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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

#291
post #127

Earlier quoted context omitted.

I actually work in this industry and adjust claims myself from time to time, so I love talking about this stuff! > that must follow rules set by Medicare. (emphasis added) Yeah, I'm not sure that anyone seriously believes that insurance companies should operate in a 100% unregulated fashion. Even the US's food industry (which is predominately privatized) is regulated in some capacity. The argument is whether regulate…

The obvious regulation which almost every other country has is direct price controls on medicines, treatments etc. Not profit percentage controls. A dead simple “this is how much you’re allowed to charge”. I don’t really understand why anybody would be against introducing this in the US.

Most countries don't have price controls, they have purchasing controls for their Healthcare systems. There is a huge difference.

For example, if someone makes a pill that cost $1 million to live one more day, they can sell it, but most national health services won't buy it.

In the US, the national health services and insurance companies are mandated to buy it, and a byzantine system of price controls ensure we only pay 900k.

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

#292
post #272

USA Healthcare is 19.5% of GDP. Canada + Australia + UK + (a few similar countries) average 10.5% of GDP. The USA healthcare price gouges via run away prices. Healthcare corporations corrupting congress is the fuel that forces this on people (and breaks a free market).

I’m a Canadian, and I would never want to give up our single payer system. That being said, Canada has a huge health care problem right now. Frequently they need to close emergency services in major (& minor) cities at night due to staff shortages. The wait times for basic diagnostics is on the order of months (not days or weeks). For example, a relative of mine has lost 90 pounds since the start of the year, complai…

To be fair, I think at least some of that is burned out healthcare professionals quitting after two+ of pandemic ridiculousness.

(Ridiculousness not being the pandemic itself, but inadequate resources, planning, and political cover from all levels of government.)

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

#293

Earlier quoted context omitted.

ProviDRs Care network is hosted in Google Drive. All 200gb compressed. The article writer has probably never heard of this network. https://drive.google.com/drive/folders/1zmNEPoVCa0kIVBIu2hu7...

I don’t think you can run BigQuery over a Google drive document.

Least you could do is search for something so simple before asserting it on HN https://cloud.google.com/bigquery/docs/external-data-drive

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

#294
post #232
post #205

Earlier quoted context omitted.

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.

> Doctors often do 2-6 years of excess schooling residencies learning areas of medicine that will never be relevant to them. Where in the world did you hear this? Don't trust anything else that person told you. Aside from some low-income clinic hours for certain specialties (which is objectively a societal good, not to mention typically specific to a given specialty, e.g. OBs have an OB clinic not primary care) no do…

> Don't trust anything else that person told you.

You just said what he said, but with emphasis on 100 hour weeks for years on end being good instead of bad. Why did you disagree with me, then go on to list how much doctors work before the get to practice on their own? His point was they get too much training, with much of it being irrelevant (not all). If you're this angry and reactive, you really shouldn't be a doctor.

People here seem to love the NHS. In the UK, doctors are not forced to study something irrelevant for four years in college, then do med school, then do a 4 year residency (i.e. age 30). They are often done by age 24, and ready to help.

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

#295

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 w…

I don't understand why this took so long when it was part of the ACA in 2014 [1].

How did it take another administration, an executive order, and 8 more years?!

Hell, even the Clinton plan was calling for it in 1993 [2] but that never went anywhere.

[1] https://www.healthleadersmedia.com/finance/new-price-transpa...

[2] https://www.heritage.org/health-care-reform/report/guide-the...

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

#296

Earlier quoted context omitted.

Quoted post unavailable.

Sometimes people do a thing where they see certain keywords in combination and reflexively respond without regard to the meaning those words are expressing. For example, it's what happens if I use a word like "welfare" near that one uncle at Thanksgiving. The signature feature is a very strong negative reaction but with content that doesn't seem related to what the previous person was saying, except that it involves…

Not GP, but if Google is the only provider hosting this data... that is not ideal.

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

#297
post #231

Earlier quoted context omitted.

> 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.

After you criticized the comment as only “sounding enlightening” I was eager to hear your thoughts. Unfortunately I think your comment is even less enlightening. I mean, not all healthcare problems are caused by lifestyle. So clearly healthcare is a base layer - there is no situation where it wouldn’t exist.

I'll concede that the comment was vague and relied too heavily on a shared intuition. Though I will admit, the reward became well played dry comedy throughout your sibling comments.

So I'll break down my reasoning a bit. It requires a full blog post to get out, so please forgive the abridged version.

Healthcare is a catch all for all the other problems of society. The top costly conditions in the US are (in order of this barely sourced article): Mental Disorders, Heart Conditions, Trauma-Related Injuries, Diabetes, Cancer, COPD and Asthma.

Every single one of these is plainly racking up unneeded costs by the daily actions of all of us. My quip on the supermarket was a remark on the total view of health (from mental to reproductive care to basic carcinogens to ...).

How many people are mindlessly scrolling on Instagram while performing another task, how many people smell of cigarettes, the marketing of 'sinful goods' (depending on the state), the near impossibility to avoid added sugar in every packaged foodstuff, the number of 'alcohol noses' you can see down a 50ft isle, the parenting of children, the smell of fossil fuel exhaust from the parking lot, the gait of the elderly, injured, or soon-to-be, the accommodations (or lack thereof) for those in wheelchairs and with living assistance, and still the primary food at checkout - And to include everyone in the conversation: think of the anyone working two jobs and has 0 time to prepare fresh food for themselves or anyone else, the eventual cost is in the habitual behaviors made in the constraints of under-compensated labor.... I could keep going and I've left out other observations contributing to other conditions but I think you understand.

The thing I'm trying to say is that there are interventions all over the place - however, the up-front costs (ignoring all else) of a 'double blind randomized trial' for every single one of them to earn the proper authority to define its relative utility to cost is unrealistic at the moment (also most governments do not allow for risk based price of care) - an economic externality.

Couple this externality behavior with a market of near perfect inelasticity for good health (and before someone comments, yes, suicide / assisted euthanasia may not be inelastic in price on this metric) - and you can't say "Healthcare is such a base layer of the economy" - an alternative analysis is "Healthcare is an externality that is priced in a government controlled market"

[Edit] I completely left out the externality of the high reward litigation industry on malpractice and all of the above conditions as evidence of harm - adding pressure on compensation to the highest paid professionals.

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

#298

Earlier quoted context omitted.

Do you consider the amount that the US spends per capita on healthcare relative to other countries for the same standard of care a "failure" of the healthcare industry? Or is there some other reason healthcare "just costs more" here? Also wondering what you think a solution is - single-payer for better and simpler price negotiations, or some other approach? My main concern is if we're spending 20% of GDP on something…

I’m not the OP and have no deep knowledge, but I’ve often heard cited that the US out-researches other nations, so we incur “R&D” costs for healthcare that other nations use. Eg pharmaceuticals are researched in the US while the patents are used in other nations through a cost structure that doesn’t allow the original researching party to recoup costs. On-shoring that research also seems to be an advantage -Looking a…

I've never seen any convincing evidence for this theory.

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

#299

Earlier quoted context omitted.

Very cool. Who do you see as the likely users of that database? Is it primarily for researchers/data journalists, or is there a commercial value to it? I'd be very curious to read more about the data cleaning phase when you get there. Specifically, how hard it is to combine this data and construct good schemas.

As someone who's worked on the provider side in different capacities, I can tell you that there could be tremendous value on the provider side. It's entirely possible that two surgeons with offices next to each other could be getting reimbursed at wildly different rates for their most common procedures for their most common procedures by the same provider. If you're that provider, you ABSOLUTELY want to know what the…

Interesting. I'm kinda surprised this is handled by the doctors themselves. I'd expect there to be professional negotiators who parse this data themselves and then use it to negotiate on their behalf.

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

#300

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…

Even private providers are affordable.
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