Show HN: I mapped US medical prices. Save thousands by driving a few miles • Hacker News Board

Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles

#181

Post by novalis78 » Sat, Dec 07, 2013, 4:32 PM UTC

clarebear wrote: post #173

thrownaway2424 wrote: post #93

This is cute, but it is based on a flawed premise. There are not "prices" for medical procedures and even the providers don't know what they are going to charge. Anecdata: when my wife was pregnant I asked the hospital what are the basic charges for normal obstetric delivery, since we were paying out of pocket. I got a reply in writing that it was $20k, a suspiciously round number without itemization. The baby comes…

Next time, try a midwife if you and your wife are comfortable with home birth. In the Denver area it runs about $3k for parental care, the birth, and post birth check ups. Also, you don't have to deal with hospitals. I had one of my kids at home with a midwife and I wish it would have been both. If you actually need one, then the midwife will take you to a hospital.

that's exactly what we did. 12k the hospital, 6k the birthing home and the midwife charged 3k. When we asked her about the price, she "admitted" feeling "guilty". She said "it's still way too high, but I get in trouble from the birthing homes, if I charge less". Talking about "market prices". There are none (yet).

Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles

#182

Post by novalis78 » Sat, Dec 07, 2013, 4:37 PM UTC

hotloo wrote: post #99

jeanlucneptune wrote: post #83

Assuming this data is from the Medicare (insurance program for those >65) dataset released by the Centers for Medicare and Medicaid services earlier this year ( http://go.cms.gov/1bowKJA ) I have a couple of points to make: 1.) Not sure if you grabbed "charges" or "payments", but "charges" are what the providers (hospitals) billed to Medicare, and "payments" are what Medicare actually paid the providers. "Payments" w…

Nice! Me and my friend made this app back in a few weeks ago, and here is the link. http://pricemaps.betterdoctor.com/#/ 1. We used the 'Average Payment' for the actual number shown on the site. 2. Even though it's irrelevant, but it actually goes back to you by your co-pay and other expenses to you. Not 100% sure though. The point in our app is that, we want to compare the price vs quality in the US top hospitals. T…

totally agree! my friend an me started in August on a similar mission http://www.pricepain.com - even tried YCombinator this winter but did not make it. If you checkout our /why section we collected a lot of recent articles and links on the subject

Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles

#183

Post by switch007 » Sat, Dec 07, 2013, 4:39 PM UTC

petercooper wrote: post #139

ghayes wrote: post #137

Earlier quoted context omitted.

There is no free lunch?

There might be. The US government spends way more money per head on public healthcare than the UK (and only slightly less than Norway) and that's totally separate to all the private spending! http://www.theguardian.com/news/datablog/2012/jun/30/healthc... Procedures are so expensive, doctors so highly paid, and insurers so profitable that the US is essentially subsidizing all that while still not providing universal…

A top-level policy with Bupa/Pru will get you easy access to top hospitals in the UK (including London), for diagnostics at least. I just got a quote for £70/mo (it will almost double if you claim, however).

EDIT: hm, not sure about 'experimental', but top quality/teaching hospitals anyway.

Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles

#184

Post by ceol » Sat, Dec 07, 2013, 5:01 PM UTC

x0054 wrote: post #142

matwood wrote: post #113

Earlier quoted context omitted.

Dispute all of it and the bill will likely be way less than 20k. I had mallet finger once and I got a bill of thousands of dollars and charge for a broken finger, then a set, and multiple check up visits. In reality I went to the doctor once, got an xray, he gave me a splint and said don't take it off for 8 weeks. I never went back for a second visit because it wasn't needed assuming I followed the treatment of did n…

This is exactly why I get so pissed about the Affordable Care Act! We are not solving the problem of why medical care in USA is so outrageously expensive, we instead are solving the problem of how to pay for it. The problem is, once most people have insurance, there will be no political will to solve the much more complex and important problem of reducing the healthcare costs for everyone. Incidentally, totally agree…

At this point, it's much easier to figure out how to pay for it than it is to revamp the entire system and stop some powerful players from making as much money as they do. It's much better to have this than to work towards fixing a societal problem for decades and get no where while doing so.

Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles

#185

Post by sp332 » Sat, Dec 07, 2013, 5:27 PM UTC

adamlett wrote: post #151

x0054 wrote: post #142

Earlier quoted context omitted.

This is exactly why I get so pissed about the Affordable Care Act! We are not solving the problem of why medical care in USA is so outrageously expensive, we instead are solving the problem of how to pay for it. The problem is, once most people have insurance, there will be no political will to solve the much more complex and important problem of reducing the healthcare costs for everyone. Incidentally, totally agree…

> We are not solving the problem of why medical care in USA is so outrageously expensive, we instead are solving the problem of how to pay for it. Perhaps, but to the individual, the first problem is by far the gravest. One can feel outraged if the taxpayers are paying too much in general, but that is not exactly a life or death situation like not being able to pay for medical aid. Also: Why can't you fix both proble…

Forcing people to pay for health insurance they don't want to drive down the cost of healthcare seems backwards. The pressure should be on insurance companies to make insurance more appealing.

Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles

#186

Post by neilsharma » Sat, Dec 07, 2013, 5:33 PM UTC

davycro wrote: post #177

Have you looked at the Dartmouth Atlas? They've been mapping healthcare costs for the last decade. Might have some good data and inspiration for you.

Thanks for the tip. I'll look into it :)

Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles

#187

Post by ensignavenger » Sat, Dec 07, 2013, 5:36 PM UTC

netrus wrote: post #152

x0054 wrote: post #142

Earlier quoted context omitted.

This is exactly why I get so pissed about the Affordable Care Act! We are not solving the problem of why medical care in USA is so outrageously expensive, we instead are solving the problem of how to pay for it. The problem is, once most people have insurance, there will be no political will to solve the much more complex and important problem of reducing the healthcare costs for everyone. Incidentally, totally agree…

Hope is that when big entities like the state or insurances have to pay the big bill, they have far superior means to enforce lower prices. That's not everything that needs to be done, but it is still useful.

I wonder though, even if the insurers can drive down prices, how do the insurance companies verify that they are only paying for services that are actually rendered? With the massive amount of medical billing fraud, I suppose insurance companies will invest in investigating and eliminating this behavior? Either that, or they will go bankrupt.

Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles

#188

Post by joshkaufman » Sat, Dec 07, 2013, 6:14 PM UTC

yodsanklai wrote: post #167

thrownaway2424 wrote: post #93

This is cute, but it is based on a flawed premise. There are not "prices" for medical procedures and even the providers don't know what they are going to charge. Anecdata: when my wife was pregnant I asked the hospital what are the basic charges for normal obstetric delivery, since we were paying out of pocket. I got a reply in writing that it was $20k, a suspiciously round number without itemization. The baby comes…

"I got a reply in writing that it was $20k" That sounds unbelievable! how can it be? it has to be a marginal case. I know at least two people that had babies in the US and barely pay anything (neither for the delivery nor for other medical acts before and after). They were PhD students or postdocs. What I am wondering is on average how much an american pays for having a baby?

It's not an edge case: we were quoted that price a few years ago. We carry high deductible insurance, and that was before the recent US health care legislation mandated maternity coverage. (Before it passed, most insurers refused to provide maternity coverage outside of large groups, or charged insane prices, since the probability of a claim was so high.)

In the end, we opted for homebirth midwifery care, which was fantastic in every way. We ended up paying around $2k for six months of prepartum care, delivery, and six weeks of postpartum care. In the event of an emergency, insurance would've covered a hospital transfer.

It was such a good experience we did the same thing for #2, and we're planning on delivering at home if we have more children in the future.

Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles

#189

Post by joshdance » Sat, Dec 07, 2013, 6:24 PM UTC

Really cool, but also not super helpful. Prices are not set. Book prices are not shared. Some prices are protected by crazy nearly anti-trust agreements (heart implants). And you have to know which procedure you want or should have for a particular condition.

But, that being said, I think it is awesome. Anything we can do to fix healthcare needs to be done.

Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles

#190

Post by rogerbinns » Sat, Dec 07, 2013, 6:29 PM UTC

dilipd wrote: post #158

rogerbinns wrote: post #32

Earlier quoted context omitted.

You forgot things like consumers needing information and having a choice. Those need to be present for capitalism to work. For fun I ask how much it is going to cost when going to my doctor. They refuse to tell me. They can't even make an estimate (tens? hundreds? thousands?) Even after seeing the doctor they can't. I pull out my card and say "I would like to pay now". I get told I have to wait for the bill. It is vi…

According to the site, for the 'Certificate of need', the main arguments seems to be following: "A number of factors spurred states to require certificates of need in the health care industry. Chief among these was the concern that the construction of excess hospital capacity would cause competitors in an oversaturated field to cover the costs of a diluted patient pool by over-charging, or by convincing patients to a…

The argument for CON is that if a new facility came in and charged less, then the existing facilities would have to charge more to cover the patients they lost which would adversely affect their remaining patients. So a new facility would need to show the need of non-served patients - ie that they wouldn't take away patients from existing facilities.

It is of course hogwash, but is a nice way for existing facilities to have a monopoly, prevent competition, and not have pricing pressure. Standard rent seeking/corruption that exists in the US.