U.S. health care's widespread overbilling problem • Hacker News Board

Re: U.S. health care's widespread overbilling problem

#11

Post by EvanAnderson » Mon, Jul 10, 2017, 3:16 PM UTC

projectramo wrote: post #4

I know this will attract a lot of people who have suggestions for healthcare. Let me add my big one: price transparency. I had a simple test the other day. I could not get a price. I could not get a price with my insurance, or without it. I called at least 9 times. I got 5 call backs from people who asked me to schedule the procedure but no price. On the 10th call, I finally got someone to tell me what the out-of-poc…

An an anecdote: I've been on a high-deductible plan for nearly 13 years. I have been regularly met with shock and incredulity that I could possibly want to know the cost of a procedure. My wife and I have spent, collectively, hours on the telephone trying to get answers. It's particularly galling when we get "guilt trip" treatment for asking about costs for procedures for our young daughter. We have been met with both tacit and stated insinuations that we're placing a monetary value on her "health" by asking what procedures or drugs might cost.

I don't think price transparency will fix much, though. The average person I know has employer-provided insurance and doesn't think a bit about the costs of procedures. Price transparency combined with individuals having to pay for their healthcare expenses would help, but there's blame enough to go around for every player in the system, too.

Re: U.S. health care's widespread overbilling problem

#12

Post by mfoy_ » Mon, Jul 10, 2017, 3:16 PM UTC

paulpauper wrote: post #5

maxxxxx wrote: post #3

To me hospitals are basically scam operations. My girlfriend has had several surgeries in the last two years. In addition to already outrageous standard prices ($40000 surgical center cost for a surgery where we spent in total five hours at the center) pretty much every bill had mistakes. Then after a few months a collection agency will try to collect for something that never got billed and never has happened. I can…

but you have to also take into account that a lot of people don't pay (charity care)

No you don't.

Re: U.S. health care's widespread overbilling problem

#13

Post by Retric » Mon, Jul 10, 2017, 3:16 PM UTC

projectramo wrote: post #4

I know this will attract a lot of people who have suggestions for healthcare. Let me add my big one: price transparency. I had a simple test the other day. I could not get a price. I could not get a price with my insurance, or without it. I called at least 9 times. I got 5 call backs from people who asked me to schedule the procedure but no price. On the 10th call, I finally got someone to tell me what the out-of-poc…

Pricing does not solve the root problem which is everything trying to get someone else to pay.

Re: U.S. health care's widespread overbilling problem

#14

Post by feld » Mon, Jul 10, 2017, 3:17 PM UTC

paulpauper wrote: post #5

maxxxxx wrote: post #3

To me hospitals are basically scam operations. My girlfriend has had several surgeries in the last two years. In addition to already outrageous standard prices ($40000 surgical center cost for a surgery where we spent in total five hours at the center) pretty much every bill had mistakes. Then after a few months a collection agency will try to collect for something that never got billed and never has happened. I can…

but you have to also take into account that a lot of people don't pay (charity care)

in reality that's covered by the price gouging and the hospital getting to write it off

Re: U.S. health care's widespread overbilling problem

#15

Post by objclxt » Mon, Jul 10, 2017, 3:17 PM UTC

Moshe_Silnorin wrote: post #2

Healthcare will always be overpriced so long as we allow this guild system to limit the supply of doctors for its own member's profit. Everything else is window dressing.

If that's the case then how come in other countries with similar strong unions/guilds healthcare costs are so much lower? Nobody complains the BMA is increasing the price of healthcare in the UK.

> Everything else is window dressing

I think most reasonable people can figure out a) the difference between the US healthcare system and nearly all other countries, and b) what that difference might mean for costs. Here's a hint, it's not "the guild system limiting the supply of doctors".

Re: U.S. health care's widespread overbilling problem

#16

Post by opportune » Mon, Jul 10, 2017, 3:18 PM UTC

Moshe_Silnorin wrote: post #2

Healthcare will always be overpriced so long as we allow this guild system to limit the supply of doctors for its own member's profit. Everything else is window dressing.

Yep. The AMA/AAMC is essentially screwing the rest of the US so that they can keep doctors' salaries artificially high. There are tons of medical school applicants who get rejected every year, and not because they can't become doctors, but because medical school sizes have remained constant while the country's population (and demand for healthcare) has increased drastically.

Re: U.S. health care's widespread overbilling problem

#17

Post by EvanAnderson » Mon, Jul 10, 2017, 3:18 PM UTC

paulpauper wrote: post #5

maxxxxx wrote: post #3

To me hospitals are basically scam operations. My girlfriend has had several surgeries in the last two years. In addition to already outrageous standard prices ($40000 surgical center cost for a surgery where we spent in total five hours at the center) pretty much every bill had mistakes. Then after a few months a collection agency will try to collect for something that never got billed and never has happened. I can…

but you have to also take into account that a lot of people don't pay (charity care)

Fraud perpetrated against some Customers is not a remedy for non-payment by others.

Re: U.S. health care's widespread overbilling problem

#18

Post by pancreas » Mon, Jul 10, 2017, 3:21 PM UTC

Moshe_Silnorin wrote: post #2

Healthcare will always be overpriced so long as we allow this guild system to limit the supply of doctors for its own member's profit. Everything else is window dressing.

You think that doctors profit from the current system? How exactly?

Applications to med schools have been down for the last few years, and the trend is worrisome. Your doctor-bashing stance is common but uninformed.

Re: U.S. health care's widespread overbilling problem

#19

Post by mfoy_ » Mon, Jul 10, 2017, 3:21 PM UTC

It's also telling when the hospital gives you different bills depending on if you're insured or not. If you're insured they charge waaay more. They give you a more "realistic" bill if you are uninsured.

It's a ridiculous system.

Re: U.S. health care's widespread overbilling problem

#20

Post by maxerickson » Mon, Jul 10, 2017, 3:22 PM UTC

paulpauper wrote: post #5

maxxxxx wrote: post #3

To me hospitals are basically scam operations. My girlfriend has had several surgeries in the last two years. In addition to already outrageous standard prices ($40000 surgical center cost for a surgery where we spent in total five hours at the center) pretty much every bill had mistakes. Then after a few months a collection agency will try to collect for something that never got billed and never has happened. I can…

but you have to also take into account that a lot of people don't pay (charity care)

Some non payment is also considered bad debt (they expect the patient to pay, the patient doesn't pay). With charity care, the bill is explicitly forgiven.

The hospital industry claims non payments total around 6% of hospital expenses.

http://www.modernhealthcare.com/article/20120106/BLOGS01/301...

I do wonder if they calculate that 6% on what they bill though, rather than on what things actually cost. The margin on an unpaid bill isn't really a cost.