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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

#171

Post by viraptor »

gavinray wrote: post #153
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…

I heard of Mumps for the first time from tdwtf. https://thedailywtf.com/articles/a_case_of_the_mumps

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

#172

Post by [deleted] »

danachow wrote: post #158
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…

> 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 lu…

[deleted]

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

#173

Post by throw123123123 »

diob wrote: post #165
smolder wrote: post #160

Earlier quoted context omitted.

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 E…

The irony of attributing the free market healthcare disaster we have here to regulation. Things are plenty regulated in Australia and other socialized countries and they have none of the crazy billing / coverage issues we have. It's frankly, bullshit.

It's not the same regulation.

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

#174

Post by cycomanic »

mgleason_3 wrote: post #7

Interesting to read that only 33%-50% of hospitals comply with the law and post their prices. If there's one thing this country needs to do it's demand transparency everywhere. Especially our government. Spending. Salaries. It all needs to be public.

Reading this thread and watching the US news in general, transparency is pretty far down the list of things the US needs.

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

#175

Post by throw123123123 »

smolder wrote: post #160
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 E…

> Progress isn't profitable enough according to the Excel spreadsheet.

It's precisely the opposite. Its a racket but its not for profit. If you made a health care service that didn't have any of this cruft and just provided great care, it would not be used, because it would not be compliant with insurance, and employees would not get the tax benefit of using it.

If it were for profit, it would work better.

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

#176

Post by ls15 »

cgb223 wrote: post #38
thedougd wrote: post #33

Earlier quoted context omitted.

Many hospitals and providers are ignoring it, perfectly willing to eat the fine, if it ever comes.

I wonder if one could automate finding the hospitals that don’t do this and filing a complaint that leads to a fine like patent trolls for a cause

The competitors that do publish the data have a reasonable interest in that, so I would expect this to happen.

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

#177

Post by throw123123123 »

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…

HDP is definitely in the right path, but you need to get rid of many layers of bureacracy and paperwork. Need an absolute de-reg.

It's not going to happen, so the most likely scenario is innovation will be coming from fringe services.

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

#178

Post by hunterb123 »

beeboop wrote: post #150
hunterb123 wrote: post #23

Earlier quoted context omitted.

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

I posed my question to warrant a discussion from either the commentary or faithful statement regardless of their intent.

Mainly to understand the expectations, values, and reasoning.

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

#179

Post by throw123123123 »

social_quotient wrote: post #21

Why can’t insurance companies post the actual price they are paying and being charged by the hospital with proper billing taxonomies. They seem like they probably have these things well ironed out since they actually deal with various hospitals whereas hospitals only deal with themselves.

Because they don't know it yet. They audit and review each claim a an office sends, which starts a negotiation process to see if each claimed item by the physician was warranted and done properly. All that information is codified then into a level of visit, which changes the amount it will be payed out.

It is grotesquely complex, but the core issue here is that patients want to consume their healthcare through insurance, because it is tax advantaged. Thus it is impossible to make a cash business that would cut through all this bullshit for the majority of healthcare.

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

#180

Post by throw123123123 »

flenserboy wrote: post #129

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 st…

You can do this with PPO insurance or paying cash.
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