patrick.net

Patrick says

What does that mean for patients? “They’ll be able to check them, compare them, go to different locations—so they can shop for the highest-quality care at the lowest cost.”

1 -You typically don't know what care you need, and
2 - people typically will not try 2-3 hospitals to see what the prices are. If you have an urgent issue, you don't have that luxury.
3 - Once you are there, you take whatever they say, in sequence they tell you it's necessary. You may come from 1 issue, then do something else.
4 - Usually you don't even care, because besides your deductible, it's for the insurance anyway.

The entire idea that competition will do the job of reining in costs is lame from the start.

Billing codes were designed to obfuscate what they were for on purpose.

Someone will make an aggregator app that will allow you to price out the cheapest options on some stuff which would help. But by and large between not knowing exactly will be done and your physician having restricted access to only a couple hospitals, I think a big impact is limited.

The only thing that will make healthcare cheaper is restricting care.

Heraclitusstudent says

people typically will not try 2-3 hospitals to see what the prices are. If you have an urgent issue, you don't have that luxury.

Right. That's why you pay cash for basic office visits or even minor emergency room visits. The neighborhood will know who charges higher fees. That sort of shit leaks out.

Then you get catastrophic insurance for real emergencies.

Pair that with improvements in drug costs and you've got yourself a market and much lower health care expenditures.

Throw in HSA and tax deduction for cat-insurance.

Oh, and none of this - can't insure across state lines bullshit.

But but but, quid pro quo...racism...porn star sex...my hurt feelings

And no legal, no docky! Go the fuck home to your shit hole country.

The sad reality is that now that we have the healthcare extortion complex, politicians do not want to break it as doing so would lose a lot of jobs, and aren't that many other jobs readily available.

Heraclitusstudent says

Patrick says

What does that mean for patients? “They’ll be able to check them, compare them, go to different locations—so they can shop for the highest-quality care at the lowest cost.”

1 -You typically don't know what care you need, and
2 - people typically will not try 2-3 hospitals to see what the prices are. If you have an urgent issue, you don't have that luxury.
3 - Once you are there, you take whatever they say, in sequence they tell you it's necessary. You may come from 1 issue, then do something else.
4 - Usually you don't even care, because besides your deductible, it's for the insurance anyway.

The entire idea that competition will do the job of reining in costs is lame from the start.

Not true, esp. not in the US. Unless you're a docile sheep. MDs will over recommend most things, esp. surgery. I've shopped around every one of those less than a handful of times where they recommended surgical treatment or anesthesia. Gastroscopy? Save 1000s by declining anesthesia plus nobody will have to pick you up and you're in and out in no time. MD tells you you need surgery? Find a specialist for a 2nd opinion and almost always you can manage and better it with steady care and no surgery. This will be huge if Trump enacts this as it is difficult today to get straight answers about pricing and they wlll try to obfuscate as much as they can. Go Trump!

Only time you can't and shouldn't shop is during a life threatening emergency. And there's catastrophical insurance for that.

Heraclitusstudent says

The entire idea that competition will do the job of reining in costs is lame from the start.

Agreed. Patrick has always been big on this and I've never comprehended it. Sure there should be transparency, but the people aren't shopping. Their insurance companies are sort of, but not by posted rates to the public.

If most people were paying out of pocket, then I can see competition by posting prices to the public would work. But sas it stands, if you have insurance through your employer, it's paid for as long as you go to the right doctors.

Heraclitusstudent says

The entire idea that competition will do the job of reining in costs is lame from the start.

I gotta say, that sounds batshit crazy.

marcus says

Heraclitusstudent says

The entire idea that competition will do the job of reining in costs is lame from the start.

Agreed. Patrick has always been big on this and I've never comprehended it. Sure there should be transparency, but the people aren't shopping. Their insurance companies are sort of, but not by posted rates to the public.

If most people were paying out of pocket, then I can see competition by posting prices to the public would work. But sas it stands, if yu have insurance through your employer, it's paid for as long as you go to the right doctors.

That's nonsense. Most plans have deductibles and percentages, you pay for outpatient surgery or hospital stay, let alone for much more with HSAs. Even with a premier plan the total amount of the bill matters for many procedures/diagnostics and hospital stays and you can easily save a grand even if you're 90% covered. Maybe more people need to do it but that's again a result of the ongoing obfuscation of medical pricing. A friend of mine has premier insurance and ended up paying cash for a few procedures at Stanford as they gave him a 90% discount just for not having to deal with the insurances and it was cheaper in the end than being 70%-80% covered in a bill that's more than 10x than the cash price he was quoted after asking for direct cash payment discounts.

Competition and price transparency can work in some aspects of health care, such as certain elective procedures or dentistry. But for most of the big items the ones that really drive costs it will have very minimal impact. People are too stupid and generally ignorant as to their options. If they have options. Many smaller cities have single hospitals if any. Of course emergency procedures it wont work at all. I think it fine to do this but not a major factor in lowering costs.

Ya markets don’t work! Remember that Trump grabbed someone’s pussy one time so nothing he does can be good. Therefore markets cannot work. IM RIGHT!

marcus says

I've never comprehended it.

That's because you have the taxpayers picking up your tab with your gold plated government plan. The rest of us have high deductible plans that require us to spend 3K-12K before insurance even kicks in and even then we are paying 30% of the rather expensive negotiated rate after that. If we had zero or $10 copays like government workers do, then we wouldn't care about the price either.

Yes, I shop around for medical services. That is why I love and recommend CVS minute clinic, which has a price list on its webpage.

marcus says

it's paid for as long as you go to the right doctors.

Nope. Research something called a high deductible plan. It's your only choice at most private employers.

:
Booger says

we wouldn't care about the price either.

I didn't say I don't care about price. Actually I think our healthcare system is broken and I know that some form of nationalized health care is inevitable. With single payer, the demand side of the equation is one entity who can say "this is what we pay for that procedure, period."

Booger says

Research something called a high deductible plan. It's your only choice at most private employers.

I know what it is, I I had it for many years. You still go to doctors in your network though, and then once you've spent your deductible - things are covered above that (minus copays).

I'm fairly certain God has no need for sex...
Patrick says

OMFG if this goes through and health plans are forced to give estimates, that got my vote for Trump right there.

Market forces have been known to restrain prices in many fields. Medical is just one more.

Also remember the ones that brag about grabbing pussy most likely didn't .
ignoreme says

Remember that Trump grabbed someone’s pussy one time so nothing he does can be good.

"When you're a star they let you do it."

Truer words were never spoken.

marcus says

You still go to doctors in your network though, and then once you've spent your deductible - things are covered above that (minus copays).

You know that the co-pay is like 30% not $10 don't you?

I think it quite clear that a strictly free market approach for healthcare will not work unless you wish to live in a society that lets people in the bottom tiers financially and those who are dreadfully sick suffer and die. Cool if that is where you want to go. Fine and dandy when you are a young, wealthy and healthy libertarian master of the universe. But remember Ayn Rand capitulated to reality and took Medicare.

How much are you willing to pay for medical care for the poor?

Infinity? Because without some market discipline or medical price regulation that's where it's going.

I do agree that we need some affordable national health insurance plan. But to be affordable, it simply cannot pay for the most expensive treatments.

Booger says

marcus says

You still go to doctors in your network though, and then once you've spent your deductible - things are covered above that (minus copays).

You know that the co-pay is like 30% not $10 don't you?

He doesn't.

It’s great, it’ll make billing real, not made up. At least harder for hospitals to make up charges.

I’ve seen charges vary by patient and insurance for same services.

Liberal_in_blackface says

You know that the co-pay is like 30% not $10 don't you?

Dont know what policy you have but co pays on mine are not % they are dollar amounts based on the procedures. And there is an out of pocket max per year (which mine is 6400 I believe) after which all costs are covered. I have Kaiser. The out of pocket max is probably the most important number that nobody looks at, as it is the limitation between you and financial ruin.

Chiromancer says

I think it quite clear that a strictly free market approach for healthcare will not work unless you wish to live in a society that lets people in the bottom tiers financially and those who are dreadfully sick suffer and die. Cool if that is where you want to go. Fine and dandy when you are a young, wealthy and healthy libertarian master of the universe. But remember Ayn Rand capitulated to reality and took Medicare.

Patrick says

How much are you willing to pay for medical care for the poor?

Infinity? Because without some market discipline or medical price regulation that's where it's going.

I do agree that we need some affordable national health insurance plan. But to be affordable, it simply cannot pay for the most expensive treatments.

There were two interesting articles on that by Karl Denninger:

https://market-ticker.org/akcs-www?post=237391 (how stents and bypasses don't work better than intensive drug treatment)

https://market-ticker.org/akcs-www?post=237317 (treatment for cystic fibrosis costs 311K per year)

Heraclitusstudent says

Patrick says

What does that mean for patients? “They’ll be able to check them, compare them, go to different locations—so they can shop for the highest-quality care at the lowest cost.”

1 -You typically don't know what care you need, and
2 - people typically will not try 2-3 hospitals to see what the prices are. If you have an urgent issue, you don't have that luxury.
3 - Once you are there, you take whatever they say, in sequence they tell you it's necessary. You may come from 1 issue, then do something else.
4 - Usually you don't even care, because besides your deductible, it's for the insurance anyway.

The entire idea that competition will do the job of reining in costs is lame from the start.

So, can you come up with a reason why this shouldn't be done?

Patrick says

Infinity? Because without some market discipline or medical price regulation that's where it's going

Yep, I agree, I think we need both.

APOCALYPSEFUCKisShostikovitch says

This makes perfect sense.

Subscribers to insurance programs who pay premiums with set and known pre-paid prices are going to drive around bleeding and barphing and losing consciousness from hospital to hospital dickering with administrators to save money on costs for their insurance companies that they'll never ever realize in pocket.

DUH!

DOI!

DONNIE! MAKE! MOO!

Don't let your hate for orange man blind you - this is a great step into the right direction. Patients with an immediate emergency will still go directly to the nearest emergency room. the majority of procedures and tests are non-emergency.

HEYYOU says

bucket list:
1 - Be a failure.
2 - Be a loser.

Just sharing for all those that ignore you.

Patrick says

Market forces have been known to restrain prices in many fields. Medical is just one more.

Free Markets smash down the prices of drugs for sure.

I live it.

My Lisinopril meds are $15 co-pays in the US with gold-plated employer provided insurance insurance, which is supposedly the same price as having one of those drug store cards.

Same drug here in South America are $10, cash total, with no insurance involved.

Heraclitusstudent says

Patrick says

What does that mean for patients? “They’ll be able to check them, compare them, go to different locations—so they can shop for the highest-quality care at the lowest cost.”

1 -You typically don't know what care you need, and
2 - people typically will not try 2-3 hospitals to see what the prices are. If you have an urgent issue, you don't have that luxury.
3 - Once you are there, you take whatever they say, in sequence they tell you it's necessary. You may come from 1 issue, then do something else.
4 - Usually you don't even care, because besides your deductible, it's for the insurance anyway.

The entire idea that competition will do the job of reining in costs is lame from the start.

All of that might be true, but only for emergency care. Most surgeries and procedures are scheduled weeks in advance.
Example: say you are a pregnant woman without insurance who knows she will need to have a c section. This would allow you to shop hospitals to find the best deal rather than just go to a random one and pray the bill is affordable.

Onvacation says

HEYYOU says

bucket list:
1 - Be a failure.
2 - Be a loser.

Just sharing for all those that ignore you.

Wish you wouldn’t. I have that idiot on ignore for a very good reason!

NoCoupForYou says

Same drug here in South America are $10, cash total, with no insurance involved.

Now if Trump just keeps his other campaign promise and let’s people buy drugs across borders medical costs will plummet.

Can’t wait for all the articles from the whiny corporate owned liberal rags about how price transparency and free markets is a bad thing because orange man bad.

Seriously, this thread is a great test. If you come to this thread and type anything negative about this policy change, you objectively have TDS.

Shaman says

Example: say you are a pregnant woman without insurance who knows she will need to have a c section. This would allow you to shop hospitals to find the best deal rather than just go to a random one and pray the bill is affordable.

Careful you are making too much sense. Also, liberals don’t care about this cause they only need abortions which is already tax payer funded.

Most able bodied males and females who don't suffer from panic attacks or excessive gag reflex don't need any sedation for a gastroscopy. Yet 99% of those are done with sedation, adding a few k to the bill every time. Anesthesiologists are among the most expensive, as there is always risk involved. Start giving discounts for saving money in this excessive racket.

ignoreme says

Shaman says

Example: say you are a pregnant woman without insurance who knows she will need to have a c section. This would allow you to shop hospitals to find the best deal rather than just go to a random one and pray the bill is affordable.

Careful you are making too much sense. Also, liberals don’t care about this cause they only need abortions which is already tax payer funded.

Right, abortions should be completely defunded, saves a lot of money. WTF if you want to kill your unborn at the minimum pay for it, don't make others pay for your moral hazard.

LIbfucks are the only known political group that demand no sedation for routine colonoscopy...

mell says

Most able bodied males and females who don't suffer from panic attacks or excessive gag reflex don't need any sedation for a gastroscopy.

mell says

Right, abortions should be completely defunded, saves a lot of money. WTF if you want to kill your unborn at the minimum pay for it, don't make others pay for your moral hazard.

Other optional stuff shouldn't be covered either. Childbirth being high on my list of optional things.