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Irrational rise in Healthcare Costs

code1211 said:
Are you asserting that if there were no insurance companies and that all medical costs were paid out of pocket that the healthcare industry would be enjoying the same cash flow as they do WITH insurance payments?
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No.. how they heck to you get that from my post? If we did without insurance.. most facilities would close and there would be very little in the way of technology and advanced medical care.

We would go back to care in the late 1800's. Except for the rich. Who would fly to other countries that had insurance where they could get care.

I was speaking to your assertion that prices were high because people who have health insurance CHOOSE.. to get expensive surgeries that they could otherwise do without.

(getting that bently). That doesn't really happen.

I also spoke to your assertion about "posting prices".. and having people shop. Shopping by "posted price".. is not very effective since depending on your insurance.. your cost may be lower than the posted price. And my be lower than another facility with a "posted price" that's lower.
 
jaeger19 said:
No.. how they heck to you get that from my post? If we did without insurance.. most facilities would close and there would be very little in the way of technology and advanced medical care.

We would go back to care in the late 1800's. Except for the rich. Who would fly to other countries that had insurance where they could get care.

I was speaking to your assertion that prices were high because people who have health insurance CHOOSE.. to get expensive surgeries that they could otherwise do without.

(getting that bently). That doesn't really happen.

I also spoke to your assertion about "posting prices".. and having people shop. Shopping by "posted price".. is not very effective since depending on your insurance.. your cost may be lower than the posted price. And my be lower than another facility with a "posted price" that's lower.
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My point about getting a Ford or a Bentley is pretty accurate.

I have a given amount of money and buy a car that will serve my needs plus a small share of luxury, and select a car from that universe of choices that are in my price range.

When I am suffering pain and go to a hospital, I seek relief of the pain and the treatment is purchased based ONLY on getting relief from the pain.

I am never offered the Ford or the Bentley solution. I am told what the issue is and what the treatment should be to correct it. When I had a sigmoid colectomy, my choice was to get it or to die.

As it happened, choosing to not die also included absolutely top shelf treatment, private room, a good recovery period and continued life. That is, a Bentley.

I should think that a Ford would have been life, a bed in a ward, a shorter in-hospital stay and maybe no TV. There were only 6 channels on the TV, but with the Morphine, I wasn't really aware of the limited selection until the second day. ;)

Regarding the lower negotiated price, that cost used to be referred to by the insurance companies as costs that were "normal and usual".

Why are these costs "normal and usual" for some folks, but not others? It's like the two guys in the commercial that are paying different rates for the same hotel room.

I just don't understand that part of the healthcare pricing.
 
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code1211 said:
I am never offered the Ford or the Bentley solution. I am told what the issue is and what the treatment should be to correct it. When I had a sigmoid colectomy, my choice was to get it or to die.

As it happened, choosing to not die also included absolutely top shelf treatment, private room, a good recovery period and continued life. That is, a Bentley.

I should think that a Ford would have been life, a bed in a ward, a shorter in-hospital stay and maybe no TV. There were only 6 channels on the TV, but with the Morphine, I wasn't really aware of the limited selection until the second day. ;)
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With a functioning insurance market, you'd be making those decisions in advance of needing care, when you're shopping for insurance for the year. Insurers would market products featuring different provider networks at a range of price points. If you want a network limited to more Ford-like options (i.e., lower priced hospitals and other providers), you save on your monthly premium. And if you want a broader network with more Bentleys thrown in the mix, you buy a product that includes them and you pay the commensurately higher premium.

Which is how it works in the only real functioning consumer-facing insurance market we have, the marketplaces.

Narrow-network plans' low premiums are a draw for many price-sensitive ACA exchange customers. A September 2017 Health Affairs article by researchers at Harvard and Northwestern University found that exchange plans with narrow physician and hospital networks were 16% cheaper than those with broad networks in 2014.
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The problem is that more people aren't shopping in the marketplaces.

There are choices to be made, it just sounds like you're not the one making them, even if it's ultimately your money financing them. Which is why insurers outside the marketplaces have difficulty restraining (e.g., via aggressive negotiation) the prices of powerful providers, and sometimes effectively throw in the towel on even trying. Which is why it ends up feeling like collusion of sorts sometimes. If you have price sensitive consumers shopping for their own plans in a structured market, it's a whole different ballgame.
 
jonny5 said:
Go look at a pharmacies shelves, shop for insurance, find a dentist. It is not FAR from a free market at all.
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It's impossible for healthcare to be a free market because the issue of demand is fundamentally broken.
 
Deuce said:
It's impossible for healthcare to be a free market because the issue of demand is fundamentally broken.
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Nonsense. People can and do shop for healthcare pretty much the same way they shop for anything else. Even in emergency situations (which is only 2% of healthcare spending) people shop for a ride to the hospital by calling uber or lyft instead of taking the local price-gouging ambulance monopoly (Thanks government regulation!).
 
aociswundumho said:
Nonsense. People can and do shop for healthcare pretty much the same way they shop for anything else. Even in emergency situations (which is only 2% of healthcare spending) people shop for a ride to the hospital by calling uber or lyft instead of taking the local price-gouging ambulance monopoly (Thanks government regulation!).
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No one shops for a cheap deal when you need heart surgery
 
code1211 said:
I recently moved and came across the bills and payment receipts saved by my mother for the costs related to my Birth in 1953. Unpacking boxes is a little like archeology.

My birth was pretty unremarkable. No problems to overcome or excessive length of stay in the hospital.

Total cost: $197.20 which included all of the nursing, room charges, doctors and any care, food or drugs needed. Total billing extended across 5 days.

According to WebMD, that cost today would be about $9600.00.

The increase from $197.20 to $9600.00 is a pretty big jump. $197.20 in 1953 was only 2% of the costs incurred on average today. 2%! stated the other way around, the current price is 4,868% of the 1953 price.

Let's compare this to the cost of new car.

In 1953, you could buy a new Lincoln off the showroom floor for about $3550.00. At the same increase in cost as the healthcare increase, that Lincoln would be $177, 500.00.

A 2020 showroom price of a new Lincoln starts at $46,305. Actual increase is 1,304% of the 1953 pricing. 1953 cost is is about 7.6% of this.

The median "Family Income" in 1953 was about $4200.00 in 1953. In 2019, the Median "Household Income" was around $63,378: An increase of about 1,509%. 1953 level was about 6.6% of this.

The cost of healthcare in this one area seems to have suffered outrageous inflation. The outrageous increase in the cost of healthcare could be one of the issues impacting the cost of healthcare insurance.

Of course, I could be wrong...

How Much Does It Cost to Have a Baby? Hospital Costs, Baby Supplies, and More

2020 Lincoln(R) Continental | Midsize Luxury Sedan | Lincoln.com

1950s Cars - Lincoln
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Well I guess it's time for republicans try once again to kill off the affordable care act so those rates can not only go higher but can exclude who they don't want to cover.

However, republicans don't vote against their own best interests. Uh huh.
 
Greenbeard said:
With a functioning insurance market, you'd be making those decisions in advance of needing care, when you're shopping for insurance for the year. Insurers would market products featuring different provider networks at a range of price points. If you want a network limited to more Ford-like options (i.e., lower priced hospitals and other providers), you save on your monthly premium. And if you want a broader network with more Bentleys thrown in the mix, you buy a product that includes them and you pay the commensurately higher premium.

Which is how it works in the only real functioning consumer-facing insurance market we have, the marketplaces.



The problem is that more people aren't shopping in the marketplaces.

There are choices to be made, it just sounds like you're not the one making them, even if it's ultimately your money financing them. Which is why insurers outside the marketplaces have difficulty restraining (e.g., via aggressive negotiation) the prices of powerful providers, and sometimes effectively throw in the towel on even trying. Which is why it ends up feeling like collusion of sorts sometimes. If you have price sensitive consumers shopping for their own plans in a structured market, it's a whole different ballgame.
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Don't you just hate it when a poster edits your words for no other reason than to change their meaning and then presents them as if they have not been changed?
 
bongsaway said:
Well I guess it's time for republicans try once again to kill off the affordable care act so those rates can not only go higher but can exclude who they don't want to cover.

However, republicans don't vote against their own best interests. Uh huh.
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ANOTHER post that is topically unrelated to anything in the post to which you responded.

Your leap to the ridiculous response you made is astonishing and nonsensical.

It was, however, everything I would expect from you.

So, there's that.
 
code1211 said:
ANOTHER post that is topically unrelated to anything in the post to which you responded.

Your leap to the ridiculous response you made is astonishing and nonsensical.

It was, however, everything I would expect from you.

So, there's that.
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Happy to help entertain you, you're welcome.
 
bongsaway said:
Happy to help entertain you, you're welcome.
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Not so much entertaining as it is mystifying.

It would be entertaining if the mystifying part was in a Penn & Teller kind of a way, but, sadly, it's not...
 
aociswundumho said:
Nonsense. People can and do shop for healthcare pretty much the same way they shop for anything else. Even in emergency situations (which is only 2% of healthcare spending) people shop for a ride to the hospital by calling uber or lyft instead of taking the local price-gouging ambulance monopoly (Thanks government regulation!).
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You don't choose to get sick, you don't choose what illness you get, and you don't get to choose what treatment is effective. Calling an uber is not "shopping" for emergency care, and the ambulance ride is just a small fraction of the bill they're about to receive. If you have cancer, you might need chemotherapy. You can't choose something else. This is what will save your life, and you will fundamentally pay any price to get it. The demand curve for continuing to live is infinitely steep. Call your local hospital and ask how much certain procedures will cost. Chemotherapy, knee surgery, etc. You wont get an answer. You can't actually shop around.
 
code1211 said:
Also undoubtedly, there would be providers that sold the Rolls Royce and providers that sold the Ford.

As it is now, most of us go to the hospital in pain and ask to be fixed with no consideration of the costs involved until the day of discharge.
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This literally cannot be fixed with healthcare. There's no "bentley" for a gunshot wound, cancer, or diabetes.

You hit it right on the head: we ask to be fixed with no consideration of the costs because we are in pain or are even dying. The demand curve for continuing to live is infinitely steep and this cannot be changed by a "free market."

Healthcare costs are out of control because we're trying to be a free market. We're trying to allow supply and demand to drive price in an industry that is fundamentally not a choice to begin with. People will pay anything to end the pain, especially when the pain is being suffered by their children. Human nature does not allow for anything else.
 
Deuce said:
This literally cannot be fixed with healthcare. There's no "bentley" for a gunshot wound, cancer, or diabetes.

You hit it right on the head: we ask to be fixed with no consideration of the costs because we are in pain or are even dying. The demand curve for continuing to live is infinitely steep and this cannot be changed by a "free market."
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Cost should never be a consideration of the patient when they are sick
 
Deuce said:
Calling an uber is not "shopping" for emergency care, and the ambulance ride is just a small fraction of the bill they're about to receive.
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But it's still a huge amount of money, thanks to government regulation creating ambulance monopolies:

https://www.washingtonpost.com/nati...e9280e-c313-11e7-84bc-5e285c7f4512_story.html

The demand curve for continuing to live is infinitely steep.
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You mean the demand is inelastic. It could be, depending on what's wrong with you, but it's still no different than food in that respect, and food is supplied by the market with prices so low that obesity is a problem.

Call your local hospital and ask how much certain procedures will cost. Chemotherapy, knee surgery, etc. You wont get an answer. You can't actually shop around.
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Yes, that's the problem. Price-gouging hospitals don't want people shopping around.
 
Apples and oranges. The cost of the delivery today includes far more advanced interventional procedures. It also adjusts for the cost of legal risk associated with a new birth, which in itself is significant.
 
aociswundumho said:
But it's still a huge amount of money, thanks to government regulation creating ambulance monopolies:

https://www.washingtonpost.com/nati...e9280e-c313-11e7-84bc-5e285c7f4512_story.html



You mean the demand is inelastic. It could be, depending on what's wrong with you, but it's still no different than food in that respect, and food is supplied by the market with prices so low that obesity is a problem.



Yes, that's the problem. Price-gouging hospitals don't want people shopping around.
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You edited out the parts you have no response to. I'll take that as a concession that you agree to those.
 
Deuce said:
You edited out the parts you have no response to. I'll take that as a concession that you agree to those.
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Another possibility is the nonsense I snipped out wasn't worth responding to.

I'll let the reader decide which one of us is more likely correct.
 
Deuce said:
This literally cannot be fixed with healthcare. There's no "bentley" for a gunshot wound, cancer, or diabetes.

You hit it right on the head: we ask to be fixed with no consideration of the costs because we are in pain or are even dying. The demand curve for continuing to live is infinitely steep and this cannot be changed by a "free market."

Healthcare costs are out of control because we're trying to be a free market. We're trying to allow supply and demand to drive price in an industry that is fundamentally not a choice to begin with. People will pay anything to end the pain, especially when the pain is being suffered by their children. Human nature does not allow for anything else.
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Don't you just hate it when a poster edits your words for no other reason than to change the meaning and then presents them as if they have not been changed?
 
aociswundumho said:
Another possibility is the nonsense I snipped out wasn't worth responding to.

I'll let the reader decide which one of us is more likely correct.
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*snort* Yeah, you do that.
 
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