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U.S. health care's widespread overbilling problem

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

#201

Post by pedasmith »

wvenable wrote: post #133
ChemicalWarfare wrote: post #97

Earlier quoted context omitted.

>> I'm a Canadian, what's wrong with our system from your perspective? longer wait times for non-emergency treatment and (most of the time) not being able to pay cash and get the procedure done without the wait. personally know ppl in Canada (Toronto, so not some little town in the boonies) who had to wait few months to get an MRI. on the US side - takes 2 weeks or so to get the insurance company's approval (they do…

Yeah, waiting a few months to get an MRI if your condition isn't serious isn't uncommon. Diagnostics like that tend to be the longest wait times -- actually getting surgery after a diagnosis is pretty quick. On the other hand, my experience with the US is that the service is great. They'll even send you for unnecessary tests just because. And it's all pretty fast. But then you have so many people who get nothing at a…

Try getting a mammogram. The wait time always seems to be in the "months" range even though the demand can be perfectly forecast in advance.

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

#202

Post by wl »

wl wrote: post #112
binarymax wrote: post #80

Earlier quoted context omitted.

Surprise! Pricing is "transparent", although massively complicated. There are several systems, but let's take a look at Outpatient procedure pricing... A good outpatient pricing guide is here: https://www.cms.gov/Outreach-and-Education/Medicare-Learning... And coupled with the OPPS dataset here: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Paymen... as well as a couple others, along with a quick read of the…

Pricing is not even nominally transparent. By law, you can get access to the chargemaster, which is the list price that nobody actually pays. If you try to get access to the negotiated price your insurance company will pay, you'll quickly discover that it's confidential up until the point where the provider actually issues a bill. Medicare pricing is a special case, but you can't get that price without being on Medic…

Replying to myself because I can no longer edit: California law requires public access to the chargemaster. This is not true in other states.

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

#203

Post by tacostakohashi »

harisenbon wrote: post #154
beat wrote: post #149

Earlier quoted context omitted.

The core difference between the American health insurance model and the Japanese model (which costs half as much and has better outcomes) is fixed pricing. In Japan, a government commission sets prices for every medical product and procedure, tuning the prices to insure profitability, while preventing profiteering. In America, price negotiation is done between providers and insurance carriers. This has a few obvious…

I'm heading back from Japan today, and my family got a bunch of checkups and medical stuff done while we were here. Even without insurance all our procedures cost total less than ~$100 apiece. The most expensive thing I've ever had in japan was my full body workup last year for $500. It included: stomach ultrasound, 5 blood tests, eye exam, MRI(brain) and barium scan. All without insurance. By comparison, in the US I…

Yep - if you're sick and in the U.S., don't go to the hospital, go to the airport.

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

#204

Post by blitmap »

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…

I would love something like census data on how much a healthcare provider paid, on top of what a procedure or medicine costs. Not just how much they paid for you or your walking cane, but how much every provider pays for a syringe.

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

#205

Post by dang »

grasshopperpurp wrote: post #116
jazzyk wrote: post #98

Earlier quoted context omitted.

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.

What a pile of garbage. Your charities and churches do more harm than good, and they allow people like you to justify your selfishness.

We've banned this account for violating the site guidelines.

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

#206

Post by dragonwriter »

blitmap wrote: post #204
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…

I would love something like census data on how much a healthcare provider paid, on top of what a procedure or medicine costs. Not just how much they paid for you or your walking cane, but how much every provider pays for a syringe.

> I would love something like census data on how much a healthcare provider paid, on top of what a procedure or medicine costs.

$0. By definition.

But I think you may be confusing a health insurance provider (equivalently, a health care payer) with a health care provider.

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

#207

Post by dang »

mfoy_ wrote: post #42

Just to be clear... the "grown up" conversation you wish Americans could stomach is the one that involves socializing medicine and not the one that involves letting random people die needlessly, right?

When a topic is divisive, please don't take discussion further into flamewar when commenting here.

We detached this subthread from https://news.ycombinator.com/item?id=14736827 and marked it off-topic.

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

#208

Post by arrty88 »

mnm1 wrote: post #72

I think this is a great argument for a single payer system. Let the government and hospitals duke it out. When it's the government's money that is being lost, the government might actually care and start negotiating with these providers. Even if it doesn't, at the very least, patients lives won't be ruined by bills for services that they had no control over or knew the cost of beforehand. Not only that, but the gover…

Since when has government cared about losing money?

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

#210

Post by dang »

pancreas wrote: post #182

While I do feel compassion for you and your pain, I need to point out to you that you are unreasonable, bordering on psychopathological irrational fear. The scenario in which "the entirety monetary value of my life's work could be destroyed in a moment by a medical issue" - is very uncommon, the stuff of scary stories, not reality. in reality, you are protected even if you don't have a good insurance. Think about "me…

> you that you are unreasonable, bordering on psychopathological

We ban accounts that go in to personal attack like this, so please don't. Also, please don't use HN primarily for political or ideological argument; occasionally that's fine, but we ban accounts that exist only to comment that way, especially when they're use flamewar phrases like "Your doctor-bashing stance" and whatnot.

https://news.ycombinator.com/newsguidelines.html

https://news.ycombinator.com/newswelcome.html

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