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

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

#121

Post by hanklazard »

mrexroad wrote: post #117
dheera wrote: post #112

Earlier quoted context omitted.

I just got billed $5000 for a routine echocardiogram at Stanford, and in the process of fighting it. My insurance is supposed to cover preventative care 100% (not even a copay). They billed $18000 total (yes, for a 1-hour ultrasound) and insurance is leaving me to pay $5000. This is about the 6th time this has happened. It's always 15+ e-mails back and forth, then threatening lawyers, then they back off. I'm wonderin…

My son had strep throat. Stanford billed us just shy of $50K, but not before sending us a letter letting us know they had stopped accepting our insurance (BCBS) a few weeks prior. Obviously, more done than just a throat swab for the 50K, but whole thing was insane.

That is nuts. Was he admitted to the hospital or something?

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

#122

Post by staticautomatic »

Glyptodon wrote: post #102
rrdharan wrote: post #87

Earlier quoted context omitted.

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.

That shit is so expensive. I think I paid nearly $800 a month for a good short term policy during my gap.

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

#123

Post by bpodgursky »

dragonwriter wrote: post #110
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/bui…

> Yet another set of independent physical infrastructure would be even less efficient.

I think this misses just how basic much of the care performed in an ER (which is oriented towards critical care for major problems) is. Duplicate infrastructure is OK when the use-cases are totally different. We need better urgent care clinics.

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

#124

Post by x-shadowban »

yborg wrote: post #50
ceeplusplus wrote: post #8

Earlier quoted context omitted.

It really is a toothless law, the hospital probably makes more surplus profit from price discrimination in a single week than their entire fine for the year. The damages should be increased 100x.

Not only that, but it costs money for the hospital to make the chargemaster available, deal with people asking about it, etc. If the fine is really just $900K, if I was a hospital CFO I'd pay that every year without a second thought, or even work up a service charge to add to all hospital billing a la the "Federal Access Charge" AT&T puts on phone bills so I can get people to blame the government for $15 Motrin table…

An interesting game. The govt could then raise the fine, but would they risk bankrupting the hospitals by pushing too far?

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

#125

Post by drdaeman »

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....

How do I figure out if I need something like this and how well my current insurance covers me?

I'm trying to find a case study but nothing turns up. A story - someone got a major injury, cancer, or other life-threatening hard/impossible-to-cure condition, and how exactly the events had unfolded financially. I.e. how many tens of millions the treatments were worth, how much insurance had covered, and how much was still left to pay and why. So maybe I could see what my insurance covers and see if I need another insurance to fill some obvious gaps.

All that my naive search attempts produce are mentions about people without coverage or with insufficient cheap coverage, which is a problem but a different one from what I'm trying to research. Oh, yes, and lots of mentions of out-of-network ambulance drives' crazy costs - I get this one.

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

#126

Post by formerkrogemp »

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.

COBRA is fuxking expensive. I have no desire to pay for it again on a low salary.

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

#127

Post by ipnon »

system2 wrote: post #24
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.

All politicians are crooks. Left or right, doesn't matter. They are both accepting bribery under "lobbying".

This seems like a perilous line of thinking: If all politicians are crooks, then we should get rid of politicians. Without politicians, we either have anarchy or dictatorship. Politicians don't seem so bad at that point.

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

#128

Post by ars »

majormajor wrote: post #57
ars wrote: post #47

Earlier quoted context omitted.

> Whoever got this legislation through deserves a pat on the back. That would be Trump.

Trump's administration offices finalized the rules on how it would work, but the law was part of the Affordable Care Act, so it would be the Democratic congress and presidency of the Obama era. Per https://www.sihd.org/affordable-care-act-price-list-2718-e and others One wonders what took so long, of course.

Not exactly: In 2019: "Specifically, we updated our guidelines to require hospitals to make available a list of their current standard charges via the internet in a machine-readable format and to update this information at least annually, or more often as appropriate." [1]

Which is part of this executive order that Trump signed: "Within 60 days of the date of this order, the Secretary of Health and Human Services shall propose a regulation, consistent with applicable law, to require hospitals to publicly post standard charge information, including charges and information based on negotiated rates and for common or shoppable items and services, in an easy-to-understand, consumer-friendly, and machine-readable format using consensus-based data standards that will meaningfully inform patients' decision making and allow patients to compare prices across hospitals." [2]

> One wonders what took so long, of course.

What took so long is that you misunderstand how these rules work, Obama didn't actually do it, Trump did.

1: https://www.federalregister.gov/documents/2019/11/27/2019-24...

2: https://www.federalregister.gov/documents/2019/06/27/2019-13...

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

#129

Post by flenserboy »

Not only do we need public price lists, the middlemen need to be cut out — specifically, the doctors. You should be able to wander into a specialist's office and get an appointment without having to go through a GP first; you should be able to get most any test done in exactly the same way. Due to the insurance companies and the hospitals they work for, doctors aren't going to suggest anything other than the basic stuff you can find through Google about a low/high count in any test. Yes, GPs are useful and have a role — but as long as their hands are tied, they're glorified flowchart jockeys. Free the data, free the patients.

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

#130

Post by maxerickson »

bpodgursky wrote: post #123
dragonwriter wrote: post #110

Earlier quoted context omitted.

> 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/bui…

> Yet another set of independent physical infrastructure would be even less efficient. I think this misses just how basic much of the care performed in an ER (which is oriented towards critical care for major problems) is. Duplicate infrastructure is OK when the use-cases are totally different. We need better urgent care clinics.

Urgent care should be a billing code at the ER. Pretty much the second they triage you out of immediate care, the separate facility and separate providers are increasing costs.

Medical providers suffer under central planning and believe that moving low risk, high value care out of hospitals will make things cheaper. The thing that will make things cheaper is to figure out ways to directly make them cheaper.

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