Live data from Hacker News

Bringing transparency to ER prices, one hospital bill at a time

cjr.org

21–30 of 121 posts

Re: Bringing transparency to ER prices, one hospital bill at a time

#21

> If you are bitten by a raccoon, you can’t really decide not to get the rabies vaccine. It’s literally a life-or-death situation. But the price is incredibly high. This, to me, is a perfect example of why healthcare should be subsidized by the government (either directly or through a government-backed insurance plan that you receive as a fallback). Health isn't a good or service you choose to purchase. Demand is per…

> This, to me, is a perfect example of why healthcare should be subsidized by the government (either directly or through a government-backed insurance plan that you receive as a fallback).

Nah, this doesn't really work in the US. All it does is to funnel money into the coffers of the companies that are creating the problem in the first place.

There has to be some more regulation – companies need to be forced to be more transparent in their pricing, as well as to limit the markup they can add so they can 'negotiate' down.

And then, there has to be some competition, as in many places people have no alternatives. That competition could even be with the government itself, in the form of government-run clinics or hospitals. This works in Brazil – you don't have to carry any form of insurance whatsoever if you don't want to. For major issues, you are covered just fine – trauma surgeons in the public network are among the best (at least in big population centers), and are often the same doctors that practice in private hospitals. My mother also got top notch cancer treatment for free. The last one is more location-dependent though.

Even as a foreigner, should you get in a car crash or something, you'll be patched up nicely and not pay anything.

Now, if you got a non life-threatening issue, then it can be a problem, as even the big hospitals may lack resources for everybody, so your appointment may be scheduled far in the future. To counter that, you can choose (and most middle class people do) to carry private insurance and not burden the public network. Private insurance is then cheaper that it would otherwise be because there is an upper limit on how much they can charge you – go too high and many people will drop insurance and private insurers (plus hospitals and clinics) would lose customers.

The government will also provide essential medication for free (diabetes, high blood pressure, etc). It doesn't matter how high your income is.

It is really not supposed to be rocket science. If a third world 'developing' economy can do it, with a much lower economic output, then the US could do it too. But not if it's a care program that's allowing companies to continue charging $100 for a band-aid.

Re: Bringing transparency to ER prices, one hospital bill at a time

#22

Earlier quoted context omitted.

And the worst thing is that there’s no way to predict the cost. Even if you go to an ER that’s in network (good luck with that in an emergency), you might be assigned an out of network doctor and be charged out of network prices

We've had 2 children in the last 4 years and this concept was foreign to me. Our 2nd child we were billed for an out of network anesthesiologist at an in network hospital. Several thousand dollars in total, I called the insurance after reading online a bit about it. Eventually they said they would "resubmit" the claim for reconsideration. A few weeks later we got an EOB showing we didn't have to pay any of it. The wh…

Regulatory capture.

Re: Bringing transparency to ER prices, one hospital bill at a time

#23

As the person who submitted this story, I have a question: why was Sarah Kliff’s name removed from the headline? I submitted it with the same title it carries at CJR, which includes her name. The story is a profile of her and her work, so removing it makes the headline less informative, not more. And she’s not a celebrity, so mentioning her by name doesn’t make the headline any more clickbaity than it would be withou…

Same thing happened to me, where the title was changed from "Java Creator James Gosling: Why I Quit Oracle" to "Why I Quit Oracle".

https://news.ycombinator.com/item?id=15163932

It doesn't make sense.

Re: Bringing transparency to ER prices, one hospital bill at a time

#24
For the past three weeks I’ve been going through a flare up of an autoimmune neurological condition. It’s been terribly painful. The treatment is high dose IVIG or plasmapheresis. Unfortunately my insurer doesn’t want to pay. I’m told if I had almost any other insurer they would. This has left me trying to find out just how much I’d have to pay out of pocket for either of these services. But absolutely no one knows and no one will work it out for me. All I know is it will be somewhere between $30k and $60k from various guesses that have been offered.

Pricing in the US health system needs regulation. The best option would be all providers must charge the same rate to all customers. Then I could look up the price and know it’s been prenegotiated by big insurance companies.

Re: Bringing transparency to ER prices, one hospital bill at a time

#26

> If you are bitten by a raccoon, you can’t really decide not to get the rabies vaccine. It’s literally a life-or-death situation. But the price is incredibly high. This, to me, is a perfect example of why healthcare should be subsidized by the government (either directly or through a government-backed insurance plan that you receive as a fallback). Health isn't a good or service you choose to purchase. Demand is per…

That sounds great, but our US government has failed us for 30 years on healthcare. Not sure why anyone thinks that tax dollars would make the problem better.

No. Politicians favoring policies that deliberately exclude the poor have failed us for 30 years.

We have never been able to make extensive progress on healthcare because voters elect politicians that fight against government health insurance (even fighting against spending government money on insurance for the disabled and elderly).

Free market ideologues have failed us, not the government. This is painfully obvious if you've ever been in another civilized country (Taiwan, Canada, UK, etc.).

Re: Bringing transparency to ER prices, one hospital bill at a time

#27

As the person who submitted this story, I have a question: why was Sarah Kliff’s name removed from the headline? I submitted it with the same title it carries at CJR, which includes her name. The story is a profile of her and her work, so removing it makes the headline less informative, not more. And she’s not a celebrity, so mentioning her by name doesn’t make the headline any more clickbaity than it would be withou…

Same thing happened to me, where the title was changed from "Java Creator James Gosling: Why I Quit Oracle" to "Why I Quit Oracle". https://news.ycombinator.com/item?id=15163932 It doesn't make sense.

Your example (taken with this one) actually makes it make more sense though -- seems like they remove names from articles.

I don't know why the mods have chosen to do that (I'm not going to speculate because there could be lots of reasons), but at the very least they're doing it consistently.

Re: Bringing transparency to ER prices, one hospital bill at a time

#28

Earlier quoted context omitted.

And the worst thing is that there’s no way to predict the cost. Even if you go to an ER that’s in network (good luck with that in an emergency), you might be assigned an out of network doctor and be charged out of network prices

We've had 2 children in the last 4 years and this concept was foreign to me. Our 2nd child we were billed for an out of network anesthesiologist at an in network hospital. Several thousand dollars in total, I called the insurance after reading online a bit about it. Eventually they said they would "resubmit" the claim for reconsideration. A few weeks later we got an EOB showing we didn't have to pay any of it. The wh…

Anesthesiology is a particularly pathological case, so to speak. You don't choose your anesthesiologist; it's the medical equivalent of a (very important and highly-paid) back-office function. So you've chosen an in-network hospital and an in-network surgeon? Surprise! You may also discover, months later, that your chart was read, while you were sleeping, by an out-of-network physician on call. Surprise!

The American system is literally (literally literally) unsustainable.

Re: Bringing transparency to ER prices, one hospital bill at a time

#30

I moved to the US about a year ago. Went to ER for the first time ~3 months ago. I was charged about $4000 for: - Cleaning a wound (with water/desinfectant). - Some antibiotics. - A band-aid and gauze. I get how, with labor cost and all, that might cost $200. Maybe $300? I have no idea how this can cost $4000.

Part of it is because consumers are completely detached from the price aspect of medical care. Getting an estimate, shopping around? Forget it. It’s a black box.

And, frankly, part of it is because hospitals can’t refuse care to anyone and if they can’t pay, someone else has to.

Post reply on HN