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Show HN: Compare prices that US hospitals charge patients, insurance companies

turquoise.health

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Re: Show HN: Compare prices that US hospitals charge patients, insurance companies

#71

Post by ArtDev »

PragmaticPulp wrote: post #33
terse_malvolio wrote: post #9

Sometimes the cost is bigger than the cost in a different country plus the plane ticket.

The U.S. healthcare system is built around the idea that everyone has health insurance. Obviously, that's not a valid assumption at all, which is one of many reasons why it's such a problem. Insurance companies each negotiate a rate for various services with hospitals. People pay different rates depending on the insurance they have, due to these different negotiated rates. This creates a perverse incentive where hosp…

It's a criminal racket.

You have no position to negotiate and I have never got them to budge. I have tried and gotten pretty angry about it.

Short-term insurance is a waste of money because the rates did not appear to be negotiated at all. They paid 5% of the bill and stuck me with the rest.

The only reason to actually pay your bills is the hospital might eventually sue you. Its messed up.

Re: Show HN: Compare prices that US hospitals charge patients, insurance companies

#72

Post by skeeter2020 »

dominotw wrote: post #12
terse_malvolio wrote: post #9

Sometimes the cost is bigger than the cost in a different country plus the plane ticket.

I guess you could roll the dice and hope the for best but you will lose your ability to sue the hospital for malpractice if they mess up.

I have never anticipated a medical procedure, emergency or otherwise, and considered "my ability to sue for malpractice if this goes wrong". I just don't believe this is a consideration for the actual patient, even if it was relevant (example: Canada with universal public system essentially has no malpractice lawsuits).

Re: Show HN: Compare prices that US hospitals charge patients, insurance companies

#73

Post by ArtDev »

londons_explore wrote: post #56
learc83 wrote: post #29

Earlier quoted context omitted.

The GP was talking about losing your ability sue for malpractice not implying that every other country has inferior medical or legal care. A country can have a fine legal system for locals that's difficult or prohibitively expensive to access for non-citizens living outside the country.

One of my businesses refuses to serve Americans simply because they have a habit of reaching for the legal system if they aren't happy with the service. All the Americans end up going to my competitor, who is currently in the midst of three lawsuits which will probably sink the company. Two of the lawsuits are with clients I turned away simply because they looked likely to sue! You can bet that as an American, you wi…

And then the hospital can't sue you if you can't pay the absurd bill?

Re: Show HN: Compare prices that US hospitals charge patients, insurance companies

#74

Post by smueller1234 »

Suggestion: I hope I didn't completely miss something, but the site seems to put average prices for procedures all over the place when the median price would actually be much more informative to somebody searching for a provider. Looking at a few procedures, the prices seem to have significant outliers, which exacerbates this.

Re: Show HN: Compare prices that US hospitals charge patients, insurance companies

#75

Post by notsureaboutpg »

emteycz wrote: post #48
dr_faustus wrote: post #44

It's always fascinating to see that even compared to prices you pay as a self-paying patient in Germany (which are already 1.5x - 2x higher than what the "public" insurances, ie. 85% of the population, pay for the same procedures), the prices in the US are about 5x to 10x higher. The standard of care seems to be quite comparable if you look at outcomes, so there must be huge inefficiences in the American system (doct…

I don't believe any medical professional in Germany has wage exceeding 150k EUR yearly after taxes - doctors in the US sometimes have multiples of that, coincidentally 5x to 10x more is not unusual.

Can confirm. $600k+ is normal in low cost of living areas in the US. Excessive pay for doctors is definitely part of the problem here. People don't like to hear it and don't like to admit it because the work they do is so important and because there are other, bigger costs, and I get that. But difficult situations have difficult answers, and doctor pay is huge in the US in a way it isn't in every other country and doctors themselves know this. It may not fix the problem overnight, but regular people would see instant savings if we fixed this issue.

Re: Show HN: Compare prices that US hospitals charge patients, insurance companies

#76

Post by ArtDev »

spaetzleesser wrote: post #13
dnautics wrote: post #10

Earlier quoted context omitted.

- paying for services for people who don't have/can't afford insurance. - medical malpractice insurance -> legal system - big pharma/med devices industry

You should add - doctors are paid higher in the US than in another countries - billing staff overhead because of the insane insurance system - highly paid hospital administration - lots of middlemen that stay invisible because there is no price transparency - shiny new buildings that are built by friends of the hospital administration

Look up the salary of your local hospital president. In my medium town of (Pop 200K) they pay him $980k per year. That is an absurd salary for a relatively small hospital!

Re: Show HN: Compare prices that US hospitals charge patients, insurance companies

#77

Post by persedes »

dante_dev wrote: post #66
emteycz wrote: post #48

Earlier quoted context omitted.

I don't believe any medical professional in Germany has wage exceeding 150k EUR yearly after taxes - doctors in the US sometimes have multiples of that, coincidentally 5x to 10x more is not unusual.

Just throwing some data, average general practice doctor is 150k$ in US vs 61k$ in germany. https://www.payscale.com/research/DE/Job=Physician_%2F_Docto... https://www.payscale.com/research/US/Job=Physician_%2F_Docto...

I believe that doctors in the US get paid more than in germany, but 60k seems very very low. Teachers have an income in that range....

Edit: Looking at some german articles, maybe they did not convert from eur to usd, ~80,000-100,000$ (depending on expertise etc) seems more likely for a dr working at a hospital (which is still low imho compared to US salaries...).

https://www.arzt-wirtschaft.de/wie-hoch-ist-das-gehalt-bzw-d...

Re: Show HN: Compare prices that US hospitals charge patients, insurance companies

#78

Post by tfehring »

travisp wrote: post #63
emteycz wrote: post #48

Earlier quoted context omitted.

I don't believe any medical professional in Germany has wage exceeding 150k EUR yearly after taxes - doctors in the US sometimes have multiples of that, coincidentally 5x to 10x more is not unusual.

It's true that US doctors are paid more (although the gap isn't as big as it used to be). However, pay for US doctors makes up a fairly small portion of overall US medical expenditures (less than 10%). So, you could ask every doctor to work for free and not significantly change costs.

There’s a similar (but smaller) differential for other medical professionals too. But more generally, when I’ve done high-level comparisons of medical spending between the US and Western European countries, it seems like every single cost element is more or less proportionately higher in the US. It seems like basically everyone is spending money in roughly the same proportions, including on things like doctors’ salaries - everything is just scaled up by ~40% to ~100% in the US, depending on which country you compare it to.

Re: Show HN: Compare prices that US hospitals charge patients, insurance companies

#79

Post by dheera »

dr_faustus wrote: post #44

It's always fascinating to see that even compared to prices you pay as a self-paying patient in Germany (which are already 1.5x - 2x higher than what the "public" insurances, ie. 85% of the population, pay for the same procedures), the prices in the US are about 5x to 10x higher. The standard of care seems to be quite comparable if you look at outcomes, so there must be huge inefficiences in the American system (doct…

Everything is inflated the whole way in the American system.

Universities overcharge in the US. The medical education costs upwards of $800K if you include the cost of lost opportunity had you gone into a different field and worked those years instead. So doctors need higher salaries. That, combined with idiotic market dynamics around medical supplies, means that all medical costs are higher. That in turn means everyone absolutely needs insurance or risk personal bankruptcy.

Re: Show HN: Compare prices that US hospitals charge patients, insurance companies

#80

Post by ArtDev »

dominotw wrote: post #51
LatteLazy wrote: post #22

Earlier quoted context omitted.

Plus - Gold plating everything to avoid getting sued. - Inflated medical school costs - the price of a huge bureaucracy for billing people, chasing them, disputing it, agreeing rates with insurers, renegotiating rates with insurers, applying the right discounts, billing a dozen different state and federal programs for various bits, those being disputed, managing all that etc.

I moved to usa from a poor country to work at a hospital. I was shocked by how awesome, clean and luxurious everything looked. Top end fancy hotel in my country would look like a slum dwelling compared to a hospital in USA.

Going from the USA to a hospital in Thailand is a similar experience. Everything is so clean!
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