some morals the issues will disappear.
VitalSigns fucked around with this message at 19:29 on May 10, 2014 |
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May 10, 2014 19:19
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It is like some IRL-Dictionary for the definition of. "Privileged and blind" "Wow I am married just fine, what is the deal with these faggots wanting to marry?" "Hey man I am white and I've never understood the problem with racism, stop whining" "Yo, what is with these sickly poor people crying? I'm healthy AND insured, life's good man" "Hey, nepotism worked for me, why won't you try the same?"
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May 10, 2014 19:29
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asdf32 posted:But it's actually not comparatively common. If you are comparing a broken transmission to a heart attack you are a god drat moron. Hint, you can die from one, but not the other!
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May 10, 2014 19:34
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Fat Ogre posted:Keep dodging what is being said because you're angry. Most people don't get primary care these days, because they can't afford it. They have to wait until emergencies to get healthcare, which ends up being more expensive in the long run but that's not the sort of decision you can make when you're barely managing to feed yourself. In an emergency, you usually don't know what you need until you're already in the hospital getting diagnosed. You and I can get preventative healthcare because we're relatively well-off and can afford to go to the doctor before something is an emergency. But (and this is a key thing to keep in mind for many political discussions:) I am not representative of an average person. I'm ridiculously unrepresentative. You are too. You'd be good to repeat that underlined statement back to yourself. It's an uncomfortable, unpleasant thing to think about, that your life is actually an outlier, on the good side. That doesn't mean your life is without difficulty, it doesn't mean you don't work hard, but it does mean that you are unequipped to give general advice to the world at large from your own life experiences.
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May 10, 2014 19:54
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FYI well over half the country already had healthcare. Most healthcare costs aren't emergency related. That you guys are resorting to screaming about privilege and conservatism instead of admitting your point isn't valid is priceless. Worst case scenario emergency healthcare costs are barely 10% of all medical expenses. Let's get angry about posting prices so that people can shop because reasons!! Many people have never needed an ambulance so to say you can't shop for healthcare because a few people need an ambulance is sheer ridiculousness. What is your real argument against hospitals posting their prices for people to see?
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May 10, 2014 20:13
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rscott posted:If you are comparing a broken transmission to a heart attack you are a god drat moron. Hint, you can die from one, but not the other! This is obviously a reason why we should keep prices secret. Every medical expense is a heart attack. Earaches, surgeries, bone setting, check ups etc are always emergencies. I love that it seems like the people in this thread have no clue how many medical expenses are bit emergency related. Fat Ogre fucked around with this message at 20:21 on May 10, 2014 |
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May 10, 2014 20:16
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What cracks me up most is not posting the cash prices up front actually hurts the poor. The ones who need to get the best price, who need hospitals to compete. You're all pissed at me for 'not caring' about the poor yet this simple fix that would help them is just conservative privilege.  We can't help the poor because the only way they can be totally helped is UHC!! Anything less is terrible!!!
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May 10, 2014 20:19
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Nobody's saying we "should keep prices secret". We're saying that making prices public won't fix the actual problems, and that offering it up as a "more achievable" goal to work towards is counterproductive.
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May 10, 2014 20:20
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Fat Ogre posted:This is obviously a reason why we should keep prices secret. Every medical expense is a heart attack. Earaches, surgeries, bone setting, check ups etc are always emergencies. That isn't what I am saying at all. If you actually read my posts in this thread you would realize that I am saying a market based solution does not work for healthcare. It doesn't matter if you make that market more or less efficient, you run into inextricable problems that can not be resolved. e: Plus the actual comparison was between automobile/plumbing emergencies and medical emergencies. You really should pay more attention to the arguments being presented in this thread, you're making yourself look like an rear end.
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May 10, 2014 20:21
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Ditocoaf posted:In an emergency, you usually don't know what you need until you're already in the hospital getting diagnosed. Exactly. Medicine is a highly specialized professional industry, and comparison shopping is asking laymen to make medical decisions. There was one really good post from a goon in a previous health-care thread (that I wish I had saved) telling a story where he took his wife to the ER in the middle of the night. She was in excruciating pain, and the doctor told him that to know if she required surgery she needed an MRI, but if it turned out to be nothing then his insurance would likely refuse to pay. He ended up doing it and it turned out she her fallopian tube was wrapped around an ovary or something (I forget what), but she needed surgery right then because every minute risked some kind of internal rupture and hemorrhage. Here he was, a layman with no medical training, being asked to wager a huge sum against the life of his wife with no way to know beforehand what the outcome would be. In a sensible world, that decision would be up to the doctor's medical judgment, not the poker hand of some dude. But hey,  free markets. What does that rube expect for trying to get an MRI in the middle of the night? A savvy consumer like me would have told his wife to shut the gently caress up about her stomach for the rest of the night so in the morning I can use my finely-honed bargain-hunting skills to shop around for MRI's during normal business hours and let the hospitals compete for my business!
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May 10, 2014 20:21
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Ditocoaf posted:Nobody's saying we "should keep prices secret". We're saying that making prices public won't fix the actual problems, and that offering it up as a "more achievable" goal to work towards is counterproductive. Why would helping the poor be a bad thing? If your goal is UHC why not get te low hanging fruit first?
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May 10, 2014 20:22
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VitalSigns posted:Exactly. Medicine is a highly specialized professional industry, and comparison shopping is asking laymen to make medical decisions. Yeah or maybe figure out which place had the best price rating before an emergency. Seriously your argument is literally emergencies happen and you can't price shop before hand because reasons. Most people don't need a lawyer, is the best time to find out lawyer prices when you need one? Same with car repairs, plumbing etc. Not every medical issue is life and death. Stop trying to imply they are.
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May 10, 2014 20:25
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Fat Ogre posted:Yeah because all medical services are emergency related
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May 10, 2014 20:25
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the only low hanging fruit is the moronic arguments you're putting forth in this thread, hth
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May 10, 2014 20:26
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rscott posted:the only low hanging fruit is the moronic arguments you're putting forth in this thread, hth Good reason to not post prices you have there 
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May 10, 2014 20:27
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Fat Ogre posted:What cracks me up most is not posting the cash prices up front actually hurts the poor. The ones who need to get the best price, who need hospitals to compete. Oooh oooh! I have a question! Me! If market forces can make hospitals compete for my business, and obviously I would prefer to patronize a hospital with published prices than one without, why haven't these market forces already compelled hospitals to post their prices?
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May 10, 2014 20:27
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VitalSigns posted:Exactly. Medicine is a highly specialized professional industry, and comparison shopping is asking laymen to make medical decisions. I was once in a conversation with a Canadian who said "It's not all roses and sunshine up here, you know; if I needed an MRI but it wasn't urgent I might have to wait for a month." When the three Americans involved informed him that if they needed an MRI they would go bankrupt, beg from family, or not even consider getting one, his response was along the lines of "hrm."
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May 10, 2014 20:28
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Fat Ogre posted:Good reason to not post prices you have there I already told you why, in the post you ignored because you can't respond to it.
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May 10, 2014 20:28
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Nessus posted:Then may I be the first to wish to you that none of your four loved ones, nor yourself, should ever have to have an emergency or a condition which will require such treatment methods. May your fiscal prudence be matched, forever, by the blessings of good fortune - so that you never are tested. I've been to the emergency room numerous times. None of them are life and death thankfully. The point still stands. For at least 90% of the time it isn't an emergency so why is it bad to be able to shop around? Seriously why should you pay 500 for X-rays when the lab across town can do the same for 200? Oh well gently caress poor people since they're the ones actually being given the cash price.
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May 10, 2014 20:29
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Fat Ogre posted:FYI well over half the country already had healthcare. The real problem is that our healthcare system is set up as the equivalent of a triage center that puts a black tag on anyone who doesn't have insurance and can't afford treatment.
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May 10, 2014 20:30
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VitalSigns posted:Oooh oooh! I have a question! Me! They aren't forced to post prices before hand so they don't have to compete for your business. You literally cannot comparison shop so there is no competition. Also insurance isn't allowed to be nationalized. Which keeps external competition low. If the insurance groups only have the population of your state to drawn from they can raise their costs because it isn't defrayed among a bigger pool.
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May 10, 2014 20:33
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Fat Ogre posted:They aren't forced to post prices before hand so they don't have to compete for your business. You literally cannot comparison shop so there is no competition. EDIT: the answer is the market isn't relevant to this kind of transaction Ditocoaf fucked around with this message at 20:40 on May 10, 2014 |
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May 10, 2014 20:38
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Hospitals are just like restaurants in your own little world. Should hospitals off two for one deals?
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May 10, 2014 20:38
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Lyesh posted:It would be great for them to post prices, but it's a tiny bandaid at best. Stuff like cancer is so expensive to treat that it's not going to be affordable to anyone who has insurance (and a lot of people who do). Even a broken limb isn't something that most people can pay for without insurance. Cost-controls are necessary, but they aren't something that patients need to be directly involved in, especially when their economic status so strongly affects what they can pay. There are a number of local places opening up medical care centers that specifically don't take health instance ( if you have it you have to do the filing yourself). They post the prices beforehand and are doing quite well people skip going to the emergency room when they can spend $50 and get a checkup and know that their antibiotics aren't going to go over $20 at most. This is already happening by doctors fed up with the current system. I'm saying we should force all places to do this to get some basic competition going. When a for profit hospital sees that it loses a ton of business because the place down the street is cheaper across the board it forces them to lower prices. Which means insurance gets cheaper for everyone. Until we get UHC it would help quite abut to know how much things are.
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May 10, 2014 20:41
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^^^ Oh, are these places that are guaranteed to give you antibiotics? That will end wonderfully. Ditocoaf posted:Wouldn't you prefer to go to the hospital that publicized its prices, if you had a choice? Why would they have to be forced to post, the free market should incentivize them to post. Y'know, if the free market was a thing that was relevant. One of them. How do I comparison shop there? To address Fat Ogre's pedantic point, it would not be a bad thing, though it might not be a useful thing, considering that even in a civilized society, medical treatment involves a poo poo ton of moving parts and the possibility that you will have an emergency crisis in the course of treatment - perhaps you should be able to declare "Well I'll take the basic course of treatment, but if it looks like it'll cost more, just let me die to spare my heirs!" and this will mysteriously and suddenly be completely OK with all the medical personnel, your family, etc. The reason why people are not warmly embracing solutions such as that or "let me give you some pro career advice (become a coder)" etc. is, I think, a lot more because these are general discussion threads. If this was a medical discussion on the virology of the common cold, someone popping in to say "Just have some chicken soup! OK, some veggie broth if you're a vegetarian. What's wrong with that? Everyone can get chicken soup, what harm does it do? It's quick and easy so what's wrong with bringing it up?" etc. etc. would get told "gently caress off."
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May 10, 2014 20:42
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You see, when I think of hospitals I think they should try to compete for my business. What they certainly shouldn't do is compete for my well-being/care.
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May 10, 2014 20:42
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Fat Ogre posted:They aren't forced to post prices before hand so they don't have to compete for your business. You literally cannot comparison shop so there is no competition. But if competition worked on hospitals then market demand should be compelling them to post prices already! You are contradicting yourself. What incentive does that hospital have to lower prices? You need to get this care somewhere, and there's no hospital glut. When the cheaper hospital has its MRI booked for the next month or is not open at 2am when you need it, you're not going to turn it down. The hospital does not need your business as much as you need it, full stop. Assuming you can even afford the somewhat cheaper hospital, which likewise has no particular need or incentive to individually bargain with you. That's why only large organizations like insurance companies or the government with a huge pool of customers can bargain with hospitals on even terms. Fat Ogre posted:Also insurance isn't allowed to be nationalized. Which keeps external competition low. If the insurance groups only have the population of your state to drawn from they can raise their costs because it isn't defrayed among a bigger pool.  The solution to the problems with our health insurance industry is to let insurance companies race to incorporate in the state that has the slackest regulations, and then contribute huge sums of cash to Delaware (we all know it will be Delaware) legislators to slacken them even more! Please never stop posting. VitalSigns fucked around with this message at 20:49 on May 10, 2014 |
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May 10, 2014 20:45
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VitalSigns posted:This "personal responsibility" nonsense is a crap feel-good measure that will do nothing to help those most hosed over by our health care system, but give Just World bullshitters cover to wag their fingers at the poor and lecture them for not being good conscientious shoppers like them. Behind every use of the phrase "personal responsibility" is the terror of a world in which bad things happen regardless of whether you're a "good person" or not. It is a talisman, an incantation, which can be repeated as a ward against having to acknowledge the reality of that world. "Well, a bad thing happened to him, but it can't happen to me, because I have personal responsibility!" Once you recognize it for what it is- a coping mechanism for people who'd rather deny the various horrors of the world we live in than work to mitigate and overcome it- it's easier to understand where the people who spout it are coming from. It looks like malice, yes, and that can be the result of it, but at its root it's just fear and a psychological inability to admit that your life isn't as under your control as you'd like to pretend it is.
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