[HN Gopher] Leaked Scripps records reveal automated mark-ups for...
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       Leaked Scripps records reveal automated mark-ups for hospital care
        
       Author : mmastrac
       Score  : 76 points
       Date   : 2021-12-10 17:05 UTC (5 hours ago)
        
 (HTM) web link (www.latimes.com)
 (TXT) w3m dump (www.latimes.com)
        
       | yborg wrote:
       | I'm wondering what it will take to stop this, it's basically
       | institutionalized loan sharking across a giant chunk of the
       | economy critical to society. The entire market, from insurance
       | companies to providers is falling over itself trying to out-gouge
       | the consumer because there's no repercussions. And why aren't
       | there startups out there coming to compete for this gigantic
       | money pool by offering a mere 400% markup?
        
         | tastyfreeze wrote:
         | The normal market pricing feedback that is present in other
         | markets is broken in medical markets. This is mostly because
         | prices aren't known and the recipient of services often isn't
         | directly the payer.
         | 
         | Publishing prices so people can shop around like any other
         | product is a good starting point. Hospitals do not have to
         | compete on price because insurance covers it in most cases and
         | in many places they have a local monopoly.
         | 
         | Also the more people pay out of pocket for medical the more
         | they care about what the price is.
        
         | 908B64B197 wrote:
         | > And why aren't there startups out there coming to compete for
         | this gigantic money pool by offering a mere 400% markup? You
         | are thinking like someone from an industry that went from a
         | $5,543 (2020 dollars) Apple ][ in 1977 to a $999 MacBook Air in
         | 2021. That's all thanks to solid engineering, innovation and a
         | competitive landscape.
         | 
         | Now, for anything touching healthcare, you'll have to deal with
         | The Cartel. You are going to get every legal challenge thrown
         | at you by every instance of government (and The Cartel itself)
         | before you can even think of helping your first patient.
         | 
         | You'll basically need a member of The Cartel to vouch for you,
         | or train as one. To even get a chance of getting in, you need
         | to accumulate at least 6 figures of debts and try to squeeze in
         | one of the limited spots The Cartel opens up for new recruits.
         | Then, after about a decade of classes (4 of them completely
         | useless to you) and a few years of pointless hazing, you'll be
         | given the privilege to price gouge yourself.
         | 
         | By then, I'm not so sure you'll want to democratize access,
         | sadly.
        
         | willcipriano wrote:
         | > And why aren't there startups out there coming to compete for
         | this gigantic money pool by offering a mere 400% markup?
         | 
         | Regulation. If you wanted to start a service that drives
         | elderly patients to get their medicine, in some justictions you
         | need the permission of the local ambulance company to make sure
         | you don't cut into their profits. This process is called a
         | certificate of need[0] and if you dont have one, you can't
         | operate.
         | 
         | It's like this with virtually everything medical related. If
         | you try to compete they have ways to shut you down or stop you
         | from starting all together.
         | 
         | [0]https://www.usnews.com/news/best-
         | states/articles/2021-07-09/...
         | 
         | See also:
         | 
         | Controlling the supply of doctors by limiting residency slots
         | (https://www.aamc.org/news-insights/medical-school-
         | enrollment...)
         | 
         | Banning the reimportation of drugs produced in the US back from
         | Canada at lower prices.
         | 
         | Keeping older, safe, and well known drugs behind the counter
         | (albuterol is a good example) to drive office visits and keep
         | pharmacy revenues up. In other countries you can just buy many
         | common drugs like that over the counter, cheaply.
        
         | handrous wrote:
         | The _single_ tool that AFAIK _every_ other advanced-economy
         | state (OECD, if you like, but even some outside that) uses,
         | despite all the different approaches in the wild, is: price
         | controls.
         | 
         | The more-free-market ones simply dictate prices on some things
         | and services (with, for the more-free-market ones like
         | Singapore, the _very real_ implicit threat of dictating even
         | more of them if the market gets too greedy, with the less-free-
         | market ones dictating more prices from the outset), and at the
         | less-free-market end of the spectrum you have state monopsony
         | (single-payer) or even direct state control of healthcare
         | service providers, so the price controls are more _de facto_.
         | 
         | I'm not aware of a _single_ system outside the US [EDIT: in a
         | developed state, that is--I 've not looked into developing-
         | world systems] that doesn't achieve their results with price
         | controls. Even the relatively "free market" ones--again,
         | Singapore is usually the prime example people bring out for
         | that, and they use some price controls and a very credible
         | threat of further intervention to make their system work. Given
         | this, I don't have much hope of success for any reform that
         | doesn't either directly set at least _some_ prices and threaten
         | to set even more, or take even more control over price-setting
         | (monopsony power, or nationalizing providers), given how
         | _universal_ that element seems to be.
        
           | SomewhatLikely wrote:
           | Are there any examples where a public option is available at
           | a reasonable price so any private practices have to compete
           | on price?
        
             | huitzitziltzin wrote:
             | Not exactly as you may be thinking, but in many countries
             | there is a parallel, private health care sector.
             | 
             | The fact that patients have the choice to go to the public
             | sector instead of the private likely keeps prices in the
             | private sector down, but if there is literature on the
             | extent and magnitude of those effects, I'm not familiar
             | with it. Mexico is an example of such a country.
        
             | handrous wrote:
             | None that I'm aware of. My _guess_ would be that this is
             | because if you do it poorly, it doesn 't help a damn thing,
             | and if you do it well, it's just single-payer with extra
             | steps. This is because to do it right you'd effectively
             | _have to_ dictate that ~all providers take the public
             | option insurance, and at that point you may as well do
             | single-payer. Otherwise, there 's no reason to expect a
             | public option, as in just another insurer that happens to
             | be government-run, would be able to compete when providers
             | can just refuse to take them unless they raise compensation
             | to roughly match everyone else. At best it would apply only
             | light downward pressure on prices.
             | 
             | There _are_ some systems that have private (though,
             | perhaps, non-profit only) insurance and a public insurer as
             | a _kind of_ public option, as an insurer of last resort,
             | but they place all kinds of restrictions on this, like
             | standardizing basic-coverage plans and dictating that all
             | insurers offer them, mandating that providers all accept
             | these plans (including the government one) and so on, and
             | often _still_ having other price controls on top of it.
        
               | Closi wrote:
               | What about the UK? Free at the point of service
               | healthcare with relatively high quality and low cost
               | private options eg via Bupa (when compared to the prices
               | in the USA)
        
               | handrous wrote:
               | That's a private system _on top of_ a universal public
               | one, no? It 's not an option as in "instead of private
               | insurance, you can do this, but you can also forego this
               | and use only private insurance". You have access to
               | public care, period, and _can_ pay for _extra_ on top
               | from the private system. Right?
        
         | Jansen312 wrote:
         | Same issue as college degree inflation. Clue : free money from
         | Uncle Sam. At the end of the day, we all need to accept
         | healthcare is never meant universal. It is limited just like a
         | Gucci bag or a Ferrari. You can't make everyone have a Tesla,
         | even if you try, the price will just go up. The only way to
         | democratize the access it to build more and not to give more
         | free money. If government build more hospitals, finance tons of
         | MDs graduate, conduct all the pharmaceutical researches,
         | hospital bills will reduce significantly. But alas, we all want
         | coverage. We all believe every Tom Dick and Harry or Jane Jill
         | or Jenny should be guaranteed with healthcare access. See Barry
         | nonsense Barrycare. We all need to learn from handphone market.
         | There will always be many tiers models to fit different
         | budgets. We shouldn't restrict doctors and care only within
         | USA. Let other countries healthcare acceptable to USA insurance
         | and medicaid claims. If every handset is made in USA, sure
         | Motorola will still be the Apple iPhone today. See when China
         | able to crank out segway and phones cheaper, many gets to
         | enjoyed it.
        
         | _jal wrote:
         | > I'm wondering what it will take to stop this
         | 
         | Single payer.
        
           | tastyfreeze wrote:
           | Single payer is not really a solution to the healthcare cost
           | problem. All it does is give government more power that it
           | doesn't have Constitional authorization to posses.
           | 
           | A real solution to healthcare cost is making healthcare a
           | functioning market where the buyer knows prices before they
           | purchase.
        
             | paxys wrote:
             | A free market solution will never work in healthcare
             | because neither side has the ability to say no and walk
             | away when they can't come to an agreement on price.
             | 
             | A consumer cannot price shop and delay an appointment or
             | procedure when it is a matter of life and death.
             | 
             | A hospital or insurance company cannot say no to someone
             | who they are 100% sure will never be able to pay the bill.
        
               | tastyfreeze wrote:
               | That is what insurance is supposed to be for. Medical
               | insurance should be more like home or auto insurance. My
               | home and auto policies do not cover maintenance and
               | improvement but they do cover rare catastrophic events.
               | My medical insurance covers every damn thing that has to
               | do with medicine. If I go to the doctor for an annual
               | check up there is no reason that insurance should be
               | involved as that is a regular and elective cost. If I
               | break my arm that is unexpected and probably costly so I
               | would have insurance to cover something like that.
               | 
               | Insurance is for uncommon events that you have little to
               | no control over. The policy you choose should reflect how
               | you want to mitigate your own risk of uncommon events
               | happening.
        
               | paxys wrote:
               | Insurance companies actually _want_ to pay for your
               | regular, non-emergency medical costs because it is way
               | cheaper for them to do so vs letting conditions go
               | undetected and then paying orders of magnitudes more for
               | surgeries, prescriptions and expert visits. Your annual
               | checkup visits aren 't what is causing ballooning
               | healthcare costs, but actually lowering them.
        
             | handrous wrote:
             | It's possible that would work, but I'd prefer to try a
             | system that's successfully in use in _any_ other advanced
             | economy, than to gamble on that. Meanwhile, if you can
             | convince some other country to try  "be _very_ free market
             | " as an experiment for their healthcare system, please do
             | so, I'd love to see the results.
        
             | jatone wrote:
             | we have that today. law was passed last year. its not going
             | to do shit.
        
               | tastyfreeze wrote:
               | Are you talking about the CMS Price Transparency rule?
               | That went into effect on January 1st this year. Is your
               | hospital compliant yet? Mine isnt. I can request a quote
               | for "shoppable services". They do not have a machine
               | readable format listing of all their "standard charges"
               | and they do not have a customer readable format listing
               | of prices for "shoppable services".
               | 
               | Rule changes like this take time to be implemented and
               | effective. You cant very well expect current practices to
               | change when effectively very little has changed in price
               | transparency yet.
        
               | jatone wrote:
               | indeed I am, and yes I know.
               | 
               | I'm asserting even if it was implemented fully it won't
               | do shit. I have insurance why would I give a shit about
               | the prices? my employer pays the majority of the costs.
               | its only going to incentives the uninsured to go shopping
               | and they're a very small market.
               | 
               | thats precisely the problem. lack of choices in the
               | insurance market where the incentives are not aligned.
        
         | jedberg wrote:
         | Most countries solve this by requiring hospitals to be non-
         | profits and making insurance non-existent or also non-profit.
        
           | ceejayoz wrote:
           | Non-profit doesn't mean you can't _make_ a profit, just that
           | you can 't distribute it to shareholders.
           | 
           | Big salaries, perks, and bonuses to executives is just fine.
        
             | jedberg wrote:
             | They usually tie it to caps on executive salary and bonus,
             | but even without it's still better than for-profit.
        
               | whatthesmack wrote:
               | Why is it better? Non-profits don't have the efficiency
               | incentive that for-profits do, as far as I understand it.
               | I've read a few things that indicate non-profit hospitals
               | are full of fiscal bloat, because there's no incentive to
               | act otherwise. On mobile now, but can search for a few
               | sources.
        
           | KoftaBob wrote:
           | Around 75% of hospitals in the US are actually non-profit.
           | 
           | Source: https://www.kff.org/other/state-indicator/hospitals-
           | by-owner...
           | 
           | All this ends up meaning is that any revenue above their
           | expenses is plowed into hiring more and more administrative
           | staff and building new facilities.
        
             | jedberg wrote:
             | I didn't say it would solve all the problems, but it would
             | help.
        
               | KoftaBob wrote:
               | Agreed, adding a profit motive on top of that only makes
               | it worse.
        
           | tyoma wrote:
           | Scripps, the hospital in question, is already a non-profit.
           | Their domain even ends in .org! They also have posters asking
           | for donations, and will send mailers asking for donations as
           | well.
        
           | jdminhbg wrote:
           | More than half of US hospitals are non-profits, and Obamacare
           | capped the profit % for insurance companies.
        
             | jedberg wrote:
             | Yep, it was a start. But the insurance companies have
             | figured out ways around the caps.
        
               | handrous wrote:
               | I've noticed that an awful lot of insurers around here
               | seem to always be crying about "losing money" on
               | seemingly every plan, now, and so demanding huge rate
               | hikes every year. I don't believe that they're actually
               | _that_ terrible at their jobs--not the parts that
               | directly relate to P &L, anyway--so I have to assume this
               | is some part of scam they've worked out.
        
         | poidos wrote:
         | Either socialized or nationalized medicine. Removing the
         | insurance companies entirely removes the price-gouging they do
         | from the equation. On the non-insurance front, every hospital
         | and care provider is then required to either
         | 
         | - negotiate with the government on prices, or
         | 
         | - work for the government, charging their rates.
        
           | dontcare007 wrote:
           | And then waste and graft moves from a semi-accountable
           | company to a group that has the use of force to enforce their
           | policies. No thanks.
        
             | jatone wrote:
             | the fact you think insurance companies are accountable is
             | laughable. last I checked I never could decide on what
             | insurance provider my employer offered.
             | 
             | I see no difference between private insurance and
             | government run except the government is constantly
             | lambasted for overspending and medicare seems to have the
             | lowest operating costs and payouts to healthcare providers.
             | 
             | which seems to be the exact metric you want.
             | 
             | edit: just move to a public option system and watch shit
             | hit the fan in the market.
        
               | handrous wrote:
               | > I see no difference between private insurance and
               | government run except the government is constantly
               | lambasted for overspending and medicare seems to have the
               | lowest operating costs and payouts to healthcare
               | providers.
               | 
               | Contrary to popular understanding, relatively low
               | (sometimes _impressively_ low) overhead  & even fraud
               | rates is the _norm_ for US government social programs.
               | This is one case where pop-culture  "common knowledge"
               | diverges wildly from reality.
        
               | jatone wrote:
               | Indeed!
        
               | throwaway0a5e wrote:
               | >the fact you think insurance companies are accountable
               | is laughable.
               | 
               | Accountable is obviously relative.
               | 
               | BigCo at least wants one thing you know about, money, and
               | that makes them far less capricious and far easier to
               | deal with than government where you don't know any of the
               | incentives that the people who (with several layers of
               | indirection) set the KPIs for the person you are actually
               | dealing with.
               | 
               | As evil as they are I'll take Comcast over some random
               | state org any day.
               | 
               | Having a public option as a backstop would probably be
               | good but I don't think I want a public option that covers
               | routine stuff, GP visits, a broken bone. Stuff with a
               | well bounded upper limit like that tends to be handled
               | well by private insurance so long as there's competition
               | (see auto insurance for example).
        
               | jatone wrote:
               | then you're ideological driven instead of results driven.
        
           | user1980 wrote:
           | I live in Saskatoon, Saskatchewan, Canada. If I want to find
           | a family doctor, there is a list of 3 clinics with doctors
           | taking patients, in a metro area of 325,000. Older people
           | have "the good doctors" and those doctors aren't taking on
           | new patients.
           | 
           | Waiting lists for specialists are ridiculous, unless it's
           | something extremely urgent. It quickly becomes about "who you
           | know" and queues can be jumped if you have the inside track.
           | 
           | I've never been encouraged or "nudged" to get a physical or
           | even blood work done. Quite frankly, the system is under so
           | much strain that getting everyone a physical would push it
           | over the brink. So they mandate them for commercial drivers
           | and other high-risk occupations, and everyone else just goes
           | to medi-clinics and sees a walk-in doctor. Zero continuity of
           | care.
           | 
           | Canada is great at treating the dying, terrible at treating
           | the healthy.
           | 
           | I'm self-employed. Dental, prescription drugs, glasses,
           | mental health: this is all out of pocket.
           | 
           | My impression is that if you have a reasonably good job in
           | the United States, you have access to reasonable health care.
           | Is that a fair assessment?
        
       | egberts1 wrote:
       | Hospitals and specialists should be made to post prices of their
       | services ... by law.
        
         | drdec wrote:
         | That is the law in the US as of January of 2021:
         | 
         | https://www.cms.gov/hospital-price-transparency
        
         | KoftaBob wrote:
         | They are, as of January 2021. The effects of that will take
         | some time to be seen in pricing.
        
           | 0xcde4c3db wrote:
           | Even if you have the list, there's not necessarily any way to
           | be sure in advance which price(s) you'll end up paying. The
           | whole system is built around an incomprehensible fog of
           | "discounts" and idiosyncratic distinctions among similar
           | procedures.
        
         | jedberg wrote:
         | We have that law in California. Enforcement is lax. Sometimes
         | it's a single piece of paper up on a wall in a hidden corner.
         | Sometimes they don't have it at all.
         | 
         | But at the end of the day, it's not like you're price shopping
         | when you're having a heart attack. You're going to the closest
         | hospital and sorting out the cost later... which is exactly
         | what they are counting on.
        
         | xyzzy21 wrote:
         | Publish ALL prices prior to admission.
         | 
         | There are hospitals overseas who precisely publish their prices
         | for standard procedures. This is why pre-COVID I would travel
         | overseas for any medical procedures that could be scheduled
         | ahead of time: it was a known, low variance expected cost.
         | 
         | There is no reason not to public pricing short of fraud,
         | conspiracy and lack of ethics. We are already seeing exactly
         | how much ethics/morals much of the pharma, health care and
         | public health of USA actually have (i.e. next to NONE).
        
       | jl2718 wrote:
       | 1. End all insurance mandates
       | 
       | 2. Allow fee-for-service Medicare.
        
       | kingsloi wrote:
       | billable amount = (pain_and_suffering / 2) + 7
        
       | servytor wrote:
       | Colleges are the exact same - once it becomes standard for an
       | intermediary to handle the bill, the costs skyrocket. From the
       | government giving anybody who goes to college a loan, means that
       | colleges can charge insane fees despite no change, and hospitals
       | charge insane fees because it is standard to gouge insurance.
        
       | kevin_thibedeau wrote:
       | Part of the problem is the loss of mutual insurance which makes
       | executives accountable to their members and forces profit
       | sharing.
        
       | ethbr0 wrote:
       | > _I started asking questions," the nurse said. "I was told that
       | if we didn't mark things up like this, insurance companies
       | wouldn't give us what we want."_
       | 
       | > _Healthcare providers routinely ignore the actual cost of
       | treatment when calculating bills and instead cook up nonsensical
       | figures to push reimbursement from insurers higher._
       | 
       | This is the real story of health care, in a nutshell.
       | 
       | Providers say "A procedure costs $100." Insurers say "Great,
       | we'll reimburse you $50 for it, or you won't be in network."
       | Providers say "But it actually costs $100." Insurers say "Fine,
       | but cut us a deal in exchange for our business, and charge us
       | $50." They hammer out a contract that specifies $55 for that
       | procedure.
       | 
       | On the next procedure, which costs $200, the providers (and their
       | facility) stops to think. "Wait, insurance is going to ask for a
       | substantial haircut on whatever number we give them." So
       | providers say "This procedure costs $400." Insurance says "Fine,
       | we'll reimburse you $200." Providers say "Oh no. Fine, we'll take
       | it."
       | 
       | Then a few years later insurance analysts get around to noticing
       | relative cost differences, and the entire dance starts over
       | again.
       | 
       | The fundamental problems with US health care are (1) the lack of
       | end-user (patient) visibility into costs _before_ undertaking a
       | procedure, (2) opaque insurance-facility contracts,  & (3) the
       | bullshit dance between facilities, middle people, and insurance
       | companies that end up adding confusion, delay, and costs to what
       | would otherwise be simpler transactions.
        
         | mjevans wrote:
         | Which is why I try to vote for politicians that support any
         | kind of single payer / medicare for all / etc healthcare and
         | was so very disappointed with what Obamacare became: just
         | payouts to the established anti-consumer groups as usual.
        
         | jimbob45 wrote:
         | I don't understand your point on #1. What good is visibility
         | going to do me? I have only so many hospitals reasonably
         | distant from me in-network such that competition isn't likely
         | to substantially alter my price, I would think.
        
       | setgree wrote:
       | This is a minor quibble, but this sentence:
       | 
       | >Scripps' automated system took the actual cost of sutures,
       | imposed an apparently preset 675% markup and produced a billed
       | amount that was orders of magnitude higher than the true price.
       | 
       | was jolting for me as a reader -- going from $19.30 to $149.58 is
       | an increase of around _one_ order of magnitude rather than many.
        
       | tastyfreeze wrote:
       | This is what happens when the buyer doesn't care what the price
       | is because its not their money and the seller doesn't publish
       | prices to allow comparison. Insurance companies only care if a
       | price is outside of "normal" as they can just increase premiums
       | as hospitals push "normal" continually higher.
       | 
       | Hospitals make ridiculous profit. Insurance companies make
       | ridiculous profit. Neither of them care at all what the real
       | customer gets charged.
       | 
       | See also Federally guaranteed student loans
        
         | evergrande wrote:
         | This chart speaks volumes.
         | 
         | https://www.investors.com/wp-content/uploads/2018/03/CPIChar...
        
           | nebula8804 wrote:
           | I've seen this chart blasted around the mainstream media and
           | I feel it is sort of cheating. The categories below the 0%
           | line: Cellphone Service, Software, Toys and TVs all benefited
           | mainly from one miracle innovation: Moore's Law. Other than
           | that, have they really done anything else innovative to keep
           | prices that low? If you eliminate anything that mainly
           | benefited from Moore's law then you can derive a very
           | different picture from the chart.
           | 
           | I guess we should be thankful to Moore's law and figure out
           | how to apply it to Childcare, College, and hospital services?
           | I guess thats where Elon Musks's robot comes in to play. It
           | can teach you skills to get a job, take care of your kids,
           | and then perform your surgery. Problem solved! :)
        
         | KoftaBob wrote:
         | > Hospitals make ridiculous profit.
         | 
         | What's interesting about this is that around 75% of hospitals
         | in the US are actually _non-profit_.
         | 
         | Source: https://www.kff.org/other/state-indicator/hospitals-by-
         | owner...
         | 
         | All this ends up meaning is that any revenue above their
         | expenses is plowed into hiring more and more administrative
         | staff and building new facilities.
        
           | huitzitziltzin wrote:
           | I'm a health economist who works on hospitals. There is a
           | long-standing question in our literature about whether non
           | profit and for profit hospitals actually _act_ differently.
           | My sense has always been no.
           | 
           | You also leave out one important place for "extra" money to
           | go: salaries within the hospital.
        
           | seibelj wrote:
           | There are many who work in non-profits with high 6 or 7
           | figure salaries. Seems like profit to me!
           | 
           | Back in 2015 the president of Boston University raked in $2.5
           | million https://www.bostonmagazine.com/education/2017/12/11/b
           | oston-u...
        
             | KoftaBob wrote:
             | That's only 50 students worth of tuition for that year, or
             | 0.3% of tuition brought in that year.
             | 
             | While $2.5M is obviously a lot of money, it's a drop in the
             | bucket in terms of how much the university brought in. For
             | universities and hospitals, it's not the high salaries of a
             | few execs, it's the massive amounts of administrative
             | staff.
             | 
             | For the larger hospital systems, several thousand admin
             | staff making 60-70k+ adds up to waaaaay more than the fat
             | paychecks that a dozen execs make.
             | 
             | It's basically a snowball effect. Execs get bonuses for
             | bringing in more revenue, but it's a non-profit so they
             | have to spend it somewhere, so they expand admin and build
             | facilities, rinse repeat.
        
               | lrem wrote:
               | Naive question: what if instead admin they would expand
               | actual medical staff?
        
               | tastyfreeze wrote:
               | That facility may not need more medical staff. Jobs can
               | always be created for administrative purposes. Have any
               | tasks you dont like doing that you have to do with some
               | regularity? Higher somebody to be in charge of that task.
        
               | lrem wrote:
               | I'm not familiar with the US hospitals... But pretty much
               | everywhere else I've seen the doctors and nurses being
               | seriously overworked. Is this different on the other side
               | of the pond?
        
           | tyoma wrote:
           | The hospital system in the article (Scripps), is indeed a
           | non-profit. They even have posters and mailers asking for
           | donations.
        
           | tastyfreeze wrote:
           | Non-profit does not mean that hospitals aren't out to make
           | money. It only means there is some restriction on where the
           | extra money goes.
        
           | colechristensen wrote:
           | All non-profit means is money doesn't go to investors. And
           | considering tax and fringe benefits going to "donors" even
           | that is somewhat less true.
        
         | WillPostForFood wrote:
         | FWIW, the institution in the article, Scripps Health, is a non-
         | profit. Would be interesting to see where the money is going.
        
           | throwaway0a5e wrote:
           | Hospitals are routinely nonprofit orgs. I assume scripps
           | overpays everyone and pays for crap it just doesn't need like
           | hospitals do.
        
         | handrous wrote:
         | > This is what happens when the buyer doesn't care what the
         | price is because its not their money and the seller doesn't
         | publish prices to allow comparison.
         | 
         | The norm in most systems (in developed states, anyway) is that
         | the buyer doesn't care what the price is, to _at least_ the
         | same degree that they don 't in ours. Yet they're _all_ much
         | cheaper than our system.
        
           | mikem170 wrote:
           | Most of those other systems have price controls for
           | everything, like Medicare does in the U.S.
           | 
           | The U.S. is different because we allow corporations to
           | lobby/bribe/buy politicians, which most other developed
           | countries consider to be corruption.
           | 
           | So we have a health care system optimized for profits, not
           | people.
        
             | handrous wrote:
             | Bingo, see my post elsewhere in this thread :-)
             | 
             | I'm no expert but have been reading about this for a couple
             | decades now, and the consistent element in _every_ non-US
             | system in developed countries, despite a vast variety of
             | approaches, is indeed price controls, either explicit or
             | _de facto_. I 'm highly skeptical of any reform attempt in
             | the US that doesn't have that as a central element, due to,
             | you know, _gestures at the rest of the world_.
        
           | derekjdanserl wrote:
           | That's right. But the employer-dependent health insurance
           | arrangement in the U.S. was implemented as an alternative to
           | the various political dynamics that regulate most countries'
           | healthcare systems and it has successfully done so.
           | 
           | The problem, in other words, is that a truly free-market
           | healthcare system would be politically infeasible in a major
           | first-world nation. So instead of a public healthcare system
           | that would provide minimal healthcare services to all
           | citizens, they tied it to employment, effectively moving it
           | from the consumer market to the labor market. So this
           | arrangement, like most neoliberal policies including
           | Obamacare, has served merely to buy more time for the ruling
           | class. And worst of all it has worked.
        
         | ethbr0 wrote:
         | > _Hospitals make ridiculous profit._
         | 
         | "It depends."
         | 
         | Non-trauma hospitals in affluent areas that perform lots of
         | elective procedures make a lot of profit.
         | 
         | Trauma centers in less-affluent, usually urban or rural, areas
         | that deliver emergency care almost always run at a loss, and
         | are subsidized by city / state / federal funds to maintain
         | capability.
        
           | derekjdanserl wrote:
           | Whether it's hospitals, hosipital owners, doctors, or other
           | healthcare industry benefactors, someone is making a killing
           | beyond just the insurance companies. Ballooning
           | administration is not only a cause but a symptom, which is
           | why free market solutions can't overcome the problem.
           | Establishing new healthcare institutions will depend on the
           | existing healthcare industry, which will expect the same
           | profits or it won't cooperate. There is no way around the
           | fact that free-market healthcare is just deeply immoral and
           | inhumane.
        
             | tastyfreeze wrote:
             | Your entire argument is based on the assumption that
             | healthcare is a free-market which it is obviously not. The
             | mechanisms of price discovery are not present to all
             | players in the market. When there is an unbalance in
             | information in any market it will always be detrimental to
             | the player with less information. The way to fix the
             | problem is to create a free-market.
        
               | lotsofpulp wrote:
               | There never will be a free market due to inability to
               | negotiate prices and obtain quotes.
               | 
               | A person who had a stroke is not going to be evaluating
               | offers from various surgeons. Nor are 99% of people going
               | to know what healthcare they need or don't need.
               | 
               | That is the service a managed care organization provided
               | (aka insurance company).
        
             | staircasebug wrote:
             | US healthcare is most definitely not free market.
        
         | afsafsaf wrote:
         | Shouldn't the insurance company care because if they can reduce
         | their premiums, they can be more competitive for
         | employers/purchasers? I don't understand why the insurance
         | company isn't cost driven.
        
           | mox1 wrote:
           | Have you ever "shopped around" for health insurance? Maybe
           | ACA people do, but amongst 2 or 3 giant companies on the
           | exchange..whose prices, features, benefits, etc. are
           | basically the same.
           | 
           | Further, most bigger companies self-insure, and only use the
           | insurance company to provide services. So F100 company
           | partners with Blue Cross Blue Shield just for billing,
           | administration of the plan, etc. What does BCBS care how much
           | surgery costs? They are getting Admin fees the same whether
           | its $5,00 or $10,000. Does a F100 employer really have the
           | time and energy to question whats going on? They just look at
           | the cost last year, raise the price for their employees by
           | %XY and march forward.
           | 
           | Even further, health insurance is incredibly regulated, on a
           | state level. If you have a good idea to "disrupt" the
           | industry, its such a slog to get anything done. Your best bet
           | is to partner with an existing insurance company and go from
           | there.
        
           | pmalynin wrote:
           | Insurance companies are require to put a certain % of the
           | premiums towards actual healthcare. In other words
           | administrative fees (read profit) is capped as a % of the
           | premium. The higher the premium the higher the profit.
        
             | SomewhatLikely wrote:
             | These ridiculous markups existed before those caps imposed
             | by the ACA.
        
               | SkittyDog wrote:
               | The ACA did not impose those caps, in the first place. It
               | merely standardized them.
               | 
               | State insurance laws have mandated the same kind of caps
               | for decades... I believe they date back to around WWII,
               | but I don't know for certain.
        
             | huitzitziltzin wrote:
             | Administrative fees =/= "profit". That is wrong.
             | 
             | Administrative fees _include_ profit, but also salaries, IT
             | expenses, whatever other costs it takes to _actually run_
             | an insurer.
        
           | quinnjh wrote:
           | Medical costs being high mean that you have to buy the
           | insurance
        
           | SkittyDog wrote:
           | Another poster mentioned this, bur I think it's worth talking
           | about in more detail, because it's at the heart if exactly
           | what's broken about US health care.
           | 
           | Every US state has laws that prohibit insurance companies
           | from collecting "too much" profit from the premiums they
           | charge their customers. In most states, the limit is given as
           | a percentage of pure profit. So insurers set their premiums
           | based on their expected payout costs plus operating expenses,
           | and usually make premium adjustments on an annual basis.
           | 
           | (That's why most US drivers received a bunch of rebates from
           | our auto insurers, early in the COVID pandemic. The sudden
           | unexpected drop in accident rates drastically reduced the
           | insurers payout costs. They were required by law to return
           | the excess.)
           | 
           | The intended purpose of these laws was to protect consumers
           | from predatory insurance companies. But in modern practice,
           | with basically zero effective cost controls on medicine, it's
           | created a perverse incentive: Rising healthcare costs are the
           | easiest opportunity for health insurers to increase their
           | absolute profits... All they have to do is sit back and let
           | health care providers keep raising their prices.
           | 
           | But:
           | 
           | * the costs are passed only indirectly to the consumers who
           | ultimately pay
           | 
           | * the market for health care is so terribly distorted
           | 
           | * health care demand is highly inelastic
           | 
           | So normal market mechanisms (like price signaling) aren't
           | very effective at containing the rise in costs.
        
           | [deleted]
        
       | tyoma wrote:
       | I am a Scripps customer. Their prices are not different than any
       | other healthcare system in the area. They all do this; Scripps
       | just made it more obvious how prices are actually set.
       | 
       | And since this has been brought up in the thread: Scripps is
       | already a non-profit! Their domain name ends in .org. They
       | routinely ask for donations.
        
       | efitz wrote:
       | As with anyone who has a soul and a conscience, im shocked by
       | health care costs.
       | 
       | A lot of people say this is a failure of capitalism. It is
       | precisely the opposite- it's regulatory capture. Healthcare and
       | insurance are among the most highly regulated industries in the
       | US. All that regulation has had decades to fix the problem and
       | hasn't; it's caused the creation of workarounds like "charge
       | masters" and "pharmacy benefit managers" that make prices more
       | opaque.
       | 
       | Why do we even allow negotiated price for insurance? Sounds like
       | antitrust/price fixing/collusion to me? Why doesn't each health
       | care provider publish their prices and the insurer publishes what
       | they'll pay and the patient is responsible for the difference?
        
       | olliej wrote:
       | I'm mostly surprised that nurses and doctors were able to see the
       | mark ups being applied. I'm sure that the next update will "fix"
       | that.
       | 
       | How these markups don't run afoul of price gouging laws is beyond
       | me :-/
        
       | huitzitziltzin wrote:
       | This is an infuriating but not surprising read. The only
       | surprising thing to me is to see the number written down. (And
       | that some part of the system was available to a nurse to see!)
       | 
       | I'm a health economist and much of my research is on hospitals.
       | As much as everyone loves to complain about drug companies and
       | insurers as being responsible for high US health care costs, that
       | _is not_ where the money goes. The money goes to doctors and to
       | hospitals. (Specifically: about half of all national health
       | spending to those two groups.)
       | 
       | If you want to save money on health care, you need to talk about
       | paying less to doctors and to hospitals. If you don't want to pay
       | less money to those two sets of entities, you aren't going to
       | save much money. That's all there is to it.
       | 
       | Yes, we can do better by spending less on drugs, but it's a small
       | amount compared to the gigantic sums which go to doctors and to
       | hospitals. (Specifically: _all_ drug spending is about ten
       | percent of national health spending.) Yes, we can do better by
       | reducing the administrative burden, but that slice of the pie is
       | less than 10%. (And you will never have 0 admin expenses.) The
       | administrative burden of health insurance is even lower than 10%.
       | 
       | So... go ahead and share your ideas for paying doctors and
       | hospitals less, because otherwise you're talking about stuff
       | which doesn't amount to much!
        
         | mschuster91 wrote:
         | > The money goes to doctors and to hospitals.
         | 
         | For doctors, that pay is well deserved given the exorbitant
         | student loans that doctors carry, and the ridiculous shift
         | length and other work related issues.
         | 
         | For hospitals? Here's the real deal where costs can be saved -
         | 25% of hospital expenses is administration expenses [1], and 8%
         | is profit margin [2].
         | 
         | Convert hospitals to non-profit operations owned by a single-
         | payer insurance and immediately save a _lot_ of costs across
         | the entire board.
         | 
         | [1] https://www.commonwealthfund.org/publications/journal-
         | articl...
         | 
         | [2]: https://www.americanprogress.org/article/high-price-
         | hospital...
        
           | munk-a wrote:
           | Having seen the working conditions of testers in the video
           | game industry I can say that:
           | 
           | > For doctors, that pay is well deserved given the exorbitant
           | student loans that doctors carry, and the ridiculous shift
           | length and other work related issues.
           | 
           | Is pure BS. Many professions end up carrying student loan
           | repayment for decades and that isn't usually used as an
           | excuse for increased pay - additionally there are plenty of
           | professions (and folks working two jobs) that end up putting
           | in more hours than doctors. These costs aren't describable
           | using either of those causes.
           | 
           | Additionally, most hospitals are already technically non-
           | profit organizations - it's just that administrators can end
           | up having purely ridiculous take-homes. A single payer system
           | probably is the solution but mostly because of the price
           | setting and ease of billing - if you compare Canada to the US
           | you'll notice that the Board of Physicians sets procedure and
           | drug pricing provincially rather than being left up to a
           | patchwork of random private corporations.
        
           | huitzitziltzin wrote:
           | >> For doctors, that pay is well deserved given the
           | exorbitant student loans that doctors carry, and the
           | ridiculous shift length and other work related issues.
           | 
           | Disagree on many, many counts.
           | 
           | - do you know many specialists? Ridiculous hours are not part
           | of the picture post-residency!
           | 
           | - deserved why? On the basis of what? More than a taxi driver
           | who works long hours? A convenience store worker who works
           | long hours?
           | 
           | - student loans are not that hard to pay off at US (medical)
           | salaries! There are surgical specialities where the average
           | pay is north of $500k. Family medicine and pediatrics make a
           | lot less.
           | 
           | >> Convert hospitals to non-profit operations owned by a
           | single-payer insurance and immediately save a lot of costs
           | across the entire board
           | 
           | - converting hospitals to non profits isn't going to do much
           | because most are already not for profit.
           | 
           | - you save money with single payer (ideally) by paying lower
           | prices... which is my original point. There is administrative
           | bloat and burden in the system but it's on the order of 10%
           | of spending, not 40%.
           | 
           | And, just to be clear, you _have to administer_ hospitals in
           | single payer too so you don't get rid of those costs
           | entirely.
           | 
           | I can support single payer, but I support it to _pay lower
           | prices_ to doctors and hospitals (and pharma, but as I noted
           | above that's not a big slice of the pie either).
        
         | YossarianFrPrez wrote:
         | Fascinating. I have some questions I'm hoping you can answer.
         | Can you speak to the narrative of administrative bloat in US
         | hospitals? Are doctors paid relatively less in other countries?
         | And is there any chance that the high pay is needed to counter-
         | act overly stressful working conditions in the US (vs., say,
         | the UK's NHS?)
         | 
         | I'm also curious about doctors' personal expenses. If most of
         | their salary is going towards rent or homeownership, short of
         | situating a hospital on something like a kibbutz... maybe there
         | is some sort of rent subsidy -- or tax break for landlords that
         | give a 10% rent discount / for banks that give a medical
         | professionals low interest home loans -- that could be enacted.
         | It could allow doctor's effective salaries to stay the same,
         | but medical prices to drop?
         | 
         | I'm afraid you are going to say that doctor's biggest personal
         | expense is student loans for medical school! If medical-school-
         | debt were to be wiped out, do you know how much salaries could
         | drop in terms of objective price without changing doctor's
         | effective income?
        
           | stonemetal12 wrote:
           | The relative difference in pay between US and UK docs is
           | 3x(in favor of US docs). In most cities across the US Drs
           | live in the wealthiest neighborhoods, they don't need housing
           | help. The main problem in the US is headcount, there just
           | aren't enough Drs to go around, as such salaries are driven
           | sky high.
        
             | YossarianFrPrez wrote:
             | Ah, interesting. Is this related to the fact that there was
             | a cap on the number of funded residencies? [0] Or maybe
             | there was some other cap in the graduate medical education
             | system between the '70s and the 90's... I have a vague
             | recollection of reading something about this.
             | 
             | [0] https://www.ucop.edu/federal-governmental-
             | relations/_files/f...
        
           | huitzitziltzin wrote:
           | - Cross-country administrative bloat is not a literature i
           | know, if it even exists. As a complicating factor, I don't
           | know if we have too many or they have too few. Probably us
           | too many, but relative to what exactly? That's hard to say.
           | 
           | - doctors in the US are paid relatively more, generally by A
           | LOT, but the only data I know about this is old. US doctors
           | are not that enthused about hearing they should be paid less.
           | 
           | - as another commenter notes, we have fewer doctors and fewer
           | hospital beds than most other OECD countries.
           | 
           | - related: despite what you may hear, our utilization is
           | lower than most other oecd countries. (At least in the
           | following dimensions: hospital visits are less frequent and
           | are shorter.)
           | 
           | - I don't know of good data about doctors' personal expenses.
           | But there is a paper from a few years ago which looked at
           | labor department data and found that a decent fraction of the
           | top 1% of the income distribution in the US was made up of
           | doctors. I may be able to find that reference and the fact
           | I'm citing may be misremembered.
           | 
           | - sure, doctors do have high medical school expenses and debt
           | here relative to other countries but for anyone who is not in
           | primary care, it's not going to take that long to retire the
           | debt. There are multiple specialties which pay north of
           | $400,000 per year.
           | 
           | - I do not think doctors' salaries are related in a
           | meaningful way to their debt. Which is to say: if you
           | canceled all medical school debt tomorrow, prices for
           | physician services would decline by about 0%. Those costs are
           | sunk. They are not going to have a large effect on prices.
        
             | YossarianFrPrez wrote:
             | Great, thanks for the detailed response. Makes me wonder
             | about if the supply of doctors in the US been artificially
             | constrained to inflate salaries.
        
               | huitzitziltzin wrote:
               | Ooh I love easy questions! The answer to this one is yes!
               | 
               | You can thank the American Medical Association.
        
           | tkahnoski wrote:
           | Another factor is not all doctor salaries are the same.
           | Anesthesiologist 400k, Family practice or OB/GYN 200k.
           | 
           | Anesthesiologist is buying a lamborghini, the family practice
           | person needs a few years before they can entertain buying a
           | house.
        
             | tastyfreeze wrote:
             | Any idea why there aren't more people training to be
             | anesthesiologists? A salary like that is a strong incentive
             | for people to enter the professions. Or is this more of a
             | training lag problem where it takes 12-14 years for a labor
             | shortage signal like high salary to start being satisfied
             | by new anesthesiologists?
        
               | cyberge99 wrote:
               | If I'm not mistaken they pay huge malpractice insurance
               | amounts because a misdiagnosed dosage of a lethal
               | chemical (sedative, anesthesia) can be, well, lethal.
        
               | conanbatt wrote:
               | Skill markets are not very efficient: not all developers
               | jump to blockchain or ML for example. Also there tends to
               | be limits on how many slots for residences and practices
               | there are for different specialties: the system is
               | purposefully capped to make sure that there aren't too
               | many doctors.
               | 
               | The way to skip all of this is massive de-reg.
        
               | huitzitziltzin wrote:
               | Generally residency spots are limited. This creates a
               | scarcity which keeps prices high.
               | 
               | I doubt the claim of the commenter below who argues that
               | it is malpractice insurance. There are by now plenty of
               | "tort reform" states where malpractice payouts are
               | capped. I would be very surprised if anesthesiology
               | prices are any lower in those states.
        
           | conanbatt wrote:
           | > Can you speak to the narrative of administrative bloat in
           | US hospitals?
           | 
           | Admin bloat is a consequence of having too few doctors, and
           | also legal requirements on how visits have to be handled in
           | the US. For each medical visit you get at least 10~15m of
           | recording the visit. A doctor without any help would spend
           | around half the time talking to a patient, and half the time
           | filling out charts for insurance and legal requirements.
           | 
           | Thus to make money you need to delegate all those tasks as
           | much as possible, and you get to a point where some hospitals
           | even offer a full medical assistant per provider. To solve
           | this you need to have way more doctors, and a lot less
           | medical liability from a legal standpoint. For example, you
           | cant have paper charts in the US, which is standard in many
           | other first world countries.
           | 
           | Billing is also a very expensive source of admin work. You
           | have to have a perfect pipeline for billing to have high
           | collections, then you have issues collecting the money months
           | after that is settled, etc etc. Many ways to solve this one,
           | but partially solved by moving a lot of expenditures to cash-
           | based payment. You can save all of this in a cash-based
           | system. Alternatively you could have competition in the
           | insurance market, but although that could improve things, in
           | the end, you still need to write medical and administrative
           | work to get paid. This problem also exists in many other
           | countries.
           | 
           | > Are doctors paid relatively less in other countries?
           | 
           | The Gross income of physicians in the US is surely the
           | highest in the world. But gross is gross. At those levels
           | taxation approaches 50%, and medical education can cost half
           | a million dollars. Its a perverse system where you pay a lot
           | to a ticket to earn a lot, but you get collected all the way
           | to the bank. And if you dont make it, you fail really hard.
           | Primary care physicians are the lowest paid in the us and
           | have an abnormally high suicide rate.
           | 
           | > And is there any chance that the high pay is needed to
           | counter-act overly stressful working conditions in the US
           | (vs., say, the UK's NHS?)
           | 
           | High pay is a simple result of too few physicians. But what
           | goes to physicians directly is a smaller part of spending:
           | only about 10% of spending goes directly to physicians. You
           | can make it better, but I think its likely they want better
           | working conditions over money, its just not an option in this
           | market structure. You cant operate part time, or with 30min
           | appointments, without charging patients above insurance
           | levels. (example, OneMedical, Concierge medicine, parsley,
           | etc).
           | 
           | > I'm also curious about doctors' personal expenses. If most
           | of their salary is going towards rent or homeownership, short
           | of situating a hospital on something like a kibbutz... maybe
           | there is some sort of rent subsidy -- or tax break for
           | landlords that give a 10% rent discount / for banks that give
           | a medical professionals low interest home loans -- that could
           | be enacted. It could allow doctor's effective salaries to
           | stay the same, but medical prices to drop?
           | 
           | This market structure needs less rules, not more rules. I
           | have NEVER seen a market so captured as this one, and its
           | captured by everyone in some way. Every single actor in this
           | market is using government to get something from someone
           | else, including patients, insurance takers, physicians,
           | admin, pharma, gov. Literally everyone.
           | 
           | > I'm afraid you are going to say that doctor's biggest
           | personal expense is student loans for medical school! If
           | medical-school-debt were to be wiped out, do you know how
           | much salaries could drop in terms of objective price without
           | changing doctor's effective income?
           | 
           | Causal relationship is backwards here. Salaries are not high
           | because medical debt is high. Salaries are high because there
           | are too few doctors, because it is too expensive to get an
           | education for it. If you wipe out medical debt, you are
           | assisting the ones that made it over, but not all the ones
           | that could not make it in the first place. To reduce the cost
           | of education you need to do a few things:
           | 
           | 1- eliminate federal funding for education, that makes it
           | only "approved" universities be able to provide limited
           | slots.
           | 
           | 2- Eliminate or reduce the cost of licensing. In the us you
           | need a license _per state_ to practice medicine, and it is
           | very stringent. If it were handled like a legal bar exam
           | instead, you would put significant pressure in the college
           | system while also allowing for independent education to
           | ocurr.
           | 
           | 3- Allow medical degrees from other countries to practice in
           | the US. This would leave the option for doctors to study
           | abroad for nearly free and come back and practice.
        
         | conanbatt wrote:
         | Hospitals are 40% of the NH spending so I would even not look
         | at doctors that way.
         | 
         | The market structure is such that there are very few doctors,
         | so you need to do your operations in a way that doctors spend
         | as little as possible with patients, and you delegate as much
         | to assistants and administrative chores. With a massive supply
         | shock on doctors you would not only lower wages for doctors,
         | you would also lower admin costs.
         | 
         | One caveat, even though doctors wages are very high, they are
         | also rent-captured by universities that charge mid six-digits
         | for an education and medical insurance, and certifications that
         | are burdensome and expensive. I remember medical malpractice
         | insurance going to several thousand a month for OBGYN. There is
         | a reason why clinical doctors have an abnormally high suicide
         | rate in the US.
         | 
         | Then hospitals get massive fed spending and money, plus often
         | local protections that mean you cant open competing hospitals.
         | In the book " The Social Transformation of American Medicine"
         | they talk a lot about how hospitals rent-seeking behavior is to
         | turn themselves as a non-profit, and then ask for federal
         | funding and getting that denied to for-profit hospitals,
         | effectively capping the amount of hospitals you can open.
         | 
         | The WHOLE market structure needs a detonation. And this is my
         | desire/wish/prediction: at some point we will get an Uber for
         | medicine. Americans will do most their telemedicine with
         | doctors outside the united states, where education is free,
         | there are not legal requirements or certifications or licenses,
         | etc. This is what immigrants like myself do. A psychiatrist in
         | argentina, for example, charges 5U$S for a visit, while one in
         | Palo Alto, CA charges 1000U$S with a 3 month wait list.
        
           | huitzitziltzin wrote:
           | Lots of stuff here...
           | 
           | >> Hospitals are 40% of the NH spending so I would even not
           | look at doctors that way.
           | 
           | Hospitals are 30% and physicians are 20%
           | 
           | >> The market structure is such that there are very few
           | doctors,
           | 
           | Agree. Add more medical schools and residency spots.
           | 
           | >> With a massive supply shock on doctors you would not only
           | lower wages for doctors,
           | 
           | Yes, this is a good idea.
           | 
           | >> you would also lower admin costs.
           | 
           | Not clear that this is true or why it would happen.
           | 
           | >>One caveat, even though doctors wages are very high, they
           | are also rent-captured by universities that charge mid six-
           | digits for an education and medical insurance, and
           | certifications that are burdensome and expensive.
           | 
           | Medical school debt may be high, but salaries are higher.
           | Certifications are not likely a large obstacle to more entry,
           | IMO.
           | 
           | >> I remember medical malpractice insurance going to several
           | thousand a month for OBGYN.
           | 
           | There are plenty of "tort reform" states that cap malpractice
           | payouts. Medical services are not cheaper there.
           | 
           | >> There is a reason why clinical doctors have an abnormally
           | high suicide rate in the US.
           | 
           | Source needed on this claim. Might be true. I'm skeptical
           | though. High relative to what?
           | 
           | >> Then hospitals get massive fed spending and money,
           | 
           | They do and certainly in the COVID stimulus bill that was a
           | HUGE waste of public money.
           | 
           | >> plus often local protections that mean you cant open
           | competing hospitals.
           | 
           | This is called "certificate of need." These laws are dumb but
           | don't exist in 15-20 states at this point. More entry would
           | be great, but you need more doctors, more competition and
           | more price transparency too.
           | 
           | >> In the book " The Social Transformation of American
           | Medicine" they talk a lot about how hospitals rent-seeking
           | behavior is to turn themselves as a non-profit, and then ask
           | for federal funding and getting that denied to for-profit
           | hospitals, effectively capping the amount of hospitals you
           | can open.
           | 
           | Certificate of need laws are state, not federal.
           | 
           | >> The WHOLE market structure needs a detonation.
           | 
           | I'm on board. But by detonation I really mean: - more medical
           | schools, - more doctors, including permitting foreign doctors
           | to practice here - price transparency - meaningful
           | competition among hospitals on price.
           | 
           | >> And this is my desire/wish/prediction: at some point we
           | will get an Uber for medicine.
           | 
           | Amazon is starting an Amazon Care product. Looks like urgent
           | care for the time being. My hope is that they open hospitals
           | eventually.
           | 
           | >> Americans will do most their telemedicine with doctors
           | outside the united states, where education is free, there are
           | not legal requirements or certifications or licenses, etc.
           | This is what immigrants like myself do. A psychiatrist in
           | argentina, for example, charges 5U$S for a visit, while one
           | in Palo Alto, CA charges 1000U$S with a 3 month wait list.
           | 
           | Great idea and this is what my (foreign born) wife does too.
           | A great way to save money.
           | 
           | For anyone else reading this far down, you can do it too.
           | There are English speaking doctors everywhere.
        
             | conanbatt wrote:
             | Excited to read this!
             | 
             | > >> you would also lower admin costs. > Not clear that
             | this is true or why it would happen.
             | 
             | There is an operational tax whenever you involve more
             | people into the operation. You need to communicate, add
             | paper trails, set up structure, etc. If say, you had one
             | person collecting payments instead of a secretary, a doctor
             | writing a paper, an insurance biller, an insurance agent,
             | etc for the same ops, it would be a lot easier. You would
             | have doctors perform many of these tasks. For example, give
             | vaccinations, take vitals, etc.
             | 
             | > Medical school debt may be high, but salaries are higher.
             | Certifications are not likely a large obstacle to more
             | entry, IMO.
             | 
             | Thats the survivorship bias. Salaries cant be lower because
             | people would go bankrupt. Certifications reduce
             | competition, and make it harder to practice. There's even a
             | startup that Raised a series A of multiple millions just to
             | make this process faster (medallion). Evidence this affects
             | the market is that most doctors are only licensed in a
             | couple of states at most.
             | 
             | > There are plenty of "tort reform" states that cap
             | malpractice payouts. Medical services are not cheaper
             | there.
             | 
             | I'd like to see some data about this if you have it.
             | Conceptually malpractice insurance is a fix cost that puts
             | downward pressure on supply. IT is particularly salient for
             | physicians that would like to work part-time.
             | 
             | > Source needed on this claim. Might be true. I'm skeptical
             | though. High relative to what?
             | 
             | https://www.webmd.com/mental-health/news/20180508/doctors-
             | su.... This is a well known fact in the profession.
             | 
             | >> In the book " The Social Transformation of American
             | Medicine" they talk a lot about how hospitals rent-seeking
             | behavior is to turn themselves as a non-profit, and then
             | ask for federal funding and getting that denied to for-
             | profit hospitals, effectively capping the amount of
             | hospitals you can open.
             | 
             | > Certificate of need laws are state, not federal.
             | 
             | The point above is that by making it impossible for for-
             | profit hospitals to compete due to lack of subsidies, the
             | supply is deliberately constrained.
             | 
             | Cheers!
        
         | mwerd wrote:
         | Get rid of onerous documentation requirements. There - you cut
         | 10%-20% of hospital administration costs, and you haven't
         | changed how much doctors are being paid per hour, but you have
         | increased their productivity, so they can see more patients for
         | the same salary.
         | 
         | Find me a payer who will agree to it and I'll show you the
         | solution to healthcare bloat.
        
           | lotsofpulp wrote:
           | The documentation requirements did not come out of thin air.
           | Some docs during the 80s/90s/00s made out extremely well. One
           | of the infamous ones is ortho surgeons hitting everyone with
           | dubious back surgeries since it was all paid for by Medicare
           | even though there was little evidence back surgeries worked.
        
         | chizhik-pyzhik wrote:
         | I googled and was surprised to see just how much more doctors
         | are paid in USA- about 2x as much as western european
         | doctors... https://www.advisory.com/en/daily-
         | briefing/2019/09/24/intern...
         | 
         | Hospitals are also privately owned in the USA, whereas they're
         | mostly government-owned in western europe. That's billions of
         | dollars redirected from normal people towards rich
         | stockholders.
        
           | huitzitziltzin wrote:
           | Most large hospitals are not publicly traded. The money is
           | not going to rich stockholders because they don't have any.
           | Many, for example, are large academic medical centers
           | attached to universities.
           | 
           | Also: most large hospitals are technically "nonprofit". Most
           | of the money there goes to salaries for hospital employees,
           | including well paid administrators.
           | 
           | As I note elsewhere in a reply to another comment: it is an
           | ongoing open research question whether "nonprofit" and for
           | profit hospitals actually do anything different. My strong
           | sense (indicated by my ""!) is that the answer is no! They
           | are equally rapacious.
        
             | conanbatt wrote:
             | The fact that the majority of hospitals are non-profit is
             | part of the racket. The money goes to the hospital
             | administration instead of stockholders. That doesn't make
             | it any better.
        
               | huitzitziltzin wrote:
               | No it isn't better. It just means that money is not going
               | to "rich stockholders" as the parent asserts.
        
         | sli wrote:
         | > As much as everyone loves to complain about drug companies
         | and insurers as being responsible for high US health care
         | costs, that is not where the money goes. The money goes to
         | doctors and to hospitals. (Specifically: about half of all
         | national health spending to those two groups.)
         | 
         | A big part of the problem is where the money _comes from,_ not
         | just where it goes. People are less averse to doctors being
         | paid well than they are being stuck with absolutely ridiculous
         | bills that they cannot reasonably pay, which should go without
         | saying.
         | 
         | This is why so many people want to rich taxed much more heavily
         | and that money used to subsidize healthcare, instead of the
         | current trend of handwaving the wealthy as "not having liquid
         | assets," something that never seems to matter when a wealthy
         | person wants to pay for something expensive but suddenly
         | matters when the working class wants the IRS to come knocking.
         | If they need to dump stock or some other assets to pay their
         | tax bill, that's their own problem and not anyone else's. It's
         | also something that could be willfully avoided on their own
         | accord.
         | 
         | That $768B "defense" budget is absolutely nauseating in the
         | face of medical debt being one of if not _the_ largest cause of
         | bankruptcy in the US.
        
           | psadri wrote:
           | The problem in the US is the individuals don't pay for
           | regular medical care - your insurance does. And that
           | insurance is usually funded by employers. So doctors and
           | hospitals have every incentive to squeeze the insurance
           | companies as much as possible (which pass on those costs to
           | employers).
           | 
           | We'd be in a completely different situation if people paid
           | for regular medical care out of pocket and paid for their
           | catastrophic insurance by themselves. There'd be competition
           | between health care providers to offer affordable care
           | directly to individuals, just like other normal markets.
        
           | rafale wrote:
           | $768B is a great deal for not being under a russian or
           | Chinese hegemony and world philosophy. Freedom comes before
           | universal healthcare.
        
             | huitzitziltzin wrote:
             | You will be delighted to learn of the existence of (inter
             | alia)
             | 
             | - France
             | 
             | - Japan
             | 
             | - Australia
             | 
             | - Great Britain
             | 
             | - Finland
             | 
             | - Taiwan
             | 
             | - New Zealand
             | 
             | - South Korea
             | 
             | - and many more!
             | 
             | All countries which do not spend anything like what we do
             | on defense, are not under Chinese or russian domination,
             | AND nearly all have longer life expectancy than we do while
             | at the same time spending much much much less _on a per
             | capita basis_ on health care than the US does.
        
               | lp0_on_fire wrote:
               | Each one of those countries you listed _heavily_ relies
               | on the United States military being on their side in the
               | event of a war. You can't make the argument you're making
               | without at least acknowledging US hegemony (which we can
               | argue is good or bad).
        
               | triceratops wrote:
               | In a war, I'd bet on a France-UK-Germany alliance against
               | Russia any day. Ditto for a South Korea-Japan-Taiwan-
               | India alliance against China. They might not win but
               | they're strong enough to keep from being pushed around.
        
               | lp0_on_fire wrote:
               | > They might not win but they're strong enough to keep
               | from being pushed around.
               | 
               | Emphasis on "They might not win". Which is exactly why
               | they rely on US support in the event of one of those
               | scenarios - it increases their chances of winning by a
               | lot.
        
               | huitzitziltzin wrote:
               | Totally agree with you! Sounds like the found a smart way
               | to reduce their defense budgets, no??
        
         | lemmsjid wrote:
         | Thanks for the context. My layperson reader-of-newspapers
         | understanding is that there are three issues with doctor
         | supply: one is that it's expensive to become a doctor, which is
         | hand in hand with spiraling educational costs, two is that it's
         | painful to be a doctor, because of red tape, and three is that
         | it is incredibly difficult to become a doctor and we actually
         | don't have a lot of knowledge as to whether or not the rigorous
         | selection process and training is actually completely necessary
         | to produce a good doctor. In fact, the rigorous process might
         | be selecting out people who would otherwise be good. (This
         | being one commentary on the subject:
         | https://www.baltimoresun.com/opinion/op-ed/bs-ed-
         | op-0516-doc...)
        
           | huitzitziltzin wrote:
           | It is expensive, but they are extremely well compensated.
           | Don't let them BS you. It doesn't take that long to pay back
           | a million dollars of med school debt at a salary of 400k per
           | year.
           | 
           | Bigger issue is low supply: too few medical schools admitting
           | too few students keeps supply Low and prices high. Current
           | doctors love it. (That's the same reason non-US-trained
           | doctors can't come to practice here. You can bet that they'd
           | love to at our salaries!)
           | 
           | Probably the training process is dysfunctional and needlessly
           | brutal. But that doesn't make prices high on its own.
           | 
           | Just open more med schools, add residency slots, and make it
           | easier for doctors from other places to come here and
           | practice.
        
       | eecc wrote:
       | The only change will be the introduction of Field Level Security
       | to hide this information from screens for the wrong RBAC role
        
         | cardiffspaceman wrote:
         | So I think a lot of us in this forum had the same thoughts. But
         | we also know a plausible story for how this person got her
         | access: The original access level was sufficient for 85% (let's
         | say) of her duties, and after she went to the other person for
         | what she needed the other 1/7 times, they gave her the broader
         | access level so she could do her job without interrupting
         | someone at a higher pay grade, or on a different floor.
        
       | mwerd wrote:
       | Snooze. What is charged in healthcare is a distraction.
       | 
       | This is likely a supply that would be used in an inpatient
       | setting and will be completely written off as a "contractual
       | discount and allowance" after the insurer pays the negotiated
       | rate, which is based on the overall case and it's severity, not
       | what supplies are used.
       | 
       | This is lazy journalism meant to generate outrage without
       | discussing the substance of the problem.
       | 
       | Relax medical licensure requirements. Cap medical malpractice
       | damages and chase the doctors' licenses instead of their
       | pocketbooks. Allow nurse practitioners to provide higher level
       | care. Allow telehealth and reciprocity for out-of-state
       | licensure. Publicly fund more medical schools and residencies.
       | Reduce burdensome documentation requirements and Medicare billing
       | audit penalties.
       | 
       | Just a few ideas that I think are more meaningful options for
       | addressing healthcare costs.
        
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