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robinhanson's profile
Robin Hanson
Robin Hanson
Robin Hanson
Verified account
@robinhanson

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Robin HansonVerified account

@robinhanson

Let's skip witty repartee & position taking, & discuss enduring fundamental questions. (& my books: http://ageofem.com , http://elephantinthebrain.com )

Fairfax, VA
hanson.gmu.edu
Joined July 2007

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    Robin Hanson‏Verified account @robinhanson Oct 21

    “cosmetic & LASIK surgery – two areas where third party payers have never been involved. In both fields there is price transparency & price competition. … real price has been falling … despite a huge increase in demand … [&] major tech. innovations."https://www.forbes.com/sites/johngoodman/2018/10/02/employers-could-slash-their-health-costs-overnight-so-why-dont-they/#7ccf87d75421 …

    4:37 PM - 21 Oct 2018
    • 185 Retweets
    • 384 Likes
    • Jokari WhySpace Travis Root 2002FlyNigga Daniel McAuley Purple Koolaid Bob Wakefield Donna W Davis and Jones Law
    13 replies 185 retweets 384 likes
      1. New conversation
      2. Dil Green Self Sovereign Data Commons Now!‏ @dilgreen Oct 21
        Replying to @robinhanson

        Interesting, surely, that both types of procedure are voluntary, not life-saving. I can't see these as commensurate in any meaningful economic (as opposed to sectoral) sense.

        1 reply 0 retweets 2 likes
      3. Robin Hanson‏Verified account @robinhanson Oct 21
        Replying to @dilgreen

        The fact that they are not life-saving explains why they are not insured. But not being insured seems to influence price transparency, cost drops, etc. Should make you think twice about wanting to insure so many things.

        3 replies 0 retweets 7 likes
      4. Mita‏ @dmisic Oct 22
        Replying to @robinhanson @dilgreen

        No, not being life saving means that they are classic commodities so they act just like any other classic commodity. So I can not only take time to choose best provider I can also choose not to do it.(and not die or severely affect my health)

        1 reply 0 retweets 3 likes
      5. Robin Hanson‏Verified account @robinhanson Oct 22
        Replying to @dmisic @dilgreen

        You can choose providers before an emergency, so that isn't what makes something deviate from being a classic commodity.

        3 replies 0 retweets 1 like
      6. Mita‏ @dmisic Oct 22
        Replying to @robinhanson @dilgreen

        you do have a point But (I'm not from US, so do correct me if I'm wrong) it's not the problem of transparency of insurance (we know what our premiums, copays etc are) It's the hospital costs that are unpredictable and opaque so you only encounter surprizes once you end up there?

        1 reply 0 retweets 0 likes
      7. Robin Hanson‏Verified account @robinhanson Oct 22
        Replying to @dmisic @dilgreen

        Its the kind of contract, not the fact of advanced purchase. Eg having a roof over your head is a strong necessity, but you can contract to rent a place ahead of time, so it can be a simple commodity.

        0 replies 0 retweets 4 likes
      8. End of conversation
      1. New conversation
      2. endril‏ @ndril Oct 21
        Replying to @robinhanson

        I used to work for one of the major insurance companies, and we did offer coverage for LASIK.

        1 reply 0 retweets 3 likes
      3. Jonathan G. Harris‏ @jgharris7 Oct 21
        Replying to @ndril @robinhanson

        I know people who have used insurance coverage for Lasik. I have gotten vaccines and other procedures done at Minute Clinic and covered by my insurance. Thus it is not the existence of insurance that is at fault. Sorry, Social Darwinists, you will have to try again.

        1 reply 0 retweets 1 like
      4. Robin Hanson‏Verified account @robinhanson Oct 21
        Replying to @jgharris7 @ndril

        The issue might be how most people buy a product - rare exceptions won't make a big difference.

        1 reply 0 retweets 6 likes
      5. Jonathan G. Harris‏ @jgharris7 Oct 22
        Replying to @robinhanson @ndril

        Show data proving that these are exceptions. Every plan I have had covers Minute Clinic visits. Many plans also have rather significant deductibles, e.g. >$1000 and ACA exchange plan deductibles are far higher. It is backroom deals, not insurance coverage that is the problem

        0 replies 0 retweets 1 like
      6. End of conversation
      1. New conversation
      2. Tim Freeman‏ @ovjocm Oct 22
        Replying to @robinhanson

        I thought the story was that the medical prices in the US are insane in part because the AMA artificially limits the supply of doctors. How do the cosmetic surgery and LASIK people cope with that?

        1 reply 0 retweets 0 likes
      3. Robin Hanson‏Verified account @robinhanson Oct 22
        Replying to @ovjocm

        Clearly that's not the only problem.

        0 replies 0 retweets 0 likes
      4. End of conversation
      1. Steven‏ @MaVASteve Oct 22
        Replying to @robinhanson @AsheSchow

        I identified as having 20/20 vision when I got my lasik in 2003. Can I make my insurer pay for it?

        0 replies 0 retweets 1 like
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      1. New conversation
      2. Joseph Andelin‏ @josephandelin Oct 21
        Replying to @robinhanson

        Add to that: Hospitals etc use the commercially insured as a slush fund to cover the medicaid and Medicare under-reimbursements.

        1 reply 0 retweets 1 like
      3. M‏ @kleib323 Nov 9
        Replying to @josephandelin @robinhanson

        If hospitals are losing money on every Medicare patient, why do they take Medicare? They could still take commercially insured patients without participating in Medicare.

        1 reply 0 retweets 1 like
      4. Joseph Andelin‏ @josephandelin Nov 9
        Replying to @kleib323 @robinhanson

        ER is a big flow of patient admits and ERs have to see all patients, so for this, plus licensing requirements for hospitals, they take Medicare.

        1 reply 0 retweets 0 likes
      5. M‏ @kleib323 Nov 9
        Replying to @josephandelin @robinhanson

        ERs have to see all patients because of EMTALA, right? And EMTALA only applies to hospitals that participate in Medicare.

        1 reply 0 retweets 0 likes
      6. Joseph Andelin‏ @josephandelin Nov 9
        Replying to @kleib323 @robinhanson

        emtala applies to all ER centers. Medicare is not paradise for doctors or facilities. Outpatient centers, doctors in general have more leeway and can choose not to participate. See public hospitals 10ks for how the financing and reimbursement messes stuff up.

        1 reply 0 retweets 0 likes
      7. M‏ @kleib323 Nov 9
        Replying to @josephandelin @robinhanson

        You sure about that? CMS says it only applies to "Medicare-participating hospitals" https://www.cms.gov/Regulations-and-Guidance/Legislation/EMTALA/ …

        1 reply 0 retweets 0 likes
      8. Joseph Andelin‏ @josephandelin Nov 9
        Replying to @kleib323 @robinhanson

        "Section 1867 of the Social Security Act imposes specific obligations on Medicare-participating hospitals that offer emergency services" It doesn't say it only applies to Medicare hospitals.https://www.acep.org/life-as-a-physician/ethics--legal/emtala/emtala-fact-sheet/#sm.00001pcyl09vieda6sgkxxlglgu62 …

        0 replies 0 retweets 0 likes
      9. End of conversation

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