This is clearly obfuscation. There is no way they have "negotiated" half a trillion of anything.
Health insurers just published close to a trillion hospital prices
381–390 of 549 posts
Re: Health insurers just published close to a trillion hospital prices
#382Earlier quoted context omitted.
What about the incentive for non profit hospitals to grow so that they can better compensate leadership, resulting in capital that must be spent on facilities and equipment to retain non profit status. Leading to a spiral? It is hard to compare details of the systems and outcomes across countries, but surely we can find where the money apent ends up? Construction firms? Doctors? Equipment manufacturers? Hospital admi…
Is there a rule that says a certain percentage of revenue must be spent on a facility to retain non-profit status? It can be spent on equipment and salaries, both of which would benefit much more than upgrading the building to no patient care benefit. This is anecdotal but the number one complaint I've heard from physicians about patient care is facilities being run and and managed by non-clinical MPH/MHA "business t…
No, but there is a "rule of thumb" that a hospital will prefer private insurance patients to medicaid patients (due to reimbursement), and private insurance patients will go to hospitals with newer and nicer facilities. If you want the elective hip replacement patient, then having a newly remodeled orthopedic ward / office building is critical. Patients probably can't tell one doctor or nurse from another, and hospitals don't advertise on actual quality measurements like staffing ratios...
Re: Health insurers just published close to a trillion hospital prices
#383I wonder if our entire health care problems in the US stem from the medical cartel itself. You have medical schools limiting seats, you have physicians and head physicians and medical groups lobbying for changes, and you have inflated doctor salaries…
A sane approach might be to let more people graduate medical school and increase the number of applicants…
Re: Health insurers just published close to a trillion hospital prices
#384Earlier quoted context omitted.
Sure, could be simpler, but there's a spec and multiple implementations: https://www.rfc-editor.org/rfc/rfc4180.html And the spec is ~5 pages. Not sure why NDJSON is considered simpler, as json objects can be arbitrarily nested. Breaking into records is easier, but parsing is harder.
(ND)JSON is simpler because people actually follow the spec, unlike with CSV.
People violate the JSON spec all the time.
And following the CSV spec is much easier than following the JSON spec. And there's only like three edge cases.
Re: Health insurers just published close to a trillion hospital prices
#385Anyone 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"
Came here to say the same thing. I would expect their internal systems to calculate certain pricing components on the fly so it feels like they’ve deliberately built all possible permutations and data dumped that.
Basically a document dump - https://en.m.wikipedia.org/wiki/Document_dump
Re: Health insurers just published close to a trillion hospital prices
#386Earlier quoted context omitted.
My experience in talking to people with chronic conditions that aren’t easily treatable is that Kaiser’s model works great until anything that’s slightly out of the ordinary happens, and then it falls apart. If you’re a zebra (as in “when you hear hooves, think horses, not zebras”), their model is pretty horrible.
Isn't it pretty bad to be a zebra in general though? Certainly there isn't any place where zebras have it better than horses.
Yes but if you're at Kaiser in San Francisco and have a zebra there may only be one doc (or a small group) at UCSF that can treat your zebra, and they are not in the Kaiser network, so you go to Los Angles where Kaiser's specialist is, get treated by a lesser doc with a virtual visit assist from LA, or pay cash out of network.
Re: Health insurers just published close to a trillion hospital prices
#387Earlier quoted context omitted.
Singapore does not control prices (though it’s moving in that direction), it’s public hospitals are privately run, and it has a system of “forced savings” to make sure patients have enough money to cover out of pocket costs and buy health insurance. It’s ethos is “the patient has to pay something out of pocket, even if it’s just $2”. It’s also more than happy to tell poor patients “if you don’t have enough money, the…
>Singapore does not control prices (though it’s moving in that direction), it’s public hospitals are privately run, Singapore controls prices through collective bargaining at the national level and unlike the US practically every purchase in its hospitals has to go through registration with the HSA (the country's relevant regulatory agency). You essentially cannot purchase any major equipment without running it by th…
Singapore doesn’t control all prices - drugs can be freely priced, but as I stated it’s changing right now.
And getting HSA approval doesn’t have anything to do with price - that regulatory. Even the FDA has to approve anything used in the US.
It is true you can’t purchase at the hospital level without some agreement on price, but the hospitals often do their own tenders, which are confidential prices. It’s not done at the national level for everything.
And yes, prices are tightening but companies are already deciding to just not market in Singapore if prices get too low.
Check out Germany, I think it was AZ that decided to just not launch a drug there at all because the price was too low.
Re: Health insurers just published close to a trillion hospital prices
#388I know that most people don't like to think twice when it's about their own health but as a society we have to ask if it's ethical to heavily indebt or tax the young working age population to extend the lives of a few old peoples who often never regain their full health.
In the actual system good lifetime is traded for bad one.
Re: Health insurers just published close to a trillion hospital prices
#389Earlier quoted context omitted.
> There are people genetically predisposed to gain weight And this genetic mutation somehow happened in the last 50-100 years or so? Obese people have always existed. Obese poor people are fairly new. The root cause is diet, not genetics.
Human HLA / MHC have a significant role in gut microbiota composition. Gut flora, in turn, play a significant role in hormone and appetite. The interactions are complex, but genetics contributes to obesity.
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Re: Health insurers just published close to a trillion hospital prices
#390Earlier quoted context omitted.
For comparison, here's the first bit of an Anthem file (which contains some of the data that's just another row in the Humana record), along with the first record "reporting_entity_name": "Excellus BlueCross BlueShield", "reporting_entity_type": "Health Insurance Issuer", "last_updated_on": "2022-06-14", "version": "1.0.0", "provider_references": [ { "provider_group_id": 302.1518360704, "location": "https://mrf.healt…
> "negotiation_arrangement": "ffs" Negotiation arrangement: for fuck’s sake
:) I couldn’t help but read it that way as well, even though I know it’s most likely “fee for service.”