Redefining health care

What Hacker News says

1. dhbradshawMay 2008
   WalMart can help by offering inexpensive pharmaceuticals. I don't know if they can help overcome a larger problem. The problem seems to be that health care providers do not compete on value delivered. Until we effectively measure value (long term benefit divided by cost) delivered and compare it across providers we will have no way to use the market to stimulate improvement.

   Right now we don't measure long term benefits and decisions are insulated from costs.

   (Yeah, I drink the Kool aid: http://www.amazon.com/Redefining-Health-Care-Value-Based-Com...)

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2. djsumdogJan 2018
   This is what was talked about in the book "Redefining Health Care." The employer based model is totally broken.

   What you're describing is more open capitalism in health care where everyone is on an open playing field. I use to really believe in this at one point years ago, even when working in Health Insurance.

   Today, I'm not even for this compromise. I think it should be taken out of our taxes in single payer. Insurance would still be contracted out to those private insurers (cause America). We might even be able to create a system where people chose which insurance provider they use, but it should be payed for by taxes .. it's there for everyone and everyone pays the same proportion of income and everyone gets the same level of coverage. If something is in short supply, then it's going to need a needs based + lottery system (just like organ transplants currently).

   For profit and _non-for-profit_ (not to be confused with non-profits; most health care companies are non-for-profits which is a weird legal area) have no place when it comes to public welfare services. People don't pay individually for private security/police. We don't pay for fire. We don't pay a fee to visit a city park (and I'm against fee based national parks actually). The general good should be paid for equally by everyone to their abilities.

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3. djsumdogJan 2017
   I worked for a health care insurance company during the 2008 debates on the cost and quality web applications.

   Like people have mentioned, they only gave a range, and a useless one at that. This was during the big push to HSAs and how healthy people could save using them and roll that money over to an IRA later in life to aid in retirement, or kept in the HSA for medicare costs.

   We read Redefining Health care at work and there was a lot of talk, but always with the for-profit ends (even through we were a non-for-profit, not to be confused with a non-profit).

   I left the US for a while and I found it interesting that in other countries, doctors could always tell me a price. An office visit was never more than $70 and when I got better work visas, the doctors offices even worked with me to get a better rate (even though I didn't have a full residence visa needed for Medicare).

   Every lab I went to for imagination told me the price on the phone.

   The Affordable Care Act is terrible. I does help the very poor, but everyone in the middle still struggles between many terrible options. Contractors often get the worst plans that have little to no substantiation.

   I have not seen a doctor for a year and only have minimal effective coverage ($17). Full plans from my employer start at $400/month. I've open enrolled in an ACA plan for next year, but it's still $200 a month and I plan on quitting my job and travelling. Because it's based on last year's income, I can't switch to a low income plan until the following year.

   Employers should have been banned from offering plans at all, or at the very least, giving any discounts. But really, we should have a single payer system. The current state of health care under the ACA is still not good, and far from our European counterparts.

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