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

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

#141

Post by CraigJPerry » Tue, Nov 19, 2019, 6:48 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…

Japan's system is interesting. Perhaps one of the most successful in the world.

Their life expectancy has gone up which obviously means the amount of care to be provided goes up. Costs haven't followed suit and the other side of the equation - outcomes, has also gotten better (comparing against 1990 since that's the first result set i can see attributed to the MHLW in JP) The challenges of their economy are well known yet they've pulled off what other countries probably would not be able to.

Yet they spend approximately half what America does - and for better outcomes.

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

#142

Post by aphextim » Tue, Nov 19, 2019, 6:49 PM UTC

TurkishPoptart wrote: post #118

dang wrote: post #109

Earlier quoted context omitted.

We took out the trigger word.

What was it? Thanks.

Original title that they changed which my original comment was based off of was, 'Hospitals pledge to fight Trump admin price transparency plan in court'

Removing the word Trump (trigger word) is what dang was referring to.

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

#143

Post by soneca » Tue, Nov 19, 2019, 6:51 PM UTC

The Econtalk podcast latest episode is about a surgery clinic in Oklahoma that has full price-transparency policy. I am outsider to US healthcare system, but after listening to it, it seems hardly controversial what would be the right thing to do here:

https://www.econtalk.org/keith-smith-on-free-market-health-c...

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

#144

Post by hkai » Tue, Nov 19, 2019, 6:54 PM UTC

CraigJPerry wrote: post #141

Berobero wrote: post #98

Earlier quoted context omitted.

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…

Japan's system is interesting. Perhaps one of the most successful in the world. Their life expectancy has gone up which obviously means the amount of care to be provided goes up. Costs haven't followed suit and the other side of the equation - outcomes, has also gotten better (comparing against 1990 since that's the first result set i can see attributed to the MHLW in JP) The challenges of their economy are well know…

If you're talking about life expectancy, certainly lifestyle means more than an excellent (as opposed to a good) hospital system.

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

#145

Post by lotsofpulp » Tue, Nov 19, 2019, 6:54 PM UTC

munk-a wrote: post #119

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…

The procedure codes involved in your visit explicitly call out what your treatment was, since information about your state of health and ongoing medical information is considered private information we have HIPAA to protect that privacy. Information about what procedures you've had done are relatively important to keep private so that knowledge of such procedures isn't used to influence your employment - while gettin…

Then they can print out a quote for me before the appointment listing the codes that will be billed so I can obtain the cost from the insurance company. My point is that they don't want to provide them before the appointment to prevent shopping around.

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

#146

Post by pnutjam » Tue, Nov 19, 2019, 6:55 PM UTC

ddlatham wrote: post #95

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…

How does contract law fit in here? If a business performs a service for me and won't tell me ahead of time how much it costs, can it afterward decide I must pay whatever it wants? One trillion dollars? For those without insurance, is there some contract agreed to with the hospital? For those with insurance, in which contract do I end up bound to pay an amount that isn't told me until after I've already made the decis…

Check this out. I had decent and expensive insurance when my wife had surgery. We hit the max Out-of-pocket, which according to my employee docs was about $6500. However, when I get the information from my insurance company it has totally different copy information with a OOP of $7300. I talked to my employer several times and eventually filed a Dept. of Labor complaint because everyone is telling me it's ultimately my employers problem to fix.

Fast forward 3 months and after multiple go arounds and hours of phone calls they finally fix it. So what does my insurer do? They claw back fully paid payments for stuff that was done after my OOP was met. I have to call multiple doctors and argue with the insurance company for every bill.

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

#147

Post by commandlinefan » Tue, Nov 19, 2019, 6:56 PM UTC

umvi wrote: post #120

commandlinefan wrote: post #99

Earlier quoted context omitted.

> doctors and hospitals don't want price transparency Well, I do want price transparency - IF it works the way they promise. It’s hard for me, as a programmer, not to draw parallels to every employer’s expectation that I should be able to listen to them describe a software problem and quote them a timeframe on the spot (which, of course, they’ll then try to “negotiate” down). On the one hand, as a non-medical-profess…

Yeah but come on. It's one thing to program something with nebulous requirements. The cost of the X-ray machine is known. The cost of collecting X-rays can be calculated deterministically. The only thing similar to programming is trying to diagnose a rare disease or tricky condition. But for run-of-the-mill deterministic procedures, the cost should absolutely be known.

Well, I think so too, but - just to play devil’s advocate - many of my former bosses would almost certainly say something like, “the cost of the web server is known. The cost of collecting the web traffic can be calculated deterministically. We’re just talking about a website here, the cost should absolutely be known.”

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

#148

Post by xrd » Tue, Nov 19, 2019, 6:56 PM UTC

I'm surprised there is no startup that sells you membership in offshore healthcare. If you want to do anything, you just jump on a short hop flight to a man made island in international waters and get healthcare. Or, coupled with a trip to Thailand. It would be disruptive and cheaper.

My wife is a doctor and last night she tried to renew her credentials at a major hospital network here. She could not, despite clear instructions, open the PDF locally to add her signature. I inspected the web view in chrome tools and see it is an awful Microsoft product behind the scenes.

This is the reason this attempt by Trump will never happen (I'm supportive even though I despise Trump). My wife's incentives and the hospital incentives are aligned, even though no one will admit it. Even if hospitals are forced to give price transparency, they will just go and buy a shitty solution from Microsoft (I'm using Microsoft as a placeholder, but it can be any large tech company who wants in on the action), who will be happy to certify it for the law. It won't work and the hospitals can blame Microsoft. Microsoft will lobby politicians to water down the law so they won't pay anything but a pittance if things don't work. Consumers will get continually screwed. The doctors and the hospitals will continue to make great money because they will still not have to admit pricing this way, with zero transparency, is the golden goose of healthcare and why costs are insane in the US.

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

#149

Post by notyourday » Tue, Nov 19, 2019, 6:56 PM UTC

lucozade wrote: post #104

js2 wrote: post #33

Earlier 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…

Sure, this is the reason why you can't get an answer but it's not a justification . There are 2 parts to it. The first, which is reasonable, is that a lot of treatments are bespoke. Fine. That's a justification for their being costly not for your having to imagine the cost because no one can tell you. Even for flights, the truth is I can get a bespoke flight if I can afford it. And if I want to know how much it is th…

> The first, which is reasonable, is that a lot of treatments are bespoke. Fine. That's a justification for their being costly not for your having to imagine the cost because no one can tell you.

Treatments are billed using billing codes so they are definitely not bespoke.

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

#150

Post by swebs » Tue, Nov 19, 2019, 6:57 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…

I was in Philadelphia last year and had a bad fall and had to get about 10 staples in my head. I went to a local urgent care center and the total cost was $150 without any insurance.