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Hospital Prices Are About To Go Public in the US (ajc.com)
Prices hospitals charge for their services will all go online Jan. 1 under a new federal requirement, but patient advocates say the realities of medical-industry pricing will make it difficult for consumers to get much out of the new data. From a report: A federal rule requires all hospitals to post online a master list of prices for the services they provide so consumers can review them starting Jan. 1. The health care industry nationally has a reputation for having little price transparency, which can make it difficult for consumers to price compare. But the hospital's master list prices, sometimes called a chargemaster, is also not a complete look, consumer advocates say. That's because the final bill a patient receives is almost never the same as the sticker price for the services they received. Insurance companies negotiate discounts on the sticker prices. Co-pays, co-insurance, deductibles also add other layers of complexity that bring discounts or increased costs before a final charge is determined.
paid by everyone via taxes, without what seems like the bureaucracy of private or employer-paid insurance
We in the Netherlands went with a great combination of public and private health care: the expense of a partly publicly funded health care system combined with expensive commercial care providers and a mandatory private insurance. And costs, while not as high in the USA yet, are perpetually on the rise. The only ones happy with this scheme are the insurance companies, who sell us the insurance while at the same time placing an insane administrative burden on hospitals. By the way, if you think this sounds a little like Obamacare, that's because it is kind of similar. At least, that suffered from the same weakness: the insurance companies (though Obamacare might still have been better than the current system in the US, hard to say)
If construction was anything like programming, an incorrectly fitted lock would bring down the entire building...
Now all we need is a Nondiscrimination law --- that is, to say,
a federal rule against price discrimination or blanket pricing deals in that: A healthcare provider may not charge individuals a higher price than a partner insurance company would pay for the same service.
To make a long story short, it's fallout from WW2.
Wage/Price controls during WW2 made it difficult for businesses to recruit talent - it wasn't like you can pay them more to get them to leave their current job.
So, someone had the bright idea of offering Medical Insurance as part of the pay package. Legal, since Medical Insurance wasn't covered by the Wage/Price controls.
Anyways, by the time the notion of Single-Payer got some momentum, Medical Insurance as a benefit of your job was so embedded in the economy that getting rid of it was next to impossible.
In the long run, Medicare will probably be gradually extended to cover everyone, which will give us Single-Payer by default. But it's hard to deal with the economic disruption (the Insurance Industry is HUUUUGE! and will pretty much vanish with Single Payer) quickly, so it'll be a while.
"I do not agree with what you say, but I will defend to the death your right to say it"
The meme among American conservatives is that the only reason other countries can afford universal healthcare is because they have weak militaries.
It's completely bonkers for many different reasons:
1) Universal healthcare is much more economically effective in relative and absolute terms.
2) Countries with strong militaries (Sweden during the Cold War, France now) still "afford" healthcare partly because of 1).
3) Sweden gives 1.4% of its GDP to foreign aid compared to 0.2% of the US and still "affords" healthcare partly because of 1).
4) The US gets a fuckton of influence and business because of its strong military.
Once they realize what an utterly stupid argument this makes, they turn to the argument of "diversity". Sweden is a less "diverse" country (read: has fewer mooching n*****s) so therefore it magically somehow works.
I broke my clavicle skiing several years back, a non-unionizing break, and had to have a plate installed. After the surgery I got a "This is not a bill" statement from the plate manufacturer, telling me the cost of the plate is $7800. I then later got a "this is not a bill" statement from the hospital, telling me the cost of the plate to them is $3400. I then got a "this is not a bill" statement from the insurance company telling me their non-negotiated cost for the plate is $1100. I then later got a "this is not a bill" statement from the insurance company telling me their negotiated cost for the plate is $391, and they're covering all of it, so I don't owe anything. I guess my question is, is anyone anywhere actually paying $7800 for this plate, or is that all bullshit?
I have lived under the British (UK) health care system and it Sucks! The reports of wait times for surgery, scans, procedures & treatment are much longer than in the USA. The overall Quality is much poorer than the USA. The overall "out-of-pocket" price may be lower but the human costs are definitely lower. USA Federal Government intervention/take-over of the America health care system is the ruin of both health insurance (a la, Obamacare) and health care (restricted treatments, proscribed treatments, etc.). My Carpal Tunnel Syndrome surgery was performed in Memphis, TN. At the time of my surgery, Memphis had more MRI machines than the entire country of Canada (a 1st World Country with single payer health insurance/care). While I can't speak about Sweden's health insurance/care system, I can address the British and Canadian systems with some sort of personal experience. The reports from the MSM in the USA all seem to note that 1-payer systems are "cheaper" for the consumer but the quality is still inferior to the USA.
Once they realize what an utterly stupid argument this makes, they turn to the argument of "diversity". Sweden is a less "diverse" country (read: has fewer mooching n*****s) so therefore it magically somehow works.
What's so funny about this smear of yours (apart from it simply being insulting BS) is that your country actually is far less "diverse".
It's not exactly ludicrous to think (or at least consider the possibility) that smaller, more homogeneous societies might be better able to pull off trust-based cooperative arrangements and schemes.
Nor is it ludicrous ro realize that when others shoulder the bulk of your geo-scale defense expenses, that you then are free to spend more of your tax money on benefits.
Well, in any case, if you continue your immigration foolishness, you won't be so non-diverse for long (demographic change is fast). The smugness will be evaporating sooner than you think.
I have a friend who lives in Denmark, When she was younger she had to have a double mastectomy because she was unable to get the care needed prior to this for breast cancer because of their financial system.
Just recently her husband had died because he was unable to get into a doctor for breathing trouble for around 4 weeks. Turned out he had a pulmonary embolism. Great health care system there.
And for those that are wondering, she pays about 50% income tax, plus around 25% VAT (this is from random conversations, so not sure if 100% accurate)
The Europeans sacrifice the young and the old. The US sacrifices the poor. What we're saying here is that there really isn't enough for everybody to have all the want all the time.
At least in the US, we can choose. If I've worked all my life to save a nest-egg, I can choose to spend it on EOL care, or I can choose to take a leisurely swim to Europe. Europe, having leaders that are smarter than the rest of us, makes those decisions for me. (Because, I can't have the nest-egg if they've taxed it out of me beforehand.)
Aah, change is good. -- Rafiki
Yeah, but it ain't easy. -- Simba
I'm not sure you are following this correctly. First off the people and politicans of the same party are in different boats as the flood of healthcare money goes to politicans and not the people. Even republican voters prefer single payer options at around 60% and democrats around 90% although if you call it single payer it drops republican support about 15 points over Medicare for all. In contrast 0 republican politicans support single payer, and almost 0 democrat politicans do as well because to not do so would erode thier campaign coffers. Republicans continually lose thier shit over single payer again and again - just visit Fox News for an example.
The real takeaway is that republican voters feel the finnancial inequality and hard times and are afraid of the change because there isn't enough money now and so how do we pay for it. Back in reality corporations have been stealing lying and griftng so much citizens don't have any money and even the Koch brothers bias study showed single payer would be 3 trillion dollars cheaper over the next 10 years despite full participation of the citizens and increased use. with single payer somewhere beteeen 70-80% approval across all people the real reason we don't have single payer is we don't live in a democracy, or even a representative democracy
I too have lived in Europe with universal healthcare.
And my experience is that the European system was way better. No arguing with insurance companies over treatments, and having to accept substandard treatments because they're cheaper.
No avoiding going to the doctor because the co-pays alone can be a fortune.
No three-month wait for an appointment to see a cardiologist.
But most of all, the quality of treatment is superior outside the US, because the US system is tailored to increase profits while reducing the liability for doctors and hospitals, meaning it's test-heavy and risk-averse.
As an example, I have bilateral total hip replacments, done in Europe. The doctors consulted with me before the procedure and gave me alternatives. I opted for uncemented threaded implants, which allows me to run as much as I want, do yoga, and pretty much function better than with the original hips. They will never have to be replaced, although the ball caps can be replaced with minor surgery. The risk is slightly higher during the initial surgery, but the quality of life afterwards is immensely better. This is not even an option for insurance-paid surgery here in the US. The slightly higher risk and higher cost of a longer surgery prohibits it. US hip replacement patients are always given cemented screwed hips, and told that they must not run or do anything hard, for the rest of their life. And that the hips will last for around 20 years.
Another example is laser vision correction surgery, which was available in the Soviet Union and then in Europe long before it became available in the US. Yet the average American thinks it's an American invention not available elsewhere...
And non-NSAID, non-opioid pain medications? There are several whole groups of medicines that have been successfully used in Europe for decades now that aren't available in the US, mostly due to lobbying from the existing drug producers.
And people here in the US accept that crap? And think they have the best healthcare in the world?
It sucks. It really does. For anything serious, I book a plane and go back to the country for which I still hold a passport. Because the service is so incredibly much better, focused on quality of life for the patients, and not maximizing profits and minimizing liability for hospitals and their marionettes.
It's truly a world of difference, and not in favour of my new country.
And for those that are wondering, she pays about 50% income tax, plus around 25% VAT
To be fair, when Americans cite numbers like these, they don't consider that the income tax includes both medical and retirement, and that a VAT is only applied to the final price, not every single step like US sales tax. The latter is a significant difference.
If a US product is sold four times from it leaves the primary industry until the end user buys it from a retailer, at an average of 6% sales tax, that equals a 26.25% VAT. In reality, far higher because factories and distributors also add their profit margins, which are also subject to multiple instances of sales tax.
One of the reason for cost difference for purchases in Europe compared to the US is due to the US being caveat emptor. In Europe, warranties and reclamation rights are mandated by law, and the typical mandatory warranty is stronger than the best you can pay extra for here in the US. Another reason is the wage level, where factory and retail staff in Europe earn a lot more than their US counterparts, with much better benefits. This raises the costs, but much of that is funnelled back into the system because the staff is better paid and pay more taxes and spend more money. So the standard of living is not worse - rather the opposite.
Great. Because, there won't be any abuse of the system problems with that.
You should use evidence based reasoning.
Plenty of countries have healthcare that is free at point-of-use. They have mechanisms to prevent abuse that work well.
In many countries, when you "go to the doctor", you see a screening nurse or PA first, when you walk in the clinic door. 80-90% of the time that is as far as you get, because your ailment is something routine, and the nurse just hands you some pills and tells you to go home and get some sleep and drink plenty of fluids. Many times there is ZERO paperwork. There isn't even a record that you were there, and the nurse may not even ask for your name. You just walk in, get some quick advice, maybe some free pills, and then you walk out. The cost to the healthcare system is maybe $5, if that.
In America, even a sniffle means 30 minutes sitting in the waiting room next to people coughing up phlegm, several insurance forms, and a whole team of people to interface with the insurance companies, prepare and clean the treatment rooms, confer with the malpractice attorneys, etc.
Cadillac plans are taxed, but most employer provided health insurance is not. This is a problem, because involving employers in the health insurance business adds a whole additional layer to the process that insulates the people receiving care from the people paying for it.
Having your employer provide heath insurance MAKES NO SENSE WHATSOEVER and you only think it does because you are used to it have been conditioned to think it is normal.
In Maoist China, each factory ran their own school for the children of their employees. So if you changed jobs, your children had to switch to a new school. That is obviously completely idiotic. But you can only see that because you are outside the system and you have seen a better way.
Employer provided heath insurance IS JUST AS STUPID. If you work for, say, an auto parts store, and they provide health insurance, then your major healthcare decision is being made by someone who:
1. Knows nothing about healthcare.
2. Has zero bargaining power.
3. Has no particular incentive to care about quality of service
We should remove all tax benefits of employer provided health insurance and transition to a system that makes sense.