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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

#191

Post by 11thEarlOfMar »

analog31 wrote: post #152
fireeyed wrote: post #102

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.

Out of curiosity, how much will this reduce the cost of health care? The idea, as it's been explained to me, is that visibility into the cost of medical care will result in downward price pressure. How much?

For example, an appendectomy (MSDRG 343) in my area will cost $56,000. With my insurance plan, that will max out my $8,000 deductible, + another $8,000 co-insurance to hit my out of pocket maximum of $16,000. That's what I'd pay, $16,000.

Or, I can go to Tennessee and get the appendectomy (MSDRG 343) for $4,700 and pay that directly.

Many people will make that choice Kaiser gets less business putting downward pressure on their pricing. And the folks in Tennessee might see they can raise their prices so that it starts to equalize to some point.

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

#192

Post by ageitgey »

yding wrote: post #183

Very cool! We've been working an app that is looking for this exact type of data. Do you have an API or plans for making an API for this?

We do have plans for an api, but we are currently working out the model for it - feel free to get in touch via the site and let us know you are interested and what you might want to do with it.

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

#193

Post by sib »

spaetzleesser wrote: post #19
LatteLazy wrote: post #15

Earlier quoted context omitted.

>How can there be such a large difference in price for something that, I believe, is legally & medically the same procedure? If no one publishes their prices how do you set yours? 2 dollars? 2000 dollars? 2m dollars?

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.

When I needed a similar non-emergency procedure (cervical, rather than lumbar, MRI), my neurosurgeon, at a large, university-affiliated hospital, referred me to the in-house radiology department.

Within a day or two, I received a phone call from some department at my health insurance provider telling me "Hey, we see that you are going to get an MRI; did you know that you can get the exact same procedure at providers A, B, and C, for a lot lower cost?" They did this even though the hospital's radiology department was in-network.

In this case, the cost difference was similar to what's noted here - about $4,000 vs $450. Since the insurance company was paying most of it, aside from my copay / share of cost, they were motivated to provide me a little transparency.

To be honest, as a patient, I would have preferred to get the MRI at the hospital; their facility was nicer, cleaner, more modern, and there was better data integration for getting the results to my neurosurgeon and keeping them as part of my holistic medical record. Nonetheless, I went to the cheaper provider.

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

#194

Post by zoomablemind »

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

... Add also the medical equipment prices inflated by layers of distributors.

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

#195

Post by lotsofpulp »

analog31 wrote: post #187
lotsofpulp wrote: post #180

Earlier quoted context omitted.

Transparent pricing enabling the comparison of pricing between different sellers is only one piece of a functioning marketplace. You also need multiple informed sellers and multiple informed buyers.

So it's a step towards a complete policy. What is the complete policy? Granted we might not see it enacted now, but it would at least clarify where the administration was headed.

Increasing supply of doctors by increasing residency funding, decreasing education costs, and decreasing the sacrifice that needs to be made to become a registered doctor.

I have no idea why doctors need to sacrifice their entire 22 to 30 year old lives constantly slaving away, working on call, sometimes 24 hours at a time.

Relax some of the draconian, outdated hazing rules. Attract more smart people, make it so young people can have lives and become doctors.

That might address the cost of labor. The cost of medicine on the other hand is simple, the government should be funding research into medicines and then offering it for sale at basically the cost of production. Only other way is to reform patents and whatnot, but it seems easier to just do the research with the top tier research facilities the US already has via the higher education system.

There’s probably some other issues such as tort reform and medical equipment costs that need to be address too. But I think all prices can be brought down by increasing supply.

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

#196

Post by kazen44 »

ep103 wrote: post #175
ews wrote: post #168

Earlier quoted context omitted.

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.

County level vs national level

which in a lot of european countries, doesn't even exist as a differentiator.

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

#197

Post by sithlord »

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.

not 100% sure on this, but don't most doctors in other countries go to medical school for free? Whereas US doctors are going into 3-400k+ debt.

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

#198

Post by kwhitefoot »

swebs wrote: post #88
terse_malvolio wrote: post #9

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

What country lets non-citizens just walk in to use the health care system?

Norway, Poland.

I'm a UK citizen, resident in Norway, who has visited Poland on business many time.

I stayed a night in the Krakow Neurological Institute somewhere between fifteen and twenty years ago, cost me about 100 USD. The ambulance that took me there was free.

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

#199

Post by pkaye »

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"?

I think outpatient care mean you don't stay in the hospital overnight. So you could have a surgery and leave within an hour in the recovery area and that is outpatient.

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

#200

Post by SilasX »

aaronblohowiak wrote: post #116
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.

>raw cost of inpatient and outpatient care I am interested to understand what makes the "raw" costs so wildly different. When my son had an infection in germany, we went to the equivalent of pediatric urgent care and after seeing the nurse, having bloodwork done and a few different 15 minute sessions with the physician we came to the end of the visit with the doctor, they apologized that we had to be charged the full…

That's what I find so depressingly hilarious about the US vs the rest of the developed world [1]: that even when they super-apologetically hit you with the full, no-mercy price, it's less than what you'd way with (already overpriced) insurance in the US.

[1] Well, also developing, but super-low prices aren't as surprising or embarrassing to the US in that case.

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