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

turquoise.health

211–220 of 389 posts

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

#211

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 wonder if the reported prices are the aggregated total price for treatment? Or is it just a price of an individual procedure, excluding whatever else that normally goes into the treatment, like diagnostics, admin and nurse time, room/facilities expense etc?

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

#212

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 this is a bit of an oversimplification; there are places where the out-of-pocket price ends up actually cheaper than the negotiated insurance price, which is mind-boggling to me.

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

#213
post #148
post #23

Earlier quoted context omitted.

Come to Brazil. The best Brazilian hospital (Albert Einstein Hospital in Sao Paulo) charges 1.7k USD for a C section (my son was born recently there), while the lowest I've found in that site is 2.6K USD (don't know about the quality) and median seems to be 8K USD. I bet the other procedures have similar price differences. You can pay for the trip, get the best care (it is a really good, international level, hospital…

And what about an MRI? This website lists rates around 2k USD, while in Brazil you can get one (in high-end modern hospitals in São Paulo) for around R$ 600 (== $120).

MRI in Mexico cost ~$200 USD ( https://www.chopo.com.mx/zapopan/estudios/resonancia-magneti... ) and is way closer than Brazil.

There are laboratories even at walking distance of the USA haha ( https://www.google.com/search?tbs=lf:1,lf_ui:4&tbm=lcl&q=lab... )

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

#214
post #202

Earlier quoted context omitted.

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.

The current tax code incentivizes insurance as compensation, which drastically distorts the market. The ACA made things even worse by introducing the individual mandate.

Indeed when ACA was passed, it was acknowledged that it was intended to reform access to health care, not the cost of health care. It was a compromise that appeased the insurance industry.

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

#215
post #175

Earlier quoted context omitted.

County level vs national level

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

Right but the biggest country in the EU isn't ~330 million people from about a half-dozen fairly distinct cultures. Remember that the US has cultural representation from many European countries and also quite a few non-European countries.

I'm not suggesting that Italy or Greece or Germany are actually homogeneous culturally but with smaller populations and significantly less immigration than the US I suspect that the variances are smaller and perhaps more surmountable.

Germany's population (83 million) is only about 1/4 of the US and as you go down the list the countries only get smaller.

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

#216

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?

It's complicated so nobody really knows. I've seen a few studies that have showed real but modest effects (2-5% decrease). The benefits tend to be concentrated because most healthcare spending is on patients who don't have an incentive to be price sensitive.

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

#220
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.

The 2017 tax reform bill [1] "seeks to address some widely acknowledged issues with corporate taxation, and takes some steps toward broadening the tax base, in part by reducing the incentive to itemize deductions." It was the first substantive piece of tax reform since 1986, and while there are many things to criticize, it at least started to align US corporate tax rates with those in other developed countries.

One of the significant changes that the tax reform brings is an increase in the cost of capital raised in the form of debt. That is a good thing. The deductibility of interest on corporate debt creates an enormous distortion that causes firms to favour leverage, which leads to greater instability in the economy. Should interest be tax deductible? Well, whether or not you think it should be, it is. And so reducing the corporate tax rate makes that deduction less valuable than it was before.

The tax reform is hugely regressive in reducing the top marginal tax rates for high income earners. That is a giant negative IMHO, because wealth and income inequality are a huge problem in American society. So, personally, I believe the only good from the tax reform is on the corporate taxation side by, effectively, making things a little more efficient than they were before.

Other things that I think were a positive:

1. Rejecting Chinese firms' from the 5G network build-out. His diplomacy and trade policy were really random, but this was one move that worked out well.

2. Operation Warp Speed. While Hillary Clinton likely would have done a FAR, FAR better job of handling the pandemic overall, credit is due to Trump for getting behind the advanced purchase of billions of dollars worth of vaccines before they were even approved.

3. Greatly increasing the standard tax deduction for low income earners. "For income earned in 2020, single people pay no income tax on their first $12,400, heads of household on their first $18,650, and married couples on their first $24,800." [2]

Again, it's too bad that all the insane stuff he did and all the things he neglected will overshadow his accomplishments. History will likely judge Trump harshly, which I think is richly deserved.

[1] https://pubs.aeaweb.org/doi/pdf/10.1257/jep.32.4.73

[2] https://www.theatlantic.com/ideas/archive/2020/12/the-things...

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