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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.

#271

Post by conanbatt »

bborud wrote: post #139
conductr wrote: post #109

Earlier quoted context omitted.

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.

What do they mean by "lose money"? Even if I turn up at a private hospital here in Norway, I pay nowhere near what you would pay in the US. Which tells me that either hospitals are run extremely inefficiently in the US (orders of magnitude worse than here) or there are layers of pretty substantial profit margins. I may be a bit peculiar, but I think a healthcare sector that is set up to mainly benefit execs and share…

Medicare reimbursements are below cost of care.

If all insurance lowered to Medicare reimbursements, you will reduce supply.

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

#272

Post by nradov »

Dowwie wrote: post #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…

Yes EMRs have been widely deployed, and the majority of providers are now connected to some sort of HIE. This has helped to improve care quality slightly by reducing medical errors and preventing the need for duplicate procedures. However it hasn't had much impact on billing or insurance issues; those will have to be addressed separately.

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

#273

Post by conanbatt »

alkonaut wrote: post #119
conductr wrote: post #109

Earlier quoted context omitted.

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.

Wouldn’t it make more sense to properly separate private and public? If hospitals can be either Medicare-only or no-Medicare (using Medicare as the name of a future broad/universal system much larger than Medicare/aid is today) then hospitals would chose to be Medicare in proportion to how many are covered. If everyone (including those who chose a private insurance) pays a full insurance premium for the public system…

If you have public hospitals that are tax funded and private hospitals, you will see that private hospitals will only provide profitable services (cardian, neuro, etc) and give all loss patients to public hospitals (psychiatry, managed care, etc). Public hospitals will have a unreasonable burden of high-cost patients.

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

#274

Post by lostlogin »

breatheoften wrote: post #93
lostlogin wrote: post #69

Earlier quoted context omitted.

Is this right though? Surely buying 20k knee joint replacements should earn a discount? Just setting it such that it wasn’t taking the piss would seem a vast improvement.

How does prepaying for treatment help with costs at all? Either you _can_ forecast accurately how many knee replacements you are going to do in which case prepaying won’t help you plan better — or you “prebill” for knee replacements and then incentivize doctors to push people into knee replacements to maximize their payouts ...

Economies of scale - if you don’t pass on the saving the money is going to someone. I guess you’re picking the providers (hospital and medical companies) and I’m picking the patient.

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

#275

Post by conanbatt »

pkaye wrote: post #10
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…

If you look at healthcare vs GDP, the US is way above the line compared to comparable countries. https://www.healthsystemtracker.org/chart-collection/health-... I think scaling the average costs from other countries accounting for GDP would be a good way to set the rates.

Honestly, how do people become so easily convinced that price controls would work in healthcare when they don't work anywhere else?

Inventing a fancy index is not a replacement for "price fixing". And price fixing does not work. You reduce supply.

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

#276

Post by nradov »

dakom wrote: post #94
trevyn wrote: post #57

Earlier quoted context omitted.

You certainly can under HIPAA, and I’ve done this several times without unreasonable delay. If you’ve had issues, I’m sure the “sternly worded letter from a lawyer” approach would get the gears turning.

Thanks! Are they all interconnected, so that if I use a service like https://www.medicare.gov/manage-your-health/medicares-blue-b... I will get the collected records from different doctor visits at different hospitals?

They are not all interconnected. Most providers have some sort of connectivity to a regional health information exchange network, but there are a lot of gaps and interoperability problems.

Blue Button 2.0 is helpful but currently it only gives authorized providers access to your Medicare claims (if you're a Medicare beneficiary), which have limited clinical value. Getting a copy of your full chart requires going through other channels.

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

#277

Post by conanbatt »

epsontmt88vi wrote: post #259

Can anyone recommend some resources to read up on the US healthcare system? I am looking to spend a good week studying the subject so I can have a more informed opinion on the subject.

To have a truly informed opinion, I recommend The economics of Healthcare class on Coursera.

Its only a couple of hours to understand why pricing is so complicated in the US, and why the problems people focus on are usually the wrong ones.

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

#279

Post by sbarre »

blitmap wrote: post #257
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…

After we establish transparent pricing across the board, we're going to have to deal with the reality that some folks seek care without having any ability to pay for services.

Yes, we will, and that will hopefully lead to a more important conversation about what the priorities of a society's medical system should really be, or how a society should prioritize funding medical services if you want to take a different approach.

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

#280

Post by epsontmt88vi »

conanbatt wrote: post #277
epsontmt88vi wrote: post #259

Can anyone recommend some resources to read up on the US healthcare system? I am looking to spend a good week studying the subject so I can have a more informed opinion on the subject.

To have a truly informed opinion, I recommend The economics of Healthcare class on Coursera. Its only a couple of hours to understand why pricing is so complicated in the US, and why the problems people focus on are usually the wrong ones.

Thanks.
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