You really should warn users to find the NEAREST hospital when they are having chest pain--which is one of the procedure selections.
Disclaimer: I am not a lawyer or a doctor.
Show HN: I mapped US medical prices. Save thousands by driving a few miles
61–70 of 229 posts
Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles
#62Earlier quoted context omitted.
As someone with a disabled mother on medicaid (whom I spend tens of thousands of dollars a year on for prescriptions and care), thank you.
Can I ask why you're spending thousands of dollars on Rx and care? From what I've gathered Medicaid patients have co-pays of $3-$5 on drugs and very small office visit co-pays. I'm not questioning your story, just genuinely curious what the extra costs are.
Not a problem
My mother is covered by Indiana's medicaid program, as she's at the poverty level but not old enough yet to qualify for Medicare. Her prescription buydown/deductible every month is $550, which I pay for. If you don't mind, I don't want to list specific medications, as it might make it easier to determine her identity. She takes medication for bone mineralization, hormone replacement due to a heart condition, a medication to reduce her blood pressure, as well as a Schedule I pain killer 3-4 times a day for pain management due to lower body nerve damage. She'll very likely have some nerves in her lower back severed in the next 6-12 months to relieve the pain.
So, her prescriptions alone cost around $5K-$6K/year. This is before her GP or specialist copays (very few providers will take Medicaid patients, so its hard to find and keep them), or a hospital visit or two. Her recent open MRI was completely out of pocket (luckily only $600 at a low-income clinic).
Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles
#63Pretty cool. You could also fly to Costa Rica, if you have the time...
Cozumel/Playda Del Carmen has a significant medical tourism industry as well (dental included!). Half the price vs the US.
Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles
#64Earlier 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.
True re: negotiated rate. However, the whole premise here is that there is some correspondence between this rate and the negotiated rate. If the negotiated rate is the same across the country across all hospital systems ("the magical mid point price") then this chart is not useful. I doubt thats the case. US Patients go to south america and Asia to get treated. I don't think shopping around the country hospitals to f…
The sad part is, there is little correlation between what the hospitals have on their charge master and what they actually get paid.
A hospital with a cost of $20K for a procedure might only get paid $5K, while one with a $10K cost might get paid $8K!
In fact, the same hospital can get paid very differently between different insurance companies.
Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles
#65Nice! Me and my friend Anders made a bit better version of this, at http://pricemaps.betterdoctor.com/#/ Check it out!
Major joint replacement is much cheaper than Major Joint Replacement.
Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles
#66Earlier quoted context omitted.
Is there evidence of correlation?
The next step would be to bring in death/complication statistics by hospital and ratings by surgeon
Some states already do this. For example, for CABG and valve surgery, NY State publishes raw, as well as risk-adjusted mortality rates (RAMR) broken down by surgeon: (warning, PDF) http://www.health.ny.gov/statistics/diseases/cardiovascular/... (begins on pg 21)
Fun fact: Dr. Oz is in there and it even looks like he might be one of the better performing surgeons too. Another fun fact: it can be hard to draw inferences about individual providers this way; check out just how wide some of the the 95% CIs for the RAMRs are, and a lot hinges on how good your risk adjustment model is (details on pg 13).
Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles
#67Earlier 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.
True re: negotiated rate. However, the whole premise here is that there is some correspondence between this rate and the negotiated rate. If the negotiated rate is the same across the country across all hospital systems ("the magical mid point price") then this chart is not useful. I doubt thats the case. US Patients go to south america and Asia to get treated. I don't think shopping around the country hospitals to f…
the whole premise here is that there is some correspondence between this rate and the negotiated rate
That is a plausible but false assumption. Different providers negotiate different rates. In many cases, the negotiated rate for a given provider is lower than the "cash rate" that an uninsured person would pay, but in many cases the negotiated rate it is actually much higher(!). Maybe in these cases the insurer gets an end-of-year volume-based discount that the insured (me) never gets to see.
Source: my recent experience shopping for an MRI while on a high-deductible plan.
Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles
#68Heroic sir.
Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles
#69Earlier quoted context omitted.
If you were a doctor, would you rather charge more, or less? What keeps you from charging the highest fees in the world? Your reputation. If you're not the best, you cannot charge the most. All of capitalism works this way.
Medical care is not really capitalism. Doctors get about the same reimbursement from any given insurance company no matter how good (or bad) they are, unless they are bad enough to get dropped from the insurance company's panel. Some negotiate for slightly better rates, but that often has more to do with the number of similar specialists in their geographic area on the insurance panel. Insurance companies consider do…
My specialties are forensic and child psychiatry.
Wow. I bet you could write an interesting book or three. (I hope you do.)
Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles
#70Brilliant! Great work.