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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

#251

Post by zarzavat »

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.

You cannot require CSV as a standard format because CSV itself has no standard. There are multiple variants of CSV and there's no way for a CSV file to declare which variant it's using in a standard way, which means you have to manually check that every single file parsed correctly, because if you accidentally parse a CSV file as the wrong variant there is no way for the parser to know and it will just silently corrupt your data.

Sometimes CSV files themselves are ambiguous because they don't use any quoting so you end up with some lines that have more columns than others, and require manual repair line-by-line by a human.

Don't use CSV, it's a dreadful format.

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

#252

Post by hansoolo »

viraptor wrote: post #171
gavinray wrote: post #153

Earlier quoted context omitted.

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

What the...?

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

#253

Post by cycomanic »

legitster wrote: post #207
cycomanic wrote: post #182

Earlier quoted context omitted.

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.

I agree they make sense, however they are incentive directly aimed at the rich/well off who will benefit most from this (and can afford it).

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

#254

Post by topspin »

majormajor wrote: post #57
ars wrote: post #47

Earlier quoted context omitted.

> Whoever got this legislation through deserves a pat on the back. That would be Trump.

Trump's administration offices finalized the rules on how it would work, but the law was part of the Affordable Care Act, so it would be the Democratic congress and presidency of the Obama era. Per https://www.sihd.org/affordable-care-act-price-list-2718-e and others One wonders what took so long, of course.

> One wonders what took so long, of course.

No One doesn't.

One need only appreciate the incestuous network of corruption that controls how long these cans get kicked down the road to fathom what took so long. Unfortunately for the medical industry someone that wasn't beholden to them got into office briefly and made it happen.

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

#255

Post by nosianu »

lelanthran wrote: post #248
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…

> "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 t…

> the purchaser does not know the price of something at the point of purchase.

This is only solvable for the cases where what needs to be done is completely known and certain in advance. Which for very complex human biological systems would not be the majority of cases, unless providers decide to only deal with health issues that fit that criteria and send everybody else to someone else.

I think the problem of not being able to accurately predict the required care is an intrinsic part of health care. Some of it actually is taken care of in some way, for example, if you go to ER they will only fix any immediate urgent issues and then send you home. Or, they send you home after n days in the hospital no matter what (example links: https://www.ombudsman.org.uk/sites/default/files/page/A%20re... or https://pubmed.ncbi.nlm.nih.gov/12568426/).

> When consumers are informed and can force suppliers to compete with each other,

Uhm... how do you imagine this would happen? Genetical engineering so all humans become standardized clones with identical completely predictable issues? I think you severely underestimate the inherent unpredictability. Simple stuff like teeth cleaning can be a price known in advance, or coming in only to renew a prescription for a known health problem, but many, most?, of the "real" issues are not.

OR, what would happen if you enforce this is that the MDs would be forced to press the cases into the pattern. They may think they should order an additional test or imaging procedure after actually looking at the patient, but since it's not in the pre-approved plan it would not get paid, so they don't, only things that were known before any doctor looked at the person get treated and only using the predicted methods.

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

#257

Post by someoneFromWeb »

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…

Have you ever heard about OpenEHR? https://www.openehr.org/
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