Hacker News Reader

Comment by ojiikun | Hacker News Reader

Every time a healthcare discussion comes up and everyone gets derailed on whether (or how much) to socialize things, I wonder the following:

from a technology, taxation, and moral standpoint, what the hell led to a system where some heavy-duty antibiotics cost about 10-15X what they should? More importantly, why do generally intellegent audiences get caught up in arguments over socialism rather than correcting the cost issue first? Is it sue-happy lawyers, is is an anti-competitive marketplace, or is it the pushing of the very concept of insurance that has given us such an unsustainable system?

I truly want to put out a call to geeks: for every healthcare dollar you spend, grill your provider. Haggle them down, and make them justify the price, or we're all screwed, no matter who is paying for things.

View on HN

The reason is simple. Many folks, myself included, hold the view that it is government intervention that has led to the insane system currently in place. Eliminating the perverse healthcare system forced on us by current policy IS the way to control the cost issue.

Most other industrialized countries have heavy government involvement and pay half what we do with the same outcomes. We just have a hybrid system with capitalism applied in the stupidest way..

This statement sounds totally odd to me on both ends.

First, the US pays more in a lot of markets. By and large, that's because we can.

Second, capitalism isn't applied. That sounds like it's some sort of regulatory tool that just isn't being used correctly. Capitalism is the absence of government force in an economic market with the notable exception of enforcing private property rights. You can say a lot about the US healthcare situation, but "applied capitalism" it is not.

...which goes to show that socialized health-care can even be worse.

> Most other industrialized countries have heavy government involvement and pay half what we do with the same outcomes.

I lived in Canada for 10 years. I live in the US now. While living in Canada, I paid more to the government then I pay now. My health care costs for myself and my family are much cheaper. In fact, ignoring the costs of insurance (which was effectively the same) and taxes (which were 3 times higher in Canada, and on everything), my costs for equal service I receive now would have been more than $36,000 more in Canada. That's partly a lie though. The services would not have been equal, as we can get home care here, whereas in Canada, we could not.

This also ignores the 1-2 year waiting list for private care we would have had to deal with in Canada. In the US, we had treatment started within 2 weeks of moving here.

Well, if you want dueling anecdotes, I lived in the U.S. for years, and now live in Denmark, and I pay much less for healthcare coverage now. My sole healthcare expense now is 8% of my salary that goes to the flat health-system tax, whereas in the U.S. I not only had to pay Medicare taxes and general income taxes that supported various kinds of healthcare, but also had to pay a large copay. And, my coverage was tied to my employment, which it isn't anymore.

You make an assertion that the heavy duty antibiotics cost 10-15x what they should? How do you know what they should cost?

    - How much money did it take to develop them? (Count the failures in your estimate)
    - What is the supply vs demand for them? (demand is probably low since you don't want to use these unless you really need to)
    - What's the shelf life for them. 
        - Do hospitals have to toss them if they don't get used? 
        - Do they have to keep them on hand or can they be Just In Time manufactured and delivered in an emergency?

As others have said here the real problem is lack of transparency into these issues. Speculating about what the cost of antibiotics should be only adds to the cloud of misinformation around medical billing.

I agree though that demanding more transparency is a good thing.

Reply on news.ycombinator.com