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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

#91

Post by TomK32 »

hardwaresofton wrote: post #27
stephenbez wrote: post #23

Earlier quoted context omitted.

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.

well, it's a very different thing if the title is "Why I quit Oracle" or "Java Creator: Why I quit Oracle" and when it's all about removing name the consequence would have been a meaningless "Why I quit".

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

#92

Post by neffy »

masonic wrote: post #82
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…

living the american dream so no insurance Since when does "living the dream" mean choosing to go uninsured?

"living the american dream" has indeed started to be used rather sarcastically in foreign parts, for exactly this reason.

Your dream, everybody else´s nightmare.

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

#93

Post by esotericn »

The practices espoused here confuse me quite a bit (essentially, variants of not being quoted a price before a thing happens).

In the UK it's common to, say, go to a pub and buy a pint. It's not usual to ask for the price first. It's possible a bar could decide to quote me 500 quid after pouring. I'd obviously decline and walk out.

How is it any different in the healthcare case? If you've made an honest effort to determine a price, been told it'll be about X, and then receive a bill for 10x, it sounds like a scam that cannot be enforceable.

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

#94

Post by maxerickson »

maxxxxx wrote: post #67
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.

"And, frankly, part of it is because hospitals can’t refuse care to anyone and if they can’t pay, someone else has to. " I think that's a cheap excuse they have to rip off everybody else. I would like to see the actual numbers of people who aren't paying and what losses they incur.

It's substantial but doesn't come anywhere near explaining prices. The PDF here has some numbers:

https://www.aha.org/data-insights/2018-01-03-uncompensated-h...

Somewhere in the ballpark of $40 billion dollars a year vs total revenues in the ballpark of $3 trillion. Various aspects of Obamacare had the effect of leveling them off.

There is likely additional underpayment due to Medicaid and Medicare (to the extent those programs are underfunded and operate by mandating care, they are a hidden tax).

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

#95

Post by ZeroGravitas »

masonic wrote: post #81
Waterluvian wrote: post #78

Earlier quoted context omitted.

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.…

There's simply no room for capitalism in healthcare Yet the very technologies you specifically required in both cases (ultrasound and genetic screening) are direct results of capitalism in healthcare.

Medical Ultrasound was pioneered by a UK university in conjunction with the NHS. Are you giving "capitalism" broad credit for everything in modern society or is there some more specific claim you're making here?

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

#96

Post by maxerickson »

jolmg wrote: post #83

> 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. We had a bill from someone who had gotten a rabies vaccine at an emergency room What the... I'm pretty sure vaccines only work to prevent illnesses and are very much useless to treat them. I mean they're supposed to be small quantities of the virus or bac…

Rabies is a slow moving infection that hides from the immune system and usually doesn't become lethal until it hits the central nervous system. The vaccine stimulates immunity before the infection becomes serious.

Modern treatment also includes antibodies that will immediately work against the virus.

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

#97

Post by zaarn »

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…

Hospitals in the US not only benefit from unpublished pricing, they also benefit from the situation of customers.

A lot of their customers will be unable to compare multiple hospitals and "shop around", so to speak. Either because their conditions is life threatening, they're actively dying or they're no longer responsive. The ambulance, in any rational scenario, will drive you to the closest hospital in terms of time-spent-driving

So from a corporate perspective it's perfect; the customer arrives and you're legally obligated to start spending money while they are likely unable to object and then you can bill them for it.

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

#98

Post by irrational »

thaumasiotes wrote: post #75
wonderwonder wrote: post #39

Earlier quoted context omitted.

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?

How would you shop around?

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

#99

Post by wonderwonder »

masonic wrote: post #82
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…

living the american dream so no insurance Since when does "living the dream" mean choosing to go uninsured?

Living the american dream as in being self employed and attempting to make your mark. America reveres the self starter and the entrepreneur. Unfortunately for small business owners that can often mean not being able to afford insurance. They did not choose to have no insurance, they were poor. Perhaps life choices led them to being poor but to suggest it was a cognizant choice is a little disingenuous.
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