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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

#161

Post by dalbasal »

bhupy wrote: post #94
btbuildem wrote: post #54

Earlier quoted context omitted.

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

It's not. There's a good breakdown that compares what drives healthcare spending between the US vs Germany (and others). https://www.healthsystemtracker.org/brief/what-drives-health... The vast majority of the difference comes from just the raw cost of inpatient and outpatient care. Even if you were to completely zero out the administrative costs per capita, you'd hardly make a dent in bridging the gap.

What does "raw" mean, in this circumstance?

Looking at the article, it's pretty hard to understand what what's actually costing more. "Inpatient and outpatient care" is a pretty enormous bucket and probably accounts for a whole lot of salaries, services, and such of pretty much any job title with "medical" in it.

Admin, does in fact represent the largest % difference... but it's not clear what's grouped into it. I assume it means government departments, insurance firms, external legal/finance services. I don't think the data refers to a salary-bysalary breakdown of costs.

Sometimes it's best to look at these things from the ground up. Doctors, nurses. How many? How much are they paid? Is the diff more or less than mean diff? If no, move on, If yes, dig deeper.

You really can't even rely on price data to tell you much. Most of these markets have a broken or absent price system. The underlying answer though, inevitably will likely be "because they're run differently."

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

#162

Post by bhupy »

giorgosera wrote: post #154
bhupy wrote: post #94

Earlier quoted context omitted.

It's not. There's a good breakdown that compares what drives healthcare spending between the US vs Germany (and others). https://www.healthsystemtracker.org/brief/what-drives-health... The vast majority of the difference comes from just the raw cost of inpatient and outpatient care. Even if you were to completely zero out the administrative costs per capita, you'd hardly make a dent in bridging the gap.

> The vast majority of the difference comes from just the raw cost of inpatient and outpatient care. Question: What do we mean by "inpatient and outpatient care"?

Inpatient care refers to any treatment where the patient is required to be admitted to a hospital or health care facility facility. On the other hand, the OECD defines outpatient care as care that "comprises medical and ancillary services delivered to a patient who is not formally admitted to a facility and does not stay overnight." Thus, studies like this try to break out "inpatient and outpatient care" as an attempt to represent the "real" service in question, while isolating things like administrative costs.

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

#163

Post by mancerayder »

bhupy wrote: post #94
btbuildem wrote: post #54

Earlier quoted context omitted.

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

It's not. There's a good breakdown that compares what drives healthcare spending between the US vs Germany (and others). https://www.healthsystemtracker.org/brief/what-drives-health... The vast majority of the difference comes from just the raw cost of inpatient and outpatient care. Even if you were to completely zero out the administrative costs per capita, you'd hardly make a dent in bridging the gap.

This is useful - as a starting point.

I want to be able to make a case for a single payer system in the U.S., but I think to be effective it's a comparison of costs and outcomes that needs to be had. In the data linked above, we're told that the 'inpatient and outpatient care' is significantly higher than in 'comparable countries.'

I believe it. But isn't 'inpatient and outpatient care' just about .. everything that goes into a health care system aside from the paper pushing and insurance pieces? And are hospitals really breaking that stuff out ?

Someone in favor of the U.S. system would say, ah hah, that's because we in the U.S. have access to better care, and more sophisticated technology, than in France or Germany, and also we don't have long waiting lists. I don't know the technology claim, but I've seen the wait list claim and I do think it's true when comparing the U.S. with Canada or the UK (the latter two have long waits for essential surgeries compared to the U.S.)

How would one counter this claim?

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

#164

Post by ryandrake »

the-dude wrote: post #28
ttul wrote: post #16

Earlier quoted context omitted.

It’s too bad that all the other insane things he did will overshadow literally anything of value that he accomplished.

Could you enlighten me and name some of those things? Not things he said, but things he did according to you.

His attacks on the immigration and asylum systems were particularly insane and cruel. A just future will forever associate the man with this dark period of Family Separation and caged children.

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

#165

Post by roganp »

giorgosera wrote: post #154
bhupy wrote: post #94

Earlier quoted context omitted.

It's not. There's a good breakdown that compares what drives healthcare spending between the US vs Germany (and others). https://www.healthsystemtracker.org/brief/what-drives-health... The vast majority of the difference comes from just the raw cost of inpatient and outpatient care. Even if you were to completely zero out the administrative costs per capita, you'd hardly make a dent in bridging the gap.

> The vast majority of the difference comes from just the raw cost of inpatient and outpatient care. Question: What do we mean by "inpatient and outpatient care"?

Inpatient: services provided by a hospital, after patient is admitted. Outpatient: services provided in other settings

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

#167

Post by therealdrag0 »

ArtDev wrote: post #76
spaetzleesser wrote: post #13

Earlier quoted context omitted.

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!

How do I look that up?

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

#168

Post by ews »

Daniel_sk wrote: post #158
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 think a lot of people are missing one key difference. Healthcare in EU is based on solidarity system where every citizen pays a percentage share of his monthly salary to the medical insurance. So if you earn more, then you will also pay more medical insurance - but you will get the same treatment as others (unless you have some fancy private insurance on top of the regular insurance). So basically any medical expen…

This is how progressive taxation works. For some reason, US people happily pay for police, firemen, infrastructure or the military as a necessity of a functioning society but have serious problems considering healthcare in the same group.

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

#170

Post by analog31 »

Sprbdg wrote: post #136
analog31 wrote: post #123

Earlier quoted context omitted.

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.

You don't need the government to solve this problem, they helped create the problem in the first place. You need to reform your political system to actually make it work.

Near as I can tell, reforming the political system and changing government policy are intertwined to the point where they amount to the same thing.
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