211–220 of 273 posts
This is what happens when you make the health care system capitalist. Despite rumours to the contrary, capitalism doesn't reduce prices, that would make no sense for a company trying to make a profit.
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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…
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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…
Did you need to speak Japanese to get this done?
In bigger cities, you'll definitely be able to find doctors who can speak English easily.
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I wonder if there is a straightforward way to aggregate people's bills to estimate the cost of a procedure (eg appendectomy) at a given hospital. Eg pay people $1 to scan their bill. This would only work for common procedures I suppose.
HIPAA was passed largely to prevent this potential catastrophe for healthcare executives. b^)
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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…
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I'm a Canadian, what's wrong with our system from your perspective? (No system is perfect; there is always room for improvement and trade offs) Just two weeks ago, my wife had an emergency appendectomy. She went to the free clinic first thing Sunday morning as she had terrible pains all night. They immediately referred to the local hospital. She had the ultrasound in the afternoon and Surgery at 3:00pm. She's been of…
>> 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…
I really want to see actual studies on this. We Americans LOVE to throw this in the face of the countries with single-payer, yet we conveniently gloss over the fact that many Americans PUT OFF health care procedures because they can't afford them. I've done it and I know many, many others that have as well. Oh, this is going to be 1500$ out of pocket and doesn't need to be done today? Great let's schedule it for 2 months out.
Additionally, Americans also have wait times for non-emergency procedures. Colon cancer runs heavily in my family and so all of the older members get regular colonoscopies. I have several anecdotes of family members having to wait 6 months before they can get it and get theirs done.
AMERICANS ARE NOT ANY BETTER WHEN IT COMES TO WAIT TIMES. However, the onus is typically not on the provider, it's on the patient. So we describe the situation differently even though it's the same outcome, the patient has to wait for treatment.
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…
And yet, the idea that health care "consumers" would price-shop for the lowest-cost procedure is a dogmatic core of some American ideas about how to "fix" cost in health care.
Just today I went to an major-hospital urgent care clinic that has an upfront $50 fee to "be seen". I normally avoid the system like the plague it is (hence not wanting to pay into its protection rackets), but my girlfriend had gone last week for the same week-long fever and had a good experience, so I figured I'd give it a shot.
The person working at the desk told me that there "could" be "extras" that would be beyond that fee. Okay, cool. The physician's assistant recommended a chest x-ray, added it was around $75, then confirmed it was $56, and I quickly agreed. My girlfriend was a bit miffed she had turned down the x-ray without knowing the actual price.
When it came time to settle up the bill, they had added on a $130 charge because the PA had added on some billable event for her seeing me, despite that this should have clearly been included in the "$50 to be seen".
This is textbook fraud, yet it is allowed to persist. I complained, and was met with the standard "it's nobody's fault" attitude, because these people are really just skinjobs on an opaque computer system. If I had been my normal self (currently dealing with some major life events), I would have only paid for the x-ray and told them to shove their unauthorized charge up their ass. Alas, they dropped the fraudulent charge to $80, but the bad taste remains.
If I had been told the higher charge up front, that would have been completely acceptable - and if I thought it too high I could have gone to a competitor, or simply not gone (never before in my adult life have I gone to the hospital for a fever).
And that doesn't even address the travesty of the only result coming out of this visit was receiving a prescription for the exact same antibiotic my girlfriend had received a week prior! It would have been much easier for her to buy two simultaneous doses from the pharmacy, but the cartel has that locked down as well.
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…
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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 bot…
My dental hygienist once told me to get 3 cleanings a year. I told her my insurance covered 2. She told me that it was like chemotherapy- you should do what's medically necessary whether or not your insurance covers it.