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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

#261

Post by Tade0 »

stickfigure wrote: post #242
el_jay wrote: post #238

Earlier quoted context omitted.

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.

Not necessarily true. At least all my medical records in all the facilities I visited in the last 5 years were digitized and I live in an eastern European, post-communist country.

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

#262

Post by badpun »

stickfigure wrote: post #242
el_jay wrote: post #238

Earlier quoted context omitted.

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.

Nope, they just use a single national health insurer instead of many private ones. This changes the problem from many-to-many (as is in the US) to just many-to-one, which is immensely simpler.

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

#263

Post by gjulianm »

ddingus wrote: post #226

Frankly, this exercise motivates me toward universal care more than ever. I do not mean to devalue the work. It's great honestly! Thank you. That said, this is a major league mess most of the world would look at and wonder whether we are crazy or high.

Yes, as someone outside the US, the fact that this is a thing is just... weird. When I go to the hospital I'm already worrying about health, I'm thankful I don't have to worry about money too.

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

#264

Post by soco »

stickfigure wrote: post #242
el_jay wrote: post #238

Earlier quoted context omitted.

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.

There's a lot of this concept, that if it doesn't work in the US, everybody else must have failed even worse. Well, not really, many times it's actually the other way around. I won't bother with other more obvious examples but in this context, even Pakistan has a digital health system in the meantime.

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

#265

Post by celdon25 »

cycomanic wrote: post #191
celdon25 wrote: post #67

Here's a solution: Let doctors be doctors and not glorified algorithmic-assembly-line workers. Incentivize transparency through something better than Yelp reviews. Incentivize diagnostic outpatient facilities, make them more accessible and discoverable. Especially through telemedicine if possible, but make sure they can be seen in person by someone competent if needed. I'm sure I'll get downvoted here for this part,…

> And for Christ's sake, stop training doctors to ask "what are your symptoms" (when they are already reasonably aware of what the type of issue is), and use more yes/no questioning about specific symptoms. If doctors can't be trained fast enough to be able to do even that, I'd think about fixing that, too. I think you really don't understand enough about why these things get asked. Yes Gp work often seems like glori…

> Asking the patient about their symptoms is an important part of gathering the history and can not be done just with yes or no questions.

I agree, but that wasn’t what I was arguing against. Absence of any yes/no question is what I was referring to.

And I’m not sure your argument is a good one. Things you do in the classroom or other training are intended to overprepare you, and are not supposed to mirror real life. While I did rebuild and scale (as a technical owner) an exam platform later used by millions, I am only mentioning that ironically. Appeals to authority tend to be pretentious, and serve to prop up an even more dangerous myth that professionals always know what they are talking about.

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

#266

Post by lelanthran »

nosianu wrote: post #255
lelanthran wrote: post #248

Earlier quoted context omitted.

> "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 be…

The majority of healthcare is for routine and known in advance procedures, not for emergency or exploratory procedures.

Sure, the GP might want to order tests, but the cost of the test will be known in advance, the cost of the consultation was already known by the patient.

The patient can tdecide which radiologist they want, using price as a criteria if they want to.

The existing method is basically "you can only know what the cost is after you owe it to us", which is, frankly, insane. It allows the sellers to set a price that the ma let cannot bear, which results in secondary markets that provide insurance and skim even more off the top.

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

#267

Post by dxdm »

parineum wrote: post #167
pc86 wrote: post #142

Earlier quoted context omitted.

Hospital IT systems are incredibly locked down, especially from a network perspective. And DICOM images (the format things like x-rays are stored in) are very large, and not readable by most image readers. I honestly don't know if there are even free DICOM readers out there, but there probably are. CD is honestly the easiest way for them to send the images to you, because you can give them to any doctor and they can…

> I honestly don't know if there are even free DICOM readers out there, but there probably are. If you've ever gotten a cd with your medical imaging on it, it will come with the software required to read it.

Yes, and that software requires some esoteric proprietary OS that I've banned from all of my memory. :D

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

#268

Post by yieldcrv »

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

If there was a bounty I would do it

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

#269

Post by rgrieselhuber »

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…

As a side note, Hanlon’s Razor is applied so liberally and in ways to shut down criticisms of what very well could be a number of root causes, some of which could include malice and greed.

At the end of the day, Hanlon’s Razor is just something some dude came up with to explain what is the most likely but not even necessarily correct assessment of a given situation. It is often unjustifiably treated as some immutable law when it is really just a flourish of rhetoric.

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

#270

Post by throwaway6734 »

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.

Voters are incredibly scared of change because it's so vital. The current situation isn't caused by a lack of resources but a lack of focused will

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