Be careful comparing costs alone. Like everything else, sometimes more expensive things are better in quality. This might manifest in a different diagnosis, a longer recovery time, complications, or no difference at all. Kind of like a bandit problem because you only get one opportunity to choose.
Show HN: I mapped US medical prices. Save thousands by driving a few miles
81–90 of 229 posts
Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles
#82Excellent problem choice and great work with the solution. http://pricemaps.betterdoctor.com/, too, have done a wonderful job with their version.
May be this will also make a great phone app. If users can pre-configure a couple of medical procedures (faced in their medical history), the app can show price comparisons on the map by default at every launch. This might help addressing the concern https://news.ycombinator.com/item?id=6864945.
Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles
#83Assuming 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" would be the best indicator of "price".
2.) Regardless of whether you are using "charges" or "payments", it's pretty much irrelevant for the average person. Why? Because the patient never pays the full amount (except for the uninsured...see below).
3.) While you don't pay the full amount in most cases, you will have to pay something. However, what you actually pay varies WIDELY based on your health insurer (the "payor") and the design of the health insurance plan.
4.) Also note that every "payor" negotiates a different price, so the Medicare price does not equal the Commercial Insurance price which does not equal the Medicaid price which does not equal the price the uninsured person pays.
5.) Finally, the diagnostic/procedural terminology in this dataset is impenetrable to most people. For example, does anyone on HN know what "transient ischemia" is? And if you do, do you understand that you can have transient ischemia in many parts of your body (FTR, I'm an MD)?
Although I appreciate the effort and the clean visualization, I don't think this data is particularly useful to an individual trying to make health care decisions for reasons 1, 2, 3, 4, and 5 (and probably others that I'm missing).
The one place where this data may be useful on an individual level is in the case of the uninsured. When you have no insurance the hospital basically makes up a price (taken from something called the "chargemaster") that is way more than what commercial insurance would pay, and WAY WAY more than what Medicare would pay. Having access to this data might help an uninsured person negotiate a lower price when the hospital comes after you with a giant bill. Medicare is a pretty solid standard to compare to - i.e. "you're charging me 5X, whereas you would only charge Medicare X".
On a societal level I think this data is also extremely valuable because now you can start to analyze pricing disparities across procedure types and geographies, which is really helpful. You can also put pressure on providers who are gouging individuals paying sticker price (i.e. the uninsured), which is important given that medical bills drive the majority of personal bankruptcies.
We ran a competition on this topic recently at Health 2.0 and you can learn more about the issue and the datasets on our site. You can also view other visualizations of this very important data:
http://www.health2con.com/devchallenge/rwjf-hospital-price-t...
Transparency in health pricing is a very important topic and something you'll hear a lot more about in the future. Happy to discuss further with anyone who wants to learn more (@jeanlucneptune, jeanlucneptune@gmail.com).
Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles
#84However, I think hand in hand with this you need to map outcomes data, especially for invasive procedures. Often, the reason to go to a "Big Hospital" say UCSF instead of Podunk Community Hospital is that there is often a big disparity in skill between a UCSF faculty surgeon vs. others. Or, even between different hospitals.
I'm not sure how to do this - hospitals like to hide adverse outcomes from the public, but it's really information in the public interest. Ideally you'd want some sort of index that weighs complication rates (something unexpected happening), outcome/effect measures (procedure did what it was supposed to do), with price.
Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles
#85Have you ever thought you were having a heart attack? Flu tends to be moved by car.
Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles
#86Earlier quoted context omitted.
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 condi…
Thanks for sharing. I wasn't aware of Medicaid patients who had to pay those types of costs. I guess my question is, what if a Medicaid patient in IN was truly destitute? There must be some mechanism for patients who can't afford those types of costs.
unfortunately, i think its usually death.
Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles
#87Earlier quoted context omitted.
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 condi…
Thanks for sharing. I wasn't aware of Medicaid patients who had to pay those types of costs. I guess my question is, what if a Medicaid patient in IN was truly destitute? There must be some mechanism for patients who can't afford those types of costs.
ER visits.
Seriously. An ER is required by law to treat anyone who comes in. If you really can't pay, go to the ER.
Some argue this is why healthcare costs so much because ERs have to be paid for.
Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles
#88Earlier quoted context omitted.
agreed. How many times have you actually shopped out a procedure by making 10 doctors appointments for checkups and quotes, typically, when they need to operate, you just go with what they say.
I don't go to the doctor much, but when I go I ask "how much will this cost?" and 99% of the time I get "hrmm... I dunno..." and a shrug.
Most doctors in rich (i.e. insured patients) hospitals have no idea. My ENT was quite surprised when I told him the charge (>$1000) for his quick look down my throat. And that was only after a lot of shopping around and negotiating on my part. And it didn't include any "treatment" - it was just to look and possibly diagnose.
Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles
#89Earlier quoted context omitted.
I don't go to the doctor much, but when I go I ask "how much will this cost?" and 99% of the time I get "hrmm... I dunno..." and a shrug.
Most doctors in rich (i.e. insured patients) hospitals have no idea. My ENT was quite surprised when I told him the charge (>$1000) for his quick look down my throat. And that was only after a lot of shopping around and negotiating on my part. And it didn't include any "treatment" - it was just to look and possibly diagnose.
I'm usually asking the receptionist or other office person - they handle most of the billing stuff, and the other response I sometimes get is "oh, we have to run it through insurance first". They just run a code, and get told what they'll get paid (apparently), not necessarily what my cost/price is.
The system is so fundamentally out of whack, and not at all 'market driven' and yet somehow... my 'free market capitalist conservative republican' friends (I have a few) are really against "socializing" medicine/healthcare. As if, somehow, what we have now in the US is a bastion of free market enterprise.
The cynic in me thinks that the conservative elite really really really enjoy having a dependent class, and ensuring people are at the mercy of private health insurance companies vs the federal or state government helps ensure that dependency in a way they can still control. But... I'm overly cynical, it's late, and my words aren't coming out exactly as I think they should. :/
Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles
#90Presume you're just updating, but I'm getting a JS error on line 21
query.ascending)(