Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Health insurers just published close to a trillion hospital prices

dolthub.com

Post reply on HN
Print view View original

281–290 of 549 posts

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

#281

Post by stackbutterflow »

themaninthedark wrote: post #252
snuxoll wrote: post #137

Earlier quoted context omitted.

Also stop getting rid of paper towels if you still have manual faucets. Nothing grosses me out more than going to a public restroom with only air dryers, but manually operated faucets that now require you use clean hands to turn off after you turned them on with presumably dirty hands.

Use your elbow to turn off the faucet(as long as it is lever type, if twist type then good luck). I want paper towels for the door knobs/pulls and the trash can should be located near the door so I can throw it out after opening the door.

Or make the door push to leave, pull to go in. I don't understand why it's not a thing.

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

#282

Post by valayal »

TimTheTinker wrote: post #25

I would love to hear from an insider on what the difference is between these published files and the internal databases - I'm sure the difference between the two is striking. Malicious compliance, indeed.

Internal systems are rules engines with hundreds of branches for the most seemingly simple claims. If every payer tried to encode the rules instead of the outcomes of those rules, it would also be entirely unusable, but for a different reason. There is no standard way to encode these contract rules. There aren't any constraints on the legal language that can exist within a contract. When CMS passed this regulation, lots of insurance companies were stuck with systems that flat out could not generate this output. They then had to pay millions to consultants to crunch historical data in order to create these files (which, by the way, is technically not in line with the regulation -- historical data should NOT be used to generate these files). CMS defined in painstaking detail the format and content of these files. Health insurance companies flagged to CMS early on that this would result in a huge amount of data, but at least at the end of it all you get a bunch of dollar amounts, instead of legalese.

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

#283

Post by vineyardmike »

ecommerceguy wrote: post #162
mskar wrote: post #63

Earlier quoted context omitted.

It's very expensive, carriers have an economic incentive to simplify it and this is still where they end up. There are a long tail of provider circumstances that the single-payer model will need to figure out. Some examples: * Small hospitals in low-density, underserved areas have to make up for underutilized equipment and personnel costs. They raise prices on unrelated, common procedures to break even (This is very…

>>* CMS (medicare/medicaid) sets a low price for a procedure that's overly common in a particular facility, now that facility loses money for each occurrence. They choose other procedures to raise the price to try to break even. This is precisely why most Doctors I speak with are abhorrently against a single payer system.

Most doctors I talk to vaguely run around the answer before mumbling that a huge way to cut costs (which will surely happen) is to cut doctors salaries.

Source: once engaged to a doctor who had doctor friends and doctor parents/family.

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

#284

Post by bhupy »

formerkrogemp wrote: post #257
bhupy wrote: post #136

Earlier quoted context omitted.

It is not so obvious at all. Medicare Advantage does not have price controls, and it still costs less per capita than Original Medicare. > A dead simple “this is how much you’re allowed to charge”. This has its own set of unintended consequences, including physician rationing (it's a huge crisis of the NHS right now), and a reduction of investment in new medical research. There are many good reasons to be against int…

> In fact, of the countries that usually make up the global leaders in health/medical innovators, all but 1 (the UK) engage in price controls ( https://immigrantinvest.com/insider/the-best-healthcare-coun ...), and the UK's NHS is suffering from a rationing crisis, and (ironically) a cost crisis. The UK's difficulty lie in their leadership and political issues and in the economic consequences of Brexit. I'm not sure…

The NHS's difficulty lies in the simple fact that it is understaffed (https://www.express.co.uk/life-style/health/1633058/general-...) and the staff are underpaid (https://www.bbc.com/news/newsbeat-62290577) — leading to unprecedented wait times. This is because the "list prices" that the NHS pays for GP, nurses, and services are not subject to market forces, they are set by the government. The government is currently failing to address the supply loss with little political will to increase list prices (which propagate to the consumer through increased taxes). Brexit's influence is tenuous at best. Switzerland is also not part of the EU and doesn't face this problem. At best, Brexit exacerbated an already existing pricing problem.

Where you're correct is that the difficulty lies in leadership's inability to actually change the prices to attract the supply necessary to reflect the increase in demand — and that's because the Single Provider system is tied to politics rather than market forces. The NHS is a third rail of politics and real reform is extremely difficult given the political buy-in necessary. In contrast, the private sector can (and will) increase prices to overcome demand — we see this happening in Switzerland (https://pubmed.ncbi.nlm.nih.gov/26766626/).

> The system offers a high degree of choice and direct access to all levels of care with virtually no waiting times

So where we may agree to disagree is that the NHS's woes are in fact a very strong example of the greater argument, on net.

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

#285

Post by RoadieRoller »

India is considered a "cheap and poor" country in many ways. It's GDP is 1/10th that of United States. Even then, India has free health care, and in many states (out of the 30+ states), Govt run healthcare is the best. Woman give birth to babies and walk out paying almost nothing, men break their bones and walk out paying nothing after a month of staying in hospitals and such. Insurance is never heard of or forced to, unless you own a automobile and pays insurance to drive it on roads. No monopoly of any kind.

And there are arguments against all these points, I concur. I just said it for the American folks to know.

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

#286

Post by rendaw »

mskar wrote: post #43

I work in data at https://www.carrumhealth.com/ , and I've been parsing this data for weeks. The transparency prices allow us to meaningfully negotiate with providers, and make tangible, incremental progress toward cheaper health care. Providers and existing insurance carriers leverage information asymmetry to control the market otherwise. For context, we bundle the 100's of itemized costs into a single, static bill…

How do you get info on bills for historic procedures? Do patients opt in, or will the hospitals provide that information as part of their cooperation with insurers?

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

#287

Post by ericmay »

anonymouse008 wrote: post #121
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…

> Healthcare is such a base layer of the economy Academically this sounds enlightening, but it only takes one cursory walk around a supermarket in the US to see this is unequivocally false. Healthcare is an externality, not a base of anything. From the average customer to the product in the aisle to the marketing - everything is 100% not a direct cost benefit function in terms of healthcare.

Walk around the supermarket that you drive to, hopefully not being maimed or maiming someone else on the way. A ludicrous expenditure of energy to avoid physical activity so that you can buy products to help alleviate the symptoms of the energy expenditure and laziness. Can’t walk, or bike, or take the non-existent public transit. That’s for sure.

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

#288

Post by smsm42 »

RhodesianHunter wrote: post #6

Anyone else get the feeling this is malicious compliance on behalf of the insurance companies? "Oh, they're going to force us to publish our prices are they? Well we'll publish so much data it'll take a herculean effort to make it readable to anyone that doesn't work in data engineering"

More like "how we do it in the cheapest way with minimum possible effort". It doesn't earn them any money, so they don't want to spend money on it.

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

#289

Post by boomboomsubban »

stackbutterflow wrote: post #245
TedDoesntTalk wrote: post #200

Earlier quoted context omitted.

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?

According to this website [0] there are 30 states with a population of less than 6 millions. Why can't they each operate like Singapore? [0] https://worldpopulationreview.com/states

Singapore's area is 283 square miles. Rhode Island is the smallest state, and it has an area of 1214 square miles. Four times larger, with people throughout needing care. That alone will add a fair amount of cost.

Granted, not the total amount spent, but city states do have some advantages on things like this.

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

#290

Post by MatthiasPortzel »

mesozoic wrote: post #18

Say someone ingests this data and clean it up make it usable, who's the customer for that service? What would they want to know from it?

I work for a company (https://careviso.com) that is in this space.

We will sell our benefits investigation services to providers (hospitals, clinics) so that they can give better information to their patients. However our main customers right now are labs that do diagnostic testing.

What we've been able to do is build data-backed algorithms to determine whether a given patient's health insurance will cover a given test. Since patients are (obviously) more willing to get tested if they know that their insurance covers it, labs that work with us can increase their volume. Labs' sticker price for tests can be thousands of dollars, and they don't want to advertise that. They need information about what insurance the patient has and whether that insurance will cover a given test.

I think most of our data is internal data we've collected, but the Price Transparency Act is definitely useful to us in delivering accurate estimates.

(This is an oversimplification of our system. If you work in the space and want details, I'm sure our team would be happy to talk with you.)

Post reply on HN