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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

#221

Post by lotsofpulp »

knubie wrote: post #202
analog31 wrote: post #187

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.

The ACA made things better than they were by eliminating maximum benefit amounts, implementing out of pocket maximums, implement maximum age rating factors, and removing all pre existing condition clauses guaranteeing access to healthcare. The individual mandate ensured that all of these increases in access to healthcare could be paid for by forcing young and healthy people to pay premiums. Without the individual mandate, premiums would have had to be even higher, causing even more people to not buy insurance, etc.

That the tax code was not updated to remove the tax benefit for employers, or give it to individuals is a shortcoming (and has long been a handout to big businesses prior to ACA). What really needed to happen was forcing everyone into healthcare.gov onto a single marketplace so healthy lives wouldn’t be locked up in employer sponsored risk pools. Then the costs would truly be shared across the whole population, and sufficient healthy lives would exist to enable multiple insurance companies to compete.

Or we could have gone with taxpayer funded healthcare and made it all simpler. But that obviously wasn’t in the cards.

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

#222

Post by SteveCoast »

echelon wrote: post #117

How do we disrupt the fucking debacle that is US healthcare? Would it be possible to create a subscription-based health network that was vertically integrated and provided just basic outpatient needs? Charge $9/mo or something ridiculously low and encourage everyone to check their health often and maintain healthy lifestyles? Use automation to reduce costs. Then gradually increase the scope of care. That won't help w…

IMHO You need to make it legal to open and run a hospital (hospitals are basically local state-granted monopolies like cable companies). You make it legal to offer differential pricing. You decouple healthcare from employment. You allow employers to offer more than one insurer.

Most of what we need to do is just remove the monopoly rules.

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

#223

Post by analog31 »

lotsofpulp wrote: post #195
analog31 wrote: post #187

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.

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 youn…

Indeed, bringing down the cost of med school might also have the effect of attracting people with a working class background, who see it as a form of labor, not as a return on an investment.

I'm not sure what the impact of tort reform would be. It's possible to look up how much is paid in premiums, but we don't know who owns the malpractice insurance industry, and I've read that it's doctors.

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

#224

Post by aksss »

11thEarlOfMar wrote: post #204
ogre_codes wrote: post #171

Earlier quoted context omitted.

I think the idea is that the poster wants people aware that at least once in his administration Trump has done something remotely correct. Of course the fact that he did this after spending 3 years trying his damndest to gut our already mediocre public healthcare system makes it a bit of a eye roller, but you know, even a broken clock is right and all that.

For completeness, a couple of other health related actions by the current administration: - 'Most Favored Nation' drug pricing. Also as of 1/1, big pharma has to charge US payers the same price as the lowest price they charge to other countries. One example cited is insulin. Apparently, the price of Insulin from the same pharma is 10% the price in Canada as it is in the US. Now that this law is enacted, that pharma h…

We should not ignore the attempt to relax restrictions on Association Health Plans in 2019, which would have made it easier for small businesses to band together to negotiate insurance terms using combined group numbers on par with that of larger corporations. This was struck down by a federal court[0], but would have moderately improved one of the biggest barriers to small business ownership/employment - unobtanium health insurance. This was a huge loss of something almost great.

[0]https://www.shrm.org/resourcesandtools/hr-topics/benefits/pa...

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

#225

Post by xyzzyz »

ews wrote: post #168
Daniel_sk wrote: post #158

Earlier quoted context omitted.

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.

Taxation in the US is significantly more progressive than in most (if not all) of Europe. In Europe, bulk of tax revenues come from high tax rates on middle class, while in the US, most of the tax revenue is paid by the wealthy. In concrete terms, Americans in top 1% of income distribution pay nearly 40% of all federal income tax, and top 10% pays 70% of all federal income tax. That’s significantly more progressive than all large European countries.

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

#226

Post by dubcanada »

apiimporter wrote: post #121
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.

And by "current" administration you mean the Trump administration because people here don't like to give credit where credit is due.

Everyone knows who the current administration is, assigning a name of a bobble head to it doesn't mean anything.

The bill [1] was introduced by Mike Braun and others. None of which have anything to do with Trump or his "administration", these are voted governs who did this all on their own.

1 - https://www.congress.gov/bill/116th-congress/senate-bill/410...

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

#227

Post by Rebelgecko »

11thEarlOfMar wrote: post #85

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.

What does pricing at Kaiser even mean? When I last looked at them, every plan had a $0 deductible and even surgery just had a single copay. Is that the price for someone out of network who goes there in an emergency?

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

#228

Post by stevenwoo »

kwhitefoot wrote: post #198
swebs wrote: post #88

Earlier quoted context omitted.

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.

Wow, you might already know this but in the USA people decline ambulance trips because the cost out of pocket can break them financially. A ambulance helicopter trip (which people are usually not in a position to decline) costs roughly 40,000 last time I read about it, a lot of people crowdfund to pay for this.

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

#229

Post by wskinner »

thatfrenchguy wrote: post #207
dcolkitt wrote: post #178

Earlier quoted context omitted.

Before coming to any conclusions on this topic, I highly suggest reading this extremely in-depth analysis on cross-country healthcare spending.[1] The simple answer is that Americans really do consume significantly more healthcare than Europeans. The most straightforward signature of this is the fact that a much higher proportion of Americans work in the healthcare industry than any other large country. The US also t…

> The strongest counterpoint to this is that despite America's high healthcare consumption, that health outcomes are significantly worse than Europe. In particular in terms of life expectancy. Just look at the life expectancy of France and Germany to disprove your theories. The big difference between the American healthcare system and the one in these countries is that people don’t have to worry about the bills, whic…

> The big difference between the American healthcare system and the one in these countries is that people don’t have to worry about the bills, which means healthcare providers have a much bigger incentive to learn what cost benefit analysis means.

Can you go into a bit more detail about how exactly this incentive linkage works?

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

#230

Post by Daniel_sk »

leetcrew wrote: post #205
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.

one could make the argument than the benefits of police, firemen, and military scale somewhat proportionately with wealth. people with meaningful assets have a lot to lose if the police stop protecting their property or the US navy can't guarantee relatively safe trade by sea. their house is probably worth more too. a homeless person probably gets hassled by police much more often than protected by them. socialized h…

That's a very American way of thinking. I am totally fine that I contribute with a bigger part and it's used for people that would not be able to afford it.
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