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

#151

Post by com2kid » Thu, Jul 07, 2022, 4:20 AM UTC

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…

> 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.

Last time I had imaging done, my doctor gave me a list of nearby imaging services, and the one I selected was able to electronically send files back to my doctor.

Heck I've witnessed my old dentist send x-rays over to my new dentist, it took like 5 minutes. Then again it seems like dentists are better at technology all around.

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

#152

Post by tooltower » Thu, Jul 07, 2022, 4:27 AM UTC

duffpkg wrote: post #65

Wrote Hacking Healthcare for O'Reilly, created ClearHealth/HealthCloud open source EMR, managed health systems for 15+ years, blah, blah, blah. It is very good there is are the transparency regulations. It is worth briefly explaining some of the reasons why many facitilities are having a hard time complying. There are some bad actors, absolutely true. However "Hanlons Razor" -- never attribute to malice that which is…

You've touched on regulation being one source of this problem. But do you think prices will become more normal if regulations disappeared? What do you think is different between the US health care regulatory structure, vs. those in other countries? Can we have the same desired effect with regulations that are easier for hospitals to follow (so as not to be dependent on Epic)?

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

#153

Post by gavinray » Thu, Jul 07, 2022, 4:32 AM UTC

duffpkg wrote: post #65

Wrote Hacking Healthcare for O'Reilly, created ClearHealth/HealthCloud open source EMR, managed health systems for 15+ years, blah, blah, blah. It is very good there is are the transparency regulations. It is worth briefly explaining some of the reasons why many facitilities are having a hard time complying. There are some bad actors, absolutely true. However "Hanlons Razor" -- never attribute to malice that which is…

Interesting to read mention of MUMPS

I'd never heard of it -- until I was at an afterparty at last year's AWS ReInvent and started talking to an older couple near us over some drinks.

The guy was well to do and had been in technology a long time. We had a great discussion where he told me about things like MUMPS and other tech I'd never heard of.

When they left, his wife gave me his name. Looked him up, it turns out he was C-Suite at a company nearly everyone has heard of (but is not known for being a tech company).

Makes me wonder how many billions of dollars are being pumped into tech I wouldn't recognize the name of.

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

#154

Post by closewith » Thu, Jul 07, 2022, 4:32 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…

> American healthcare works well if you have money and better than anywhere else in the world if you have money and a chronic condition.

Citation needed.

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

#155

Post by Wistar » Thu, Jul 07, 2022, 4:34 AM UTC

micromacrofoot wrote: post #77

spaetzleesser wrote: post #63

Earlier quoted context omitted.

"No, the solution to most social ills in America is to simply not be poor. If you are poor, stop " In healthcare not being poor is sufficient. You actually have to be quite well off in order to not worry about cost.

Yes! My salary is twice the local average and still worry a medical event could wipeout my life savings.

Me. too.

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

#156

Post by ransom1538 » Thu, Jul 07, 2022, 4:35 AM UTC

formerkrogemp wrote: post #126

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.

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

Sigh. This isn't your fault. But COBRA is retroactive. EG. You have 60 days to find new insurance with a new employer. So you don't have to ever pay for COBRA. IF / when something happens - you pay all the missed bills and you are covered. That is the entire point of COBRA. People paying for COBRA are using it wrong or can't find employment in 60 days.

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

#157

Post by caramelcustard » Thu, Jul 07, 2022, 4:36 AM UTC

ipnon wrote: post #127

system2 wrote: post #24

Earlier quoted context omitted.

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.

"All politicians are crooks" is often used as a way to discourage the public from participating in any sort of politics. Outside of this threads context – don't take it that seriously.

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

#158

Post by danachow » Thu, Jul 07, 2022, 4:40 AM UTC

dheera wrote: post #112

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…

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…

> I am insured and it is preventative care

How or why do you think an echo is preventative care? While insurance plans are free to define any additional menu of services as preventative - an echo is not included in the minimum set required by the federal government - which are procedures based off of US preventative services task force guidelines - there are no published guidelines that include an echo.

I wish you luck on your billing problem but I think you’re going to hit a wall on your own definition of “preventative”.

https://www.healthcare.gov/preventive-care-adults/

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

#159

Post by closewith » Thu, Jul 07, 2022, 4:40 AM UTC

IncRnd wrote: post #54

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…

The Pharmacist is a doctor and can offer the generic version. They do that regularly. There is no need to go back to the original doctor you saw.

That depends on your state and country. It's certainly not universal.

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

#160

Post by smolder » Thu, Jul 07, 2022, 4:45 AM UTC

duffpkg wrote: post #65

Wrote Hacking Healthcare for O'Reilly, created ClearHealth/HealthCloud open source EMR, managed health systems for 15+ years, blah, blah, blah. It is very good there is are the transparency regulations. It is worth briefly explaining some of the reasons why many facitilities are having a hard time complying. There are some bad actors, absolutely true. However "Hanlons Razor" -- never attribute to malice that which is…

The difficulty of fixing and improving these systems is frankly overrated. It has more to do with penny pinching and profiteering that they haven't modernized. I don't mean a rewrite in JavaScript either, I mean sensible engineering, which many people are ready to do but not paid to do, because it weakens the upwards money vacuum the finance cabal wants to maintain. Progress isn't profitable enough according to the Excel spreadsheet.