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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

#331

Post by dakial1 »

xtracto wrote: post #213
pqdbr wrote: post #148

Earlier quoted context omitted.

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... )

Might be interesting to check how much "Medical Tourism" happens between US and other countries. This might be an interesting industry to get into. If I remember well there was a health insurance company that was promoting Medical Tourism for their clients

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

#332

Post by 5cents »

A famous Norwegian professor of social medicine, Per Fugelli, once told a story in a talk that has stuck with me for some reason; Per was talking to a taxi driver, and the driver told him that he was having surgery on his heart valve. Per asked if he was scared , and the driver looked at him and said "No, Per, would you like to know why? Because the surgeon who will operate me has also operated the King" (the King of Norway has had several heart surgeries through ht eyears). I think it's a nice story.

Unfortunately, most of his works are in Norwegian, but his last essay before dying from cancer was called Thank you, Norway - and good luck on your watch (Google Translate uses "god vakt", but I guess it is an idiomatic greeting to guards whos shift is starting) [0] - he was afraid the three pillars of the Norwegian society was somewhat threatened: justice, trust, freedom

[0] https://translate.google.com/translate?sl=no&tl=en&u=https:/...

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

#333

Post by bazooka_penguin »

1024core wrote: post #231
bazooka_penguin wrote: post #108

Earlier quoted context omitted.

Physicians and hospitals have 2 of the most powerful lobbies in the US and have previously gatekept the doctor profession.

AMA (American Medical Association) is known to play games to limit the supply of doctors, so they can keep salaries high. http://www.econ.yale.edu/seminars/strategy/st03/nicholson-03...

Do you have a different link? The file is missing

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

#334

Post by ageitgey »

SteveCoast wrote: post #219

A number of people, including me, have been building similar things, see http://price.hospital The problem seems to be figuring out a revenue model, and translating all the medical terms in to human.

For us, the revenue model isn't this site itself. It's other work we do in the industry - this just helps us get notice and leads to the other things we can build on top of this data in combination with other data. I'd be happy to chat more about this if you were ever interested.

Side note - I'm a long, long time OSM fan and contributor. Thanks!

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

#335

Post by pvaldes »

bhupy wrote: post #153
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. There are a number of reasons. One big one is simply that doctors in the US command a much higher salary than their counterparts elsewhere in the world: https://economix.blogs.nytimes.com/2009/07/15/how-much-do-do... https://www.politico.com/agenda/story/2017/10/25/doctors-sal... Another big reason is that the US is unique in that it's on…

> doctors in the US command a much higher salary than their counterparts elsewhere in the world

Yes, but salaries are also linked to huge debts to pay in their first years, a permanent state of fear to be sued by negligence (losing their license and seeing their only possibility of income vanished). It seems that suicide and depression are too common among young students. They also work too many hours in irregular schedules (working in sundays, holidays or passing one on each three weekends at the hospital is not uncommon. This will add a lot of stress for parents with small children trying to having a normal life. And is a emotionally charged work.

... So either you provide a particularly high reward in form of a golden salary, or perhaps nobody would wanted to be a doctor.

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

#336

Post by aksss »

lotsofpulp wrote: post #235
aksss wrote: post #224

Earlier quoted context omitted.

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…

The better, and simpler option is to remove employers from the equation entirely. Either go with taxpayer funded healthcare, or force everyone to buy from healthcare.gov where they can choose whichever insurance company they want.

In terms of moderate tweaks to an enormous problem, AHP reform for small businesses is comparatively low-hanging fruit that could help businesses today meet the minimum requirements for attracting talent - health insurance. Your proposal may be better in the long term, but the journey there is not simple by any means.

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

#337

Post by applecrazy »

mrnickel001 wrote: post #43
subhro wrote: post #4

This seems to be the GoodRx of medical procedures. This is tremendously helpful. How do you plan to keep the data current? Also, in the US, is a patient realistically able to say, “Hospital X is able to get my compound fracture surgery done for 65% less. Match it or I walk”, especially when insurances have negotiated rates. Or is this only useful for people with no insurance?

Hey man! This is a great comment. I work with Turquoise. We're actually building some stuff where patients can collectively bargain outside their insurance. But for now, it's most useful to people with insurance that see that one hospital down the road has a lower rate for their given insurance. (EG, the blue cross rate is better the next town over). We're going to make it easier to filter for insurance shortly. Also…

This is an amazing product and I congratulate you on your launch! Like the parent, I'm also really curious how you plan to update the data and also wanted to ask how you normalized the data.

I ask because this space has always been interesting for me. Funny enough, I helped build almost the exact same thing at a hackathon (https://devpost.com/software/liform), but the project didn't pan out after that due to our team's lack of medical knowledge. So I'd love to learn from your experience processing this data into a usable form.

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

#338

Post by mrnickel001 »

ilaksh wrote: post #318
mrnickel001 wrote: post #119

Earlier quoted context omitted.

Thanks for the feedback! We'll be improving our filter/sort here in the coming days and we'll take this feedback into our plan.

My searches so far show insane differences between insurance rates and cash rates. The cash can be 5-10x higher than what the insurance company pays. It seems like a clear case of systemic fraud to me. Am I missing something? Also I am not able to find any fundoplication or LINX (43284).

Many hospitals don't discount from their list price for self pay. Medicare pays ~10% of list price. So, for example, if there is an insurance rate set at "130% medicare" (common to have a coefficient between 1 and 2), then yes, you'd still see many cash rates that are 5x insurance. However, many hospitals also listed Managed Medicaid insurance rates. These are generally 3-5% of list price & look for similar to normal insurance plans. So, what you're seeing may also be comparing a Medicaid rate to a very high cash rate.

Will add 43284 & other gastro procs shortly. Thanks!

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

#339

Post by jackson1442 »

pkaye wrote: post #210
azalemeth wrote: post #34

I think something else that would be of interest would be doing this for drug prescriptions: compare the cost that my employer, the NHS, pay for a compound and those that Americans pay for the exact same compound. This is easy on my end at least -- prices and prescription guidance are released in the BNF / British National Formulary annually and are all made available in public. I have never understood the US system…

One of the things that EU countries do is negotiate with the the drug manufacturers. So UK in this case of Lumacaftor, didn't cover the drug until they got a reasonable price. This meant a 4 year delay in access to the drug vs the US. > It was approved for medical use in the United States in 2015, and in Canada in 2016.[3][5] In the United States it costs more than $US 22,000 a month as of 2018.[6][7] While its use w…

I don't think you can really say that the US has "access" to a drug when it costs $22,000/month, which, given the median household income of $68,700/yr, is nearly 4x more than the average American makes in a month.

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

#340

Post by analog31 »

coredog64 wrote: post #255
analog31 wrote: post #223

Earlier quoted context omitted.

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.

There’s two costs to the US legal environment: Insurance premiums and defensive medicine. It’s in the doctor’s interest to run every test because it’s free to him, but failure to do so raises his risks. So you wind up spending money non-productively and you have a non-zero rate of false positives, unnecessary treatment, etc.

Interestingly, I think they may be bringing that cost under control. I had an injury recently, and it took 2 trips to the doctor (each one with a fee) before they agreed to do a cat scan (with another fee) and find out what was actually wrong with me.
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