News for hackers. Stuff that matters.
Re:The ER charged him $6,589.77 for 6 stitches, cost that le... by HPsquared on Saturday November 20, 2021 @06:51AM (#29287281)
The stitches are expensive mostly because of many regulatory factors that restrict the supply of medical services and drive costs up, with the "free market" component being in how much they can charge the patients. It's the worst of both worlds in the US.
Re:The ER charged him $6,589.77 for 6 stitches, cost that le... by helloguillecl on Saturday November 20, 2021 @06:55AM (#29287304)
I can tell you that you cannot freely open a clinic in Chile, and Doctors have the monopoly on many treatments that are delivered by nurses or other workers in Europe. Becoming a Doctor is not easy, and foreign Doctors must go through difficult tests before working for the public system.

Additionally, I remember that many supplies come from... the United States? So what regulations are you talking about?

Maybe you meant monopolies?

Re:The ER charged him $6,589.77 for 6 stitches, cost that le... by chiph on Saturday November 20, 2021 @07:26AM (#29287482)
There's three areas that I'm aware of. Certificates of Need, which some states require before you can offer certain services (like MRI/CT scanning). Supply contracts, where a hospital has a pre-set price for consumables like IV solutions, scalpels, and bandages with a supplier. And advertising.

The Certificate reduces competition because they impose geographical exclusivity. If you want to buy a MRI machine for your clinic, you cannot if the state determines if your area already has enough of them. And if you file a Certificate with the state intending to buy one, your nearby competitors are likely to place objections to your purchase. This is because the machines are expensive and the other clinics want to ensure their investment gets paid for. But this process also ensures they're expensive because the machines aren't able to be built in volumes large enough to result in a cost reduction.

The supply contracts make things easier for the hospital, as they only have to deal with one supplier for an item or class of item. The price is known up front for the duration of the contract. But this also means that the hospital cannot change suppliers if another one has a lower price for the same item midway through the contract period, reducing competition. They also restrict choice by the doctors at the hospital - doctors have strong preferences for items like gloves because of sizing & fit, and the way they transmit feeling through them (thinness, texture, etc). If a hospital changes suppliers to one that doesn't carry their favorite glove, they aren't able to perform as well. And they can't bring their own into the operating room because of liability.

I don't know how many advertisements you see in Chile for medicine, but here in the US I would guess that a quarter of advertisements on TV are for them. All those ads cost a lot of money, and they're not being targeted at doctors, but patients: "Ask your doctor if {brand} is right for you"

Re:The ER charged him $6,589.77 for 6 stitches, cost that le... by vidarh on Saturday November 20, 2021 @07:46AM (#29287611)
The certificate of need business seems bizarre. I live in London, and the place is so crowded with clinics offering cheap MRIs it's ridiculous, despite the fact you'll get them covered in the NHS I'd you actually need them (literally the very first ad I found for MRIs offered them for 200 pounds).
Re:The ER charged him $6,589.77 for 6 stitches, cost that le... by maxerickson on Saturday November 20, 2021 @09:08AM (#29288182)
The incumbent providers like the restriction on competition.
Re:The ER charged him $6,589.77 for 6 stitches, cost that le... by helloguillecl on Saturday November 20, 2021 @07:44AM (#29287596)
Well, I think then you'd agree with that we need the right regulation so the right incentives are put in place, and that at best would be better not to have the industry dictate the regulation, that in this case sounds absurd.

I was very surprised the first time I watched an open-tv US Channel seeing thousand of ads for prescription medicine. Which I believe are forbidden the countries I have lived in (CL, ES, DE)

Re:The ER charged him $6,589.77 for 6 stitches, cost that le... by coldtea on Saturday November 20, 2021 @08:04AM (#29287731)
We have more "regulatory factors" in Europe, and much cheaper treatment... Like 1/40 or so as much in this case...
Re:The ER charged him $6,589.77 for 6 stitches, cost that le... by nameunimportant on Saturday November 20, 2021 @08:11AM (#29287770)
WHen I stopped living in the USA, I realized that there is only one reason the USA is behind the rest of the developed world when it comes to healthcare, a social safety net and education. The USA likes it that way.

The American culture is one of rugged individualist pioneering cowboys who won't be told what to do, even if you're warning them that if they take another step they'll fall off a cliff.

Re:The ER charged him $6,589.77 for 6 stitches, cost that le... by christophilus on Saturday November 20, 2021 @08:32AM (#29287903)
I don’t think it’s the rugged individualism that’s at fault, so much as an emergent, insane incentive structure that has grown out of control. The confluence of big insurance, big hospitals/ practices, and regulatory capture have given us a completely warped system.
Re:The ER charged him $6,589.77 for 6 stitches, cost that le... by adnmcq999 on Saturday November 20, 2021 @08:56AM (#29288080)
In just what century did you live here?
Re:The ER charged him $6,589.77 for 6 stitches, cost that le... by kcplate on Saturday November 20, 2021 @11:15AM (#29289328)
Definitely a common mindset, particularly of gen x and generations prior. I know I have it. Wouldn’t surprise me a bit if someone born and raised outside the us came away with this impression after living here for a while.

Honestly when I read the headline my first thought was “six stitches? Crazy glue is cheaper…”

Re:The ER charged him $6,589.77 for 6 stitches, cost that le... by throwaway0a5e on Saturday November 20, 2021 @07:57PM (#29293205)
>Honestly when I read the headline my first thought was “six stitches? Crazy glue is cheaper”

Unless you live across the street from the hospital it's just less hassle to do it that way. Any injury not worthy of an ambulance can be cleaned, glued and taped in the time it would take to sit in the waiting room while they serve all the people who are dying faster.

Re:The ER charged him $6,589.77 for 6 stitches, cost that le... by nameunimportant on Sunday November 21, 2021 @01:57PM (#29298717)
1979 - 2015, I finally escaped and haven't returned since, happily.
Re:The ER charged him $6,589.77 for 6 stitches, cost that le... by watwut on Saturday November 20, 2021 @07:04AM (#29287360)
Regulatory factors exists in all mentioned countries. Medical services being restricted is not some kind of exception.
Re:The ER charged him $6,589.77 for 6 stitches, cost that le... by temac on Saturday November 20, 2021 @08:03AM (#29287726)
Not so sure for the impact of regulatory. Tons of other countries/areas have equivalent regulatories req, if not more strict, yet does not yield to absolutely insane prices.

Regulatory is there to prevent e.g. killing patients in a Therac-25 like events. When you have a too weak reg, you end up with things like 737-max situations.

Now maybe regulatory can also go too far in some niches, but the correct solution is not to blindly go in the other direction.

And anyway, absurd prices in cases of e.g. ER are most of the time explained not by the cost of medical supplies but by random attempts to purely extorts the patients: 6 stiches and a shot do not imply thousands of dollar of BOM, nor are physicians paid hundreds per minute. Look at the cost of covid vaccines if you want to know more realistic costs.

Re:The ER charged him $6,589.77 for 6 stitches, cost that le... by tasubotadas on Saturday November 20, 2021 @06:59AM (#29287328)
Exactly. What the US lacks is actually more liberal market in health. Less regulations and more competition.

When talking about regulations people usually mean regulating pricing and/or service quality but what actually needs to be tackled are the factors that limit competition, like: - process for opening new clinics/hospitals should have little to none restrictions - requirements for doctors (no doctors from outside can work in the US unless they complete $400k degree) - Drugs from outside countries should be allowed to be imported without FDA's approval

and so on

Re:The ER charged him $6,589.77 for 6 stitches, cost that le... by namdnay on Saturday November 20, 2021 @07:20AM (#29287454)
None of the other countries being discussed have any of that, and yet their systems work fine. So I don’t think the solution is there