Hospitals lift curtain on prices, revealing giant swings in pricing by procedure • Hacker News Board

Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure

#41

Post by bcrosby95 » Wed, Sep 22, 2021, 5:07 PM UTC

toast0 wrote: post #22

breckenedge wrote: post #6

Earlier quoted context omitted.

I like the idea of getting rid of in/out of network. Both recent administrations have taken steps in this direction.

Networks are a double edged sword. They're a pain to use (especially for things where network facilities have non-network providers or network providers steer you towards non-network accessory care like labs and what not), but network agreements are also a way that insurers control costs. Forcing insurers to cover every provider means insurers can't exclude overpriced providers.

Yep. These agreements cut out some ridiculous fees some might try to charge.

E.g. when my wife had surgery, the hospital tried to charge $20k for the surgery room and $20k for the recovery room. Our insurance pointed out that by their agreement they aren't allowed to charge for use like that.

Instantly cut the hospital portion of the bill from $49k to $9k.

Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure

#42

Post by arcticbull » Wed, Sep 22, 2021, 5:08 PM UTC

mistrial9 wrote: post #29

arcticbull wrote: post #19

Earlier quoted context omitted.

Yes, in a single-payer environment everyone is in-network. Every doctor in Canada providing covered medical services is in-network.

I was told by a cancer patient in the US, who is a Canadian citizen, that specialized equipment and certain tests are not available in the entire system, or months-long wait times.

Medical bankruptcy is the most common form of bankruptcy in the US. I would say that for the massive portion of the US that is un-insured, under-insured or faces bankruptcy in the event of a medical procedure that substantially any tests and equipment for them are not available.

Canada has some of the best cancer survival rates in the world, and is substantially identical to the US. [1]

Further the US tends to skew towards early detection without a commensurate increase in survival rates, which means 5-year numbers in the US are higher than elsewhere in the world but it does not necessarily translate to lower mortality.

[1] https://www.ctvnews.ca/canada-gets-high-ranking-for-cancer-s...

Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure

#43

Post by lolpython » Wed, Sep 22, 2021, 5:08 PM UTC

missedthecue wrote: post #24

scheme271 wrote: post #5

This will probably help a bit but in an emergency people don't have the time to compare prices. And with US health care, it just takes one accident that sends you to the ER and where someone that's out of network performed a procedure to end up with a bill that's tens or hundreds of thousands of dollars.

Emergency care accounts for just 2% of healthcare spending. https://www.politifact.com/factchecks/2013/oct/28/nick-gille...

That is not a useful statistic here. We are talking about an individual’s financial obligations in a medical emergency. A $10,000 bill is not 2% of an individual’s yearly spending.

Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure

#44

Post by intrasight » Wed, Sep 22, 2021, 5:08 PM UTC

Someone1234 wrote: post #28

ed25519FUUU wrote: post #25

Earlier quoted context omitted.

I would think hospitals like people paying the cash price?

They make less that way. If they know you're insured they won't allow you to pay the cash price, only the much higher negotiated price.

There is a loophole in ACA specifically for this. A loophole that you can drive 20% of all Americans through (That's roughly the percent I've heard).

https://www.nytimes.com/2020/01/02/health/christian-health-c...

https://www.nytimes.com/2016/12/10/opinion/sunday/should-i-l...

Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure

#45

Post by jjoonathan » Wed, Sep 22, 2021, 5:09 PM UTC

kindle-dev wrote: post #34

Someone1234 wrote: post #28

Earlier quoted context omitted.

They make less that way. If they know you're insured they won't allow you to pay the cash price, only the much higher negotiated price.

But someone told me insurance companies are bad and are stiffing those poor, struggling doctors and hospitals.

Every head of the insurance/drug/provider dog points at the other two heads when somebody accuses it of being the problem.

Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure

#46

Post by weberer » Wed, Sep 22, 2021, 5:09 PM UTC

scheme271 wrote: post #5

This will probably help a bit but in an emergency people don't have the time to compare prices. And with US health care, it just takes one accident that sends you to the ER and where someone that's out of network performed a procedure to end up with a bill that's tens or hundreds of thousands of dollars.

I'd imagine that prices will now plummet simply due to the fact that prices are now transparent and real competition can actually exist.

Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure

#47

Post by breckenedge » Wed, Sep 22, 2021, 5:09 PM UTC

novok wrote: post #38

breckenedge wrote: post #6

Earlier quoted context omitted.

I like the idea of getting rid of in/out of network. Both recent administrations have taken steps in this direction.

Psychologists want to charge $200-$250/hr, but insurance only reimburses $120-$160/hr. You might think these are high prices, but chargeable hours isn't hours worked for psychologists, since they have to do notes for every meeting, manage the business, appointments, etc, which reduces their total take home to something below $200k/yr, which is below a typical bigtech Eng II with only a couple years of experience, pot…

FWIW I pay mine in cash from my HSA because he doesn’t accept any insurance due to the headaches involved getting reimbursed.

Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure

#48

Post by mullingitover » Wed, Sep 22, 2021, 5:10 PM UTC

gfodor wrote: post #33

It will be fun to watch people be positive on this until they are reminded who we have to thank for it. Edit: CNN hasn't forgotten, notice the obvious negative spin, with literally zero argument of how this may be beneficial: https://www.cnn.com/2021/01/04/politics/hospital-price-trans...

I mean, that's nice, but I'm not going to fall all over myself thanking the people who have fought viciously for decades to maintain the current profit-driven health care system and block single payer health care. It's like an abusive spouse who, out of the blue, brings you flowers and chocolate.

Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure

#49

Post by dehrmann » Wed, Sep 22, 2021, 5:10 PM UTC

gfodor wrote: post #33

It will be fun to watch people be positive on this until they are reminded who we have to thank for it. Edit: CNN hasn't forgotten, notice the obvious negative spin, with literally zero argument of how this may be beneficial: https://www.cnn.com/2021/01/04/politics/hospital-price-trans...

Biden doesn't run his mouth when he shouldn't, but foreign policy with China and along the southern border are essentially the same as under Trump, and the Afghanistan withdrawal alienated some NATO allies. Biden is carrying over more of Trump's policies than you'd expect.

Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure

#50

Post by throwaway0a5e » Wed, Sep 22, 2021, 5:11 PM UTC

peterangular wrote: post #35

Someone1234 wrote: post #10

Local hospital released this as an Excel spreadsheet (Chargemaster). They have a column called "Uninsured cash price." These prices are And, no, I don't think this was by accident as they have updated this Excel spreadsheet several times and only that one column is always set to 0 size.

And this can really cause issues for people who are insured because if an insurance company decides not to cover something (very very common, even in-network) then the inflated price is what you end up getting billed for. That is until you call the hospital and find out there's all sorts of "sliding" prices etc... I had a procedure billed for one of these drastically larger "insured" codes which got denied based on t…

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