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

dolthub.com

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

#241

Post by sl-dolt »

JohnJamesRambo wrote: post #217
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.

Good point. With the data as sparse and dirty as it is, it's hard to get a reliable analysis for specific procedures. Or at least one I consider publishable. That, plus, I don't have a good understanding of how medical billing works on the inside.

Some of that will hopefully change in the coming months as new data comes in (will write more about that in another blog.)

If you want to look at how prices for different procedures can vary between hospitals, you can get a rough idea from a previous blog post I wrote:

https://www.dolthub.com/blog/2022-05-06-the-most-expensive-h...

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

#242

Post by stickfigure »

el_jay wrote: post #238
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, thank you. One remark: > Modernization is hard, time consuming and very expensive. These regulations are a good driver for all that, but it takes time. Having been in some of these boardrooms there is not typically a cartel of evil executives figuring out how to screw patients. A lot of the time it is a group of relatively normal people trying to hold up a technological and business process house of card…

> It bears questioning how, in ”the richest country on Earth”, something as important as a hospital ends up held together with spit and twine.

In less rich countries they use paper records, which are worse. Everything is held together with spit and twine.

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

#243

Post by silvestrov »

thewebcount wrote: post #141
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 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…

also: when wealthy you become a customer instead of a patient.

So they will do all kinds of useless tests and treatments because that is what they earn money on.

You will never really know if this treatment is good for you or good for the hospital.

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

#244

Post by nopenopenopeno »

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…

In other words, it is a matter of priorities. If the fines were significant, the initiatives would be prioritized. It is that simple.

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

#245

Post by techdragon »

el_jay wrote: post #238
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, thank you. One remark: > Modernization is hard, time consuming and very expensive. These regulations are a good driver for all that, but it takes time. Having been in some of these boardrooms there is not typically a cartel of evil executives figuring out how to screw patients. A lot of the time it is a group of relatively normal people trying to hold up a technological and business process house of card…

The problem is that it was built by the last 50+ years of technology and regulations. The system is a product of its upbringing. A company could starts out with noble goals of doing better and slowly year by year sink into this morass and become just another “part of the problem” before it becomes obvious to everyone that it’s now just another entity making things worse.

These kinds of reforms would have had to begin decades ago to make much of a difference.

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

#246

Post by nopenopenopeno »

mapt wrote: post #220
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…

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.

All you need for those things is a complete overhaul of capitalism itself.

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

#247

Post by nopenopenopeno »

twicetwice wrote: post #186
throw123123123 wrote: post #173

Earlier quoted context omitted.

It's not the same regulation.

Yeah. A lot of flamewars have happened: "regulation bad!" vs "no, regulation good!". But in reality, good regulation is good, and bad regulation is bad. It sounds silly written out because it's a tautology, but if more people internalized it we could have much more productive conversations. Instead of going back and forth on whether regulation is good or bad, we should try to figure out which regulations are good and…

It sounds silly because it is silly. Interested parties prioritize various policies with varying degrees of priority.

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

#248

Post by lelanthran »

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…

> "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."

This is the reason that non-emergency healthcare is so expensive - the purchaser does not know the price of something at the point of purchase.

This results in the price being significantly higher than what the market can bear.

When consumers are informed and can force suppliers to compete with each other, prices go down to exactly what the market can bear.

Emergency healthcare is a different beast, but will probably also decrease if non-emergency healthcare prices was left up to the market to set.

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

#249

Post by Ndymium »

yuretz wrote: post #240
junofan wrote: post #201

Earlier quoted context omitted.

The code looks like this: ``` I X?1.N1"H" S X=X 3600,%H=$H,@("X=$P(%H,"","",2)"_Y_X),%=$S(X 2-1 I @("%I(1)*100+%I(2)"_$E("> I mean, I can see why reimplementing could be scary even with org churn.

What language is it?

From the context I'm guessing MUMPS, and it kinda seems to resemble it, if it had more line breaks: https://github.com/programarivm/mumps-examples/blob/f160bfb6...

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

#250

Post by liotier »

legitster wrote: post #48
briHass wrote: post #39

Earlier quoted context omitted.

> doctors prescribing named brand, and you not be allowed to switch back to generic without another $100+ appointment I'm not sure this is that common, unless you have an adversarial relationship with your doctor. It's actually the opposite: in most states the Dr. must write DAW-dispense as written or 'name brand only' to get the expensive brand. Otherwise, the pharmacist can and will substitute a generic if availabl…

Fun fact, your pharmacist is allowed to change your prescription in some states! Try asking them if there are cheaper generics.

In France, the pharmacist is legally obliged to offer the cheaper generic. If the doctor wants the primary brand specifically, he has to write "non-substitutable" on the prescription and a shorthand mention of the reason.
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