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Hospital prices are about to go public in the U.S.

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Re: Hospital prices are about to go public in the U.S.

#101

Post by StudentStuff »

Sacho wrote: post #97
tehlike wrote: post #56

Earlier quoted context omitted.

most doctors in the US actually do not know about the prices of treatments as it changes based on insurance administrator/insurer, and then what the patient pays also have huge variability based on insurance administrator/insurer.

I get why they might not be able to tell you how much you'll pay because of your specific insurer, but why would the overall price of the treatment change with it? That seems bizarre.

The doctor has no clue how the nurse (or assistant that handles billing) will bill the interaction, as they'll often optimize billings to extract the most money possible from your insurer.

Its scummy and fraudulent, but issuing a large bill to an insurer, then getting a much smaller check back is how medical billing works here in the USA. Having your insurance pay for a trip to the ER after a car accident would be $7k for them, or $84k for your car insurance, hence why one should carry a car insurance policy with good driver/passenger injury coverage :P

Re: Hospital prices are about to go public in the U.S.

#103

Post by StudentStuff »

setr wrote: post #98
feanaro wrote: post #71

Earlier quoted context omitted.

That still doesn't explain how prices of medical services in many other countries turn out several order of magnitudes smaller than commonly encountered prices in the US.

I've discussed this before, but I think there's quite a bit of funny money in hospital bills -- a 10k bill rarely actually materializes in 10k transferred across all parties involved. Doctors bill $10k to your insurance, the insurance decides its too much, lawyers are on-hire to negotiate and take a 30% cut of the outcome, and finally 2k is paid out; the absurd bill naturally accounts for the absurd process, and I do…

This type of billing practice causes a mess of winners and losers, essentially unless your insurer has good pricing with wherever you end up getting treatment (often not a choice you get to make in an emergency), you can end up holding the bag for the cash price, usually half of the $10k number you mention. Quite ridiculous when other insurers are paying less than half that price, smells of a scam.

Re: Hospital prices are about to go public in the U.S.

#104

Post by intralizee »

TheSpiceIsLife wrote: post #90
trevyn wrote: post #48

Earlier quoted context omitted.

The further toward the poles you go, the more mental healthcare is needed, so it makes sense they would have the experience and infrastructure! (Completely serious.)

I think I might have heard this at some point in the past. Anyway, I found a reference to support your claim: Also consistent with the conclusions of Torrey1 and Saha et al,2 our analyses shown in table 3 found a strong tendency for prevalence to increase with latitude. [1] 1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2669590/

I'm not aware from the article of how the illness "schizophrenia" foreshadows all of mental health. My illness being Gender Dysphoria.

Vitamin D deficiency from what I've read is common everywhere. It does make sense that longer winters would impact a person such as staying inside more. Yet I doubt any evidence can confirm lack of Vitamin D is associated with the illness schizophrenia.

Re: Hospital prices are about to go public in the U.S.

#106

Post by TheSpiceIsLife »

intralizee wrote: post #104
TheSpiceIsLife wrote: post #90

Earlier quoted context omitted.

I think I might have heard this at some point in the past. Anyway, I found a reference to support your claim: Also consistent with the conclusions of Torrey1 and Saha et al,2 our analyses shown in table 3 found a strong tendency for prevalence to increase with latitude. [1] 1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2669590/

I'm not aware from the article of how the illness "schizophrenia" foreshadows all of mental health. My illness being Gender Dysphoria. Vitamin D deficiency from what I've read is common everywhere. It does make sense that longer winters would impact a person such as staying inside more. Yet I doubt any evidence can confirm lack of Vitamin D is associated with the illness schizophrenia.

Ah, yeah, that's a good point. Schizophrenia is probably a poor proxy for all mental illness.

And there's probably at least quite a few things that aren't mental illness that benefit from mental healthcare.

Re: Hospital prices are about to go public in the U.S.

#107

Post by jacobr1 »

benj111 wrote: post #95
homero wrote: post #83

Earlier quoted context omitted.

They know how it works but not the exact price of an aspirin. They can't exactly tell you to go to the pharmacy out of your hospital bed to get a $2 bottle vs a $50 pill from them.

Is it not reasonable for them to ask, if they don't know? Also should they not have a general ballpark idea? I'm British and would expect Drs to be aware of costs before advising treatment (ruling out cheaper to rule out things etc).

No, because it will be different for every patient (for the same treatment) and will fluctuate widely from year to year. Also there is a general ethical sense of recommending the best treatment and dealing with cost as an afterthought.

Re: Hospital prices are about to go public in the U.S.

#108

Post by barrkel »

jclulow wrote: post #78
StreamBright wrote: post #74

Earlier quoted context omitted.

The US health care is optimised for the the p99, top 1% of the population who can afford anything. The other countries you mentioned optimise for the p50, the average person.

p50 would be the median, surely?

Technically, mean, median and mode are all averages. Handily, parent clarified what they meant.

Re: Hospital prices are about to go public in the U.S.

#109

Post by conductr »

huac wrote: post #63
refurb wrote: post #9

My guess is that eventually the govt will step in and start regulating prices if providers don’t. One interesting idea (not well thought out at all) would say that all prices need to be +\- 50% of what Medicare pays. Medicare pays $20,000 for stent placement? Great! You can charge whatever you want up to $30,000. A lot of effort goes into setting Medicare rates (and they are based on self reported costs across the co…

> all prices need to be +\- 50% of what Medicare pays. This is actually close to what happens with private insurers- they negotiate with a hospital to pay n-times what Medicare pays for some set of treatments. So why does Medicare pay the least? Because they have the most patients covered of any insurance network in the US. That's a hell of a bargaining factor. More patients = cheaper prices. The logical conclusion i…

No. Medicare pays the least because the don’t negotiate. They just set prices. As a hospital/doctor you can choose to accept Medicare patients or not. Most providers lose money on Medicare patients, or so the like to say.

Re: Hospital prices are about to go public in the U.S.

#110

Post by QuantumGood »

mikedilger wrote: post #21

I actually stiffed a doctor once because he refused to give a price up front and when I got the bill it was outlandish. I also made a huge scene in the intake/waiting room about this. I was leaving the United States at the time so I didn't really care about my credit record. To be slightly more honest: he wasn't the doctor assigned to me on intake, he was another doctor from another hospital across the street as a co…

Had new insurance and a sore shoulder. Was billed ~$1,400 for a physical therapist to examine it ("evaluation"). No treatment. Very little covered by insurance.

The next day had a chiropractor treat it and shoulder was fine. $25 with coupon. Funny part is, as it was new insurance, I spent over 30 minutes with insurance rep in advance on phone going over options and trying to get an idea of likely costs.

When I had a heart problem and no insurance, we called providers all over town (Minneapolis) to try to get prices in advance. Most would only give estimates over a wide range. Some flat out said it was there policy to not give estimates. Eventually found a cardiologist who worked basically free ($30 plus donation). I bought a Kardio to record my own ECG so I can have more data to improve my communication with cardiologists, who are (understandably) a bit alarmist about what can go wrong and tend to err on the side of (expensive) caution without sufficient data.

Feels like a broken system.

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