Live data from Hacker News

Insured price $2,758, cash price $521

latimes.com

1–10 of 345 posts

Re: Insured price $2,758, cash price $521

#3
post #2

My understanding is the insured patients are subsidizing all the others covered by medicare, medicaid or those uninsured.

Why? Why are insurance companies not demanding cash price and reducing premiums? There should be lawsuits against hospitals, this seems like something which is generally considered highly illegal at this sort of scale... charging different customers different prices -- especially when the ones paying more are more than capable of taking hospitals to court.

Re: Insured price $2,758, cash price $521

#5
post #3
post #2

My understanding is the insured patients are subsidizing all the others covered by medicare, medicaid or those uninsured.

Why? Why are insurance companies not demanding cash price and reducing premiums? There should be lawsuits against hospitals, this seems like something which is generally considered highly illegal at this sort of scale... charging different customers different prices -- especially when the ones paying more are more than capable of taking hospitals to court.

The 80/20 Rule could be one reason -- the more they spend on health care, the more they can spend on other things.

https://www.healthcare.gov/health-care-law-protections/rate-...

Re: Insured price $2,758, cash price $521

#6
post #4
post #2

My understanding is the insured patients are subsidizing all the others covered by medicare, medicaid or those uninsured.

Exactly! Nobody seems to realize that we already have a shitty (for-profit) form of socialized health care.

Yup. We've taken the worst aspects of both sorts of system and combined them into a Kafkaesque nightmare.

Re: Insured price $2,758, cash price $521

#7
post #3
post #2

My understanding is the insured patients are subsidizing all the others covered by medicare, medicaid or those uninsured.

Why? Why are insurance companies not demanding cash price and reducing premiums? There should be lawsuits against hospitals, this seems like something which is generally considered highly illegal at this sort of scale... charging different customers different prices -- especially when the ones paying more are more than capable of taking hospitals to court.

I'm a generally anti-legislation kind of person, but as long as breaking up big tech is a hot topic, why not pass a bill requiring cash prices for any not-for-profit insurance providers and co-pay networks? There's a lot of interesting competition happening in those spaces, and making not-for-profit insurance a better deal seems like a great way to get capitalism grinding at the issue of overpriced healthcare.

Re: Insured price $2,758, cash price $521

#9
Beyond opaque and variable pricing for the same service, there is also the question of whether something simpler would do the trick.

Some years ago, I thought I might have broken my finger. I went to the doctor and it was actually the physician's assistant who saw me. I'd explained at the front desk that I had a high-deductible policy and I would be paying in full for the visit.

The PA said "Usually we would send someone for an X-ray, but since your insurance won't cover it, there is a quick test we could do and it would just be part of this office visit."

He opened a drawer and pulled out an instrument and asked me if I knew what it was. Being a musician, I said "Yeah, that's a big tuning fork. And with those weights on the end it must vibrate at a very low frequency."

He said, "You got it! The idea is we get the fork vibrating and then hold the end against your finger. If it's broken, it will hurt like the dickens, so just holler and we will stop and you go get that X-ray. If it doesn't hurt much, it's just a sprain, so take it easy and you should be fine."

We did it, and my finger was fine. Saved me a bunch of time and money!

Edit: Thank you everyone for the lively commentary! I would like to mention something that I forgot at first (it was ten years ago) and your comments reminded me of.

The PA didn't pull out the tuning fork until going through a complete set of manual range-of-motion and "does this hurt" tests. All indications were that my finger was not broken, it was just a mild sprain. I'd only gone to the doctor in the first place out of the proverbial "abundance of caution".

So it was my decision not to get the X-ray. Please, everyone, do not blame this on the American medical insurance system! I could have easily afforded the extra $150 for the X-ray, and of course I still had that option after the tuning fork test. But since both the PA and I were both so sure at this point that it was just a sprain, I figured I would same both time and money by skipping it.

It was my call how to proceed with this very minor injury, no one else's.

Post reply on HN