
The Doctor Is In. Co-Pay? $40,000 - chmars
https://mobile.nytimes.com/2017/06/03/business/economy/high-end-medical-care.html?referer=&pagewanted=all
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carbocation
> For five-figure annual fees, boutique medical services offer the wealthiest
> Americans the chance to cut the line and receive the best treatment.

Whether this buys you the _best_ treatment is highly contestable and, I think,
unlikely. It would probably buy you the _most_ treatment, which is not
necessarily what you want.

On the other hand, the long wait time to see physicians is a real concern, and
it is advantageous to be seen sooner rather than later for essentially every
condition. I think the moral hazard lies in the fact that you can buy access
to earlier care, rather than with the fact that you can buy access to "top"
physicians.

These are empirical questions which can/should be studied.

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jbeales
As someone who lives in a country with socialized medicine, (Canada), the
discussion of hospitals removing "normal" (shared) rooms to replace them with
more-profitable private rooms is disturbing.

Here, private rooms have become the standard that all new hospitals are built
to. Not only are patients generally happier, but they drastically reduct the
spread of germs between patients in hospitals. When my kids were born,
(they're quite young - <6 years old), my wife had a private room. When my son
was hospitalized for a couple of months last fall, he had a private room, with
a couch-ish thing that I could sleep on. We didn't pay extra for these, the
were the only options at the hospitals we were at. These are not special,
private, hospitals in any way, they're just renovated and/or built within the
past decade.

It seems like the profit-based healthcare system south of the border is
keeping patients in shared rooms, which are nearly a generation out of date
here.

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fladrif
Can you explain your first sentence? What is the discussion surrounding shared
vs. private rooms?

~~~
candiodari
If it's anything like Europe, doctors and hospitals get to charge extra (not
covered by the state medical insurance) if the patient is in a private room.
Plus the private room itself costs extra too.

It has different names depending on the country.

PS. private medical insurance may cover the private room thing. Also, doctors
are effectively incentivized to give private room patients preferential
treatment. So it is one source of inequality in Europe's health services.

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JshWright
> “They’re taking him to a local hospital,” Mr. Battelle’s wife, Michelle,
> told Dr. Shlain as the boy rode in an ambulance to a nearby emergency room
> in Marin County. “No, they’re not,” Dr. Shlain instructed them. “You don’t
> want that leg set by an E.R. doc at a local medical center. You want it set
> by the head of orthopedics at a hospital in the city.”

So, tying up an ambulance for a couple hours because they "too good" for an ER
(which would be completely capable of dealing with a broken leg)?

~~~
PhasmaFelis
Yeah, setting a leg bone isn't normally a challenging or delicate procedure. I
feel like either there were complications we don't know about or Dr. Shlain
was bullshitting them to justify his bill.

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PhasmaFelis
> _He sees no reason that the medical world should not respond to consumer
> demand like any other player in the service economy. “Whenever I bump into a
> bleeding-heart liberal, which I am, I mention that schools, housing and food
> are all tiered systems,” he said. “But health care is an island of socialism
> in a system of tiered capitalism? Tell me how that works.”_

I can't decide if this is the "two wrongs make a right" fallacy or the
"whataboutism" fallacy.

[https://en.wikipedia.org/wiki/Two_wrongs_make_a_right](https://en.wikipedia.org/wiki/Two_wrongs_make_a_right)
\-
[https://en.wikipedia.org/wiki/Whataboutism](https://en.wikipedia.org/wiki/Whataboutism)

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FussyZeus
I just love how seemingly everyone involved in this is like "Wow this is so
much, I mean I can't believe money gets you this, but I have the money/have
been given the money so I guess we should do it" like this somehow manifested
out of the thin air and everybody was just going along with it. Horseshit.

At some point, someone sat down with a few other people and proposed "Hey what
if we charge rich entitled people insane fees so they never need to wait among
the proletariat for medical care, you know, the ONE TIME in life when everyone
is more or less equal" and they went along with it and now it's a business.
Because apparently, when you're wealthy, the best thing you can find to do
with your money is demonstrate to everyone else (or at the very least shield
your delicate eyes from the suffering of) those less fortunate.

Crap like this really makes me look forward to capitalisms inevitable
collapse.

~~~
BrandoElFollito
This, until it is your child who is waiting with a broken leg and crying with
pain.

This is the moment where theoretical political ideas go down the drain and you
pull your gold credit card.

~~~
FussyZeus
I guess my theory is take more of that persons money via taxation and make the
hospital work faster and better for _everyone_ , not just his lucky offspring.

~~~
BrandoElFollito
This has never worked in the history of humanity, except maybe in some remote
tribes.

The closest was communism and French Revolution, which failed, among others,
the idea of equality.

