There are 157 comments.

1. Member
   Miffed White Male

   @MiffedWhiteMale

   

   6:42 PM EDT ⋅ Mar 21, 2017

   Kozak (View Comment):

   ModEcon (View Comment):
   Yes, treating hospitals as common carriers would not be free, but they aren’t anyways. Arguably, they would be more free since people could look into their local hospitals and keep a little card in their wallet saying which hospitals they prefer.

   Well for real emergencies that could be problematic as well. Hospitals do not have interchangeable resources or skills. Where I would prefer one hospital to treat my Myocardial Infarction, they may not be a Trauma Center. Proximity at time of emergency is critical too.

   When my brother was a cop, there were two hospitals in the city, and he said that if he got shot while standing in the front doorway of the emergency room of one of them he’d want to be taken to the other.

2. Coolidge
   Chris Campion

   @ChrisCampion

   6:46 PM EDT ⋅ Mar 21, 2017

   Larry Koler (View Comment):

   Spin (View Comment):

   Larry Koler (View Comment):

   Spin (View Comment):

   Larry Koler (View Comment):
   who is MORE to blame here — the government or the insurance companies?

   I blame the people. We did it to ourselves.

   Yes, we share the blame with the people who actually carry out the evil. But, we are not the proximate cause nor are we mostly to blame. We are not the government and the government can do bad things that we don’t endorse and we are now living through a time when the people are roused up to fix the problems that several decades of bad ideas in government have been experimented with and found wanting.

   I disagree most vociferously. We are entirely to blame. We do not want to pay for our own health care. We simply don’t. We want someone else to pay for it. We do not understand how insurance works, which is why we want it to pay for every last thing we think we need.

   The root cause of the problem is people not wanting to foot their own bill, to treat health care like a the financial transaction it is.

   Let’s establish clearly what you are saying. Is the government as a separate entity not to blame for anything? There’s no point in arguing about where to lay blame if you are opposed to blaming the government for anything. And if the government has some blame we need to then sort out how much is apportioned. Let’s save some time here and flesh this weird idea out.

   How about 1/3 of it, then?  (sighs deeply)

   Historical NHE, 2015:

   • NHE grew 5.8% to $3.2 trillion in 2015, or $9,990 per person, and accounted for 17.8% of Gross Domestic Product (GDP).
   • Medicare spending grew 4.5% to $646.2 billion in 2015, or 20 percent of total NHE.
   • Medicaid spending grew 9.7% to $545.1 billion in 2015, or 17 percent of total NHE.
   • Private health insurance spending grew 7.2% to $1,072.1 billion in 2015, or 33 percent of total NHE.
   • Out of pocket spending grew 2.6% to $338.1 billion in 2015, or 11 percent of total NHE.
   • Hospital expenditures grew 5.6% to $1,036.1 billion in 2015, faster than the 4.6% growth in 2014.
   • Physician and clinical services expenditures grew 6.3% to $634.9 billion in 2015, a faster growth than the 4.8% in 2014.
   • Prescription drug spending increased 9.0% to $324.6 billion in 2015, slower than the 12.4% growth in 2014.
   • The largest shares of total health spending were sponsored by the federal government (28.7 percent) and the households (27.7 percent).   The private business share of health spending accounted for 19.9 percent of total health care spending, state and local governments accounted for 17.1 percent, and other private revenues accounted for 6.7 percent.

    

3. Inactive
   ModEcon

   @ModEcon

   7:05 PM EDT ⋅ Mar 21, 2017

   Miffed White Male (View Comment):

   Kozak (View Comment):

   Well for real emergencies that could be problematic as well. Hospitals do not have interchangeable resources or skills. Where I would prefer one hospital to treat my Myocardial Infarction, they may not be a Trauma Center. Proximity at time of emergency is critical too.

   When my brother was a cop, there were two hospitals in the city, and he said that if he got shot while standing in the front doorway of the emergency room of one of them he’d want to be taken to the other.

   No doubt there is an issue here.

   The only way I have currently thought of to help is to make emergency care actually run by voting in a provider. Kind of like we vote for judges in some areas. We could also present government contracts for emergency care (where emergency workers will take injured) that providers could bid on and the public in the area could vote on which provider to choose. Repeat every 5 years or so. However, there are so many issues with this that it is impossible.

   I think dealing with emergency care could be a big help in fixing the rest of the problems as well though.

4. Inactive
   Larry3435

   @Larry3435

   5:43 AM EDT ⋅ Mar 22, 2017

   Amy Schley (View Comment):

   Larry3435 (View Comment):
   If I could be part of an organization that would negotiate the same prices for me that the insurance companies get, I would much prefer to pay out of pocket for everyday medical expenses, and insure only for catastrophic medical events.

   What’s funny is that if you go to the vets at PetSmart, that is exactly what they will sell you. $15/mo/pet to get “free” annual exam, shots, and a 15+% discount on all other services.

   Not to mention the fact that if you get an X-ray for your pet, using the same X-ray machine that is used on humans, the pet X-ray will cost $100 and the human X-ray will cost $3,000.

5. Member
   Stina

   @CM

   5:59 AM EDT ⋅ Mar 22, 2017

   If there were adequate pricing information and the prices affordable, I would budget to pay out of pocket for the most likely scenarios in my family.

   But you can’t plan without information and there is no information.

6. Inactive
   Larry Koler

   @LarryKoler

   Post author

   9:45 AM EDT ⋅ Mar 22, 2017

   Stina (View Comment):
   If there were adequate pricing information and the prices affordable, I would budget to pay out of pocket for the most likely scenarios in my family.

   But you can’t plan without information and there is no information.

   This is so right.

   At the very least we all must agree that the information is confusing and illogical and worrisome. I insist that my bill (or explanation) above is something to watch and when we see it looking like it’s run by a business with some transparency then we can trust it. As things are now this is unacceptable for a modern country and modern financial system.

7. Coolidge
   Chuckles

   @Chuckles

   12:37 PM EDT ⋅ Mar 22, 2017

   Only because it came in the mail today:

   Total billed charges, $175.00

   Plan exclusions, $160.96

   Allowed amount $14.04

   Amount plan pays, $14.04

   Amount you pay, $0.00