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Hospitals pledge to fight admin price transparency plan in court

healthcaredive.com

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

#161

Post by carapace »

commandlinefan wrote: post #147
umvi wrote: post #120

Earlier quoted context omitted.

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.”

The prices don't change in a supermarket if you edit your shopping list, eh?

A hospital can't predict everything a patient will need (their shopping list), but they should be able to account for the cost of each procedure/drug/test/bandage/etc... eh?

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

#162

Post by triceratops »

mark-r wrote: post #138
triceratops wrote: post #39

Earlier 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…

> 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.

I'm not disputing pharma advertising is profitable for individual products. I'm skeptical if it's profitable in aggregate. Drug demand is a function of the occurrence of disease. Advertising can increase profits by:

1. Taking market share away from a competitors. Profitable for that product, zero-sum for the industry. Competitors respond by increasing their ad spend, equilibrium returns (unless one drug is genuinely superior to another)

2. Increasing demand for unnecessary medicines. Profitable for the market, bad for society.

Advertising is an arms race. Even if I don't want to advertise, I have to because my competitors do. If it's banned, everyone saves the expense of advertising.

Unless pharma companies are engaging in cartel-like price-fixing some of that money will definitely go to lower prices (some will also go to R&D, dividends/buybacks, and exec pay). It only takes one company to do it and the rest have to follow.

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

#163

Post by TMWNN »

AnIdiotOnTheNet wrote: post #60
throw1234651234 wrote: post #6

This is purely anecdotal, but I had a 15 minute (literally) ultrasound. Hospital "facility use" fee: $800. 15 minutes of technician's time: $250. Bill came down to $650 after adjustments. This is messed up. I imagine people with serious health problems just kill themselves or ruin their lives forever.

I don't know about suicide or ruining their lives per-se, but people often go bankrupt from medical bullshit. Also it is quite common for people suffering from all sorts of things to wait until their minor discomforts become intolerable suffering before seeing a doctor, which is how I operate. Too many physician visits where a doctor filled out some Epic form bullshit while ignoring me and then pushing me out of thei…

>I don't know about suicide or ruining their lives per-se, but people often go bankrupt from medical bullshit.

One study found that only 4% of US bankruptcies are because of medical bills https://www.washingtonpost.com/blogs/post-partisan/wp/2018/0... . A tipoff that [insert large percentage here] of bankruptcies aren't actually because of medical costs is that only 6% of bankruptcies by those without health insurance are because of that cause. The biggest cause of bankruptcies is lack of income, which health insurance doesn't affect.

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

#164

Post by XG6 »

commandlinefan wrote: post #99
XG6 wrote: post #14

Of course doctors and hospitals don't want price transparency. That would create pricing competition, which would drive down consumer prices, lower profit margins, and force them to become more efficient. Price transparency is one of the key elements of the highly successful Singapore healthcare system. Add in universal tax-free (or tax-deferred) Health Savings Accounts, and we could not only improve the US healthcar…

> 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…

> 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

I don't agree with that parallel. It would be like a patient asking, "How much to cure my cancer?" Total cost will of course differ for each patient, but the doctor should be able to tell me the exact cost for a 20 minute office visit or a single session chemotherapy. I think that's all anyone could expect.

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

#165

Post by oh_sigh »

sam36 wrote: post #81

My uncle wrecked his motorcycle once. He ended up in a ditch unconscious. Someone called 911. For what ever reason a life flight helicopter was then called and picked him up and took him to a local county hospital. He woke up there a few hours later. After they had already ran all kinds of tests. They had a large list of all the problems from busted spleen, broken bones, head concussion, etc. After a day of rest in t…

Are individuals on the hook if they are unconscious and have things done to them without their consent for their own good?

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

#166

Post by DanBC »

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 are allowed to chose whether they get certain tests or not; and whether they get treatment or not for stuff found by those tests.

America has a problem with over-testing, over-diagnosis, and over-treatment. It seems that merely giving people a choice, telling them the cost, and getting them to pay a contribution isn't enough to prevent this.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5708862/

https://jamanetwork.com/journals/jama/fullarticle/2662877

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

#167

Post by carapace »

braythwayt wrote: post #36
bcrosby95 wrote: post #17

Earlier quoted context omitted.

There are shades of bad. The US health care system with price transparency is better than the US health care system without it. The same procedure can cost 1,000x more if you go across town. It's been long reported that Hospitals mostly pull prices out of their asses. The health care problem in the US is not just a health insurance problem, it is also a health care provider problem. Even if you had a single payer sys…

What you say is true, but does not negate or discount what I said in any way. Again, with the XY problem... If someone asks for X, but really needs Y and there is a better way to get Y than to help them with X... Of course X is better than no X and no Y. But that doesn't change the fact that Y is much, much better than X. And in the case of health care, it is not even close. Price transparency may lead to each person…

I think you're right (profit motive and health care don't mix) but then how do you cut the Gordian Knot? I'm cautiously hopeful that price transparency might be a start.

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

#168

Post by DanBC »

whb07 wrote: post #154
jakobegger wrote: post #133

Earlier quoted context omitted.

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.

So a quick way to check reality is by looking at behavior, so say you wanted the "best" care for something no matter the costs. Most people would fly to the U.S from wherever. That is telling you something. I agree the "general" care like broken bones etc its probably all the same, but healthcare innovation is done in the U.S. So it is kind of moot to say "its good here"... yes after the innovation trickles its way o…

> Most people would fly to the U.S from wherever. That is telling you something.

> but healthcare innovation is done in the U.S

These are assertions without much evidence. Don't forget that the US does well on relatively meaningless measures (5 year survival rates for cancer) but poorly on all cause mortality. Why do US citizens die younger than people of other countries if the US healthcare system is so innovative?

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

#169

Post by carapace »

woopwoop wrote: post #160
aphextim wrote: post #142

Earlier quoted context omitted.

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.

Oh. I still don't understand how the word "Trump" makes the title non-neutral.

It doesn't. The "non-neutrality" is in the minds of the readers, it's "triggered" by the name of the orange man.

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

#170

Post by sigstoat »

bluGill wrote: post #114
legitster wrote: post #8

The previous administration had a similar effort that failed. I hope that this effort is successful. >"For instance, it could allow one provider to follow and match the prices of the other provider (like two gas stations across the street from one another who face no other competition)," Garmon said. I understand this argument, but I think they underrate how much people are willing to shop around when they actually h…

I'd pay more for quality. If I knew hospital X is better at hip replacement I'd pay extra to go there. Of course how much extra I'm not sure, and I'm also not sure how you compare hip replacement quality like that. It is only emergency rooms where I don't get a choice - if you need an emergency room close is important.

> It is only emergency rooms where I don't get a choice - if you need an emergency room close is important.

i feel like the folks on here peddling this line have not ever spent any time watching who comes through an ER.

most of the people who go into an ER aren't dying, or screaming in pain. they've just got a problem that can't wait until urgent care opens up again in the morning. or they need something done that urgent cares aren't equipped to do (fancier diagnostic equipment; whatever). they've got plenty of time to consult with a hypothetical "find a cheap/good ER near me" app.

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