Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

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

healthcaredive.com

Post reply on HN
Print view View original

311–320 of 463 posts

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

#311

Post by good8675309 »

0xcde4c3db wrote: post #294
hartleybrody wrote: post #196

Earlier quoted context omitted.

> (they’re scams). citation or story?

https://www.buzzfeednews.com/article/lauraturner/christian-h... They're not inherently scams, but a major reason that the "premiums" are lower is that they have hardly any legal mandate to actually provide anything, which comes as a surprise to some members who are denied reimbursement. Their authority to deny "coverage" (scare quotes because that's not, technically, what they provide) is huge. In particular, HCSMs f…

If you agree to a contract and then break the terms of the contract why would you be surprised when things aren't covered? It's the same thing with insurance companies. Also, many of these examples are broad generalizations that may apply to some but not all of the health sharing groups out there.

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

#312

Post by rsj_hn »

alex_smart wrote: post #261
nickff wrote: post #208

Earlier quoted context omitted.

> "This change alone would remove 25+% of unnecessary bloat from the US system." Where do you think the money is going? Insurance companies are not as profitable as you might think, drugs are not a massive burden on healthcare expenditures, and many hospitals are non-profits. The truth is that most of the money is going to staff wages; if you want to reduce healthcare spending, the only way to do it sustainably is to…

>the only way to do it sustainably is to increase the numbers of doctors and nurses, so as to drive down their salaries Getting the hospitals to accept a price ceiling which forces the issue is another way to do it.

Yes, but supposedly the author was referring to a way to lower prices while maintaining an equilibrium of supply versus demand.

You can always lower prices by fiat proclamation, but then you have shortages and wait lines as hospitals go bankrupt and shut down, which will hit rural areas particularly hard.

If you want to lower prices and make sure that everyone gets served, you need to be a bit more sophisticated than just cutting hospital revenue in half and washing your hands of the consequences.

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

#313

Post by throwaway23438 »

kube-system wrote: post #301
throwaway23438 wrote: post #291

Earlier quoted context omitted.

Even with identification, healthcare systems usually will not do more than they're required to under EMTALA. The hospital will provide intensive care to the uninsured DKA patient, since they're obligated to do so under EMTALA, but they will not provide that patient the insulin and other care necessary to prevent them from needing ICU in the first place, since it's not yet an emergent condition. If there's no risk of…

If I'm dying, I want the best care I can get. I'm not about to argue with someone trying to save my life to make a political point to an ER doctor who didn't have anything to do with it in the first place. And I'm certainly not about to risk my own health outcomes by withholding the insurance that I paid for to help me in that exact scenario.

Oh, I wouldn't be arguing with the ER doctor. I'd be arguing with the billing murderers, like the one that comes in to shake you down for money while in the ER bed.

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

#314

Post by rhacker »

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.

What's hilarious about that - is this:

Instead of giving a hospital your insurance info, say "you don't know if you have it, the last one expired" - even if you have insurance they couldn't prove you did "know you had it".

Then get the bill in the mail.

Submit the bill to your insurance company.

Bill gets paid.

Hospital doesn't get to inflate.

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

#315

Post by tobr »

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.

Reminds me of that time I exported a bunch of strings to Excel for translation. Was very confused when I got surprisingly short translations back.

Turns out the translator didn’t know you could resize the rows, so they had only translated the first few words that happened to be visible in each cell.

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

#316

Post by dougmwne »

throwthere wrote: post #243
garettmd wrote: post #234

Earlier quoted context omitted.

How does the cost of a drug change based on who is consuming it? That's like saying the cost of a loaf of bread changes based on who is buying it. The price you charge for the bread might change, but the cost is the same regardless of who is purchasing it. There's a difference between varying costs of an item based on accounting methods, versus varying costs of an item due to who is buying it. There seems to be huge…

The hospital's drug cost is the price the distributor charges it. That price varies for each individual patient. It's turtles all the way down.

This reads like straight up corruption and extortion. There could be no other reason to do this than to milk as much money as possible out of people who have no alternative.

You should absolutely be testifying before Congress, not before HN.

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

#317

Post by jonathan-adly »

mchusma wrote: post #190
jonathan-adly wrote: post #167

Earlier quoted context omitted.

There is no internal reliable system. Healthcare in the US uses faxes. People here thinks that their local hospital is Google, while in reality it's a badly managed/badly funded 100 year old non-profit organization full of middle managers who just learned how to use their email.

I think if your point is "the system is broken today", basically everyone agrees with you. If your point is "it is not possible to have transparent pricing", that seems also insane. IMO we should pass a law that says if you can't give people transparent upfront pricing, you can't bill them at all. The idea that you can "figure out a price later" seems absurd.

It is not possible to have transparent pricing in the current broken system.

It's like trying to put a bandaid on an arm that met a chainsaw. Not really a good first step and a waste of time. The solution is to go to the OR, and give him a new arm. The more bandaids and time you waste, the worse it is.

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

#318

Post by rhacker »

loeg wrote: post #83
mullingitover wrote: post #73

Earlier quoted context omitted.

> These prices are There are some clever insurance companies whose entire model is "tell the hospital you don't have insurance, get the cash price, pay it with this debit card we give you."

You’re probably thinking of “healthcare ministries,” which are not insurance (they’re scams).

No, this technique works with plain old insurance companies too. It's just that no one does it because they mistakenly give the hospital their insurance info - because, guess why? They ASK.

Also, healthcare sharing ministries are not scams. However they are simply not guaranteeing payment. It sounds like the truth of it is that the "guarantee" of payment is what makes traditional insurance expensive. Is that worth it? I think that's up to each individual.

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

#319

Post by lostlogin »

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.

Would a local news outlet publicise this?

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

#320

Post by OrvalWintermute »

sk00tmer wrote: post #251
peterangular wrote: post #206

Earlier quoted context omitted.

I know that any anti-capitalism comments get immediately downvoted here but yeah... The privatization of healthcare is a conflict of interest which is a product of our hyper-capitalistic society. You can't make a profit center out of human services without dehumanizing it in the process - the very nature of profit/capitalistic societies means someone has to lose and I see no place for these interests in healthcare or…

I have to agree with you for the most part, as a Canadian, I know our healthcare system is flawed, deep systemic problems, problems I'm not even familiar with. However, we don't have to deal with any of these price lists or copays or pre-approvals or debt (inside the scope of hospitalisation) I've even heard arguements that many of the pitfalls stem from privatised aspects. I'm a fairly capitalist person, but there i…

> However, we don't have to deal with any of these price lists or copays or pre-approvals or debt (inside the scope of hospitalisation) I've even heard arguements that many of the pitfalls stem from privatised aspects

Many of the current US medical problems (bureaucratization of medicine) actually evolved out of massive government regulation with debatable value. EMRs, ICD/coding, the bureacracu that eats up 25% of your doctor's day? It is mainly for insurance companies and Medicare/Medicaid.

https://healthncare.info/history-healthcare-insurance-united...

> I'm a fairly capitalist person, but there is something awfully and fundamentally wrong about a society that monetizes well-being and health

All the medical providers (doctors/nurses/therapists/techs/PAs/etc) do not work for free, and there is a significant logistics and technology tail in providing medical services at huge scale.

If you really want to go after waste in medicine ask the following questions:

(1) How much are the nonclinical hospital mgmt & insurance executives paid?

(2) What is the ratio of clinical to non-clinical personnel?

(3) Why is the US subsidizing the vast majority of the medical research, and drug profits for the entire world?

These are serious questions because, as my nearby regional hospital group was firing hundreds of nurses during COVID, their CEO was collecting millions.

Post reply on HN