Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Medical equipment pricing is completely broken when a sling costs $200

latimes.com

Post reply on HN
Print view View original

161–170 of 370 posts

Re: Medical equipment pricing is completely broken when a sling costs $200

#161

Post by jcater »

nickjj wrote: post #112
merpnderp wrote: post #15

Earlier quoted context omitted.

I had a deep split over my eye (metal ring tossed while I was still down range) and knew going to the ER for stitches would end up costing thousands for a five minute stitch job, so I pinched it together and put on superglue. Healed better than stitches and cost me nothing. I hate our medical system too.

When you say superglue, do you mean an off the shelf superglue that you would pick up at a hardware or craft supplies store? Did it just dissolve on its own after X number of days?

Yes, cyanoacrylate (the group of adhesives that superglue belongs to), are used in medical and veterinary situations for exactly this purpose.

https://en.wikipedia.org/wiki/Cyanoacrylate#Medical_and_vete...

I've used off-the-shelf superglue on cut fingertips where I couldn't get bandages to stay. I believe it's also commonly used in place of stitches where you don't want the scarring that stitching would cause (e.g., parts of the face.)

It wears off in 3-4 days.

Re: Medical equipment pricing is completely broken when a sling costs $200

#162

Post by crooked-v »

mikeash wrote: post #153
cosmodisk wrote: post #46

Reading this in Europe.I'm sure if I'd go with article alone to my American colleague on Monday, he'd defent the system even if he'd have to die for it. Knowing he's a healthy 20something man with affluent parents that could potentially bankroll even a year's stay in a private hospital- I could understand it to certain degree, however I fail to understand why nobody really is up for changing this system,where million…

Essentially everyone wants to change the system. The problem is that half of the voters want to fix it by having the government provide universal coverage, and half want to fix it by getting government out of the picture as much as possible and letting the market solve everything.

Of course, when it comes to health care, 'letting the market solve everything' actually means 'letting poor people die'. Sometimes it even means 'letting poor people die because poor people deserve to die' (look up prosperity gospel).

Re: Medical equipment pricing is completely broken when a sling costs $200

#163

Post by mjevans »

eblanshey wrote: post #111

If healthcare costs are so astronomically high, why are so many Americans supportive of mandatory insurance that forces insurance companies to pay those prices? It sounds as bizarre. It's like if a normal pair of shoes cost $1000, and people decided shoes are a right and everyone should subsidize each other's $1000 shoes. How about fixing the root problem first: a pair of regular shoes shouldn't cost a thousand dolla…

American's hear a word like "socialism" and think that it's a lack of competition and thus innovation. They don't think of it as a regulatory floor to a market. A standard of service to surpass (if even possible).

The correct way to sell this to the populace is probably by framing it as a "minimum standard of service for all", and "getting the full value out of your taxes".

Re: Medical equipment pricing is completely broken when a sling costs $200

#165

Post by kbutler »

My son had a minor in & out surgery earlier this year. Could have done it in the office, but the doctor recommended a surgical center that was out of my insurance network. "Our patients have been very happy with the price."

I called the surgical center, and was told it was a flat fee of $500, payable in advance, for which I received a receipt: "Facility fee".

We did the surgery. The doctor's bill was well under a thousand dollars.

Almost six months later, the surgical center sent a bill to my insurance for $48,000 as a half-dozen line items, each listed as "facility fee". My insurance says they paid $25,000 and the patient responsibility of about $10,000.

We haven't seen a bill from the surgical center, and I told the insurance it was either a billing error or fraud, as it was 100x the price I was quoted and accepted up-front.

Re: Medical equipment pricing is completely broken when a sling costs $200

#166

Post by refurb »

Retric wrote: post #136
AnimalMuppet wrote: post #128

Earlier quoted context omitted.

Given that it's a common misconception, would you supply some evidence for your position?

Hospitals receive extra payments when they have an unusual number of Medicare patients. https://www.medicaid.gov/medicaid/finance/dsh/index.html It’s just another case where the government splits spending across multiple programs.

When they have a disproportionate share of Medicaid, not Medicare patients.

And the added payment isn’t that much.

Generally Medicaid pays below cost. Medicare is reasonable and leaves providers with a small profit (single digit percentage).

Re: Medical equipment pricing is completely broken when a sling costs $200

#167

Post by HorizonXP »

I realize that this article and the HN comments are centred on the US, but here's a link to the Schedule of Benefits (i.e. the costs) for all insured services that are compensated for by the Ontario Health Insurance Plan (OHIP): http://www.health.gov.on.ca/en/pro/programs/ohip/sob/

Meaning, while most Canadians do not know what our healthcare actually costs, it's all itemized, standardized, and freely available.

I just looked it up and was surprised to see that C-sections are only about $80 more than vaginal delivery (we just had a kid), so it's nice to know that there isn't much incentive for doctors to push one over the other. I realize that's a gross oversimplification, since there's probably a lot of other billing codes that get tacked for surgeries.

Re: Medical equipment pricing is completely broken when a sling costs $200

#168

Post by jameshart »

lightgreen wrote: post #95

The hospital sling was $200 according to the article. Amazon sling is $12.99 to $16.99 according to the article. So hospital sling is 12-15 times more expensive. So I suspect that the original writer of the article correctly wrote that hospital sling is 10 times more expensive. Then the editor came and decided that 10 times more expensive looks not as scandalous as 900% more expensive. The result is false precision h…

I have no idea what you're complaining about here.

If they had taken the $12.99 price (an actual exact price, with 4 actual significant figures of precision), the $200 bill (also an actual price paid, with five significant figures of precision) is actually, really-not-false-precisely, 1440% more expensive than amazon.

They allowed in the article that the sling might be a bit nicer than the ones on amazon - it had some padding. So they rounded its value up to roughly $20, giving, as you suggest, 10 times more expensive, as an estimated factor. Let's assume that's only good to one sig fig. That's fine for an estimate, and consistent with the 'probably worth a bit more than the ones on Amazon, let's say somewhere between $16 and $25' methodology.

"900% more expensive" is a perfectly accurate restatement of "10 times as expensive" to a single significant figure. Would you rather they went with "1000% more expensive" to make it feel more Benford's-law-comliant in its imprecision? That would surely have helped your supposed sensationalist editor, right?

"900% more expensive" is literally just another way of writing "ten times as expensive".

So I really don't know what kind of editorial sensationalism conspiracy you are trying to posit here. Wouldn't a sensationalist have gone with the 1440%, and nefariously rounded it up to 1500% to punch up the headline?

This seems like a weak place to try to hang an argument about the innumeracy of the press....

Re: Medical equipment pricing is completely broken when a sling costs $200

#169

Post by refurb »

danans wrote: post #68

I have very good insurance by US standards through my FAANG employer. My son recently got a full body reaction to poison oak exposure. No hospitalization, just a couple dermatologist visits, 30 minutes each. After insurance paid its portion, I got a bill for $800 in out-of-pocket charges.

How much of that was your deductible?

Generally really good insurance has a 10% co-insurance charge. But the first $X amount is entirely borne by you.

Re: Medical equipment pricing is completely broken when a sling costs $200

#170

Post by dragonwriter »

mkhalil wrote: post #129
repiret wrote: post #106

Earlier quoted context omitted.

They’re not shell organizations, hospitals just outsource tons of stuff, frequently including physicians. (In fact, in California, hospitals may not legally employ physicians to practice medicine)

Yeah, but when you pay for services you don't expect to have to write checks for every subcontractor your service provider users. They do that. You pay them. Everywhere but our messed up Medical System is like that. Imagine if every time you went grocery shopping you had to pay for the people stocking the shelves, putting the carts back if you used one, the cashier, and each wholesale distributor. It's crazy and sens…

> Yeah, but when you pay for services you don't expect to have to write checks for every subcontractor your service provider users.

Well, yeah, that's true by the definition of “subcontractor”, which doctors in hospitals often are not.

OTOH, healthcare isn't the only place where you might pay a fee to a facility for use of the facility and a fee to a service providers associated with the facility for services they provide in the facility. It's perhaps an inconvenient arrangement, but by no means unique.

Post reply on HN