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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.

#191

Post by onetimemanytime »

kristopolous wrote: post #165
tertius wrote: post #161

Earlier quoted context omitted.

I meant the best answer to the "there is no competition in emergency care" objection. Is there a current good answer to a consumer having the ability to competitively (without too much work) receive emergency care?

You could do limited supply side bidding and some of that already happens, but proximity to care matters so much that I think structuring it like all the other emergency services (such as police and fire) is probably the right way to go. Urgency is the only maximizing function.

Public utility, no competition for emergency given how it works. Nose job or breast implants are another thing. Emergency prices linked to Medicare.

But then, I can imagine them charging, say, $3800 to stabilize you with whatever surgery (there goes the urgency) and start billing you normally for the rest of the care. They'll make it back and then some.

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

#192

Post by drewg123 »

kristopolous wrote: post #167
tertius wrote: post #163

Earlier quoted context omitted.

Perfect competition? There is no such thing in practice. Also potentially a way to outsource this to a group with better knowledge. Dentistry is a good example of competitive service, eye care is as well. And negotiation is normal. You're moving the goal posts in the right direction, but to the edge.

Plenty of things are pretty close to perfect competition Grocery stores, sandwich shops, coffee houses, clothing stores, coin laundromats, circuit design, postal carriers, kitchen utensils and serving equipment, rental cars, housekeeping things like brooms and dustpans, bouquets and flowers, nuts bolts and fasteners, airlines... Essentially anything where the brands are fairly indistinguishable and you have a hard ti…

Eyeglasses, at least, are a monopoly controlled by one company, Luxottica. See https://www.forbes.com/sites/anaswanson/2014/09/10/meet-the-...

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

#193

Post by assblaster »

SQL2219 wrote: post #164

Now this is the way it should be: https://surgerycenterok.com/pricing/

These prices seem reasonable, even though the cost is in the thousands of dollars.

The question is what happens when you try to get your insurance company to pay this quoted price.

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

#194

Post by loblollyboy »

justaguyhere wrote: post #182
bookofjoe wrote: post #172

Pro tip: I was a neurosurgical anesthesiologist at the University of Virginia Health Sciences Center for twelve years (1983-1995). Every now and then I'd get a call from our billing office that they'd received a letter from a patient I'd cared for who was too poor to pay what our department had billed (usually many thousands of dollars: I had NO IDEA what our charges were, BTW, nor did any of my colleagues in the dep…

by my initialing a form we had, their balance due us was 0 That is very nice of you. I hope others like you in positions of power do the same!

Like our elected officials for example

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

#195

Post by karmelapple »

I was in a hospital in Singapore recently, and the prices for doctor consultation fees, staying in a room, and even certain tests were listed right at the front of the emergency room desk.

After the patient I was with was stabilized, the nurse confirmed with us verbally what the rough cost should be for the rest of what the doctor prescribed, and asked if we wished to proceed. We could have said no and gone elsewhere if we wanted, since the patient at least was relatively stable and we knew what was wrong.

I want this experience to be the norm in the USA.

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

#196

Post by ___alt »

assblaster wrote: post #189
___alt wrote: post #102

I'm so glad I live in a country with single-payer healthcare.

I'm so glad I live in the United States, arguably the greatest country in the history of the world.

US is a great country for many things, but having any serious health problem putting you in financial jeopardy (or throwing you in an inextricable administrative maze to dodge high and cryptic charges) in ridiculous for a "great" country.

Having a life-threatening condition is already scary enough that you don't also have to dread bankruptcy at the same time.

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

#197

Post by BigChiefSmokem »

justaguyhere wrote: post #186
bookofjoe wrote: post #184

Earlier quoted context omitted.

As I recall, every fellow attending did exactly what I did whenever they received a letter like that. It happened so infrequently, and our department billed so many tens of millions of dollars/year, it wasn't even a ripple in the pond.

it wasn't even a ripple in the pond. True, but it did make a difference to those people you helped! so yeah, kudos to you.

I'm up voting your comment, people on this site can be ridiculous.

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

#198

Post by rcafdm »

sitkack wrote: post #53
telotortium wrote: post #45

Earlier quoted context omitted.

If you look at the actual household income in various countries, as opposed to the GDP, which doesn't always track household income as well for many OECD countries, it turns out that the US has pretty much the healthcare consumption expected for its average household income: https://randomcriticalanalysis.com/2018/11/19/why-everything... . Based on this analysis, I think the primary issue with US healthcare is the fa…

Please stop using average. Median is a much better measure.

It’s really not in this context. The median household vis-a-vis income isn’t necessarily the median household vis-a-vis health consumption. More generally, health spending is massively subsidized by society writ large. Society’s willingness and capacity to pay is much better indicated by average income than the income of the median household (never mind issues pertaining to measurement of the income distribution within countries!). Furthermore, the vast majority of health expenditures in most high-income countries are spent on a small fraction of the population in any given year (those that are very sick, badly injured, etc.)

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

#199

Post by rcafdm »

rcafdm wrote: post #198
sitkack wrote: post #53

Earlier quoted context omitted.

Please stop using average. Median is a much better measure.

It’s really not in this context. The median household vis-a-vis income isn’t necessarily the median household vis-a-vis health consumption. More generally, health spending is massively subsidized by society writ large. Society’s willingness and capacity to pay is much better indicated by average income than the income of the median household (never mind issues pertaining to measurement of the income distribution with…

P.S.: It’s my blog.

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

#200

Post by alehul »

sturgill wrote: post #190
mwerd wrote: post #133

This won't help consumers. The prices (both charges and what Medicare pays) are already effectively public: https://data.cms.gov/Medicare-Physician-Supplier/Medicare-Pr... The problem, as some other comments point out, is that they're way too complicated. The link I posted, for example, is just the provider charges. A hospital visit typically has a facility claim and at least one provider claim. Depending on the type…

I shared this experience before on HN, but I once cut my leg quite severely playing ice hockey. Ended up at the ER dripping blood everywhere. I went to the desk and asked if they took my insurance. Said I was only interested in treatment if my insurance would cover it. I was assured it was fine. Naturally the doctor assigned to me did not take my insurance... I got out of the out-of-network billing after hours of pho…

Just out of curiosity: have you tried calling your insurance to ask them where you should go?

I haven't either, and have generally gone by your route of asking the hospital whether it will be insured, but I'd imagine calling insurance (if a feasible option?) would provide a lower rate of error.

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