131–140 of 389 posts
I tried to total the cost of the care my son received when he was born, had we been American. I stopped counting at $1million.
Being in the UK, I even got a few meals at the hospital canteen thrown in. Not to mention the time in nICU etc. It is horrifying that people have to compare prices and haggle for care anywhere on earth.
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I am pretty sure the providers and insurers know exactly what everyone is charging. It’s the patients that are being kept in the dark.
Like any opaque market, bigger players will have more info, but I doubt anyone will share information as its collusion (maybe illegal) and also advantages either your negotiating opponent or your competitors...
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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.
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…
Those are "sticker prices", the opening for negotiation/haggling.
This is made possible thanks to the current administration’s CMS price transparency rule which went into effect Jan 1,2021 http://www.cms.gov/hospital-price-transparency Edit: By “current” I mean the Trump administration.
And by "current" administration you mean the Trump administration because people here don't like to give credit where credit is due.
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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 every…
I believe a reform of the healthcare system should include paying for medical school. Let's offer a deal: You go to med school for free, then you work for the government for a decent professional salary.
One day I asked how much go get shot without insurance.
It was $15.
I was paying 4x to use insurance. And insurance was getting billed on top of that.
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…
To do a real analysis you'd need to see a breakdown of where the money goes. What percentage is to a physician's salary, hospital overhead, insurance premiums, etc. for both countries and see where the big disparities are. My guess is, everything is more expensive on the US side, including salaries, and adds up to the big difference in price.
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...
Anecdote aside, your point stands. Shopping, across state lines for surgery is ridiculous.
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.
It's simple: waste. Everywhere. There is no incentive for doctors to be efficient so they aren't. They order too many supplies, do too many procedures quickly (when doing them slowly would be fine, and cheaper, etc). Price discipline is like gravity. It affects everything. In most American businesses subject to market forces, there is an enormous push to optimize every single little bit of the business to control cos…