8 ms·

Makes one wonder - in the absence of thorough regulation, why a third-party evaluator hasn't arisen to provide real risk analysis for patients regarding each de

Makes one wonder - in the absence of thorough regulation, why a third-party evaluator hasn't arisen to provide real risk analysis for patients regarding each device (the good device seal) - and I'm surprised insurance companies aren't more aggressive in ensuring that they aren't making the patients worse 9which would increase their insurance costs).

Ididntdothis 6y ago
My theory is that insurance companies don’t try to save money as long as they can pass the cost to the patient or whoever pays the premiums. Otherwise I can’t explain the insanity of the charges hospitals are getting away with.
- novok 6y ago
  If your limited to a certain percentage of costs as your profits, you have an incentive to increase costs. Hospitals and insurance enter into an unholy pact to increase costs implicitly as a result.
  - Klinky 6y ago
    Doesn't gaming the system to increase profits by increasing costs show malevolent motives which would not be fixed by removing profit restrictions? I mean if you're "evil" with regulations, why should I trust that removing regulations will make you "less evil"? It sounds like a crook asking you to remove the handcuffs.
    - nickff 6y ago
      Removing the profit regulations has less to do with enabling greed (which exists either way) than it does with aligning incentives. The idea is that you want the insurance companies to profit from patients getting timely, cost-effective care, rather than incentivizing them to drive up costs and delays.
      - Ididntdothis 6y ago
        If you remove the profit regulations insurances will keep doing exactly what they are doing now while making more profit. The won’t pass savings to the patient unless forced to do so. Health care is just a very bad area to apply regular economics. As far as I know most countries have some kind of price control including the US with Medicare.
        nickff 6y ago
        You are proposing a cost spiral due to greed; why doesn't this happen in every industry which provides 'essentials' but has no profit-limiting regulations? Examples would be grocery stores, clothing, transportation, etc. You can say 'this one is different' about every single industry, but why does that difference matter?
        Ididntdothis 6y ago
        Because in all these industries pricing is relatively clear, customers have some level of understanding of the product and they can choose between competitors. In US health care you have zero pricing information, the employer chooses insurance based on their needs, not the patient’s, and people are not in a position to judge the quality of procedures so they do what the doctor tells them. It’s not a functioning market and probably can’t be.
        nickff 6y ago
        Employer-provided healthcare is a result of tax policy, so it is tough to blame that on insurance companies. The average person understands much more about healthcare products than they do about transportation products. Your car is made up of >20k components, and extremely intricately designed. Understanding the factors that go into a reliable car requires a fairly advanced understanding of thermodynamics, metallurgy, fracture mechanics, electronics, software engineering, statistics, and manufacturing. Most healthcare is comparatively primitive. If you're worried about the quality of procedures (as I am), it's a doctor/hospital issue, not an insurance issue. Doctors have very effectively avoided oversight, and they often cause huge problems for their patients. The leading cause of death in hospitals in medical error.
jellicle 6y ago
How exactly would this work? Station someone on the sidewalk outside the hospital and interview people leaving the building? "Excuse me sir, have you received a medical implant today? We're interested in enrolling you in our study group which will take a good deal of your time and give you no benefit..."
- Balanceinfinity 6y ago
  More systematically: offer a "good housekeeping" seal. Presumably those who have good implants will cooperate and open their books so you can look at who they install to and outcomes. Being a reliable 3rd party, cooperating and getting a gold medal seal will help with sales.
  - mattkrause 6y ago
    1) For current patients, how will you get their data. I'm reluctant to give some places my email address; access to my complete medical records for the rest of my life is a giant stretch. 2) For future patients (or their doctors), how will you convince them that your recommendation is credible and not some kind of front for a specific manufacturer?

Ididntdothis 6y ago

My theory is that insurance companies don’t try to save money as long as they can pass the cost to the patient or whoever pays the premiums. Otherwise I can’t explain the insanity of the charges hospitals are getting away with.

novok 6y ago
If your limited to a certain percentage of costs as your profits, you have an incentive to increase costs. Hospitals and insurance enter into an unholy pact to increase costs implicitly as a result.
- Klinky 6y ago
  Doesn't gaming the system to increase profits by increasing costs show malevolent motives which would not be fixed by removing profit restrictions? I mean if you're "evil" with regulations, why should I trust that removing regulations will make you "less evil"? It sounds like a crook asking you to remove the handcuffs.
  - nickff 6y ago
    Removing the profit regulations has less to do with enabling greed (which exists either way) than it does with aligning incentives. The idea is that you want the insurance companies to profit from patients getting timely, cost-effective care, rather than incentivizing them to drive up costs and delays.
    - Ididntdothis 6y ago
      If you remove the profit regulations insurances will keep doing exactly what they are doing now while making more profit. The won’t pass savings to the patient unless forced to do so. Health care is just a very bad area to apply regular economics. As far as I know most countries have some kind of price control including the US with Medicare.
      - nickff 6y ago
        You are proposing a cost spiral due to greed; why doesn't this happen in every industry which provides 'essentials' but has no profit-limiting regulations? Examples would be grocery stores, clothing, transportation, etc. You can say 'this one is different' about every single industry, but why does that difference matter?
        Ididntdothis 6y ago
        Because in all these industries pricing is relatively clear, customers have some level of understanding of the product and they can choose between competitors. In US health care you have zero pricing information, the employer chooses insurance based on their needs, not the patient’s, and people are not in a position to judge the quality of procedures so they do what the doctor tells them. It’s not a functioning market and probably can’t be.
        nickff 6y ago
        Employer-provided healthcare is a result of tax policy, so it is tough to blame that on insurance companies. The average person understands much more about healthcare products than they do about transportation products. Your car is made up of >20k components, and extremely intricately designed. Understanding the factors that go into a reliable car requires a fairly advanced understanding of thermodynamics, metallurgy, fracture mechanics, electronics, software engineering, statistics, and manufacturing. Most healthcare is comparatively primitive. If you're worried about the quality of procedures (as I am), it's a doctor/hospital issue, not an insurance issue. Doctors have very effectively avoided oversight, and they often cause huge problems for their patients. The leading cause of death in hospitals in medical error.

jellicle 6y ago

How exactly would this work? Station someone on the sidewalk outside the hospital and interview people leaving the building? "Excuse me sir, have you received a medical implant today? We're interested in enrolling you in our study group which will take a good deal of your time and give you no benefit..."

Balanceinfinity 6y ago
More systematically: offer a "good housekeeping" seal. Presumably those who have good implants will cooperate and open their books so you can look at who they install to and outcomes. Being a reliable 3rd party, cooperating and getting a gold medal seal will help with sales.
- mattkrause 6y ago
  1) For current patients, how will you get their data. I'm reluctant to give some places my email address; access to my complete medical records for the rest of my life is a giant stretch. 2) For future patients (or their doctors), how will you convince them that your recommendation is credible and not some kind of front for a specific manufacturer?