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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

#201

Post by junofan »

ineptech wrote: post #194
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…

> Everyone is deathly afraid of making too many changes too fast because when those systems break the money stops flowing and a health system will literally go insolvent. Isn't this the desired outcome, that such organizations go broke? And let their assets, employees and customers go to some other organization that isn't saddled with technical debt?

The code looks like this:

``` I X?1.N1"H" S X=X3600,%H=$H,@("X=$P(%H,"","",2)"_Y_X),%=$S(X2-1 I @("%I(1)*100+%I(2)"_$E("> I mean, I can see why reimplementing could be scary even with org churn.

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

#202

Post by brundolf »

Despite all the problems with the law and with compliance, I'm optimistic about this. I think various orgs are going to ravenously pick apart this data, normalize it, make it easy to use for regular people, etc. Gaps are gaps, but messy formats and inconsistent codes and such are the smallest of speedbumps, in my mind.

Journalists, nonprofits, and startups are going to extract every bit of juicy truth there is to find in this stuff. They're going to get to the bottom of every cryptic string by hand if they have to, because there's so much value in this for nearly our entire society. And hopefully, the fines will mean the true gaps get smaller and smaller.

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

#203

Post by pishpash »

brundolf wrote: post #202

Despite all the problems with the law and with compliance, I'm optimistic about this. I think various orgs are going to ravenously pick apart this data, normalize it, make it easy to use for regular people, etc. Gaps are gaps, but messy formats and inconsistent codes and such are the smallest of speedbumps, in my mind. Journalists, nonprofits, and startups are going to extract every bit of juicy truth there is to fin…

I'm not optimistic. The data that has been out there for years has not yielded end-user usable information. There is too much missing context and billing trickery that it's not possible to tell how much something costs unless you're a medical coder.

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

#204

Post by albertopv »

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.

In 2007 (15 years ago) Veneto and Lombardia italian regions elder health care ptivate facilities had to provide monthly data with a specific, mandatory excel template provided by regional health authorities. The company I worked for was in charge to collect data and create those files. It was not a perfect format, it was closed source format (still .xls) but everyone knew it was that format. Standards matter.

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

#205

Post by [deleted] »

brundolf wrote: post #202

Despite all the problems with the law and with compliance, I'm optimistic about this. I think various orgs are going to ravenously pick apart this data, normalize it, make it easy to use for regular people, etc. Gaps are gaps, but messy formats and inconsistent codes and such are the smallest of speedbumps, in my mind. Journalists, nonprofits, and startups are going to extract every bit of juicy truth there is to fin…

[deleted]

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

#206

Post by Ekaros »

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…

On other hand looking at experiences here the projects to change these systems seem not to go well... So there is also not promise that things will get better...

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

#207

Post by legitster »

cycomanic wrote: post #182
robocat wrote: post #137

Earlier quoted context omitted.

HSA for those who are “international”: https://en.m.wikipedia.org/wiki/Health_savings_account

That's insane! Goes to show again that the solution in the US is "be rich" and then you'll be given additional benefits.

They're usually offered as an option for work-sponsored plans. You can get a low deductible plan that your work pays $1k a month for, or you can get a high deductible plan for $500 a month and the company gives you the other $500 into your HSA tax-free (oversimplified, of course).

They actually make a ton of financial sense, but too many in the US would rather overpay for insurance rather than have to shop around.

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

#208

Post by bitcharmer »

cyanydeez wrote: post #45
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…

Or don't be racist and rebuild the social safety net Americans desocialized because of equal rights.

What does racism has to do with broken medical health care system in the US?

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

#209

Post by onli »

twicetwice wrote: post #188
throw123123123 wrote: post #175

Earlier quoted context omitted.

> 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.

Yes, the fact that literally all health care goes through insurance is a big part of the problem. As my dad says, if you had to get all car maintenance done through your car insurance, changing your oil would cost $5,000.

It is not like that at all in countries like Germany and France, where really literally all health care (for a lot of people) is covered (mostly) by general medical insurance. The pricing explosion is exclusively an US problem.

(Germany has private insurance and France as well in parallel, but the main system is "sozialised")

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

#210

Post by pishpash »

throw123123123 wrote: post #180
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.

No you can't. Some specialists are referral only. They do this to satisfy medical necessity requirements to make sure they get paid by insurance.
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