I was listening to the Acquired episode on Epic and they touch on the severe cost overruns in our healthcare system. They make a point to share that hospitals aren’t the ones making a killing. It’s insurance companies.
They make a compelling argument that if you add up the total that you pay to insurance, taking into account what your employer pays, there’s no way you get that much value out of your health insurance annually.
insurance is always a gamble, and the house always wins
don’t insure anything you can afford to lose, and save up money you’d put into insurance in a HISA
that said, things you can’t afford to lose probably include your house, someone else’s lamborghini, your health
buuuuuuut US health care is set up for bargaining: hospitals overcharge, pharmacies overcharge, drug companies overcharge because they all know insurance companies aren’t gonna pay what they actually charge because they have bargaining power… which, if you don’t have insurance, leaves you holding the fucking ball with no bargaining power
… all of this is said as an aussie, with universal healthcare and only a passing (but real life) experience of the US healthcare system (and in general a system that will protect me from fucking up so hard i can’t even imagine being completely destitute), so grain of salt n all that
Oh man, epic is such complicated garbage that even with a company brought in to set it up, the center I worked at during the rollout was a fucking mess. I left 14-18 months after initial deployment and they were still ironing bugs out, and I heard they rolled back within a year or so of leaving. Also, it’s almost hilarious how often I hear nurses bitching about using epic just when I have to go in for anything, and none of them are related to the place I worked.
I respectfully disagree after you try other EHRs like Cerner lol
I also haven’t heard complaints about Epic with bugs at least in my org. They are pretty user friendly especially when we have some staff that can barely type. The only complaint was documentation. Nursing documentation was tedious with like over 250 options for “adult assessment” but they’ve slimed it down to like 50 earlier this year for my healthcare system. Lastly, I think things work better the more money hospitals put in the EHR. I was per diem for another healthcare system. It was pretty cool how many other features they had than ours.
Must just be one of those “yeah my product is awful but have you seen the other guy?” sort of situations. I never had to use the EMR directly outside of troubleshooting, but both epic and the previous EMR were pretty garbage so I don’t really have a good baseline to go off of.
The costs are inflated for sure, but compared to to cost of paying for cancer treatment entirely out of pocket, it’s still cheaper. That’s the whole point of insurance, to cover the event of a catastrophic cost.
I’m not as sure about that. If you paid your premiums, etc. into a low yield savings account, especially when you start when you’re young, I think the value proposition would be more than insurance where you have no way to control payment decisions.
Please do not read this as me saying don’t get insurance. Read it as our insurance is failing to provide the value that we pay into it and need something better.
The Acquired episode goes into detail how we ended up with a private payer system and it’s so infuriating. Our health system was being set up around the same time as the UKs and they show how different incentives lead to where we are.
Why do you think the cost of paying out of pocket is so high? Private insurance bears a significant part of the responsibility for causing that problem.
Structurally, yes, you need a system that amounts to healthy people saving, and sick people being taken care of from those savings, whether it’s individual or social. But our current system of private for-profit insurance is about as bad as such a system could be while still technically sorta working.
