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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

#291

Post by bcrosby95 »

xyzelement wrote: post #278
4ec0755f5522 wrote: post #265

I just read an article about quiet / dream jobs (park ranger etc.) In it, every single person has a side gig(s) or is otherwise making decisions on their careers based on medical coverage. Every one of them! One of the people says most people leave when they turn 26 because they can't stay on their parents' health insurance. What?! > And like other dream jobs I learned about, it’s not enough to survive on: During > o…

// Having the freedom from health care costs is more freedom for more people than the "freedom" to not pay health insurance or taxes to cover it. This is not how freedom works. Your argument is akin to saying "freedom from hearing uncomfortable opinions" benefits more people than "freedom of expression" does. On the broader level, I got to experience healthcare in the US both as a broke-ass immigrant child and as a w…

My experience as a child was great. As a working adult I spend hours fighting with insurance, hospitals, and doctors to get my bills properly covered. It feels like a bunch of wolves arguing over whose gonna eat the sheep (me). For this privilege I get to pay insurance a minor fee of 3k/month for my family of 5.

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

#292

Post by huitzitziltzin »

zirkonit wrote: post #166

Cardiac valve procedure at Kaiser Foundation Hospital - Redwood City Medical Center - $458,254.00 cash price. Oh my. I get it that it's an expensive procedure, but OH MY.

Kaiser might be a weird outlier. IT is a very different kind of organization (vertically integrated - physicians/insurers/hospitals).

It might be that the price is that insane elsewhere, but Kaiser may not be the best way to judge.

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

#293

Post by huitzitziltzin »

ummonk wrote: post #218

And of course the FTC doesn’t care about the blatant anticompetitive behavior by hospitals.

Where do you get that from?

The FTC has challenged a lot of hospital mergers. They are not always successful, but they do challenge them.

Source: healthcare/competition economist.

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

#294

Post by xyzelement »

bcrosby95 wrote: post #291
xyzelement wrote: post #278

Earlier quoted context omitted.

// Having the freedom from health care costs is more freedom for more people than the "freedom" to not pay health insurance or taxes to cover it. This is not how freedom works. Your argument is akin to saying "freedom from hearing uncomfortable opinions" benefits more people than "freedom of expression" does. On the broader level, I got to experience healthcare in the US both as a broke-ass immigrant child and as a w…

My experience as a child was great. As a working adult I spend hours fighting with insurance, hospitals, and doctors to get my bills properly covered. It feels like a bunch of wolves arguing over whose gonna eat the sheep (me). For this privilege I get to pay insurance a minor fee of 3k/month for my family of 5.

There definitely had been a few snags with insurance that we had to work through - not claiming it's perfect.

However I recall the night my son was born - the facilities, staff and resources of the hospital were unmatched - the mother and baby would not have the same experience anywhere else in the world.

My wife works in the ER - they constantly use procedures and deploy resources in ways that would be considered impractical elsewhere in the world.

For example: an 65+ year-old patient comes in with a specific complaint. It could be cause A or the more rare but serious cause B. It takes imaging to determine whether it's A or B. Elsewhere in the world, they just assume it's A as the patient is "old" because it's financially impractical to test for B. My wife on the other had has no constraints from ordering the imaging test even though 9/10 times it's "wasted" as it just confirms A. But the other 10% of the time, it saves the life.

We make a different tradeoff in the US, some of us prefer this trade off.

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

#295

Post by LouisSayers »

Trill-I-Am wrote: post #282
xyzelement wrote: post #278

Earlier quoted context omitted.

// Having the freedom from health care costs is more freedom for more people than the "freedom" to not pay health insurance or taxes to cover it. This is not how freedom works. Your argument is akin to saying "freedom from hearing uncomfortable opinions" benefits more people than "freedom of expression" does. On the broader level, I got to experience healthcare in the US both as a broke-ass immigrant child and as a w…

Would the general public of other developed nations be happier if their healthcare systems were more like the US's?

Haha nope, ya’ll be crazy

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

#296

Post by CogitoCogito »

theplague42 wrote: post #87
k3liutZu wrote: post #62

Oh wow, so a "Tonsil Removal (Patient Under 12)" procedure has a huge price-range: $298.00 $7,830.76 $7,299.85 $10,243.23 $13,964.19 --- How are these even comparable?

It's probably bad data. 7k vs 13k is reasonable, but nobody is removing tonsils for $300.

$300 seems low to me as well, but the order of magnitude spread isn't suprising at all. About 5 years ago I went into the ER in NYC due to extreme dehydration. They gave me some saline and sent me home a few hours later. Later I got a bill for $250 which was above my ER $150 copay so I called them up and it turned out they didn't realize I had insurance. A month later I got a "fixed" bill for $3000 to my insurance of which $150 was my responsibility.

My example of a magical 12x increase given single exact same procedure coded identically, means I find a price increase of ~43x from $300 to $13,000 between different hospitals quite believable.

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

#297

Post by [deleted] »

dante_dev wrote: post #66
emteycz wrote: post #48

Earlier quoted context omitted.

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.

Just throwing some data, average general practice doctor is 150k$ in US vs 61k$ in germany. https://www.payscale.com/research/DE/Job=Physician_%2F_Docto... https://www.payscale.com/research/US/Job=Physician_%2F_Docto...

[deleted]

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

#298

Post by ska »

eldavido wrote: post #250
ska wrote: post #155

Earlier quoted context omitted.

aside: Singapore is a weird case and probably not a good comparitor for most healthcare systems. > 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 solution…

The main thing I take on faith is that people are different and one-size fits all solutions don't produce good outcomes. We have different car brands, grocery stores, non-health insurance companies, package delivery companies, retailers, and housing options. Some people want fast and cheap. Others want to drive an hour to save a few bucks. This isn't some technical academic point. Without a range of choices, you actu…

> Umm...why not? You can't just hand-wave that away.

Sorry, I should have elaborated. It's a city state with unusually high levels of both social compliance and government control, population is fairly wealthy and fairly evenly distributed. So - small population is a very small area simplifies logistics a ton. Especially ignoring problems related to migrant workers (it's own set of problems), most people have both high social support and some financial depth, there is also little to no housing insecurity.

It's basically unclear if you can successfully scale the Singapore model, nobody has tried. As against, e.g. , the several universal models that are outperforming the US currently, with more comparable populations etc.

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

#299

Post by maxerickson »

mschuster91 wrote: post #146
aaronblohowiak wrote: post #116

Earlier quoted context omitted.

>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…

> I am interested to understand what makes the "raw" costs so wildly different. In the US, hospitals lose a lot of money on patients who don't pay at all or pay pennies, and in order to not make a loss at the end of the year they charge those who can pay more money. Also, insurances have an incentive in having hospitals set high "sticker prices" because then they can claim "higher savings" for their members. Contrast…

Uncompensated care (includes unpaid and forgiven charges) is in the ballpark of 5% of costs, according to hospitals themselves.

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

#300

Post by CogitoCogito »

xyzelement wrote: post #294
bcrosby95 wrote: post #291

Earlier quoted context omitted.

My experience as a child was great. As a working adult I spend hours fighting with insurance, hospitals, and doctors to get my bills properly covered. It feels like a bunch of wolves arguing over whose gonna eat the sheep (me). For this privilege I get to pay insurance a minor fee of 3k/month for my family of 5.

There definitely had been a few snags with insurance that we had to work through - not claiming it's perfect. However I recall the night my son was born - the facilities, staff and resources of the hospital were unmatched - the mother and baby would not have the same experience anywhere else in the world. My wife works in the ER - they constantly use procedures and deploy resources in ways that would be considered im…

> For example: an 65+ year-old patient comes in with a specific complaint. It could be cause A or the more rare but serious cause B. It takes imaging to determine whether it's A or B. Elsewhere in the world, they just assume it's A as the patient is "old" because it's financially impractical to test for B. My wife on the other had has no constraints from ordering the imaging test even though 9/10 times it's not needed. But the other 10% of the time, it saves the life.

This just plain isn't true in general. I grew up in the US with probably the best insurance of anyone I've ever known. I've also lived in Sweden with the state-run insurance (without any private addition). I've had great care in the US. I've had great care in Sweden. In fact, my care in Sweden has honestly probably been better in my cases including where I had overuse injury to my knee due to sports where they really could just say "well quit running so much and let your body rest and leave the healthcare system to those not actively inducing their own injury", but they did not. Fast MRIs, fast diagnosis, fast help, fast everything. I understand this is entirely anecdotal, but the fact is there are many much cheaper systems out there run by governments that actually function _better_ than the US system even for those in the US with good insurance.

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