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

bestmedicareprice.com

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

#191

Post by tunesmith »

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…

That's not quite true - part of the problem is that we don't know exactly how, in the American system, to reduce the healthcare costs effectively. But I feel like I've read multiple times that the ACA funds pilot programs to try out many many different ways to change incentives to see if they help health care costs come down.

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

#193

Post by thesis »

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…

Wow. Next time shop around a little. We did and the hospital stay for my wife and baby was around 2800. Our doc was 2700. The anesthesiologist was a shocking 2500 though. Our doc and the hospital had to be prepaid, or else we would be charged higher rates. Some places call them "Stork plans"

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

#194

Post by carlosrt »

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…

Companies, like Safeway, that self insure pay $3,000 to $5,000 per procedure. For example:

Colonoscopy: $897 Breast excision of lesion procedure: $2,569 Gall bladder procedure: $4,212 Cardiac Catheterization (no angioplasty or stints): $4,900 Knee Arthroscopy: $3,039

I wrote about it here:

http://www.quora.com/Medicine-and-Healthcare/What-are-some-o...

The CEO of SafeWay, started a company that sells this data. Unfortunately its typically only sold to companies that self insure and have ~10,000 employees. You can watch him talk about the data and the company here:

http://coe.berkeley.edu/static/streaming/gtl-conference/2009...

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

#195

Post by anoncowherd »

rnd33 wrote: post #161
klausjensen wrote: post #147

Earlier quoted context omitted.

It certainly is not. It is paid for by one of the highest tax rates in the world. I currently work in Norway and pay more than 50% in income tax and social contributions - and that does not even include other taxes and excise duties like the 25% VAT, the 9USD/gallon gas price (mostly tax) or the new car tax of something like 150-200%, property taxes, road taxes, vehicle taxes, alchold and tobacco taxes... So no, it i…

And people in America stating that healthcare is not free is a rant-trigger for me. Everyone here knows that it's not "free" but subsidised by taxes. That's what "free" means when talking about healthcare, free at the point of service, and free as equally available to everyone. How else would it work? Are the doctors without pay and with no equipment?

It's an important point to make that even "free" healthcare is not actually free - the money has to come from somewhere, and most of it comes from forcefully confiscating it from people.

Not only that, but if you're using money, it's much easier to use someone else's money instead of your own, you just won't be too careful about how you spend it. In fact, if you've got a "limitless" supply of other people's money, you just won't give a fuck about what you do with it. This is one reason why public healthcare (and public anything) turns to shit sooner or later.

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

#196

Post by Splendor »

benmaraschino wrote: post #73
refurb wrote: post #37

Earlier quoted context omitted.

The issue is that if you have insurance, you're not paying the charge master rate or the Medicare rate, you're paying the negotiated (and likely non-public) rate for your insurer. The 20% co-insurance you pay is based on the negotiated rate.

One factor that keeps these negotiated rates from becoming public is that a lot (actually, almost all) of these contracts signed between hospitals and insurers have a gag order of sorts built into the contract by the hospital. These gag orders prevent the insurer from making the hospital's rates public, and what's more, the terms of these contracts usually forbid insurers from even revealing the existence of these ga…

Luckily insurers have begun to find a way around this by selling bulk claim data to third parties who can analyze them and extrapolate the contracted rates on their own (a la Castlight, Change Healthcare, etc.).

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

#197

Post by codequickly »

aestra wrote: post #164
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…

>Needless to say that this American hospital would not even have admitted us without a certified check in advance. An emergency room cannot refuse treatment to a women in labor. http://en.wikipedia.org/wiki/Emergency_Medical_Treatment_and...

I worked at ER. No, you don't want to have a baby in ER. ER doctors are dealing with emergency situations and patients (auto accident,cardiac arrests,gunshot wounds,etc). I've seen one baby being delivered in ER, and it wasn't a good experience for the patient. Rather, you'd want proper pre-natal care and comfortable delivery room, with your own doctor. Also, ER treatments are more expensive. Way more expensive.

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

#198

Post by xxpor »

anoncowherd wrote: post #195
rnd33 wrote: post #161

Earlier quoted context omitted.

And people in America stating that healthcare is not free is a rant-trigger for me. Everyone here knows that it's not "free" but subsidised by taxes. That's what "free" means when talking about healthcare, free at the point of service, and free as equally available to everyone. How else would it work? Are the doctors without pay and with no equipment?

It's an important point to make that even "free" healthcare is not actually free - the money has to come from somewhere, and most of it comes from forcefully confiscating it from people. Not only that, but if you're using money, it's much easier to use someone else's money instead of your own, you just won't be too careful about how you spend it. In fact, if you've got a "limitless" supply of other people's money , y…

So I assume you don't buy insurance, for anything ever, correct?

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

#199

Post by nimble »

_delirium wrote: post #156
netrus wrote: post #152

Earlier quoted context omitted.

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.

They are actually pretty good at driving the prices down to something reasonable in most cases. While the headline prices are absurd, the prices actually paid by public and private insurers, whether Medicare or Blue Cross or Aetna, are much more reasonable. Not as reasonable as in much of the rest of the developed world, but the gap is not as gigantic as it initially seems. The really big gap between the U.S. and the…

Where do you find a breakdown of the costs? Anyone have links?

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

#200

Post by x0054 »

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…

Fixing both problems is ideal, and we should do both. But, I fear, that after fixing the "how to pay for it" problem, no politician will try to fix the much more complex, and much more important problem of the very high costs. At the rate we are going, by 2021 US is expected to spend nearly 20% of GDP on health care. To address this we will need to cut the spending on last-6-months care as well as reduce procedure costs. Even if we address the latter, I doubt any one in congress has the spine to address the former.
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