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

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

#101

Post by bentruyman » Mon, Jul 10, 2017, 7:45 PM UTC

yequalsx wrote: post #10

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.

Guild systems do not inevitably resort to overbilling. They may resort to being overpriced but not to overbilling or lack of transparency in billing. I've not heard of doctor salaries being the reason for the U.S. spending far more per capita than other nations. It definitely contributes to this but my impression is that it is a very small part of this. Do you have evidence to the contrary? Note that the same guild s…

This is basic supply/demand. We have an increase in demand with the supply of doctors apparently staying stagnant. I think that's the point of this particular thread – not necessarily the billing issue.

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

#102

Post by grasshopperpurp » Mon, Jul 10, 2017, 7:49 PM UTC

cmurf wrote: post #86

wlesieutre wrote: post #41

Earlier quoted context omitted.

Related to 1 and 2, people on high deductible health plans are paying everything out of pocket until they hit their yearly cap (then insurance kicks in). It's not even whether you have insurance or the insurance company wanting to reward you, it's trying to save your own money like any other purchase. High deductible health plans are becoming more and more common, from what I gather.

Mine's $5500. The monthly premiums are ~$300. It's an obscenity for someone who's healthy, runs, bikes, or swims pretty much every day. But it gets worse. Recently I went to a doctor for a minor problem, but did not get pre-authorization. I knew exactly what it was going to cost for the visit, and knew it would not be covered by insurance. What I did not know is, due to lack of pre-authorization, it also would not be…

What about people who live in food deserts?

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

#103

Post by mabbo » Mon, Jul 10, 2017, 7:50 PM UTC

trey-jones wrote: post #51

At the risk of spiking my blood pressure I will write a few words on this topic. I will start by saying this: The whole system is fucked. I am referring to the system that facilitates American residents getting healthy and staying that way. What is the basis of my claims? I admit that I am a healthy 33 year old white male and I probably have only seen that tip of the iceberg. I am also a father of 3. My oldest daught…

I cannot imagine how America let this cancer of a health care system grow.

I live in Canada. For the next couple weeks, I'm unemployed. During this time, I'm planning to get some health checkups done, possibly get a referral to a sleep clinic, and maybe get my hearing checked. I don't have any fears or worries about this.

Friends always tell me I could be making so much more money in America... It's not worth the stress, the bullshit.

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

#104

Post by arethuza » Mon, Jul 10, 2017, 7:51 PM UTC

jazzyk wrote: post #98

dboreham wrote: post #88

Earlier quoted context omitted.

Because Americans are selfish. Source: lived in US for 20 years.

I have lived in the US for 27+ years and I think Americans tend to be very generous, a lot of people donate their time and money to charities, churches, etc. They just don't want to give their money to a bunch of bureaucrats, who spend it mostly on themselves, and seem to multiply like rabbits.

Do you have any evidence that socialized health care systems have more bureaucrats?

[NB I'm just out of a UK NHS hospital so therefore feeling very warm and fuzzy about our favourite chunk of socialism].

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

#105

Post by francisofascii » Mon, Jul 10, 2017, 7:52 PM UTC

opportune wrote: post #16

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

#106

Post by rsync » Mon, Jul 10, 2017, 7:53 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…

"Let me add my big one: price transparency."

Lack of price transparency bothers me as well and I wish we had it.

However, I don't know if there will ever be enough pressure to manifest this. Price transparency really only matters to the person paying the bill. Our society is very rapidly evolving to consider any healthcare cost of any kind to be an insurmountable burden that no normal person could ever be expected to pay. I suspect that the incomprehensible, ridiculous healthcare schemes that we are living through currently are just death spasms on the way to fully socialized medicine.

I'm sure there are rare people here and there that care how much a mile of highway costs to pave or how much a mile of city sewer line costs to install ... I would expect the same number of people to care about the cost of a medical procedure when their own cost is $0.

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

#107

Post by creaghpatr » Mon, Jul 10, 2017, 7:54 PM UTC

maxxxxx wrote: post #28

maxerickson wrote: post #20

Earlier quoted context omitted.

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…

I remember reading that the 6% are from the billed prices, not the cost. The same when they claim to do things for poor people. They do a few procedures for free and claim the billed price so they can have nice PR for cheap.

Also for tax reasons, although different hospitals have different tax classifications.

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

#108

Post by AngeloAnolin » Mon, Jul 10, 2017, 7:56 PM UTC

code_duck wrote: post #94

My friend's wife resigned from a nursing position over this issue. A superior asked her to falsify billing records to say they were providing a higher level of care than they actually were, and she refused.

Instead of resigning, wouldn't it have been better if she exposed the malpractice? Or would the consequences on her part damage her so much that their lives would be destroyed? Ethics would dictate she would fight otherwise.

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

#109

Post by ghaff » Mon, Jul 10, 2017, 7:56 PM UTC

astrodust wrote: post #55

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…

This strikes me as absolutely absurd. Here, as an example, dentistry is highly regulated and prices are listed in a book. If you want procedure X done it will cost $Y no matter which dentist you visit. This means it's easier to budget for such things, you never have to price shop, and the insurance companies can also easily predict what the costs will be given statistical trends. This idea of medical procedures havin…

In the US dentists don't all charge the same thing in my experience although they're probably in the same general ballpark for a given procedure. A quick Google seems to confirm that. There is definitely more transparency in pricing because many/most people don't have insurance and insurance for semi-cosmetic procedures is somewhat limited. (And there are often treatment options that people will reasonably choose from based on price.)

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

#110

Post by nucleardog » Mon, Jul 10, 2017, 7:57 PM UTC

camiller wrote: post #63

mfoy_ wrote: post #46

"The United States remains one of the only advanced industrialized democracies in the world without universal coverage. While this in and of itself is not a problem, the United States also spends more on health care as a percentage of GDP than any other advanced country in the world and has worse health outcomes – with lower life expectancy, higher infant mortality and higher obesity rates than comparable countries l…

I think this is because we choose to live less healthy lifestyles rather than the quality of medical care. Super size that...

I don't think the lifestyles are all that different between Canada and the US, and the healthcare expenditures in Canada are significantly lower.