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

#391

Post by mardifoufs » Wed, Sep 22, 2021, 9:38 PM UTC

SavantIdiot wrote: post #370

mardifoufs wrote: post #366

Earlier quoted context omitted.

Thinking that trump is the worst president in the past 100 years just betrays either an insane privilege[1] or just ignorance. You realize the hundreds of thousands of lives lost directly or indirectly in the war on terror, a war almost completely engineered by the Bush administration, are actually real right? They were people with hopes, plans, dreams that were all wiped out, and for a lot of those who are still ali…

That's a fair criticism, although you really pulled out the big hyperbolic guns. Insane? Not really. And you continue to make personal attacks even in your footnote. But hey, it's an internet discussion board, I'm guilty of the same. The guy broke democracy and started a trend that IMHO will inevitably break the US. There's no stopping the nihilistic-right's rise fueled by an uneducated white minority bent on revenge…

Yet that white minority is more willing to stop bombing non white across the world. It's a bit unreal but it's the truth. You ought to realize that you are also coming from an imo pretty... White-democrat point of view right? And my argument is exactly that a segment of the country, mostly white, went to such a extent to get revenge on the 2016 election that they sided with literally everyone they used to hate not even a decade ago. I'm sorry but how is that for nihilism? Your arguments are again very philosophical, but in a way just dismiss the destruction of an entire generation of Iraqi (and Syrian, by ripple effects) because a nihilistic trend of your political opposition rising? I'm sorry but come on! Like you are exactly doing what I was critizing in the first place. "those people may have died, and that region may have been hopelessly destabilized but at least Bush (who literally was elected by the supreme Court which makes this even more ironic) wasn't nihilistic?". The guy that came up with you are either with us or you are with the terrorists?

Of course it's worse than 2 wars you have never been affected by. The entire USA had a complete meltdown over allegations of Russians rigging the elections, without any American casualty. In fact I'd bet that one of the reason you are saying trump broke democracy is probably related to those allegations. But when the US is destroying entire countries it's no big deal? I hope you can see the cognitive dissonance there or at least why your point of view is very very white centered. And that's without even getting into how the democrats attacked the integrity of the elections for years, rightly or wrongly yet I don't see how that didn't directly undermine trust in democracy. It was a dance-à-deux, and if trump ends up breaking democracy down the line it's not because one side pushed against it. My point here is that no matter how you look at it, the entire thing is related to partisan politics not a righteous crusade that couldve somehow justified arguing that 2 desastrous, decades long wars were in fact less important/bad.

But that's all unrelated. Look, I'm not American, not white and not Christian.to me it boils down to this. I don't think anything is more cynical and cold than to publicly downplay and rehabilitate a figure that caused so much more pain and suffering because that would score points. That's it.

I really didn't want to come off as insulting you, honestly. And I get that some things can't really be expressed in a non offensive way (even if that's not the intention) when it comes to heated subjects like this. That's why I'm not going to touch on some of your other points. Again, it's not because I'd have insulted you otherwise, but because I don't know how to express what the war on terror felt like from the "inside" without inevitably sounding hyperbolic.

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

#392

Post by SavantIdiot » Wed, Sep 22, 2021, 9:43 PM UTC

mardifoufs wrote: post #391

SavantIdiot wrote: post #370

Earlier quoted context omitted.

That's a fair criticism, although you really pulled out the big hyperbolic guns. Insane? Not really. And you continue to make personal attacks even in your footnote. But hey, it's an internet discussion board, I'm guilty of the same. The guy broke democracy and started a trend that IMHO will inevitably break the US. There's no stopping the nihilistic-right's rise fueled by an uneducated white minority bent on revenge…

Yet that white minority is more willing to stop bombing non white across the world. It's a bit unreal but it's the truth. You ought to realize that you are also coming from an imo pretty... White-democrat point of view right? And my argument is exactly that a segment of the country, mostly white, went to such a extent to get revenge on the 2016 election that they sided with literally everyone they used to hate not ev…

> I'm sorry but come on! Like you are exactly doing what I was critizing in the first place.

Shit. That's an excellent point. Thanks for making me realize it. I'm being absolutely glib about 1M+ deaths. Yeah, that's totally privilege. My bad. I'll go think on that for a while. Yes, I'm a white liberal and I haven't been called out this succinctly and correctly in a long time. I responded like shit because I got angry, my apologies. Thanks again.

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

#393

Post by satronaut » Wed, Sep 22, 2021, 9:49 PM UTC

merpnderp wrote: post #253

satronaut wrote: post #189

Earlier quoted context omitted.

You're in charge of literally saving lives but you can't handle something as standard as cost estimation? How can you joke about that? Figuring out the cost to the hospital in terms of materials and labor should be standard. Example, an x-ray. You know you need to pay an x-ray tech X$/Hour and after doing 1,000's of x-rays, a hospital should have it down that somebody with a broken leg will require N hours (maybe .5,…

You forget that the x-ray is propping up about 50 admin job positions that don't directly generate revenue. The army of compliance, insurance, billing, etc etc etc employees have to get paid somehow. But hopefully this price transparency helps us ask the question of why does an x-ray have to pay for a ton of positions which have nothing to do with x-rays, and how do we correct this situation.

You could say the same about any other service work. If I have the internet guy come out there's probably 50 admin job positions that bill for that time too. Internally they bill the installation department. Hospitals are just complaining to make it seem more complicated than it actually is.

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

#394

Post by noelsusman » Wed, Sep 22, 2021, 9:51 PM UTC

nums wrote: post #328

I studied this years ago for years. My summary: - a mandated MLR of 85% means the insurance companies have zero incentive to reduce the cost of items. In fact, their toplines and real (non%) profits increase as healthcare gets more expensive. - industry profitability for insurance companies is around 3%. So, their overhead is around 15%-3% = 12%. They have an incentive to do their job cheaper. This pales in compariso…

I've worked in healthcare my whole career and you hit the nail on the head. Costs keep going up because nobody involved in healthcare has an incentive to make it cheaper, including the patients. We've designed a system that is doomed to fail and nothing short of tearing it down will fix it.

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

#395

Post by joshAg » Wed, Sep 22, 2021, 9:51 PM UTC

nradov wrote: post #286

joshAg wrote: post #169

Earlier quoted context omitted.

Only to a degree because policies basically always have an upper limit on coverage. If the payouts are dropping because there's a massive reduction in claims, then there's a pretty decent chance that paying the policy maximum on each claim still won't be enough. Plus, profits don't come directly from the premiums anyway. They come from the investments the insurer makes with the premiums. So sure, they can try to conv…

The Affordable Care Act (Obamacare) eliminated lifetime coverage limits. There are also limits of the minimum medical loss ratio. Unlike property and life insurers, medical insurers generate very little income from investments. Premium revenue comes in at about the same rate as claims are paid out. They don't have large reserves to invest. And most large employers are self insured anyway, so the ”insurance" company j…

The parents in the thread don't specify medical insurance. They're talking about a moral hazard in all forms of insurance.

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

#396

Post by satronaut » Wed, Sep 22, 2021, 9:51 PM UTC

jonathan-adly wrote: post #263

satronaut wrote: post #189

Earlier quoted context omitted.

You're in charge of literally saving lives but you can't handle something as standard as cost estimation? How can you joke about that? Figuring out the cost to the hospital in terms of materials and labor should be standard. Example, an x-ray. You know you need to pay an x-ray tech X$/Hour and after doing 1,000's of x-rays, a hospital should have it down that somebody with a broken leg will require N hours (maybe .5,…

Because the broken leg could be a gun shot wound, or an alcoholic who fell down and now is withdrawing, or a geriatric patients who is abused at home or a person who fell due to side effects of drugs with alternatives, or a cancer patient with bone metastases. No one gets an x-ray for a broken leg then leaves with their foot broken. Even assuming that you are just trying to figure out the cost of an x-ray - there is…

I'm talking about the x-ray, nothing more and nothing less. If they have a broken foot and need a cast, the cast should be an estimatable line item based on where it's broken, age/gender/size of the patient, and materials used. If a doctor has put a cast on 1,000 broken feet on men aged 12-16, they should have a very good idea of the material and time it will take and the number of nurses or whatever else they need to put it on.

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

#397

Post by satronaut » Wed, Sep 22, 2021, 9:53 PM UTC

silverlake wrote: post #245

satronaut wrote: post #189

Earlier quoted context omitted.

You're in charge of literally saving lives but you can't handle something as standard as cost estimation? How can you joke about that? Figuring out the cost to the hospital in terms of materials and labor should be standard. Example, an x-ray. You know you need to pay an x-ray tech X$/Hour and after doing 1,000's of x-rays, a hospital should have it down that somebody with a broken leg will require N hours (maybe .5,…

To be fair Boeing doesn’t know how much an airplane cost.

There's R&D, and then there's the actual manufacturing. Sure, prices go down after a while, but you can track costs accordingly.

If you know (because you have blue prints) that the materials will cost 1,000,000 to build the plane (because your suppliers gave your price quotes), you can have a very good idea of what that plane will cost before putting it on the assembly line.

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

#398

Post by elihu » Wed, Sep 22, 2021, 9:59 PM UTC

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.

It can go the other way too. Some hospitals will charge uninsured people much more than they would charge the insurance company for the same procedure.

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

#399

Post by gameswithgo » Wed, Sep 22, 2021, 10:01 PM UTC

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.

Excuse me. But fucking cunt asshole motherfuckers, we should be lining the people who are intentionally deceiving the public up against the wall, they are causing people to DIE.

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

#400

Post by mardifoufs » Wed, Sep 22, 2021, 10:03 PM UTC

SavantIdiot wrote: post #392

mardifoufs wrote: post #391

Earlier quoted context omitted.

Yet that white minority is more willing to stop bombing non white across the world. It's a bit unreal but it's the truth. You ought to realize that you are also coming from an imo pretty... White-democrat point of view right? And my argument is exactly that a segment of the country, mostly white, went to such a extent to get revenge on the 2016 election that they sided with literally everyone they used to hate not ev…

> I'm sorry but come on! Like you are exactly doing what I was critizing in the first place. Shit. That's an excellent point. Thanks for making me realize it. I'm being absolutely glib about 1M+ deaths. Yeah, that's totally privilege. My bad. I'll go think on that for a while. Yes, I'm a white liberal and I haven't been called out this succinctly and correctly in a long time. I responded like shit because I got angry…

Hey this is actually really nice to read, and no matter what you end up concluding I think it's good to just put things in perspective.

I totally realize it's harder to get the whole picture for a lot of people who weren't really affected or involved, just like it is harder for me to relate to let's say the current Ethiopian civil war and it's very harsh effects on the local population since it's so detached from my every day life. Even as a Muslim , I'd probably have been oblivious to the war on terror if it wasn't for my parents being very into Arab politics and the family tv always tuned to Arabic news. Growing up with daily reports of bombings, suicide bombings, mothers crying on TV, and just footage of destruction everywhere is what made me realize and process how much misery was brought upon so many people. it got to the point where the opposite of the normal media sentionalism happened and a few dozen people dying in a suicide bombing/drone strike barely made it in the news. the weird part was that it somehow was never ending.from the invasion of Iraq, to the insurgency to the Iraqi surge to the afghan surge to libya to Syria to Isis to... A bit of very relative peace now? I think everyone would've felt the same if they were in the same situation I think. Even many Arabs and Muslims in the US don't fully realize that either. Cheers!