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Comment by iso1631 | Hacker News Reader

Healthcare demand seems to be boosted by the profit motive. The healthcare industry has an incentive to increase healthcare usage - by oversubscribing unneeded drugs and procedures and through constant daytime adverts about "talk to your GP about thing which has a list of side effects longer than the commercial break"

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In the US we actually use quite a bit less healthcare than some other places in the developed world (Japan, for example). Which is what you would expect, that our high prices would reduce the consumption of healthcare. We in the USA have come to believe, as a society, that healthcare is exorbitantly expensive. But it's not actually exorbitantly expensive to provide healthcare, we just pay exorbitantly high prices. Which actually helps convince us that healthcare is, by nature, exorbitantly expensive.

I can tell you from sitting in meetings with insurance brokers that people (employees) consume healthcare with very little regard for price. ER and urgent care usage is too high, MRI's vary in price in the same city by 400%, but there is no price discrimination going on for the consumer because they just pay a copay or less (if they've hit their deductible) - it's "free". You say we actually use quite a bit less healthcare, but I'm not sure who "we" is. "We" make dumb decisions about healthcare - preferring UC clinics to preventative healthcare and sanitation, we overpay because we can't price shop services, we don't know the actual costs of what we're consuming and so make very dumb decisions, and sorry, that opaqueness is by design. It's a fantastic money machine.

Notice, you're not complaining about employees using too many health services, you're complaining about you and your employees getting massively overcharged for the (let's be honest, relatively few) healthcare services they get.

My point is -- almost none of those things should have exorbitantly high prices, because they don't actually cost that much.

Do urgent care centers actually use an exorbitant amount of resources to provide health care services? They do not. Does getting any MRI actually consume thousands of dollars of resources, even counting labor? It does not.

To me, the main reason we still have not had meaningful healthcare reform in this country is that Americans have seen the made up numbers on those ridiculous works of fiction called "medical bills" and "statements of benefits" for long enough, that they think they are real. They are not.

Yep, I wasn't (intentionally) disagreeing with you, though if I were nit-picking, I'd say they're using too much of the wrong services - going to the emergency room for a tooth ache or some similarly minor reason would maybe get a second thought if they saw how much it cost. When I went for several years without any insurance (starting a business), I became far more discriminating on the services I was paying out of pocket for, and also opted not to go to the hospital for minor stuff I would have gone to when I had insurance.

Yeah, this is definitely part of the reason for the cost, but overall healthcare is pretty inelastic.

(Ads for meds are so odd: I spent a couple of years in Canada and they don't do that there and it was bizarre coming back to the US and hearing them.)

Another reason for this is that Americans are so litigious: tests are ordered because otherwise the patient can sue. Which in turn is the case because the only way to hold companies/professionals accountable is to sue them. I'm not sure what the answer is.

In the UK we have medical malpractice too (and far to much of it), but we also define what tests are expected. My understanding is the people defining those tests aren't incentivised to overtest (by companies trying to sell the tests) or undertest (through fear of being sued).

Yeah, I imagine having some sort of central authority (NHS) against which even private practitioners can compare themselves helps here. American healthcare is just chaos. I guess the closest thing here would be Medicaid/Medicare but even those are administered through private companies with variances in what is covered.

Also there's probably less resorting to suing in the UK since people whose doctors mess up can get the resulting problems treated. In the US, if a doctor fucks up and you need more treatment, it can bankrupt you and the only way to recoup the costs is to sue.

The article's about health care, not healthcare the neologism.

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