Healthcare in US

[SAPPORO]

Gross underestimation of American innovation & ingenuity. Hope the ingenuity shines bright as ever for India's and rest of the world's sake since more than half of all medical inventions, innovations and drugs originate in the US. India is where US was 30 years ago in terms of lower percentage old people, higher birth rate and less influence of insurance industry on healthcare and so they would badly need these innovations sooner than later.

Actshually that is a good thing. Let America innovate/invent, Indian medical/pharma industry will copy and provide the same service for $100 vs $10K in US - similar to McGraw Hill Low Cost edition text books in engineering that is sold for 15% the cost of US in Nai Sarak market.

My kid is already asking me to take Netflix family subscription in India for fraction of the cost in US and share the password with her. Americans invent Java, Python and latest in tech. Within a month you will find computer institutes in Bareilly and Meerut advertising courses in AI/ML/ Data Science and then export those techies on H1B whereas ABD kids will be spending $200K to acquire the same knowledge here.

I was talking about how innovations can reduce the healthcare costs in the US. But Desi "copiers" have some use as well in spite of the fact they are only good for 'production-support" and not special-ops health procedures. There is no need to go thru pollution, bad infra, lack of property rights, classism, keeping up with the Joshis, inquisitive relatives, far-off from children/grandchildren and so on just so one can pay $100 vs 10K for a medical procedure. One can always live where the cutting-edge technology is fly to India for production-support assembly-line procedures and get to visit Taj Mahal as a bonus. Best of both worlds!

PS: Hopefully, Trump doesn't pour cold water on the patent violations by sanctioning the heck out of India.

[Returning_Indian]

Disclaimer: In my mind, healthcare is about longer life and does not involve letting people die off early!
Innovations are already happening every day to reduce costs. Early detection, non-invasive remote procedures, robotic surgery to name a few. I did not have to go to a hospital to get my colonoscopy and did not have to go thru the painful procedure, but it was done using a stool sample collected at home. Similarly, capsule endoscopy is non-invasive and possibly performed remotely by someone sitting in India, perhaps. Surgeries are going to performed more precisely by robots using AI with all the big data collected on each and every split-second movement currently made by surgeons and analyzing the outcomes.

Coming to India, in a few decades, India would also become a land of the old, entrenched insurance and expensive labor increasing the healthcare costs. To reduce costs, they would need the American innovation in the first place to be able to copy it. Not sure about how long they can violate patent laws blatantly though.

don't know why you think these surgeries done by robots are cheaper than humans (and all the other 'innovation' you listed). They are all more expensive than how it was done previously, both in performance and maintenance. Yes it improves quality of life for recipient but it's actually more expensive. And it's only getting worse with innovation. Innovation is keeping grandpa on ventilator for months/years. None of the things you mentioned are making it any cheaper and that is also a problem. Users have paid for cheap process and when it comes to using healthcare they are using a proces that is 10 times more expensive. This is in turn creating a problem for the program as it is not well funded.

It is all well documented in how the medical inflation (both due to wages and new tech) is spiraling out. It has already more than doubled in last 10yrs. If anything this innovation will only make things worse, financially. Not sure why you think it will bring the cost down. Early detection doesn't mean treatment is cheap. Pure financially speaking it's extending life of someone who was modeled to die earlier and not use services. All the new age personalized medicine is many times more expensive than past treatments and current users have not paid for such innovation. It's coming out of general budget where govt is borrowing to pay for it. And that makes program unviable in long run.

[SAPPORO]

Disclaimer: In my mind, healthcare is about longer life and does not involve letting people die off early!
Innovations are already happening every day to reduce costs. Early detection, non-invasive remote procedures, robotic surgery to name a few. I did not have to go to a hospital to get my colonoscopy and did not have to go thru the painful procedure, but it was done using a stool sample collected at home. Similarly, capsule endoscopy is non-invasive and possibly performed remotely by someone sitting in India, perhaps. Surgeries are going to performed more precisely by robots using AI with all the big data collected on each and every split-second movement currently made by surgeons and analyzing the outcomes.

Coming to India, in a few decades, India would also become a land of the old, entrenched insurance and expensive labor increasing the healthcare costs. To reduce costs, they would need the American innovation in the first place to be able to copy it. Not sure about how long they can violate patent laws blatantly though.

don't know why you think these surgeries done by robots are cheaper than humans (and all the other 'innovation' you listed). They are all more expensive than how it was done previously, both in performance and maintenance. Yes it improves quality of life for recipient but it's actually more expensive. And it's only getting worse with innovation. Innovation is keeping grandpa on ventilator for months/years. None of the things you mentioned are making it any cheaper and that is also a problem. Users have paid for cheap process and when it comes to using healthcare they are using a proces that is 10 times more expensive. This is in turn creating a problem for the program as it is not well funded.

It is all well documented in how the medical inflation (both due to wages and new tech) is spiraling out. It has already more than doubled in last 10yrs. If anything this innovation will only make things worse, financially. Not sure why you think it will bring the cost down. Early detection doesn't mean treatment is cheap. Pure financially speaking it's extending life of someone who was modeled to die earlier and not use services. All the new age personalized medicine is many times more expensive than past treatments and current users have not paid for such innovation. It's coming out of general budget where govt is borrowing to pay for it. And that makes program unviable in long run.

Not sure why you keep saving innovation and automation would not reduce costs. In the next decade, Americans can probably have a robotic surgery in their own bed with only a nurse setting up and supervising the process. No costly surgeons, no hospital bills!

"Medicare going bankrupt" is as much a scare-tactic as "Immigrants are killing people' which comes up every 4 years. It was supposed to go bankrupt in 2003.But it stayed solvent in spite of the bad economy for the entire decade due to the fact that the pool became stronger with the inclusion of a lot of younger-old people in their 60s from the baby boomer generation. It will be fine as long as the economy is humming.
According to some estimates, all it needs to stay solvent in the long term is an insignificant 0.35% increase in the payroll taxes without any other changes.

https://www.kff.org/medicare/issue-brie ... -solvency/

[r2somewhere]

US has the best healthcare if you are worth more than USD 15-20 million.

Means only NVDA employees

Top 1% is in the $15M range. What happens to the rest of the 99% of Americans - do they just die on the streets next to the hospitals waiting for a specialist appointment?!

Whatever happens to the bottom 99% in India!

[Returning_Indian]

Just heard a story of 19yr old working in construction, no health insurance. Got into an accident, was at fault. Had major injuries, cannot work for 2yrs. Probably not on parent insurance either. Now owes $115k to hospitals. I guess at 19 you are not smart enough to understand repercussions but parents should have pushed the child to keep health insurance. Or maybe because at this age you feel invincible. Cars and girls is what matters the most. But obviously this sucks as his credit history will be ruined for next 7yrs. I thought car insurance came with accident medical cover but I suppose it's not when you are at fault. Who knows there are always these loopholes.

There has to be a solution where healthcare in richest country in the world should not be the shittiest. Universal is obviously not the answer as other countries are struggling with it.

[SAPPORO]

Just heard a story of 19yr old working in construction, no health insurance. Got into an accident, was at fault. Had major injuries, cannot work for 2yrs. Probably not on parent insurance either. Now owes $115k to hospitals. I guess at 19 you are not smart enough to understand repercussions but parents should have pushed the child to keep health insurance. Or maybe because at this age you feel invincible. Cars and girls is what matters the most. But obviously this sucks as his credit history will be ruined for next 7yrs. I thought car insurance came with accident medical cover but I suppose it's not when you are at fault. Who knows there are always these loopholes.

There has to be a solution where healthcare in richest country in the world should not be the shittiest. Universal is obviously not the answer as other countries are struggling with it.

All he needs to do is to negotiate with the hospital to bring down the bill 80-90% down and get into a payment plan of as low as $25 for 20-30 years or apply for charity care. I know this since when my son crashed into a utility pole, and we had only $10K as property damage coverage insufficient to cover the damages but was able to enter into a payment plan with even the utility company for $25 a month for 20 years! All one has to do is to google, go on reddit and ask for help.

[r2somewhere]

There has to be a solution where healthcare in richest country in the world should not be the shittiest. Universal is obviously not the answer as other countries are struggling with it.

Which country has healthcare running right?

[Returning_Indian]

Just heard a story of 19yr old working in construction, no health insurance. Got into an accident, was at fault. Had major injuries, cannot work for 2yrs. Probably not on parent insurance either. Now owes $115k to hospitals. I guess at 19 you are not smart enough to understand repercussions but parents should have pushed the child to keep health insurance. Or maybe because at this age you feel invincible. Cars and girls is what matters the most. But obviously this sucks as his credit history will be ruined for next 7yrs. I thought car insurance came with accident medical cover but I suppose it's not when you are at fault. Who knows there are always these loopholes.

There has to be a solution where healthcare in richest country in the world should not be the shittiest. Universal is obviously not the answer as other countries are struggling with it.

All he needs to do is to negotiate with the hospital to bring down the bill 80-90% down and get into a payment plan of as low as $25 for 20-30 years or apply for charity care. I know this since when my son crashed into a utility pole, and we had only $10K as property damage coverage insufficient to cover the damages but was able to enter into a payment plan with even the utility company for $25 a month for 20 years! All one has to do is to google, go on reddit and ask for help.

It is possible to negotiate with hospitals. I was able to get lot of my bill waived off back in 2002, except for Indian doctors who didn't reduce a penny. But in last few years it's becoming difficult as hospitals are not willing to negotiate anymore. They would rather sell it cheap debt than negotiate with patients. Charitable programs are also reduced significantly. Things have changed for the worse and lot of it has to do with intense negotiations by insurance companies and less profits for hospitals. It is also driven by guidance from their investors.

[SAPPORO]

Just heard a story of 19yr old working in construction, no health insurance. Got into an accident, was at fault. Had major injuries, cannot work for 2yrs. Probably not on parent insurance either. Now owes $115k to hospitals. I guess at 19 you are not smart enough to understand repercussions but parents should have pushed the child to keep health insurance. Or maybe because at this age you feel invincible. Cars and girls is what matters the most. But obviously this sucks as his credit history will be ruined for next 7yrs. I thought car insurance came with accident medical cover but I suppose it's not when you are at fault. Who knows there are always these loopholes.

There has to be a solution where healthcare in richest country in the world should not be the shittiest. Universal is obviously not the answer as other countries are struggling with it.

All he needs to do is to negotiate with the hospital to bring down the bill 80-90% down and get into a payment plan of as low as $25 for 20-30 years or apply for charity care. I know this since when my son crashed into a utility pole, and we had only $10K as property damage coverage insufficient to cover the damages but was able to enter into a payment plan with even the utility company for $25 a month for 20 years! All one has to do is to google, go on reddit and ask for help.

It is possible to negotiate with hospitals. I was able to get lot of my bill waived off back in 2002, except for Indian doctors who didn't reduce a penny. But in last few years it's becoming difficult as hospitals are not willing to negotiate anymore. They would rather sell it cheap debt than negotiate with patients. Charitable programs are also reduced significantly. Things have changed for the worse and lot of it has to do with intense negotiations by insurance companies and less profits for hospitals. It is also driven by guidance from their investors.

Valid point about hospitals not willing to negotiate since they are now taken over by private equity companies and big corporations like Amazon and CVS health. But charity care is mostly funded by the govt, and no one would be going after this 19-year-old with limited means.

For example, I had recent experience with UPMC, one of the premier university hospital systems in the country. Lesser-known fact is that they provide 100% assistance for a typical family of 4 with income up to 95K and 80% assistance for income up to 125K! Considering PA's median household income is only 75K, an overwhelming majority of its residents would qualify for this assistance.

https://www.upmc.com/locations/hospital ... arity-care

[SAPPORO]

What you see is not what you get in pharma/insurance industries. They appear to be capitalist but underneath they're actually socialist. A friend of mine had to go on an expensive bimonthly medication that needs to be injected, and it has a list price of around 7K per month. But the pharma company gives them a savings card that knocks his costs all the way down to $0. The pharma company pays the insurance company on behalf of the patient until the annual deductibles are met so that insurance company can pay for it fully after that for the rest of the plan year.

In short, pharma companies throw the baitfish to catch the big fish, and everyone's premiums goes up resulting in the socialized healthcare!

I guess the same "strategy" of paying the all or part of the deductible and having the insurance company pay for the rest, is used by roofers as well.