Medical equipment pricing is completely broken when a sling costs $200 • Hacker News Board

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

#321

Post by Retric » Sat, Sep 14, 2019, 10:36 AM UTC

refurb wrote: post #166

Retric wrote: post #136

Earlier quoted context omitted.

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).

Should have been more clear.

From 2015 to 2017 Medicare lowered it’s uncompensated care payments. However, that program covers uncompensated care underpayment. Medicare explicitly does not pay for everything at hospitals: https://www.medicare.gov/coverage/inpatient-hospital-care

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

#322

Post by Bootwizard » Sat, Sep 14, 2019, 10:37 AM UTC

ttul wrote: post #195

My son broke his femur at school. He was transported to hospital where he underwent surgery to insert rods. He stayed for four nights in a state of the art, brand new children’s hospital, brimming with wireless tech. The nursing care was top notch. I had to pay for parking. Once he was back at school, the school district brought out occupational therapists who assessed his new disability and provided extra assistance…

Is the parking $20,000?

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

#323

Post by Keverw » Sat, Sep 14, 2019, 10:54 AM UTC

kartayyar wrote: post #313

I went to a travel medicine clinic, and got two shots. The cost for the shots was ~200$, and ~300$ for consultation, which was a PA giving me printouts about information of what diseases are found in which countries. What a scam.

Interesting. I know some places require yellow fever but think that’s the only one commonly required. Seems common for South America. I think a world cruise be fun if ever rich enough so sounds like would need to get it.

Personally not a fan of vaccines for multiple reasons, but I got a feeling at some places if you just wanted only what was required they’d try to convince or guilt you into getting the others. Maybe though if knowing you are going to go on a trip where you need it, get it elsewhere... say you go vacation in Europe, probably cheap enough to self pay even without being covered by their insurance. Plus the ingredients can vary by country too. I guess the one approved for Canada and the one approved for the US are different yellow fever wise.

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

#324

Post by crankylinuxuser » Sat, Sep 14, 2019, 11:39 AM UTC

nickjj wrote: post #125

awb wrote: post #44

Just to pile on about how ridiculous medical costs are: After giving birth my wife was offered Ibuprofen. On the bill we were charged $80 for the 2 pills she took. This was before Obamacare. After Obamacare I twisted my ankle and the doctors insisted I wear a cheap fabric boot with stiff plastic plates while it healed over the next couple weeks. I asked how much it cost and they said $280. I took it off and refused i…

Yeah it's nuts. Someone I know sprained their ankle. They recommended that he should use a cane for a while and said they had one to give him. When the bill came weeks later it was $200 for the cane that looked really close to what you can get for $20 at Walmart. The really messed up thing is I drove him to the doctor and I carried some of the paperwork out (wasn't the bill) so he could use both hands to move around…

Yeah for spite, I would have bled all over their counter and caused a biohazard mess. If you laugh at me like that, I'm not going to be pleasant.

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

#325

Post by crankylinuxuser » Sat, Sep 14, 2019, 11:51 AM UTC

foobarbecue wrote: post #261

cpursley wrote: post #83

Earlier quoted context omitted.

> And the Republican party is currently avoiding discussing Are you so sure about that? A republican president recently signed an executive order for more transparent pricing: https://www.npr.org/sections/health-shots/2019/06/24/7355785...

I couldn't believe when I first heard about this -- Trump doing something potentially beneficial. Sounds like it will have no actual impact, but I hope it does.

And early on prior to the election, Trump was also talking about repealing Obamacare and putting in single payer.

As much as I despise Trump, this idea wasn't terrible. Obamacare/ACA was only a stepping stone. But the republicans had a 'talking' with him.

https://www.npr.org/2019/04/02/709175203/trump-backs-off-oba...

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

#326

Post by mruts » Sat, Sep 14, 2019, 11:56 AM UTC

jorblumesea wrote: post #143

oppositelock wrote: post #86

Earlier quoted context omitted.

I went to the ER with chest pains seeming like a heart attack. They did an EKG, determined it wasn't a heart attack, then a blood test, which determined it was low potassium, and did a chest x-ray just in case. I received a saline IV and potassium pills as treatment, and went home after a couple of hours. The bill was about $18,000 for this. The insurance negotiated rate was about $1,500, of which I had to pay about…

> These people are all acting in violation of tons of existing laws - I don't understand why this isn't prosecuted. $$$$$$. The Medical system is being used to transfer wealth from the working and middle classes to the capital class under the guise of "free market". That money is being used to shape legislation, buy politicians, influence elections and kill threats to the system, allowing for even greater wealth tran…

I don’t think you could find even one person who thinks our healthcare system is a free market system. If only we could make it a free market system I think most of the problems would solve themselves. Unfortunately, I don’t think it’s feasible to untangle the decades of junk laws. Instead, it honestly might just be a better idea to implement single-payer. At least the incentives mostly line up unlike 3rd party payer.

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

#327

Post by jrs235 » Sat, Sep 14, 2019, 12:13 PM UTC

dawhizkid wrote: post #209

brink wrote: post #4

I just got an itemized bill today for a minor fall I took a couple months back.. On top of the nearly $6k in other charges from the hospital, they charged $531 for one dab of superglue or "liquid stitches" on my forehead for something that would have healed by itself. One of my friends died two years ago from pneumonia. He didn't go to the hospital when symptoms first started because he was afraid of the bills that w…

For whatever reason, the cost issue is completely missing from the dem primary debates on healthcare. Everything so far has been focused on health insurance coverage, and the candidates are really just debating what is the best way to cover more people. A world where 100% of Americans are covered under the existing healthcare system is still a disaster because everything still costs so much between premiums, deductib…

Exactly. I don't care about health insurance costs as much as I can about health care costs.

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

#328

Post by mkhalil » Sat, Sep 14, 2019, 12:46 PM UTC

brians wrote: post #226

MegaButts wrote: post #194

Earlier quoted context omitted.

> 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. Where else does this occur?

Weddings: you pay the caterer directly, even if the facility dictates which caterer you use

That's a really obscure example. I have a lot of family around me and we have many weddings. Most of the time the venue is the caterer since that is what they charge for the venue.(500-900 people weddings, over 10 a year). Not always though.

BUT STILL, weddings are a really bad example here.

The people getting married get to chose from whom they want the table and chair covers, flowers, singer/band, catering, belly dancers/entertainment, lights people, AV people.

Those are choices you got to make and the bills will obviously come separate since there is clear distinction of entities. Heck, the venue and the singers might not even of said a word to each other, let alone have a billing agreement.

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

#329

Post by mattmcknight » Sat, Sep 14, 2019, 1:57 PM UTC

noelsusman wrote: post #199

mattmcknight wrote: post #154

Earlier quoted context omitted.

Simple change to next year's Medicare plans: if you accept Medicare you cannot charge any patient more than you charge Medicare.

Simple way to put most hospitals out of business overnight. Or, more likely, simple way to force hospitals to make drastic cuts to services.

Or Medicare prices rise to be closer to real costs, instead of forcing them to be subsidized by the uninsured.

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

#330

Post by mattmcknight » Sat, Sep 14, 2019, 1:57 PM UTC

hollerith wrote: post #264

mattmcknight wrote: post #154

Earlier quoted context omitted.

Simple change to next year's Medicare plans: if you accept Medicare you cannot charge any patient more than you charge Medicare.

That was tried during the Clinton administration. Result: many doctors dropped all their Medicare patients, making it impractical for Medicare patients to find a doctor to treat certain conditions.

Then Medicare needs to pay a little more for those specialists.