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

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

#71

Post by ekarulf »

erentz wrote: post #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 a…

I get IVIG 3x / week for a primary immune deficiency I’ve had since birth. For my dosage, it’s billed weekly at a rate of ~$32K of which my insurance company pays around ~$3K.

I hit my max out of pocket the first month of each year and the rest of the year is “free.”

I know that all the IVIG pharmaceutical companies offer a “I can’t afford this” option if you’re going out of pocket.

Good luck, it’s stressful to get but it’s a miracle blood product for those who need it.

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

#72

Post by irrational »

umvi wrote: post #44
irrational wrote: post #12

Earlier quoted context omitted.

Not just ER. We went to urgent care with a bean stuck up my sons nose. The doctor spent about 30 seconds getting it out. We were in and out in 10 minutes or so. The bill was $2000.

Is that what you had to pay out of pocket? With or without insurance?

Unfortunately we thought that urgent care clinic was in-network, but it wasn't. Insurance covered a little bit, but we were left with the majority of the bill. We complained about the high cost and asked for a discount to no avail.

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

#73

Post by hardwaresofton »

smacktoward wrote: post #66
dang wrote: post #48

Earlier quoted context omitted.

We often remove names from titles, because HN works better when the focus is on content rather than personalities. https://hn.algolia.com/?sort=byDate&dateRange=all&type=comme...

But it's an interview with a specific person, focused entirely on her work. The entire content of the article is tied to who she is and what she does. Removing her name from the headline just obliterates the value of the headline as a way to determine what you're going to see when you land on the other side of the link. This is a misguided policy and I hope you reconsider it.

Just want to note that I'm on the other side of this -- I think this is a great moderation policy for this specific forum.

Including names seems like a good way to:

- let people exercise their people-related biases

- encourage gaming of the system by appealing to authority

- encourage gossip-y headlines "X's techchruch interview whatever whatever"

> Removing her name from the headline just obliterates the value of the headline as a way to determine what you're going to see when you land on the other side of the link.

I'm not sure I agree with this at all... What she did is what's valuable right? When I clicked that headline, I expect to see something or some process that is actually bringing transparency to ER prices.

Also at the end of the day HN isn't a democracy :), but I think I happen to fall in the majority here (or at least in line with what was decided).

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

#74

Post by analog31 »

randyrand wrote: post #29

While it wouldn’t be my first go to, I have to wonder if complete 100% deregulation would be better than what we have today.

We'd be bailing it out in 5 to 10 years, guaranteed. That's what happens when utilities that should be public, are privatized.

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

#75

Post by thaumasiotes »

wonderwonder wrote: post #39
irrational wrote: post #12

Earlier quoted context omitted.

Not just ER. We went to urgent care with a bean stuck up my sons nose. The doctor spent about 30 seconds getting it out. We were in and out in 10 minutes or so. The bill was $2000.

Should have planted that bean. Maybe it would have grown an entire stalk of $2,000 beans. In all seriousness, that they are able to charge that much with no upfront warning is pretty insulting. But then again they know they have you hostage, its not like you are going to change your mind and tell the doctor to just leave it in there.

> But then again they know they have you hostage, its not like you are going to change your mind and tell the doctor to just leave it in there.

I hear people make this argument about patients who are bleeding out, and that's one thing. You're not going to suffer any extra harm from leaving a bean in your nose for a week. The nose just dumps out into the back of your throat. Why wouldn't you shop around in that case?

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

#76

Post by olliej »

darkerside wrote: post #50
xienze wrote: post #30

Earlier quoted context omitted.

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.

It's crazy because the initial idea was, insurers would be more educated buyers and thus better able to negotiate with medical providers. As it turns out, with no skin in the game, they hardly seem to care to negotiate prices at all!

They do negotiate - the prices they’re charged are vastly less than what you would be as an individual.

As far as I can tell the problem is really the big HMOs seem to be essentially managing another companies money, rather than their own, and they essentially get a cut of money going in and out of them.

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

#77

Post by olliej »

olliej wrote: post #56
wonderwonder wrote: post #45

Anecdotal story, a few years ago my dad had a heart attack. He was self employed, living the american dream so no insurance. He had to stay 2 nights plus ambulance ride. Total bill ~80k. I kid you not, 3 days after he got out my mom shattered her wrist and was taken to emergency surgery. ~40K. They wracked up a bill slightly less than their mortgage in under a week. Of course they could not pay and the hospital dropp…

That’s easy - medical debt isn’t written off by bankruptcy. So they’re pretty much guaranteed unending money.

Ok - I’d swear when I moved here I was told that it was excluded from bankruptcy proceedings (much like student loans) - maybe I misunderstood?

Anyway, I’d directly correct my comment but it’s been too long for edits apparently :-/

Upvote the replies :)

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

#78

Post by Waterluvian »

outworlder wrote: post #10
halflings wrote: post #4

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.

I got an abdominal ultrassound, because some of my bloodwork was off and the doctor wanted to confirmed my liver was ok. Very routine. So I agreed. 15 minutes from the time I got to the reception desk to the time I was out of the door. Hospital billed $6000 (already negotiated down with insurance). Insurance paid around $4000. They wanted me to pony up 2k. Told no. Went to collections, negotiated to just under 1000.…

My wife is scheduled for ultrasound #4 because of pregnancy irregularities. The fact that it's covered by universal healthcare gives me peace of mind in a few ways: I don't have to worry about affording it, I can just worry about keeping my family healthy. I don't have to doubt if the medical experts have my family's interests at heart or if it's just a cash grab.

First pregnancy we had a scare about genetic issues. Instead of wondering where the money would come from, I was able to take time off work and be there for my wife between the phone call and the battery of tests done 45 mins away. Another hour long ultrasound and a sit down with a geneticist in the afternoon. No bills, invoices, anything.

There's simply no reason for capitalism in healthcare to directly involved the patient. At least I believe that to be true.

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

#79

Post by mikeash »

robertAngst wrote: post #16
airstrike wrote: post #5

> 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.

Because it works fine in other places. The US government isn’t uniquely incapable. We just have to stop electing people whose major goal is to make it fail.

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

#80

Post by masonic »

bakenator wrote: post #60
calebm wrote: post #43

I consider myself a "pragmatic libertarian", and by "pragmatic", I mean I'm in favor of legislative intervention when the free market often goes awry. Examples of this would be combating monopolies (since I don't want feudal system 2.0) , preventing immoral practices (like child labor), and controlling prices when there is no competition at work, such as utilities. It seems that with hospitals, there effectively is n…

The US government has put in place extremely heavy barriers to open a medical care facility. If we were to allow people to open facilities that compete with hospitals, we would very quickly see advertised prices and dramatic price drops. The medical cartel and all its bizarre non-market activities are a result of the existing legislation in place.

  The US government has put in place extremely heavy barriers to open a medical care facility
That's not true at all. The federal government wouldn't gave any reason to intervene unless you end up falsely billing a Federal program like Midicare, Medicaid, or VA.

The reason for consolidation in ERs is cost -- uf you run an ER, you are obligated to treat anybody who cones in without regard to ability to pay. It's a money pit in many urban areas.

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