KwameKilstrawberry: Article says we're just basically too dumb to know what's best for us and after that, he lost me.

Intentional or not, that made me LOL.

I never understood the line about shopping around for health care.

Doc:: You are going to need to have a foot of intestines removed.

Me:: How much is that going to cost?

Doc:: Everything included (hospital stay, medicine, surgeon, surgery room, etc) around 80 to 100 grand.

Me:: What can I get for say 3000?

Doc:: Oh you want the 1400.

Me:: What is the 1400?

Doc:: We will give you a proper blood letting, first time use leeches, and a Priest to stand around shouting prayers to drive the devil out of you.

A Fark Handle: single payer system is the solution. some day we as a nation will realize this.

/and while we're at it, fund quality public health.

If God wanted a socialist health care system then he would have went around healing people for free!

Uh, the "consumer" isn't the one paying for health care costs anyway. That falls on the insurance companies. When the bill comes for that operation that says $250k, but that your contribution is only $5k, who is really concerned with the total cost?

Competition at the hospital level can't fix the system. Their costs are already very tightly controlled. Most hospitals flat-out refuse to pay their bills to vendors, just because they can. We don't see payment from the bigger players for 6-12 months after their account comes due.

Expenses creep as each little thing consumed in the process of healing is VERY expensive. A single $0.50 IV tubing set is marked up by the manufacturer 5000%, then marked up again by the supplier 30%. Items that have to go through FDA certification also have to be recertified anywhere from every year to every 90 days, at a cost of over $200 per unit. Various parts for the various pieces of equipment are ridiculously overpriced, due to patents. Sure, I could use any $20 gas flow block from a chemical supplier, but they haven't been approved by the FDA for use on human patients, so I have to order the ONE AND ONLY flow block available from the same manufacturer who makes the (total POS - breaks all the time) vent, who will charge me $450 for the privilege.

Little things being over priced, and the need for LOTS of those little things for each patient leads to massive bills. The only room left for hospitals to compete over is the cost of the bed stay and the amount they charge for their nursing staff. Nurses are already under paid, so all that's really left is the cost of the room itself.

My gf was just denied private insurance, but they conveniently sent a piece of paper detailing the high risk pool that she could get in to because they won't take her. I'm currently in the process of getting my acl/knee surgically repaired, it's going to cost me about 2 grand out of pocket (500 for one mri that I have scheduled tomorrow) and that's with reasonable health insurance that my employer helps pay for. It would really suck to have to choose between rent, food, or knee pain for life if I couldn't afford the co-pays and deductible.

KwameKilstrawberry: "As patients, we are just not equipped to absorb and process the information needed to make healthy choices on our own."

ORLY?

How the fark have I managed to choose a plan over the six that my employer offers me?

Article says we're just basically too dumb to know what's best for us and after that, he lost me. What a tool.

You missed the point. It's not that consumers won't be able to choose (indeed, plenty of them will end up choosing something, even if it's via coin flip or throwing darts at a board); it's that they won't know whether they've made the right choice till they actually have to rely on their plan to cover urgent care that they're in need of. The infrequent and high-stakes nature of this feedback is what might prevent the traditional efficiencies associated with competition from being realized.

Corvus: I agree mostly with what there he is saying but I think if you have enough stats about each healthcare provider someone could make a pretty informed choice. But a system would need to be set up to provide real information that consumers could use.

That is the problem with the "invisible hand" it only works when people can make informed decisions and the "free market" people are also against giving people that information to allow them to make those informed decisions.

"invisible hand" does not work on commodities/services with an inelastic demand. Economics 101.

Amitai Etzioni is a sociologist and professor of international relations at George Washington University

So! He admits that he's nothing but a goddamn Socialist! I knew it!

You homocommieabortionists simply will not rest until we all stand in line for our daily ration of black bread and vodka. I spit at you!

Corvus: Kuroshin: Uh, the "consumer" isn't the one paying for health care costs anyway. That falls on the insurance companies. When the bill comes for that operation that says $250k, but that your contribution is only $5k, who is really concerned with the total cost?

Your right. I am just getting operations for the fun of it!! And 5k is like the money I find in the cushions of my couch!

Hmmm, I don't think you got my meaning.

You, as the patient, do not pay for the services rendered. You pay a percentage/flat fee based on your insurance coverage. Your contribution has zero relation to the care being given. That's between you and your insurance provider. This article isn't about insurance, it's about the cost of care. $5k isn't the cost of the care rendered - only your reduced contribution. No amount of hospital competition will ever affect that number. Hell, no amount of hospital competition will affect the $250k bill either. Their costs are super-inflated from the bottom-up.

Lenny_da_Hog: Kuroshin: Uh, the "consumer" isn't the one paying for health care costs anyway. That falls on the insurance companies. When the bill comes for that operation that says $250k, but that your contribution is only $5k, who is really concerned with the total cost?

Which is why the insurers formed HMOs and exclusive agreements with certain providers, further limiting the "consumer choice."

Exactly. Not only that, but HMOs are often being shot-supplied by vendors due to lack of payment. I have yet to find an HMO that pays any of their bills within the same calendar year. It's how they pad their accounting. Sit on any money that comes in from members, then refuse to pay any late fees caused by delayed payments - pocket the interest. If a vendor writes you off to collections, just settle for a much-reduced amount. Lather, rinse, repeat. We've had some fun repo runs to one of the larger HMOs in the country, only to get stuck with them as a customer again after one of the national accounts sales morons signs them back up at a reduced cost!!!

HMOs are cheap and give crap service because they don't pay their damn bills. The patient gets screwed in the end, because staff stops giving a shiat (low pay, horrible hours), they can't get/keep decent doctors, and vendors give them only the worst possible equipment and supplies.

If you want to lower health care costs, look to where the costs are being jacked up - at the bottom.

Communist_Manifesto: My gf was just denied private insurance, but they conveniently sent a piece of paper detailing the high risk pool that she could get in to because they won't take her. I'm currently in the process of getting my acl/knee surgically repaired, it's going to cost me about 2 grand out of pocket (500 for one mri that I have scheduled tomorrow) and that's with reasonable health insurance that my employer helps pay for. It would really suck to have to choose between rent, food, or knee pain for life if I couldn't afford the co-pays and deductible.

$2K out of pocket. Holy shiat! I know we wait longer in Canada for elective surgery but the fact that it is free is pretty cool.

mrshowrules: Communist_Manifesto: My gf was just denied private insurance, but they conveniently sent a piece of paper detailing the high risk pool that she could get in to because they won't take her. I'm currently in the process of getting my acl/knee surgically repaired, it's going to cost me about 2 grand out of pocket (500 for one mri that I have scheduled tomorrow) and that's with reasonable health insurance that my employer helps pay for. It would really suck to have to choose between rent, food, or knee pain for life if I couldn't afford the co-pays and deductible.

$2K out of pocket. Holy shiat! I know we wait longer in Canada for elective surgery but the fact that it is free is pretty cool.

I had that conversation with a friend of mine today, I have already put off the surgery for 2 years due to cost, I wouldn't give a fark if I had to wait another one to get it taken care of for free. Our system blows giant farking donkey dicks and anyone who says otherwise is either rich, evil or both.

KwameKilstrawberry: Biological Ali: KwameKilstrawberry: "As patients, we are just not equipped to absorb and process the information needed to make healthy choices on our own."

ORLY?

How the fark have I managed to choose a plan over the six that my employer offers me?

Article says we're just basically too dumb to know what's best for us and after that, he lost me. What a tool.

You missed the point. It's not that consumers won't be able to choose (indeed, plenty of them will end up choosing something, even if it's via coin flip or throwing darts at a board); it's that they won't know whether they've made the right choice till they actually have to rely on their plan to cover urgent care that they're in need of. The infrequent and high-stakes nature of this feedback is what might prevent the traditional efficiencies associated with competition from being realized.

So basically, you have to have a crystal ball to know what you'll need.

However, just as insurance companies rely on actuaries and statisticals, there are certainly demographics that can reasonably forecast their healthcare needs: kids that have just been thrown off their parent's plans are better off with high deductible, low premium plans; families are going to need physicals, well-baby care, emergency room trips, maternity, ob/gyns; and the old folks are going to need all the diagnostics and major medical coverage. Then you have your mental health and disability / chronic / terminal issues. All these groups can predict certain needs. A nice bonus would be the availability of affordable gap insurance for the anybody who wanted it.

The other alternative, of course, is just getting rid of all the bullshiat and nationalize health care already. But if we're going to have a mandate, we're going to have to have informed consumers that have the right to make choices, even if there are risks involved.

Just nationalize the insurance portion. That is the weak link. Health care can remain completely privatized if you want.

KwameKilstrawberry: The other alternative, of course, is just getting rid of all the bullshiat and nationalize health care already. But if we're going to have a mandate, we're going to have to have informed consumers that have the right to make choices, even if there are risks involved.

It's not just about being informed - it's about feedback. That's what ultimately lets the consumer know whether they've made the right call, and will allow them to adjust their choices if they made the wrong call. If they've made the wrong call here, they generally won't figure it out on their own - they'll find out the hard way, when they time comes to pay for care. As for being generally knowledgeable about insurance - that is at best only a partial substitute for regular, low-cost feedback, particularly when much of that information inevitably comes from self-interested sources.

Once again, the article isn't about whether you're smart or dumb - it's about the kinds of choices consumers facing consumers in healthcare, and whether that makes it conducive to the competition-related efficiencies you'd find in some other industries.