There should be a basic law of health care: no person is liable for a debt they incurred before they were presented with the price and had an opportunity to refuse. I'd give some amount of leeway for unconscious patients, but aside from that every single penny of expense should be agreed to up front. The absence of this policy explains a lot about how things have become so perversely broken.
Hospitals pledge to fight admin price transparency plan in court
61–70 of 311 posts
Re: Hospitals pledge to fight admin price transparency plan in court
#62Here in Canada, there is no price transparency whatsoever. Just when people are facing the stress and uncertainty of fighting a crisis like Cancer, they are given absolutely no inkling what their treatment will cost. When a physician makes an appointment for you with a plastic surgeon to discuss reconstructive surgery... No transparency about the cost. When they prescribe chemotherapy... No transparency about what th…
So in your opinion, neither France nor Switzerland are “functioning, civilized countries”? Price discovery works for a certain kind of care (e.g. non-emergency outpatient care), and we shouldn’t discard it without any consideration.
I am not familiar with France, but the first line in Wikipedia is:
"The French health care system is one of universal health care largely financed by government national health insurance."
https://en.wikipedia.org/wiki/Health_care_in_France
Then when I look into Switzerland, I see:
"Healthcare in Switzerland is universal and is regulated by the Swiss Federal Law on Health Insurance. There are no free state-provided health services, but private health insurance is compulsory for all persons residing in Switzerland"
I also read:
"Swiss are required to purchase basic health insurance, which covers a range of treatments detailed in the Swiss Federal Law on Health Insurance. It is therefore the same throughout the country and avoids double standards in healthcare. Insurers are required to offer this basic insurance to everyone, regardless of age or medical condition. They are not allowed to make a profit off this basic insurance, but can on supplemental plans."
"The insured person pays the insurance premium for the basic plan up to 8% of their personal income. If a premium is higher than this, the government gives the insured person a cash subsidy to pay for any additional premium."
https://en.wikipedia.org/wiki/Healthcare_in_Switzerland
---
Now let's not quibble. The core question her is, "Should basic healthcare be a marketplace?"
If basic healthcare is a marketplace, providers can charge what they like, and it's "caveat emptor" when it comes to purchasing healthcare, whether it's directly purchasing treatment, or purchasing insurance.
Here in Canada there are lots of non-basic kinds of healthcare that are a marketplace. How much does it cost to get a cortisone shot so that I can cycle? I don't know until I shop around. Same for physiotherapy, chiropractic care (is that heath care or phrenology?), dental care, orthodontics, and lots of things involving mental health.
But basic health care--for some definition of "basic"--is not a marketplace, and it is not optional whether you are covered.
Re: Hospitals pledge to fight admin price transparency plan in court
#63Earlier quoted context omitted.
Americans already have co-pays, deductibles, coinsurance and whatever other terms the insurance industry has cooked up, with no visible effects on costs. In addition to your other changes the following would also help: - Allow competition. Don't give hospitals the power to veto new hospitals in their area. - Disallow regional consolidation of hospital systems and medical practices. Regional monopolies are bad. - Incr…
There's an argument to be made with respect to advertising to physicians, but not the general public. Doctors have limited time and they ought to know what meds are available somehow..
I thought that was called pharma marketing, not advertising. That too has had corruption and perverse incentives in the past. However, I did mean banning advertising to the general public.
Doctors have the knowledge and expertise to critically evaluate statements presented to them by marketing materials (whether they do so or not is a different story). The general public, modulo the odd autodidactic genius, largely does not. If someone from the general public wants this information, they are free to find it on the Internet. In fact maybe we could make it mandatory that any materials presented to doctors are also posted on the company's website for anyone to see.
Re: Hospitals pledge to fight admin price transparency plan in court
#64We need price transparency! Went to a quick care the other day because of a flu that would not go away, was seen and diagnosed with bronchitis in less than 5 minutes. The quick care billed my insurance $1,840, which they talked down to $300, and had me pay $115. What?
From the UK. Health care cost stories in the US seem incredibly dreadful. Hard to grasp how a huge power like the US can't get itself around decently-priced healthcare.
Re: Hospitals pledge to fight admin price transparency plan in court
#65There should be a basic law of health care: no person is liable for a debt they incurred before they were presented with the price and had an opportunity to refuse. I'd give some amount of leeway for unconscious patients, but aside from that every single penny of expense should be agreed to up front. The absence of this policy explains a lot about how things have become so perversely broken.
Or we could just make healthcare a human right. No debt at all.
Re: Hospitals pledge to fight admin price transparency plan in court
#66Earlier quoted context omitted.
From a Bogleheads topic titled “How to Minimize Your Emergency Care Expenses”: > Fifth, nobody you interact with at the hospital at the time of your visit has any idea how much anything costs. Part of that is the whole price transparency thing. Those who know the price don't want the front line workers to know it. Part of it is the fact that there are so many moving parts. Medicine gets inappropriately compared to av…
Thing is, this was self-pay for a single routine lab test. It's the simplest possible scenario.
So few people self pay that hospitals just aren't set up to make the experience make sense. All of their resources are devoted to dealing with insurers and the government.
Re: Hospitals pledge to fight admin price transparency plan in court
#67Earlier quoted context omitted.
Americans already have co-pays, deductibles, coinsurance and whatever other terms the insurance industry has cooked up, with no visible effects on costs. In addition to your other changes the following would also help: - Allow competition. Don't give hospitals the power to veto new hospitals in their area. - Disallow regional consolidation of hospital systems and medical practices. Regional monopolies are bad. - Incr…
Copays aren’t transparent and essentially do nothing to support comparison shopping.
That's true, you are right. I guess they're meant as a "brake" to prevent hypochondriacs from spamming doctors.
Re: Hospitals pledge to fight admin price transparency plan in court
#68I spent 45 minutes at the hospital where I was to get a lab test done, trying to get a quote for said test. Prescribing doctor didn't know the cost. Lab tech didn't know. Billing department told me I needed a procedure code. Lab tech who was ready to draw blood couldn't tell me the needed code even after spending five minutes at a computer looking for it. Prescribing doctor gave me the code. Called back billing. They…
And god forbid anyone in healthcare communicate to you in writing or via email.
That's because it's illegal.
Re: Hospitals pledge to fight admin price transparency plan in court
#69I spent 45 minutes at the hospital where I was to get a lab test done, trying to get a quote for said test. Prescribing doctor didn't know the cost. Lab tech didn't know. Billing department told me I needed a procedure code. Lab tech who was ready to draw blood couldn't tell me the needed code even after spending five minutes at a computer looking for it. Prescribing doctor gave me the code. Called back billing. They…
And god forbid anyone in healthcare communicate to you in writing or via email.
Too risky. You can thank a litigious society for that one.
Re: Hospitals pledge to fight admin price transparency plan in court
#70You cannot do any good in this industry.