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Health insurers just published close to a trillion hospital prices

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Re: Health insurers just published close to a trillion hospital prices

#201

Post by ironick09 »

easrng wrote: post #72
A4ET8a8uTh0 wrote: post #50

Earlier quoted context omitted.

In their defense, if it was anything but CSV files, they would be accused of making it too complicated/locking into proprietary formats and so on. I can't say CSV would be my first choice, but I don't really want to think what the alternative would be.

NDJSON? Sqlite?

csv is many times over again a simpler format than sqlite and easier to understand by anyone across the world.

Never heard of ndjson, can’t see one publishing this data in a format that isn’t nearly as common as something like csv (or regular json which some of the data is published in).

Re: Health insurers just published close to a trillion hospital prices

#202

Post by ecommerceguy »

This "data dump" is step 2 of 4 to deliver "on President Trump’s executive order on Improving Price and Quality Transparency in American Healthcare to Put Patients First."(1)

By January 1, 2023, plans and issuers must make price comparison information available with respect to an initial list of 500 identified items and services. By January 1, 2024, plans and issuers must make price comparison information available with respect to all covered items and services. This information must be made available through an internet-based self-service tool and in paper form, upon request. Typically, consumers receive an Explanation of Benefits after receiving care, which details the prices charged by the provider, the plan’s contracted or negotiated rates, consumer cost-sharing obligations, and other information. Consumers will have access to this type of information before receiving care and can use it to compare prices and better estimate potential out-of-pocket costs.(2)

(1)https://www.cms.gov/newsroom/fact-sheets/transparency-covera... (2)https://www.cms.gov/healthplan-price-transparency/consumers

Re: Health insurers just published close to a trillion hospital prices

#203

Post by nradov »

kev33 wrote: post #169
duffpkg wrote: post #89

Earlier quoted context omitted.

Healthcare is such a base layer of the economy, I find comparisons to be extraordinaly difficult between countries. On the most basic level our pathway to becoming a healthcare provider of all sorts is dramatically more expensive and limited than other countries, what healthcare providers are paid is dramatically more than other countries, we invest many times per capita what other countries put into basic medical re…

Quoted post unavailable.

About 90% of Americans have medical insurance. Coverage caps were eliminated years ago, and the out-of-pocket maximum is low enough that the medical expenses from a single incident are unlikely to drive middle class people to bankruptcy.

Where bankruptcy becomes an issue is when a medical condition leaves someone unable to work for months. With no income they can burn through savings and credit quickly. Then when they file for bankruptcy of course they have some medical debts, but those medical debts are typically not the primary cause of the bankruptcy and even if the medical debts were eliminated they would still be insolvent.

Re: Health insurers just published close to a trillion hospital prices

#204

Post by nradov »

notch656a wrote: post #196
dominotw wrote: post #171

Earlier quoted context omitted.

> Singapore which has exceptionally low healthcare spending yea because they have healthy population, its not because of some smart govt policy( if only it was that easy). singapore obesity rate = 10% usa obesity rate = 42 % usa obesity healthcare spend = 90%

My state has a "stupid motorist" law that requires people who negligently put their vehicles in danger and then use state resources to get bailed out, to pay for the rescue themselves. Perhaps we could create a "stupid eater law" for medicare/medicaid, forcing obese people etc to pay for their own private health insurance or healthcare which would free up money for others to buy more healthcare privately (via lower t…

Should we apply the same sort of "stupid X law" to people who drink alcohol or drive motorcycles or play rugby? This is one of the moral hazards of a socialized medical system. When the rest of society is paying for your medical care it becomes tempting to save money be dictating exactly how you're allowed to live your life.

Obesity is a serious public health problem but we won't fix it by calling people stupid or charging them extra.

Re: Health insurers just published close to a trillion hospital prices

#205

Post by kolbe »

linkdink wrote: post #77
duffpkg wrote: post #70

I'm author of Hacking Healthcare for O'Reilly, 20 year health system executive, blah, blah. It's very easy for people to forget the scale of the US "health system", we are talking 1/5, maybe more, of the entire US economy. If US healthcare spending were a country, it would have the third largest GDP in the world. Accidents of history and the massive federal beauracracy created the crazy monster of ICD/CPT codes that…

In your opinion, what would be the lowest hanging fruit that could be changed to have the largest positive impact?

I've been told credential easing is by far the easiest one to implement. Doctors often do 2-6 years of excess schooling residencies learning areas of medicine that will never be relevant to them. That's 10-20% more time working for existing doctors, and who knows how many more people would enter the profession. Nurses could be empowered to make doctor lite decisions very easily.

Re: Health insurers just published close to a trillion hospital prices

#206

Post by notch656a »

nradov wrote: post #204
notch656a wrote: post #196

Earlier quoted context omitted.

My state has a "stupid motorist" law that requires people who negligently put their vehicles in danger and then use state resources to get bailed out, to pay for the rescue themselves. Perhaps we could create a "stupid eater law" for medicare/medicaid, forcing obese people etc to pay for their own private health insurance or healthcare which would free up money for others to buy more healthcare privately (via lower t…

Should we apply the same sort of "stupid X law" to people who drink alcohol or drive motorcycles or play rugby? This is one of the moral hazards of a socialized medical system. When the rest of society is paying for your medical care it becomes tempting to save money be dictating exactly how you're allowed to live your life. Obesity is a serious public health problem but we won't fix it by calling people stupid or ch…

>Should we apply the same sort of "stupid X law" to people who drink alcohol or drive motorcycles or play rugby?

Yes, precisely. Keep chopping down at these factors until all that's practically left is private healthcare -- that's a feature not a bug. It's enough that I have to pay the bill to scrape the blood off the street when a motorcycle is crashed, not interested in paying someone elses motorcycle related health premiums on top of that (I've gotten enough motorcycle injuries while carrying my own private healthcare :) )

>This is one of the moral hazards of a socialized medical system.

As you say with public healthcare the effect (you say temptation) is to socialize your health related losses while privatizing the gains you reap.

Re: Health insurers just published close to a trillion hospital prices

#207

Post by cammikebrown »

TedDoesntTalk wrote: post #200
Barrin92 wrote: post #129

Earlier quoted context omitted.

beyond Europe as well. Singapore which has exceptionally low healthcare spending (5.9% of GDP) heavily controls prices and purchases down to individual equipment in hospitals.

Singapore has a population of 5.6 million. USA has a population of 330 million. How would you control prices and purchases at that level?

Perhaps on a state level?

Re: Health insurers just published close to a trillion hospital prices

#208

Post by easrng »

ironick09 wrote: post #201
easrng wrote: post #72

Earlier quoted context omitted.

NDJSON? Sqlite?

csv is many times over again a simpler format than sqlite and easier to understand by anyone across the world. Never heard of ndjson, can’t see one publishing this data in a format that isn’t nearly as common as something like csv (or regular json which some of the data is published in).

CSV only seems simple. Lots of parsing edge cases. Sqlite isn't readable by hand but it's basically bulletproof. NDJSON is literally just newline seperated JSON, it's just easier to process as a stream without a special parser.

Re: Health insurers just published close to a trillion hospital prices

#209

Post by kev33 »

nradov wrote: post #203
kev33 wrote: post #169

Earlier quoted context omitted.

Quoted post unavailable.

About 90% of Americans have medical insurance. Coverage caps were eliminated years ago, and the out-of-pocket maximum is low enough that the medical expenses from a single incident are unlikely to drive middle class people to bankruptcy. Where bankruptcy becomes an issue is when a medical condition leaves someone unable to work for months. With no income they can burn through savings and credit quickly. Then when the…

That's a good point, I may have overstated the issue. However, from what I understand it is not too difficult to find oneself being treated by somebody outside of their insurance network. This could easily lead to a bankruptcy. Furthermore, many do not feel comfortable or confident navigating these byzantine insurance landscapes. This leads to people avoiding medical care regardless of insurance status.

Re: Health insurers just published close to a trillion hospital prices

#210

Post by imapeopleperson »

groby_b wrote: post #194
dominotw wrote: post #171

Earlier quoted context omitted.

> Singapore which has exceptionally low healthcare spending yea because they have healthy population, its not because of some smart govt policy( if only it was that easy). singapore obesity rate = 10% usa obesity rate = 42 % usa obesity healthcare spend = 90%

That 90% number is plain not true. Please cite any source for that. The costs for obese folk are on average 90%-100% higher than for non-obese folk, but that's not 90% of total spending. (See e.g. https://pubmed.ncbi.nlm.nih.gov/33470881/ ) Total cost approaches 20% of spending: https://www.hsph.harvard.edu/obesity-prevention-source/obesi...

Don’t get so hung up on precise numbers. We all know Americans are obese and that greatly adds to healthcare costs.

I can’t imagine any downside of trying to prioritize lowering obesity.

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