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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

#141

Post by thewebcount »

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 in the world if you have money and a chronic condition.

Which isn’t saying much. Even for wealthy people in the US, chronic conditions get you labeled anywhere from annoying to chronic drug seeker to mentally ill. Many doctors simply don’t believe that conditions that thousands to millions of people have are real, and no amount of money will change their minds. You do however get targeted for all kinds of scams!

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

#142

Post by pc86 »

bsimpson wrote: post #106
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% us…

Hospital IT systems are incredibly locked down, especially from a network perspective. And DICOM images (the format things like x-rays are stored in) are very large, and not readable by most image readers. I honestly don't know if there are even free DICOM readers out there, but there probably are.

CD is honestly the easiest way for them to send the images to you, because you can give them to any doctor and they can load them within minutes. For the hospital to send them directly to another hospital would literally take weeks (at a minimum) of back and forth between two overworked and incompetent IT teams.

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

#143

Post by onphonenow »

dheera wrote: post #119
mrexroad wrote: post #117

Earlier quoted context omitted.

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.

I really want to expose Stanford's ridiculous billing and shame them to no end, but I don't have enough Twitter followers. I know healthcare billing in the US is f-ed up but Stanford is particularly bad.

Not really that bad. San Francisco used to have crazy bills. Trauma response fees go up to 50k even if nothing is wrong.

I can get the price of my fast food burger to the penny - but good luck getting a quote on something that will cost 50,000.

I did medical billing for a bit and in my space 70% of the issue was stupid politics

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

#144

Post by pc86 »

jjoonathan wrote: post #100
duffpkg wrote: post #75

Earlier quoted context omitted.

The primary cause today of doctors prescribing name brand medications without the ability for substitution of generics is a form of institutional stupidity. EMR prescribing systems are driven by a common "formulary" that has an entry for each drug and defaults. Often the people that define formularies are a weird mix of technological people that don't know anything about the drugs/medicine and medicine people that do…

> institutional stupidity If you are a hospital, and you are shopping for an EMR to maximize revenue, is that a feature or is it a bug? Evil, yes, stupid, no.

I've worked with many, many hospital IT departments as a consultant, contractor, and vendor.

It's absolutely stupidity.

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

#145

Post by thewebcount »

macintux wrote: post #131
phonon wrote: post #46

Earlier quoted context omitted.

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

Having two different forms of medical insurance can be worse than one. I’ve not had such an experience, but I’ve heard horror stories of the two providers pointing fingers at each other and refusing to pay.

My spouse is on a very expensive treatment. For the first 5 years or so, the insurance company would call us every six months to ask if we had other insurance because they do not like paying for it. I think they’ve finally stopped asking. Next, they started harassing our doctors telling them to switch her Rx over to their (fucked up) internal pharmacy. Luckily the doctor knew they couldn’t be forced to do it and called us about it. We had to call the insurance company and tell them we aren’t changing pharmacies and to stop calling us or our doctors about it. They continued to call for a few months but have apparently relented.

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

#146

Post by nicolas_t »

jjoonathan wrote: post #104
JumpCrisscross wrote: post #51

Earlier quoted context omitted.

> 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.

That's something I've always been very curious about as someone who doesn't live in the US and was very unimpressed by the healthcare there when he lived there and had to deal with issues with my Asthma.

What documentation/studies did you find in your deep dive?

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

#147

Post by Temporal_Trout »

pc86 wrote: post #142
bsimpson wrote: post #106

Earlier quoted context omitted.

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% us…

Hospital IT systems are incredibly locked down, especially from a network perspective. And DICOM images (the format things like x-rays are stored in) are very large, and not readable by most image readers. I honestly don't know if there are even free DICOM readers out there, but there probably are. CD is honestly the easiest way for them to send the images to you, because you can give them to any doctor and they can…

I'm not sure if "proper" DICOM files are different (DRM?) but during my undergrad I had a medical imaging class working with anonymized DICOM files and we used Pydicom (With Jupyter Notebook) to display the images and annotations: https://pydicom.github.io/pydicom/stable/index.html

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

#148

Post by mauvia »

pc86 wrote: post #142
bsimpson wrote: post #106

Earlier quoted context omitted.

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% us…

Hospital IT systems are incredibly locked down, especially from a network perspective. And DICOM images (the format things like x-rays are stored in) are very large, and not readable by most image readers. I honestly don't know if there are even free DICOM readers out there, but there probably are. CD is honestly the easiest way for them to send the images to you, because you can give them to any doctor and they can…

I've worked in a medical image processing field and there's a few out there, Orthanc is the most featureful one I know of.

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

#149

Post by solumos »

pc86 wrote: post #142
bsimpson wrote: post #106

Earlier quoted context omitted.

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% us…

Hospital IT systems are incredibly locked down, especially from a network perspective. And DICOM images (the format things like x-rays are stored in) are very large, and not readable by most image readers. I honestly don't know if there are even free DICOM readers out there, but there probably are. CD is honestly the easiest way for them to send the images to you, because you can give them to any doctor and they can…

There are multiple free DICOM readers, but each imaging device manufacturer has its own interpretation of what a "DICOM" file is, so there are a lot of quirks.

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

#150

Post by beeboop »

hunterb123 wrote: post #23
rinze wrote: post #11

What a strange concept, "hospital price".

Why? What do you think pays for the "hospital cost"? (That's not to say there aren't MANY opportunities to reduce the price and cost, starting with complying with the law to post prices, which many hospitals don't adhere to because the current administration isn't enforcing the EO)

Pretty sure he's just writing commentary on the US not having a single payer healthcare system
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