I analyzed hospital price lists so you didn't have to • Hacker News Board

Re: I analyzed hospital price lists so you didn't have to

#101

Post by remflight » Thu, Jul 07, 2022, 2:35 AM UTC

legitster wrote: post #53

remflight wrote: post #22

I hate Trump and am glad he was voted out, but you have to give him his dues. This is 100% his doing, through executive action. The Dems could have done this but never did. It’s just another example of how neither side of the aisle is truly on your side.

The price transparency rule was actually an ACA provision. It just got tied up in legal limbo for a long period. It was finalized during the Trump administration, but in no way should he get 100% of the credit.

No that’s not what happened. Obama came up with a toothless proposal and once ACA was passed he didn’t push further because he didn’t want to piss of the AHA.

So it languished for 6 years with no movement. Trump came in a added it with an executive decision, and it was then that there were legal challenges that were denied. And that’s how we got here.

Like I said, Trump is the worst president of all time but give him his dues when he deserves them. This is one of them.

Re: I analyzed hospital price lists so you didn't have to

#102

Post by Glyptodon » Thu, Jul 07, 2022, 2:36 AM UTC

rrdharan wrote: post #87

mushbino wrote: post #83

Earlier quoted context omitted.

Not just if you have money. If you have a lot of money. The majority of the country is one major accident away from being completely wiped out. It's the number one cause of bankruptcy. I had an emergency this year within a very tiny insurance gap between employers and now all of my savings and retirement are gone. I'm really not sure who it works out better for versus universal healthcare, but I can't imagine it's a…

You weren’t able to use COBRA? Or was the coverage just very poor even with it? My probably naive understanding was that COBRA can be activated retroactively if you get in an accident during the coverage gap.

I don't know about poster, but offering COBRA isn't required for companies below a certain size. (I had to unexpectedly obtain private insurance to cover a gap in the pre-Obamacare era because the co I worked for only had a few employees.) It is a qualifying event for using the exchanges, but no idea about that being retroactive.

Re: I analyzed hospital price lists so you didn't have to

#103

Post by elhudy » Thu, Jul 07, 2022, 2:37 AM UTC

> 1)The hospitals that comply often publish the least information they can get away with 2)The CMS law appears to be written by non-technical people and leaves room for hospitals to do (1)

I know the people who wrote this law. #2 is actually a false assumption. The law was written like that to incur the least resistance as a first step toward change.

Re: I analyzed hospital price lists so you didn't have to

#104

Post by jjoonathan » Thu, Jul 07, 2022, 2:38 AM UTC

JumpCrisscross wrote: post #51

javajosh wrote: post #37

Earlier quoted context omitted.

>So I guess I should shop around by moving cities No, the solution to most social ills in America is to simply not be poor. If you are poor, stop it. Then you don't have to worry about any of this. Consider abortion, a procedure now outlawed in many US states. If you're not poor, you can just pay to travel to another state or country, have the procedure, do some sight-seeing, and come home. The law has no de facto ef…

> the solution to most social ills in America is to simply not be poor American healthcare works well if you have money and better than anywhere else in the world if you have money and a chronic condition. If you get in an accident, however, particularly while away from your posh neighbourhood, you’re getting the same overworked, hyper-indebted surgeon as the homeless man. (If you’re a billionaire or head of state, t…

> better than anywhere else

Spoken like a salesman!

It's mostly false. Last time I did a deep dive on this, the US had a genuine but small edge in treatment for diabetes and breast cancer, but that was it -- and the edge was nowhere near proportional to price.

Re: I analyzed hospital price lists so you didn't have to

#105

Post by [deleted] » Thu, Jul 07, 2022, 2:40 AM UTC

exabrial wrote: post #86

Where to start... 1. Somehow in the mid-2010s congress decided that anyway that walks onto private property, demands care from a private organization, will receive it, even if they declare they will not pay a dime to the staff working. 2. Congress could have totally create/build a system of hospitals that provides "one time care" for those people, but doesn't. 3. Instead they pass the buck and say "figure it out" to…

[deleted]

Re: I analyzed hospital price lists so you didn't have to

#106

Post by bsimpson » Thu, Jul 07, 2022, 2:41 AM UTC

Someone1234 wrote: post #13

When High Deductible Insurance was introduced the supposed concept was to "give employees a stake in their costs, and therefore lower them for both employer and employee." However, even today doing so is very challenging, and before laws like this it was essentially impossible. There's no way to shop around American healthcare, with the system itself working against you at every turn (e.g. doctors prescribing named b…

I broke my foot recently. Calling around and asking for quotes ranged from a straight up "I don't know" to "Here is the cash price. We won't know your HDHP insurance price until after we bill them, which could be good for you or could be bad. It will probably be bad, because there are more middlemen."

I tried paying the cash price. They inadvertently billed my insurance anyway. Turns out, I actually saved like 33% using the insurance price ($180 vs $120 for an xray + analysis).

They said the only way to get a copy of the x-ray was to pay $5 for a CD. None of the computers I still use have a CD reader.

The whole system is such a clusterfuck. I understand the aversion to giving a governmental bureaucracy more control (esp over something as important as healthcare); however, it's hard to imagine a worse way to pay for care than what we have now.

Re: I analyzed hospital price lists so you didn't have to

#107

Post by slivanes » Thu, Jul 07, 2022, 2:42 AM UTC

sp332 wrote: post #91

stevage wrote: post #82

>Require a standard format. Pick JSON or CSV in some standard encoding. We don't need hospitals publishing XML files and Excel spreadsheets. Definitely CSV. Always CSV. It's easy to produce, easy to parse, and kind of human readable. And easy to do some basic analysis with tools that everyone has access to - Excel, Google Sheets etc.

I didn't like CSV because too much actual data has commas in it, so commas aren't a good delimiter.

Quoting every column is a safe way to handle this, at the cost of slightly larger files. You can then escape a quote with another quote.

Re: I analyzed hospital price lists so you didn't have to

#108

Post by pengaru » Thu, Jul 07, 2022, 2:42 AM UTC

cecilpl2 wrote: post #96

pengaru wrote: post #78

Earlier quoted context omitted.

Doesn't seem to add up though, if you keyword search for "teacher" [0], the results are dominated by GCC with consistently elevated benefits. Once you get out of GCC dominated results, the numbers start looking a lot less surprising - until another GCC entry shows up. [0] https://transparentcalifornia.com/salaries/search/?q=teacher

My completely uneducated guess is that GCC reports the entire value of the DB pension as "income" for that year, whereas all other institutions correctly report just the increase in value.

Plausible, maybe the Superintendent/CEO would be willing to comment if contacted:

> Please feel free to contact me at cindy.petersen@gcccharters.org, or (916) 286-5129.

From https://www.gcccharters.org/welcome/

Re: I analyzed hospital price lists so you didn't have to

#109

Post by zeusk » Thu, Jul 07, 2022, 2:45 AM UTC

phonon wrote: post #46

leeoniya wrote: post #42

Earlier quoted context omitted.

cancer treatment costs can make anyone poor. just sayin'

That's why AFLAC offers cancer insurance. https://www.aflac.com/individuals/products/cancer-insurance....

Do they offer poverty insurance?

Re: I analyzed hospital price lists so you didn't have to

#110

Post by dragonwriter » Thu, Jul 07, 2022, 2:46 AM UTC

exabrial wrote: post #86

Where to start... 1. Somehow in the mid-2010s congress decided that anyway that walks onto private property, demands care from a private organization, will receive it, even if they declare they will not pay a dime to the staff working. 2. Congress could have totally create/build a system of hospitals that provides "one time care" for those people, but doesn't. 3. Instead they pass the buck and say "figure it out" to…

> Somehow in the mid-2010s congress decided that anyway that walks onto private property, demands care from a private organization, will receive it, even if they declare they will not pay a dime to the staff working.

False. I mean, not only is this an exceptionally emotionally loaded description of EMTALA, it was adopted in 1986 which is not, even approximately, the mid-2010s.

> Congress could have totally create/build a system of hospitals that provides "one time care" for those people, but doesn't.

Yet another set of independent physical infrastructure would be even less efficient. The multitude of separate payment and delivery systems is a major source of the US inefficiency

> Instead they pass the buck and say "figure it out" to the private industry.

No, instead they find hospitals that have a large share of uncovered patients through the Medicaid's Disproportionate Share Hospitals payments program.

> E.R.s are now becoming "primary care" for large majority of the US population

Some support for this “majority” claim would be welcome.

> Members of Congress literally don't give a crap about "common folk" and go on golfing and enjoying their free healthcare for life.

Under the ACA, members and staff of Congress don't have special government healthcare plans, they have access to plans they are required to have coverage through plans available to others created under the ACA including exchange plans.