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

Also coverage is also a huge deal in the US, although it may not be a problem for you specifically. Obamacare covered millions who otherwise might have stayed home instead of seeing the doctor.

The problem with US health is scoping. Insurance companies are effectively “certifying” which hospitals and doctors you can see instead of actual certification bodies.

There are a number of reasons. One big one is simply that doctors in the US command a much higher salary than their counterparts elsewhere in the world:

https://economix.blogs.nytimes.com/2009/07/15/how-much-do-do...

https://www.politico.com/agenda/story/2017/10/25/doctors-sal...

Another big reason is that the US is unique in that it's one of the only countries in the world where you get your healthcare through your employer. What we're seeing in healthcare costs is analogous to what you might see happen to airline ticket costs if we all got our air tickets through our employers: the vast majority of us would fly business class, while the unemployed would be simply unable to pay for business class fares out of pocket. Employers (especially medium-to-large businesses) have a much higher purchasing power (and hence, willingness to pay) than individuals.

Now, if you take this behavior and combine it with the fact that health insurers' profit margins are capped by law by percentage, insurers pay more for treatments (which doctors happily accept), charge more to employers (who are generally less price conscious vs individuals), thus bring in more absolute revenue, and therefore more profit because a capped profit percentage of a higher revenue is higher than a capped percentage of lower revenue. It's somewhat counter-intuitive, but the policy combination of an employer mandate and insurance profit cap results in the mother of all local optima.

Disclaimer: I work on health pricing in the US and sometimes adjust claims myself.

> If people can't pay as much, the only thing for them to do is drop prices.

Or not offer the product at all. One problem with this entire area is that "healthcare" is really not one service/product area, and it is probably a mistake to treat it as such.

To be transparent, I don't share your optimism about market solutions to problems like this in general (more about their implementation in practice than theoretical benefits) but I can see how it might help with parts of the routine healthcare. However, when you are talking emergency and major treatments, it's well into the range where direct consumer driven decisions are more likely going to mess up the incentives badly.

If you are lucky enough to have the time (often not true), most people can become reasonably expert in their own disease state and treatment options. But that is a tiny slice of what is going on in a hospital system for example, and it's completely unreasonable to expect people to become informed enough to make good decisions there. If we want to benefit from market forces here, it's probably much more effective to have large (or single) payers who understand what the standard of care should be, and can encourage price competition from providers.

It's worth noting that in theory this is what the insurance industry does in the US, though, but is an expensive mess. Another confounding factor is that many obvious price discovery mechanisms will be completely unacceptable to most people.

Honestly, it's a mostly faith-based argument that a cash-based market approach can find a better global solution than universal health care, at least in a relevant amount of time. It's really hard for me to see why the country should take that risk when there are well understood and well modelled approaches (albeit imperfect) that should be able to reduce costs by at least 1/2, probably more.

Why not start there?

Turned out the hospital was not in network, they charged me $15,000 (including $10,000 for a "level 5" ER room stay, which is twice the most expensive price listed on the OP's website and is 10x the local average price for that service, despite the fact that my experience could not possibly have been Level 5 service). Eventually they just sold the debt to a collections agency. I tried to fight but they didn't seem to care, and why would they? They already sold the debt!

I have taken extra measures to ensure that myself and my family are healthy in the last year and with a tax-free HSA account that is invested into ETFs, I am literally printing dollars just by following basic principles of being healthy.