Insurers must have data on pricing. You can call up some already before having imaging procedures for some guidance on cost. Maybe they can expand price transparency as a differentiator to their competitors.
Hospitals pledge to fight admin price transparency plan in court
251–260 of 311 posts
Re: Hospitals pledge to fight admin price transparency plan in court
#252Earlier quoted context omitted.
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?
The problem is a lot of that isn't deterministic. There's a lot of "If Then" statements that aren't easy to price ahead of time.
Like, your procedure is very different if your doctor decides they could use a specialist consult.
Re: Hospitals pledge to fight admin price transparency plan in court
#253Of 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…
Probably, but not certainly: https://marginalrevolution.com/marginalrevolution/2019/06/wi...
I favor price transparency (https://seliger.com/2018/11/11/health-insurance-security-fqh...) but the Dutch cement market work does give one pause.
Re: Hospitals pledge to fight admin price transparency plan in court
#254Earlier 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…
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…
> that medicine and healthcare is commercialized to the max
There are commercial problems but it isn't totally fair to call a system where nobody can tell you a price 'commercialised to the max'.
The problem isn't the commerce, the problem is that someone has set up a regulatory framework where people don't pay for services.
A perspective that could be important when it comes to American healthcare: insurance doesn't on average pay out more than people pay in. My understanding is traditionally insurance actually pays out exactly what people pay in and profits off the float. 'Having insurance' doesn't make anything more affordable for anyone, it is more like hiring someone else to track the savings for you and a few conveniences massaging risk through time.
Re: Hospitals pledge to fight admin price transparency plan in court
#255Earlier quoted context omitted.
Its from a book, Code Blue: Inside Americas Medical Industrial Complex, by Mike Magee. The author is a Doctor and distinguished medical academic and past hospital executive.
I believe you, but it's hard to square that ratio with the actual administrative overhead of US health care, which is under 15%.
Billing Personnel to Doctors seems to ignore the squads of Nurses and maybe it also ignores the Doctors in Residency?
Re: Hospitals pledge to fight admin price transparency plan in court
#256Earlier quoted context omitted.
> Your insurance will pay for it either way This is an assumption based on a very good insurance package. Most have out of pocket co-pays . So yes, we have to gross it up by the co-pay percent and discount it by the Annual deductible limitt, but generally the point stands. If I can save enough money I might travel away from the monopoly. Until that data is transparently available I can't optimize that scenario w/ my…
Sort of; in my experience, even with a high deductible health insurance plan, the insurance company's negotiated rates are still in effect. In other words, if a visit would be billed to an uninsured person at $200, but my insurance caps it at $100, then $100 is the price accepted by the doctor's office no matter if I'm paying because I haven't reached my high deductible or insurance is paying because I have a regular…
right, but now you're talking about in-network vs out-of-network rates. I believe should disappear with price transparency...
Re: Hospitals pledge to fight admin price transparency plan in court
#257Earlier quoted context omitted.
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…
Have you seen radiologist salaries? It's a scam, Jim. There are four pigs at the trough of US health care: Insurance Device/Drug Lawyers Doctors Everyone points the finger at other people and desperately fight to maintain their bloated share of the bloating pie. Unfortunately doctors are not your friends in hospitals. They are trying to get billing.
This is also a side effect of how much medical education costs in the US, though. Education is so expensive that medical professionals have to have eye-watering salaries to have any hope of paying it off.
Of course, this is partially the fault of the AMA restricting medical school slots, but also is part of the general trend of tertiary education in the US being ridiculously expensive.
Re: Hospitals pledge to fight admin price transparency plan in court
#258Earlier quoted context omitted.
Thing is, this was self-pay for a single routine lab test. It's the simplest possible scenario.
Couldn’t you have called Labcorp and got the test from a lab? My doctor doesn’t do any lab testing. It goes to the lab in my county that’s connected to the hospital or to lab corp.
My father has been monitoring his calcium levels and uses Labcorp directly. It is great that you can cut out the middleman. They draw blood right there and you can view your results very quickly online.
This process is a hidden gem in our bloated system.
Go directly to the lab.
Now obviously this is just for health maintenance and dietary checkups.
Not to many people are aware that you can go right to the lab directly.
Re: Hospitals pledge to fight admin price transparency plan in court
#259Earlier quoted context omitted.
Have you seen radiologist salaries? It's a scam, Jim. There are four pigs at the trough of US health care: Insurance Device/Drug Lawyers Doctors Everyone points the finger at other people and desperately fight to maintain their bloated share of the bloating pie. Unfortunately doctors are not your friends in hospitals. They are trying to get billing.
This is also a side effect of how much medical education costs in the US, though. Education is so expensive that medical professionals have to have eye-watering salaries to have any hope of paying it off. Of course, this is partially the fault of the AMA restricting medical school slots, but also is part of the general trend of tertiary education in the US being ridiculously expensive.
And also partly the fault of the government paying whatever schools ask for in loans.
Re: Hospitals pledge to fight admin price transparency plan in court
#260Earlier quoted context omitted.
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…
Interesting comparison, because airline pricing is notoriously complicated, resulting in things like hidden-city fares[1] and such considerations as "do we expect to be able to be to sell that seat to some business traveler at the last minute whose only choice is us?" Furthermore, there are all kinds of unknowns that can happen on the flight.[2] And yet they still have no problem quoting you a price. [1] where a flig…
[deleted]