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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

#271

Post by grecy »

soco wrote: post #264
stickfigure wrote: post #242

Earlier quoted context omitted.

> 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.

I honestly think it's because Americans are told from birth they live in "The greatest country in the world". In that context, it feels like trying to fix anything is not really a worthy pursuit, because it's already better than everywhere else anyway. So even if healthcare sucks, it's better than everywhere else. (Which everyone in a developed country knows first hand is simply not true)

I personally think it's a very dangerous thing to believe, because it means there's no driving force to improve, and it's a part of the reason the country has stagnated so badly.

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

#273

Post by nickip »

SilasX wrote: post #29
pengaru wrote: post #20

Earlier quoted context omitted.

W T F https://transparentcalifornia.com/salaries/2021/gateway-comm...

WTF about, not just the compensation, but the fact that some of these show a salary of $200k with $2.X million in benefits. Like, what? https://transparentcalifornia.com/salaries/2021/gateway-comm...

Transparent California is also incorrect in a lot of cases. I worked in CA as a seasonal worker and they reported what I would have earned if I worked full time for a year. In reality I only worked at that rate for 3 months making a quarter of what was reported. So I am not sure how much I trust it anymore.

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

#274

Post by creakingstairs »

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…

I’d argue that the underlying system that makes the regulation in US is broken. So you aren’t going to end up with many good regulations without changing the system. Which looks nigh impossible until some black swan event.

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

#275

Post by xtiansimon »

techdragon wrote: post #245
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…

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…

> “… noble goals of doing better…”

Compliance within regulation is a noble goal? I should think it’s ethical goal.

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

#276

Post by Joeri »

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…

When you take your car in for repair, you also can’t know for sure what the cost will be, because cars are complex systems and every car is unique in its own way. But if the garage overcharges you then you will figure this out and you will not go there again.

In the US healthcare system because of the lack of price transparency it seems to be impossible to know which hospital or doctor overcharges, and so a free market cannot arise. It is not even possible for a competitor to advertise better prices, because there is no practical way to check that their prices are indeed better.

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

#277

Post by loonster »

GoOnThenDoTell wrote: post #193
throw123123123 wrote: post #173

Earlier quoted context omitted.

It's not the same regulation.

Effective regulation is somewhat of an organisational skill. Perhaps its just low pay attracting low talent

No. It's the high profit attracting high incentive to capture the regulation.

The goal of the regulation is to increase prices (profit) while preventing other parties from competing on prices

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

#280

Post by joshgel »

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.

> You have to hope your hospital uses CPT codes and not, say, DRG coding, or something else entirely, otherwise you'll need to look up those codes too.

This is a bit of a misunderstanding. CPT codes are part of professional services billing, while DRGs are exclusively for inpatient acute care billing. If you are admitted to a hospital, you’ll probably have to deal with both.

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