# Industries Ripe for Disruption

**URL:** <https://boards.straightdope.com/t/industries-ripe-for-disruption/939859>\
**Category:** In My Humble Opinion\
**Created:** [April 12, 2021, 5:53pm UTC](https://boards.straightdope.com/t/industries-ripe-for-disruption/939859 "2021-04-12T17:53:05Z")\
**Posts on this page:** 7\
**Page:** 6

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**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\
**Post date:** [April 18, 2021, 10:18pm UTC](https://boards.straightdope.com/t/industries-ripe-for-disruption/939859/101 "2021-04-18T22:18:05Z")

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> [@Bootb](#):
>
> > [@Wesley\_Clark](#):
> >
> > We lack market forces, both public and private. The public sector can’t set prices or negotiate, and the private market can’t compete since prices are hidden.
> 
> That’s something that Trump tried to change. Not surprisingly, the hospitals are deeply unhappy about it. Some of them are not yet complying with the new rules requiring them to list their prices.
> 
> Even a seemingly-simple change is hard to implement.

And it was a move in the right direction. I believe in places where prices are transparent, the more expensive medical facilities end up having to reform to remain competitive.

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**Author:** ![Sam\_Stone](https://avatars.discourse-cdn.com/v4/letter/s/ecccb3/32.png) [@Sam\_Stone](https://boards.straightdope.com/u/Sam_Stone)\
**Post date:** [April 18, 2021, 10:27pm UTC](https://boards.straightdope.com/t/industries-ripe-for-disruption/939859/102 "2021-04-18T22:27:45Z")

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One of the problems with transparent pricing is that hospitals shift bad debt to others. There is a sort of black market health care system in which hospitals are forced to treat uninsured people and bill them, but the bills often go unpaid. So the hospital eats the debt and it translates into higher prices for everyone else.

Hospitals also like to price discriminate, and will therefore adjust their prices based on ability to pay, insurance coverage, etc.

Another problem is that fixed pricing for many procedures are difficult because of varying difficulties encountered during the procedure and varying patient outcomes. A healthy 25 year old will probably need less after-surgery care and a shorter post-op stay than someone in their 70’s with other health complications. One price doesn’t fit all.

Still, more transparency is better.

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**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\
**Post date:** [April 18, 2021, 10:32pm UTC](https://boards.straightdope.com/t/industries-ripe-for-disruption/939859/103 "2021-04-18T22:32:08Z")

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A variety of other nations system manage to function fine with a national price setting system. Medicare and medicaid set prices (although their prices are low, especially medicaid, and many places can’t function on medicare/medicaid care alone).

But uncompensated care is maybe 40 billion a year. Not nothing, but our health systemin total is almost 4 trillion a year now.

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**Author:** ![slash2k](https://avatars.discourse-cdn.com/v4/letter/s/439d5e/32.png) [@slash2k](https://boards.straightdope.com/u/slash2k)\
**Post date:** [April 19, 2021, 1:07am UTC](https://boards.straightdope.com/t/industries-ripe-for-disruption/939859/104 "2021-04-19T01:07:31Z")

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> [@Wesley\_Clark](#):
>
> But uncompensated care is maybe 40 billion a year. Not nothing, but our health systemin total is almost 4 trillion a year now.

Uncompensated care, however, is not distributed evenly across the health system. Emergency rooms do a lot of it; cancer centers and transplant facilities don’t. Retail prescription drugs, for example, accounts for about ten percent of overall health spending, and only a miniscule percentage of uncompensated care because the pharmacy won’t generally give you the pills until you give them the cash; nursing homes are under no obligation to admit you until a source of payment is identified. Most uncompensated care is provided by hospitals, and it can range up to ten percent of the hospital’s total budget.

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**Author:** ![DavidNRockies](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/davidnrockies/32/6279_2.png) [@DavidNRockies](https://boards.straightdope.com/u/DavidNRockies)\
**Post date:** [April 19, 2021, 1:08pm UTC](https://boards.straightdope.com/t/industries-ripe-for-disruption/939859/105 "2021-04-19T13:08:55Z")

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Another suggestion for the OP, triggered after I recently watched John Oliver (“Last Week Tonight”) do an episode about long-term care facilities:

[![](https://img.youtube.com/vi/2xlol-SNQRU/maxresdefault.jpg "Long-Term Care: Last Week Tonight with John Oliver (HBO)") ](https://www.youtube.com/watch?v=2xlol-SNQRU)

When I’ve poked around to validate verifiable statements that he’s made in other shows – though he can often be charged with making a prosecutor’s case – he tends to get his hard facts right.

ISTM that the current model emulates the incarceration/human detention model way too closely: pile in the bodies and mercilessly cut costs.

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**Author:** ![Dark\_Sponge](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dark_sponge/32/121_2.png) [@Dark\_Sponge](https://boards.straightdope.com/u/Dark_Sponge)\
**Post date:** [April 19, 2021, 5:49pm UTC](https://boards.straightdope.com/t/industries-ripe-for-disruption/939859/106 "2021-04-19T17:49:00Z")

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> [@Sam\_Stone](#):
>
> One of the problems with transparent pricing is that hospitals shift bad debt to others. There is a sort of black market health care system in which hospitals are forced to treat uninsured people and bill them, but the bills often go unpaid. So the hospital eats the debt and it translates into higher prices for everyone else…

Yes, this is the biggest problem facing smaller hospitals. Some people treat the ER as a walk-in clinic because they don’t have insurance. The hospitals are required by law to treat them (which is good) but end up eating the cost which far exceeds what a normal clinic visit would cost.

A single-payer system would be a huge benefit to hospitals. They’re not the ones fighting it.

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**Author:** ![carrps](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/carrps/32/2957_2.png) [@carrps](https://boards.straightdope.com/u/carrps)\
**Post date:** [April 19, 2021, 8:39pm UTC](https://boards.straightdope.com/t/industries-ripe-for-disruption/939859/107 "2021-04-19T20:39:32Z")

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> [@silenus](#):
>
> If Bevmo doesn’t have it, I head to the [little grocery store](http://www.gerrardsmarket.com/liquor.html) down the street from my middle school. That Beer Cave is something else.

Dang. Redlands is a bit far for me to go.

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