This weekly roundup thread is intended for all culture war posts. 'Culture war' is vaguely defined, but it basically means controversial issues that fall along set tribal lines. Arguments over culture war issues generate a lot of heat and little light, and few deeply entrenched people ever change their minds. This thread is for voicing opinions and analyzing the state of the discussion while trying to optimize for light over heat.
Optimistically, we think that engaging with people you disagree with is worth your time, and so is being nice! Pessimistically, there are many dynamics that can lead discussions on Culture War topics to become unproductive. There's a human tendency to divide along tribal lines, praising your ingroup and vilifying your outgroup - and if you think you find it easy to criticize your ingroup, then it may be that your outgroup is not who you think it is. Extremists with opposing positions can feed off each other, highlighting each other's worst points to justify their own angry rhetoric, which becomes in turn a new example of bad behavior for the other side to highlight.
We would like to avoid these negative dynamics. Accordingly, we ask that you do not use this thread for waging the Culture War. Examples of waging the Culture War:
-
Shaming.
-
Attempting to 'build consensus' or enforce ideological conformity.
-
Making sweeping generalizations to vilify a group you dislike.
-
Recruiting for a cause.
-
Posting links that could be summarized as 'Boo outgroup!' Basically, if your content is 'Can you believe what Those People did this week?' then you should either refrain from posting, or do some very patient work to contextualize and/or steel-man the relevant viewpoint.
In general, you should argue to understand, not to win. This thread is not territory to be claimed by one group or another; indeed, the aim is to have many different viewpoints represented here. Thus, we also ask that you follow some guidelines:
-
Speak plainly. Avoid sarcasm and mockery. When disagreeing with someone, state your objections explicitly.
-
Be as precise and charitable as you can. Don't paraphrase unflatteringly.
-
Don't imply that someone said something they did not say, even if you think it follows from what they said.
-
Write like everyone is reading and you want them to be included in the discussion.
On an ad hoc basis, the mods will try to compile a list of the best posts/comments from the previous week, posted in Quality Contribution threads and archived at /r/TheThread. You may nominate a comment for this list by clicking on 'report' at the bottom of the post and typing 'Actually a quality contribution' as the report reason.
Jump in the discussion.
No email address required.
Notes -
Not giving prices is more misleading and confusing. Hence the legislation efforts and assassinations. Stop acting like people are so stupid that they can't understand costs/benefits. Inform your patients, just like you do with medical costs/benefits, even though there is also a knowledge gap there, too. Stop practicing unethically.
I'm hoping we don't go there, but you need to fix things. Ask the techies in the IoT space how just stomping their feet, refusing to do anything, and resting on, "Regulation is bad, m-kay," worked for them.
This is utterly false and is completely unsupportable. You couldn't imagine saying such a thing for any other industry, because it's nonsensical.
I'm glad that you had no problem with the entire rest of my list of benefits. Given that the only benefit you gave on your side rests on the assumption that everyone else is too stupid (a bad assumption) that you need to be appointed to keep them in the dark and make all their choices for them (which isn't likely to help, anyway; how are you currently preventing them from going to the hospital where they happen to end up with the bill for $300k?), I think it's pretty clear that your approach is not helping. It's hurting. It unethical. It's bad business practice. It's bad economics. There is nothing good about what you are doing.
NYT had a doctor apologist op-ed this morning. Hilariously skewed, of course, but they also disagreed with you.
Costs matter. Inform your patients. Stop lying and saying that they don't. I've given you a long list of reasons; compared to your one, extremely terrible reason for doing what you're doing, the choice is clear.
Costs matter for some things, you gave a good example which is drugs. We will set people up with GoodRx, use generics, inform people of choices they can make amongst similar options and so on.
That is not what you are talking about though, you are suggesting that hospital services provide information on some combination of cost/price/charges.....but those things don't matter to patients.
What your insurance does with that service at that hospital is not something the hospital is in charge of and therefore completely untethers this information from decision making.
The more expensive option is very often cheaper for the patient.
Medicine is not like other industries. I don't know how many times I can tell you this. We are often legally prohibited from considering cost or making less expensive choices. Your intuitions are wrong and do not apply.
If you would like to make medicine like other fields then propose that. It may even be a better state, but most people have decided that the drawbacks are unacceptable.
Medical care in the U.S. does not function as a market. If you assume it will function as a market you will be wrong about your conclusions.
If you would like it to function as a market....don't push it further away from a market by adding on more regulatory burden and unnecessary complexity.
Awesome. I'm glad we've made progress. Start giving prices. Sometimes, they won't matter. Do it anyway. Sometimes, they matter. You can do it. Just do it.
Wouldn't it be nice if they had a way of getting this information? Perhaps you could help. You could, for example, share the information that you have with them. You've agreed that you do have relevant information. We all know that it's not perfect, but it can be useful. You've agreed that you do give it to patients sometimes. Just do it.
We are talking about patient choices.
Mostly because you do shit like lie and hide prices. Stop hurting. Start helping.
What value does a posted price of a gallbladder removal provide for a patient if:
That number is incorrect the majority of the time due to clinical circumstances.
That price is not what anybody involved (either the insurance or the patient) actually pays.
Remember, if they make decisions off of this information they may spend more money.
The cheaper sticker price can be more expensive by hundreds of thousands of dollars.
At this point I think you make a compelling argument for why this information should not be delivered to patients. I'm sure many people would understand the problem here, but you post here and are therefore presumably reasonably intelligent and educated and you don't seem to get it.
What you are asking for is anti-information, in the sense that is intrinsically inaccurate, unhelpful, unrelated, and may lead people to make the wrong decision.
If you want to know how much something costs a patient, ask the person who is actually paying for it...the insurance. Why are we involved when it's the insurance who decides what things costs and how much to pay. You want patients not to be surprised by uncovered stuff? Ask the person who decides what is covered.
We are not in charge of this for gods sake.
You can provide them the information that you have. That includes information like negotiated prices, so they are not only looking at sticker prices.
You are both parties to the determination of price. If you don't think you're involved at all, then I will just go tell all the health insurance CEOs that they can stop getting shot by just paying you $1 for everything. After all, you're not involved at all with anything related to prices, so that couldn't change anything, right?
...or are you involved somehow?
Again, the only group that actually gains anything from maximally clear information is insurance companies since it improves their bargaining position. This information has no practical value to consumers and as is self-evident at this point, is confusing and misleading.
So is your goal to improve profits and rent-seeking for insurance?
If your goal is improve consumer choice or spending, or decrease healthcare costs...pick something that does that.
You are not providing any information to the insurance company. They already get the price that you charge them (that's in the bill that you send them); they already have the negotiated price (you both agreed to it). You are providing information to your patients.
EDIT: I love how it magically changed from totally meaningless information that was complete nonsense, because the insurance company decides everything anyway and they have it all anyway.... to absolutely critical and vital information, such that if the insurance company gets even a whiff of it, it'll be an insane disaster. Like wow, dude. Listen to yourself.
This information has no value to patients. You cannot use this information to make more informed decisions. You cannot use this information to find cheaper care. Or more expensive care. You can give them false certainty, that's about it.
In situations where the information has value (like prescriptions)....we give this information to patients and there are a number of robust tools to facilitate this, even apps.
You are asking for something that has no value and has costs. Stop doing that. This is why healthcare is expensive. If you want to improve something please do! I'll support you. Don't make things more expensive for no reasons for fucks sake.
You already agreed that it can have value. Just give them the information that you have. You're out of excuses.
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link