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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

#101

Post by rtx »

wjossey wrote: post #36
nugget wrote: post #5

Earlier quoted context omitted.

In 2015 I did several months of due diligence in this market - price comparison for diagnostic imaging - before concluding that it wasn't feasible to build the product we wanted to build. This new law provides the data that we were unable to access (at scale) on our own. From the data we did get our hands on, I remember seeing price differences like $200 vs $4k for the exact same procedure. The low cost provider was…

For folks who don’t believe in universal medical coverage, this is part of the reason why it’s so inefficient for it not to exist. The uninsured person going to the hospital at 1AM that requires an MRI because slipped a disc in their back still ends up getting that MRI. When they fail to pay that bill, which would be 5%-10% of their annual earnings, we all still pay for it. We just decided to layer in debt collection…

Why add additional steps, government should open hospitals and provide healthcare directly.

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

#103

Post by moooo99 »

marcinzm wrote: post #67
btbuildem wrote: post #54

Earlier quoted context omitted.

I imagine it's on account of all the administration and intermediaries.

Probably some of it but I suspect the lack of limitations on services rendered plays into it as well. If someone in the US wants to see specialists 50 times in a month due to munchausens then they'll just be charged their co-pay each time (in most insurance plans). In Germany I suspect they'd not be allowed to book appointments anymore or would require a gatekeeping referral. Same with expensive drugs that don't help…

Thats not right. You can easily get an appointment in Germany, even multiple times. If you have a referral, you usually get an appointment earlier than people who directly went to the specialist. However, if you have acute pain you will quickly get an appointment on the same or the next day.

Source: Me. just made the second appointment with a specialist within a week thanks to pain, appointment is tomorrow

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

#104

Post by dominotw »

jasonpeacock wrote: post #21
dominotw wrote: post #12

Earlier quoted context omitted.

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.

You're making a lot of assumptions here that an out-of-country hospital would be of questionable quality and not have medical malpractice laws. Just because other countries medical & legal systems are different than the US doesn't mean they are inferior.

> legal systems are different than the US doesn't mean they are inferior

Yes. Indian legal system is very inferior compared to USA. My family is fighting a garden variety land dispute case for over a decade. I cannot even imagine someone successfully suing a doctor here for malpractice while living in USA.

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

#105

Post by jimmaswell »

eldavido wrote: post #58
wjossey wrote: post #36

Earlier quoted context omitted.

For folks who don’t believe in universal medical coverage, this is part of the reason why it’s so inefficient for it not to exist. The uninsured person going to the hospital at 1AM that requires an MRI because slipped a disc in their back still ends up getting that MRI. When they fail to pay that bill, which would be 5%-10% of their annual earnings, we all still pay for it. We just decided to layer in debt collection…

Also a fiscal conservative, I completely agree single-payer would be much better than what we have now. What I think would be best though, is to eliminate medicare/medicaid, hand people cash, and get out of the way. The high-order problem with medicine isn't coverage or insurance. It's price. There are only two ways to get price under control: meaningful competition, or government price controls (e.g. single payer).…

Patients would still decide where to be treated based on those factors, the only difference is the insurance is standardized. Nobody in countries with socialized health insurance seems to complain about lack of choices or any of that, and rich people in those places can still get private insurance to get their nose job done right away from a private practice. For everyone else I get the impression it works just fine.

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

#106

Post by dominotw »

ArtDev wrote: post #73
londons_explore wrote: post #56

Earlier quoted context omitted.

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?

Here in India. You pay upfront. No payment = no surgery.

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

#107

Post by fireeyed »

dnautics wrote: post #10
rplnt wrote: post #8

Why are the prices so insane? Where do the money go? I'm from Eastern Europe so of course the prices would be different, but by an order of a magnitude at the minimum seems strange.

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

Don’t forget AMA antitrust violations but curbing the number of doctors that could get into the system.

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

#108

Post by bazooka_penguin »

btbuildem wrote: post #54
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 imagine it's on account of all the administration and intermediaries.

Physicians and hospitals have 2 of the most powerful lobbies in the US and have previously gatekept the doctor profession.

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

#109

Post by yyhhsj0521 »

11thEarlOfMar wrote: post #85

Even I am surprised: Appendectomy: MSDRG 343: at Kaiser in Santa Clara: $56,000 Appendectomy: MSDRG 343: at Holston Valley Medical Center, TN: $4,700 Our healthcare system is even more broken than I ever imagined.

Too bad it is an emergency condition, otherwise people could just fly to TN for the same procedure...

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

#110

Post by jfk13 »

eldavido wrote: post #58
wjossey wrote: post #36

Earlier quoted context omitted.

For folks who don’t believe in universal medical coverage, this is part of the reason why it’s so inefficient for it not to exist. The uninsured person going to the hospital at 1AM that requires an MRI because slipped a disc in their back still ends up getting that MRI. When they fail to pay that bill, which would be 5%-10% of their annual earnings, we all still pay for it. We just decided to layer in debt collection…

Also a fiscal conservative, I completely agree single-payer would be much better than what we have now. What I think would be best though, is to eliminate medicare/medicaid, hand people cash, and get out of the way. The high-order problem with medicine isn't coverage or insurance. It's price. There are only two ways to get price under control: meaningful competition, or government price controls (e.g. single payer).…

> I know people are going to worry about rare (expensive) conditions not being covered, and this is indeed a problem. I don't have an answer to this. One good thing about competition though, is that it drives innovation. Provider prices will absolutely be set based on what they know people can pay. If people can't pay as much, the only thing for them to do is drop prices.

I don't think so. If providers can't expect to be paid adequately (in relation to their capital investment, research costs, operating costs, etc) for dealing with "rare (and expensive) conditions", because people don't have insurance (whether private, medicare, or whatever), just a modest amount of cash in any given patient's pocket, do you really think they'll want to stay in that market?

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