Hospitals pledge to fight admin price transparency plan in court • Hacker News Board

Re: Hospitals pledge to fight admin price transparency plan in court

#131

Post by sol_remmy2 » Tue, Nov 19, 2019, 6:44 PM UTC

madamelic wrote: post #76

topicseed wrote: post #64

Earlier quoted context omitted.

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.

>Hard to grasp how a huge power like the US can't get itself around decently-priced healthcare. To be honest, it's not that hard to figure out. The US gov't largely believes itself is ineffective and needs to be privatized and ran like a business. Private businesses are held up as beacons of innovation and efficiency without the "red tape" the gov't has due to purposefully created checks, balances and regulations. He…

> The US gov't largely believes itself is ineffective and needs to be privatized and ran like a business. Private businesses are held up as beacons of innovation and efficiency without the "red tape" the gov't has due to purposefully created checks, balances and regulations.

The medical system is really not private. It is a hybrid of a state-controlled system and a capitalistic system. Here are some ways of how the system is state-controlled:

1. Hospitals cannot be freely constructed. One must apply for a "certificate of need" to gain permission from the government to build a hospital. This is not a free market.

2. Credentialism is BAD in our medical system. There is only one group of people approved by the government to do prescribe most medications and perform most surgeries - doctors. This is not a free market and greatly increase costs. Doctors earn a median of 300k/year and are the highest paid profession in every state. This is not a free market.

3. Hospitals are legally forced to treat anyone who shows up at their door - even if they can't afford the treatment. This is not a free market.

4. Medicare/Medicaid are forced to nearly buy any drug, regardless of cost, if it could save a live. Even if a drug is 500k/year, the system is forced to buy it. This is not a free market and greatly increases costs.

Re: Hospitals pledge to fight admin price transparency plan in court

#132

Post by bluGill » Tue, Nov 19, 2019, 6:44 PM UTC

maerF0x0 wrote: post #49

> Transparency is not going to work where there is no competition, Emily Gee, a health economist at the left-leaning Center for American Progress, told Healthcare Dive. That's bs. I will drive to a further away hospital if it saves me $75 an hour of time spent... (edit: clearly I'm talking about non-emergency here)

But it won't. Your insurance will pay for it either way, so you are spending an hour of your time to save your insurance $75 - which won't even be given back to you in form of lower premium.

Re: Hospitals pledge to fight admin price transparency plan in court

#133

Post by jakobegger » Tue, Nov 19, 2019, 6:44 PM UTC

triceratops wrote: post #39

glofish wrote: post #13

This is IMO the "simple solution" to healthcare - nothing will bring down healthcare costs faster than the following - be allowed to choose - know how much something costs - pay some of the cost themselves (co-pay, health savings account) etc.

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…

Or, you could do what other developed countries do: Don't rely on private for profit hospitals.

Here, most hospitals are run either by cities or counties, or by the public insurance companies themselves.

This ensures that hospitals have an incentive to be efficient.

There are private hospitals, but only very few people go there, since they are very expensive, and you get good care in the public hospitals.

Re: Hospitals pledge to fight admin price transparency plan in court

#134

Post by brutal_boi » Tue, Nov 19, 2019, 6:44 PM UTC

Berobero wrote: post #98

istjohn wrote: post #22

I 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…

I was in Japan two years ago; got pneumonia and needed antibiotics. Went to a hospital with no insurance and no appointment. I was being seen by a doctor within 30 minutes. Doctor wanted to do some additional labs just to rule other things out, but he was worried that it would be expensive for me given the lack of insurance. He called up billing with me still in the room and had a price within a couple minutes: ~$70…

Similar story, s/France/Japan.

I had to go into emergency for a bronchitis, after all tests and getting everything the spot, the bill was around 40eur. The doctor asked me if I wanted the additional forms and paperwork to claim it on my US insurance.

I just said no.

Re: Hospitals pledge to fight admin price transparency plan in court

#135

Post by AlexTWithBeard » Tue, Nov 19, 2019, 6:45 PM UTC

Miner49er wrote: post #65

mullingitover wrote: post #61

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.

Or we could just make healthcare a human right. No debt at all.

It's an interesting question. Health care is a human right. Therefore it must be free.

A prompt and fair trial is also a human right. Therefore legal help must be free.

Moving around, staying warm and basic hygiene - a lot of stuff sound like basic human rights, but very few argue that transportation, heating and sewer draining services should be free.

I think most people around don't mind paying for the service. They just want the prices to be reasonable and predictable.

Re: Hospitals pledge to fight admin price transparency plan in court

#136

Post by munk-a » Tue, Nov 19, 2019, 6:45 PM UTC

noelsusman wrote: post #85

lotsofpulp wrote: post #73

Earlier quoted context omitted.

Is it illegal to write “we will bill your insurance for procedure codes x y z for your visit”? They don’t need to tell you the cost, but they know what they’re going to charge you beforehand. They should be able to tell you the codes so you can give it t your insurance company to find out how much it will cost. The reason healthcare providers don’t give out codes for known predictable procedures is it would enable cu…

Yes, it is illegal to send that information to your email account or your mailbox. These days most providers have services that enable them to communicate with patients electronically, but it's a totally separate system that you have to login to. Your private health information will never show up in your email inbox.

This is generally incorrect, sending PHI over email is not inherently a HIPAA violation, it all depends on factors that really need to be reviewed by a compliance officer.

Re: Hospitals pledge to fight admin price transparency plan in court

#137

Post by Thriptic » Tue, Nov 19, 2019, 6:45 PM UTC

stefan_ wrote: post #121

Thriptic wrote: post #71

Earlier quoted context omitted.

Lab tests are particularly complicated to price because usually they are being processed by someone else. Usually labs won't even try to get an authorization from insurance until they get your sample and start working on it as it affects their turnaround time which is one of their main differentiators, and each insurer will have different rules about what they will pay for under what conditions (insurers also have se…

None of this has anything to do with lab tests, which are an absurdly routine procedure. It's entirely divorced from the subject matter. It's not "complicated" out of necessity, but for profit.

I'm not justifying the situation, I'm simply saying this is how it works which is why the situation plays out how it does.

Re: Hospitals pledge to fight admin price transparency plan in court

#138

Post by mark-r » Tue, Nov 19, 2019, 6:46 PM UTC

triceratops wrote: post #39

glofish wrote: post #13

This is IMO the "simple solution" to healthcare - nothing will bring down healthcare costs faster than the following - be allowed to choose - know how much something costs - pay some of the cost themselves (co-pay, health savings account) etc.

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…

> all the pharma companies would save millions every year.

Their savings would never be passed on to the customer. And it's hard to believe there would be any savings overall, because the advertising must be bringing in more money than it costs or they wouldn't be doing it.

Re: Hospitals pledge to fight admin price transparency plan in court

#139

Post by Zenst » Tue, Nov 19, 2019, 6:46 PM UTC

aphextim wrote: post #7

I don't think anyone who has had to pay hospital bills would agree with the hospital lobby's decision to fight this. The article's title makes it give the impression this is okay because, orange man bad, however regardless of the party pushing for transparency it is something everyone would benefit from (other than the heal care industry/insurance company's profits).

Sadly in many walks of life (more so politics) we see people focus upon the messenger instead of the message. It stems IMHo from that primitaive tribal legacy that we still see play out today, be that sports with the teams or party politics. This is not a trait that all have and many have thru various factors, moved on and with that there are many who focus upon the message and put aside and loyalty or prejudices they may have in how they recieve and approach the message.

So with that, like yourself I view this transparency price thing as a good thing as it boils down to ticking the fairness box and being good for the people.

Equally, I can see how from business aspect wise it is bad and heck - what business would love to service a customer and not tell them the price only after the work has been dowe without them having any say in it. I'm sure many, however unfair/unscrupulous it may seem. So I see why they will fight it, be it to revoke it, change it or delay it in legal red-tape in the whole process. However, the approach of invoking the tribal support aspect to kill this of and by that, everybody who dislikes the party or the president that made this come about would be a devious tactic and unfair approach. Yet, that does appear to be the one being driven, be that directly or perhaps more so, the biases played out by the reporter/media outlets.

But a tribal bias in media outlets is something we are all aware of, some more balanced than other. But imagine if you had those opposing biases in the same location debating things and how that would deteriorate. Well, imagination is not needed as you get exactly that upon social media platforms.

So will be interesting and equally, concerning how this whole fight by hospitals plays out. As will the effect if/when it comes to pass. Will it help lower prices or will it drive up health tourisim abroad as you may find it is cheaper to hope on a plane to say Canada and get the blood test done there and work out cheaper. As will be the case with a few procedures using other countries.

Also be interesting how people react to this and will we see hoards of protestors fighting for the hospitals to stop this happening based solely upon party political tribal mentalities. I'd like to think not, but we live in such interesting times, you just can't rule that out.

Re: Hospitals pledge to fight admin price transparency plan in court

#140

Post by programmertote » Tue, Nov 19, 2019, 6:46 PM UTC

Berobero wrote: post #98

istjohn wrote: post #22

I 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…

I was in Japan two years ago; got pneumonia and needed antibiotics. Went to a hospital with no insurance and no appointment. I was being seen by a doctor within 30 minutes. Doctor wanted to do some additional labs just to rule other things out, but he was worried that it would be expensive for me given the lack of insurance. He called up billing with me still in the room and had a price within a couple minutes: ~$70…

Exactly the way it works in a SE Asian country I grew up. The private and public hospitals have price quotes on different procedures and it's for everyone to see. The comments above using Boglehead's quote as a justification of why medical pricing has a lot of variance is mostly a lie. My wife, who is a doctor trained in our home (SE Asian) country and is doing her residency in the US, and I were just laughing at the fact that it's much, much more expensive to get an X-ray here in the US than it is in our country (which costs ~$4 at most). Here, there's no price list for procedure as simple as taking an X-ray.

Hospitals, doctors, insurance companies and pharma companies are all scamming the US population. Every evening, my wife and I watch TV (WNBC to be exact) and we see many commercials from hospital networks, insurance companies and drug companies. This reminds us everyday that medicine and healthcare is commercialized to the max in this country and the only way from here is downhill. We both don't hope to retire in the US; when we grow old, we will go back to our home country and live there in the hope of getting much more affordable (and yet, of more or less similar quality) medical treatments.