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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.

#291

Post by AnthonyMouse »

Holybeds wrote: post #210
karmelapple wrote: post #195

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…

Where I live you know the cost before you go to the doctor since you will only pay a symbolic sum of 30 USD even if the visit ends up with something like a life long cancer treatment. If you need medicine you will pay at most 120 USD per year regardless of the costs. The idea that your access to healthcare should be linked to your own or your parents financial is crazy.

> Where I live you know the cost before you go to the doctor since you will only pay a symbolic sum of 30 USD even if the visit ends up with something like a life long cancer treatment. If you need medicine you will pay at most 120 USD per year regardless of the costs.

Then the problem is you have no pricing mechanism for determining how much the provider should actually be paid. If you offer less than what people value the service at, you'll get shortages (or, in this context, waiting lists and less life-saving medical R&D). If you offer too much, you're overpaying (see also US government contractors).

Governments in Europe apparently solve the "paying too much" problem by systematically underpaying, but that doesn't work if everybody does it. The US can't subsidize your medical R&D if they're doing the same thing.

> The idea that your access to healthcare should be linked to your own or your parents financial is crazy.

I've never understood why people have this idea about healthcare but not even more immediate necessities like food and housing. It's not as if the solution you're proposing is even analogous to the solutions we use for the poor there (i.e. free clinics akin to homeless shelters and soup kitchens). If the problem is that free clinics are poorly funded, why isn't the solution to fund them better rather than nationalizing the entire healthcare system?

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

#292

Post by jlebar »

miketery wrote: post #284
Holybeds wrote: post #210

Earlier quoted context omitted.

Where I live you know the cost before you go to the doctor since you will only pay a symbolic sum of 30 USD even if the visit ends up with something like a life long cancer treatment. If you need medicine you will pay at most 120 USD per year regardless of the costs. The idea that your access to healthcare should be linked to your own or your parents financial is crazy.

I agree in principal to an extent - however economics need to be tied to the end product somewhat. Otherwise many people would opt for $100k healthcare cost (at the expense of the public) to extend their life for a few more months, this is not reasonable. Resources are finite - therefore we need appropriate allocation. In the end I agree that a basic safety net is necessary and serves a greater good - providing thing…

Serious question: Do you live a perfect life? Do you exercise daily? Do you never eat processed meat (linked to cancer)? Do you never drink soda (linked to metabolic syndrome)? Do you not smoke? Do you not drink any alcohol (linked to cancer)? Do you live close to your work so as to minimize the time spent in a car (car accidents are a major cause of preventable death)? Are you not overweight, even a little? And so on.

Do you think that someone who follows all but one of those rules still deserves healthcare? All but two? What's the moral difference between someone who smokes and someone who hasn't taken heed of diet/exercise advice after getting heart surgery? Where do you draw the line?

It's easy to say, "I don't want to pay for the healthcare of some hypothetical 'slob'". But make it real, consider what this actually means, and I think it's not something most of us want.

None of us is perfect. I'm sure that even olympic athletes occasionally eat bacon. Let he who is without sin cast the first stone, right?

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

#293

Post by epsontmt88vi »

pjc50 wrote: post #142
m1sta_ wrote: 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.

just make robot politicians, duh

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

#294

Post by Faark »

dfxm12 wrote: post #225
karmelapple wrote: post #195

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…

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. Next question, if the patient did go elsewhere, would they get to keep all the test results/would the hospital share the test results with the new facility? Or would the new place have to rerun all those tests?

> would they get to keep all the test results

Huh, is that a thing in the US? I understand the old hospital might not automatically giving them to you or the new one rerunning them anyway for practical reasons. But if you've payed for the tests, I'd expect you to own the results...

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

#295

Post by cryptonector »

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…

Doctors don't know the prices, and neither do the customers (not without doing a lot of homework that can't be done during emergencies). Even when you know the list prices, the actual prices your insurance negotiates are almost certainly different, so asking for list prices isn't enough.

Basically, in the U.S. the healthcare system is not exactly a free market as pricing signals are unclear, and most consumers have no idea how or inclination to price shop as they have been trained for decades to not bother. The problem is now not just a matter of how insurance is structured, but cultural.

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

#296

Post by cryptonector »

karmelapple wrote: post #195

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…

What are prices like? I suspect they are much lower than the equivalents in the U.S. Thesis: transparent pricing tends to keep prices down.

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

#298

Post by alkonaut »

conanbatt wrote: post #273
alkonaut wrote: post #119

Earlier quoted context omitted.

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.

I think you misunderstood: anyone who uses private would do so while also paying for a full public health insurance. That is, the public system is fully funded regardless of whether anyone wants to operate private hospitals.

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

#299

Post by casual_slacker »

Cthulhu_ wrote: post #137
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…

> It's a total mess and hopelessly complex for the average consumer. But not for insurance companies; it's in their interest to compare hospitals and get the best care for the lowest price. I for one hope this will trigger competition. On the other hand, it'll probably end up shafting the personnel instead of the ridiculous profit margins.

I'm not sure this is the case. Since medical insurance companies are heavily regulated on margins, their primary way of making money is investing the "pool" that's used to pay out claims. The size of this pool is determined by actuaries, so it can't be increased arbitrarily. But it grows in two ways: more patients, or more required reserve per-patient. In this way, insurance companies actually benefit from higher hospital prices.
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