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

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151–160 of 390 posts

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

#151

Earlier quoted context omitted.

Are the prices that Medicare pay orders of magnitude different? ISTR that Medicare and the VA both pay about $10k per patient per year, which I think is comparable with the NHS. No sources as this is half-remembered.

NHS spending is £2892 per person/year, that's quite a bit lower.

Huh, that's much lower than I thought.

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

#152
EMR, Health Information Exchanges, teams of analysts organizing standards for information exchange, and mandates for upgrades should have set the stage for transparency beyond published fictional information by providers.

Would someone please comment about these projects? The affordable care act gave more than a billion dollars away for people to work on the exact same, redundant projects in regions across the United States. Did these initiatives reach production and are they running today?

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

#153

Earlier quoted context omitted.

NHS spending is £2892 per person/year, that's quite a bit lower.

Huh, that's much lower than I thought.

There's a bit of complication because we're comparing one system with not much insurance with a different system that has a lot of insurance.

Here's a nice run through of the numbers.

https://www.bbc.co.uk/news/uk-42950587

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

#154
post #95

Earlier quoted context omitted.

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.

Car insurance prices vary widely from year to year, and person to person. I still expect a somewhat accurate price when I give some minimal information.

Agree with the ethics, but if someone presents with a broken leg do you xray it (cheap) or mri (expensive)? For anything vaguely complicated the Dr is basically just eliminating likely culprits. Its preferable for everyone (that doesn't have a profit motive) if they try the cheap/quick ones first.

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

#155

Earlier quoted context omitted.

Ambulance staff are incentivized by pretty nurses and free food/snacks. Ask any paramedic in a city with enough choice of hospitals and they'll tell you. What is the best answer to the "emergency care competition" that you've found? And what proportion of medical spending is on emergency vs. not?

Even in non-emergency care, perfect competition requires perfect knowledge (the consumer to know medical knowledge), perfect information (knowing the exact quality of care from all competitors beforehand), rational buyers (having no preexisting biases based on irrational cognition), no barriers to entry or exit (ie, being able to switch hospitals mid stream), no network effect (the previous state...eg who does the la…

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

#156

Earlier quoted context omitted.

The idea of effective competition in emergency services has always struck me as fanciful. The benefit that competition provides to incentivize lower prices and better services is a consumer's ability to easily deny someone their business and go elsewhere. What would this look like here? Would one be in the back of an ambulance doing price shopping on a tablet as they are fighting some terrible injury? Perhaps tie in…

Ambulance staff are incentivized by pretty nurses and free food/snacks. Ask any paramedic in a city with enough choice of hospitals and they'll tell you. What is the best answer to the "emergency care competition" that you've found? And what proportion of medical spending is on emergency vs. not?

>>What is the best answer to the "emergency care competition" that you've found?

Pay what the insurance or medicare pays, plus a capped xx% because they got a volume discount. By law hospitals have to stabilize you, can't let you die, money or no money. (I know they have been cases of trying to dump patients but...)

So you saved me, but how did you come up with the $455,000 bill? We entered into a contract without prices, so the prices should be customary. 5-10X what insurance pays isn't fair.

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

#157
post #149

Earlier quoted context omitted.

So you have insurance but it doesn't cover stuff when you are actually ill? Does your insurance policy actually spell stuff out so that you can predict what will or won't be covered? Note: I'm from the UK and find the stories about US healthcare insurance grimly fascinating....

Not just health insurance, but healthcare is crazy too. Spent a total of 36 hours on the phone with the hospital to figure out how much something would cost because I knew I had to pay out of pocket. And they weren't even right when they finally gave me a number. Had a doctor remove a cotton ball from my ear in the hallway. Charged me 2.4k for that. Didn't have insurance either. My wife's friend delivered her own bab…

I couldn’t even get the billing codes for a routine ultrasound. And no one will ever respond to you in writing for anything.

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

#158
post #145
post #142

Earlier quoted context omitted.

It's not a technological problem but a political one: the obfuscatory pricing is deliberate. Maybe you could have "fighting hospital billing as a service", but that's definitely going to need a chunk of human labour on top of whatever AI assistance you apply.

Is there any way this could be represented via interactive graph? We were able to tame much complex stuff than deliberate obfuscation by people not aware what tech can do. I guess there is not enough incentive ($$) to solve this problem.

The $$ is being made by the hospitals

See https://www.vox.com/health-care/2018/12/18/18134825/emergenc... to start digging into the mess

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

#159
post #142
post #140

Earlier quoted context omitted.

> It's a total mess and hopelessly complex for the average consumer. Sounds like something the people on this forum can help improve.

It's not a technological problem but a political one: the obfuscatory pricing is deliberate. Maybe you could have "fighting hospital billing as a service", but that's definitely going to need a chunk of human labour on top of whatever AI assistance you apply.

I agree that the problem is political.

While it might be nice in the short term to see some technological approaches to address the mess, the solution is ALSO political, NOT technological.

Making the information public, however obfuscated, will enable journalists and activists to systematically expose this problem for what it is and that's the first step towards fixing it.

The next thing that will happen is that many more people will be able to win massive lawsuits which is the only recourse the healthcare/insurance industrial complex understands.

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

#160

Earlier quoted context omitted.

Are the prices that Medicare pay orders of magnitude different? ISTR that Medicare and the VA both pay about $10k per patient per year, which I think is comparable with the NHS. No sources as this is half-remembered.

NHS spending is £2892 per person/year, that's quite a bit lower.

Interesting, this paper gives £2256 (table 2) https://www.health.org.uk/sites/default/files/AutumnBudgetWh...

This page gives $4246: https://www.healthsystemtracker.org/chart-collection/health-...

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