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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

#211

Post by deelowe »

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.

There can be bad actors in free markets or socialist institutions. The issue isn't the system itself, but instead the people overseeing it.

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

#212

Post by pjerem »

obventio56 wrote: post #198
diob wrote: post #165

Earlier quoted context omitted.

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 seems more regulated healthcare systems are also significantly less capable of developing innovative treatments (although this could be a misunderstanding of mine)

You are wrong on this point. Some years ago, I’ve undergo some pretty innovative surgery procedure (I was one of the first hundreds people in the entire world).

I don’t know how it works in the US but at least in France, most hospitals are part of universities so they are also doing a lot of research.

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

#213

Post by pishpash »

refurb wrote: post #134

I believe that this price transparency will have a pretty radical impact. I used to negotiate with hospitals on reimbursement and if I were still doing the job, the first thing is do is pull up this data and say “This other plan of similar size is paying $X. I’m willing to pay the same.” Sure it will take time to shake out. Hospitals will reject super low prices (that they were possibly losing money) for all payers.…

What's cost though? You've seen inflation when the supply chain is constrained. This is the case with medicine so the cost is possibly infinity here.

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

#214

Post by deelowe »

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…

Bullshit.

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

#215

Post by pishpash »

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…

It costs money for the hospital to do payroll for the CEO too but that never gets dropped somehow!

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

#216

Post by davidkuennen »

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'm from Germany and just recently got a preventative coloscopie.

I'm not 50 years old yet, so I had to pay for it myself. A magical experience, since it's the first time I ever saw a medical bill in my life.

It was two pages long. Everything from taking blood to the medication and doctor was listed there, but the price at the end was only 200€. I thought it was a joke and expected a lot more.

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

#217

Post by JohnJamesRambo »

sl-dolt wrote: post #164

I'm as surprised as anyone to see this #1 on HN. Glad y'all like it. AMA. Feedback, criticism, comments, directions to go, whatever.

I wanted to see how different the price for the knee replacement would be at different hospitals.

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

#218

Post by jamra »

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…

I was in the physical therapy space for over 15 years. The penny pinching that comes from healthcare giants towards their software vendors are dreadful. It prevents any serious software engineering from happening. One customer billed over a billion dollars in a year to Medicare through our software and paid us $1M that year. I'm still not certain that we didn't take a loss to take that client.

Passing around financial data on SFTP drops is something that irked me. Having the total not add up from the line items is also pretty ridiculous. The systems in place are all about edge cases that have formed over decades.

Software engineers are not invited to the discussions in a lot of these companies. The area is gate kept by healthcare people, which tend to be people who don't know how to do technical writing or planning.

Our company wasn't a huge one. But the huge ones looked to me as run by accountants. If you can't establish an income stream for them, they won't even talk to you.

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

#219

Post by nostromo »

javajosh wrote: post #37
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…

>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

No, the solution is to be either poor or well off. The lower middle class are the people that have the most to worry about in the US healthcare system.

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

#220

Post by mapt »

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…

All you need for progress is a sensible regulatory environment.

"Some of you may not be in compliance. We start you off at a fine of $1. For every month this continues, the fine doubles."

All you need for a sensible regulatory environment is a complete overhaul of how your society works, starting with a campaign finance & congressional staffing system that isn't built on implicit corruption.

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