Health insurers just published close to a trillion hospital prices • Hacker News Board

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

#481

Post by Broken_Hippo » Wed, Sep 07, 2022, 2:33 PM UTC

hpkuarg wrote: post #460

c7b wrote: post #448

Earlier quoted context omitted.

> our patient population is very different from other countries > our expectations are very different from other countries > our scale is dramatically different than other countries > the way are population is taxed is very different than other countries do you have evidence to support these claims? what makes the US patient population or their expectations or the US taxation system unique in the world?

Not the OP, but Americans as a whole are very unhealthy (with 42% of the population being obese and over two-thirds being overweight) and culturally have very high expectations of what medicine can do for them, as opposed to making difficult changes to their lifestyle. A part of the latter is based on the actual superiority of the quality of medical care in this country -- due to the high levels of wealth produced by…

A part of the latter is based on the actual superiority of the quality of medical care in this country...

How is it superior? Sure, some countries fare worse. But folks aren't getting the healthcare they need because of cost, and the results aren't exactly the best in the world. I'm not convinced that "culturally" folks have high expectations either, and sure, you might want to change your lifestyle to lose weight - but at the same time, you might just need medical oversight to do so. Not to mention that a bunch of things medicine helps are not things that lifestyle just fixes.

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

#482

Post by qzw » Wed, Sep 07, 2022, 2:55 PM UTC

kasey_junk wrote: post #455

Arkhaine_kupo wrote: post #432

Earlier quoted context omitted.

> The wait times for basic diagnostics is on the order of months (not days or weeks). The crazy thing to me about this is, most Americans simply skip medical procedures, or tests due to cost. So American wait times aren't lower because their hospitals are better, they just server a much smaller pool of people due to so many being priced out of being healthy. And honestly, the longer you go without doctor visits, more…

“Most” Americans do not skip procedures due to cost. About 1/3 have ( https://www.kff.org/health-costs/issue-brief/americans-chall... ) and that is mostly dental procedures. That is an atrocious number and something that needs fixing but we don’t need to exaggerate it to make that true.

Good link there, but assuming I’m looking at the same section as you, it seems like the 1/3 figure is for skipping or delaying tests and treatments recommended by their doctors, which doesn’t really tell us how many people forego seeing a doctor altogether due to cost concerns.

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

#483

Post by Goronmon » Wed, Sep 07, 2022, 2:58 PM UTC

kasey_junk wrote: post #455

Arkhaine_kupo wrote: post #432

Earlier quoted context omitted.

> The wait times for basic diagnostics is on the order of months (not days or weeks). The crazy thing to me about this is, most Americans simply skip medical procedures, or tests due to cost. So American wait times aren't lower because their hospitals are better, they just server a much smaller pool of people due to so many being priced out of being healthy. And honestly, the longer you go without doctor visits, more…

“Most” Americans do not skip procedures due to cost. About 1/3 have ( https://www.kff.org/health-costs/issue-brief/americans-chall... ) and that is mostly dental procedures. That is an atrocious number and something that needs fixing but we don’t need to exaggerate it to make that true.

That's the lowest percentage out of all the sentences from that paragraph.

The 1/3rd is people avoiding treatment recommended by a doctor. 43% of people reported to have avoided healthcare due to costs.

To me "Not most people, only 43%" isn't what I would consider too much of an exaggeration.

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

#484

Post by kolbe » Wed, Sep 07, 2022, 2:58 PM UTC

avarun wrote: post #352

kolbe wrote: post #294

Earlier quoted context omitted.

> 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 doc…

One thing that makes conversations with doctors about regulations around board certifications easier to understand is that anybody who is currently a doctor in the US is heavily disincentivized from improving or changing the system in any way. The absurdly onerous restrictions on becoming a doctor work to the benefit of current doctors by artificially restricting supply and thus keeping wages high. Why would doctors…

This is correct. And the AMA isn't ignorant of this, either.

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

#485

Post by kolbe » Wed, Sep 07, 2022, 3:05 PM UTC

pc86 wrote: post #435

kolbe wrote: post #294

Earlier quoted context omitted.

> 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 doc…

I'll be more clear - doctors have almost no extra or unnecessary training during their residencies. It's all very specialty-driven, or at the very least is specialty-specific public service (e.g. low-income clinics). If anything, the doctors I've spoken to said they should all probably be a year or two longer across the board if only to allow for better work-life balance, but none of them would want to have to go thr…

You realize that 4 years of residency isn't the magical number of the perfect amount? Two could very well be sufficient, and the other two "extra or unnecessary training." Also, you keep ignoring the college requirement, which makes you seem very disingenuous, and if you are a doctor, makes me worry for your patients.

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

#486

Post by wahnfrieden » Wed, Sep 07, 2022, 3:07 PM UTC

tsimionescu wrote: post #419

autoexec wrote: post #355

Earlier quoted context omitted.

It is offset at all by all the workers who are forced to sit their entire shifts? It's probably better on our bodies to stand than to sit for 6 hours at a time, but it starts in schools and ends at desk work. Standing desks are nice, and can help, but not everyone has access to them. One of the nice things about working from home is that it allows people to escape that kind of environment to a point, but it just enab…

> It's probably better on our bodies to stand than to sit for 6 hours at a time, but it starts in schools and ends at desk work. It definitely isn't, standing puts enormous strains on our bodies. Walking for 6h is much easier and better, but sitting out lying down are much better than just standing.

They're also talking about a population of workers - this includes elderly people with bad hips, bunions, handicapped people who aren't always given proper accommodations, etc.

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

#487

Post by sl-dolt » Wed, Sep 07, 2022, 3:08 PM UTC

sajacy wrote: post #369

sl-dolt wrote: post #3

Earlier quoted context omitted.

It's all fully public. Here are some tools that will get you the negotiated rates links along with the sizes of all the files: https://github.com/alecstein/transparency-in-coverage-filesi... This won't get you all of the insurers, but it'll get you a a few of the major ones. If you want links to the files of more insurers, here's a project from one of my friends at Postman: https://github.com/postman-open-technologie…

So - veteran data wrangler here. I skimmed some of Humana's files. There's lots of repetition that can easily be removed when converting from a raw input to an analytical dataset - basically the huge blocks of text in "BILL_TYPE_CODE: 130,139,..." in the ADDITIONAL_INFO field can be normalized away by building a quasi-Huffman-encoded lookup table. Noteworthy(?): there seems to be a limit of ~100~ 140 sets of prices,…

Love the insights! Making a note to dig deeper into this. Feel free to reach out to me via email as well if you want to discuss more: alec@dolthub.com

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

#488

Post by hellotomyrars » Wed, Sep 07, 2022, 3:22 PM UTC

jaarse wrote: post #272

seaourfreed wrote: post #246

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…

For what it’s worth, this experience isn’t entirely uncommon in the US either. I live in a rural area that has a trauma center and a hospital because it is X distance from the next closest hospital and gets money from the state/county to exist. But that is all they are. Outside of diagnostic imaging and very basic healthcare, you are shipped off to either Portland, Seattle, or in some cases Idaho. Everything is backed up and it is largely due to a lack of personnel because people are just not joining the field. It is basically the inversion of your problem. We burn out everyone who works in a hospital specifically because of the pursuit of profit. They’re all understaffed and everyone works shifts that are unsafe due to their length to compensate. Hospitals are an incredibly stressful place to work and doctors and nurses have inherently difficult jobs. Yet they’re treated largely like disposable assets to be burned through. It is bad for patients and it is bad for the staff. But it is apparently good for business.

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

#489

Post by ceeplusplus » Wed, Sep 07, 2022, 3:25 PM UTC

ejb999 wrote: post #425

ceeplusplus wrote: post #302

Earlier quoted context omitted.

Probably because the people pushing for free college etc tend to be ones studying the humanities, which gives people a bad impression of the whole thing. People make fun of Fox News touting lesbian dance studies majors, but the reality is most people don't support funding your bullshit gender studies degree with their tax dollars. > the AMA agrees there is a problem and is onboard with expanding the pipeline Oh come…

>>Oh come on, they could start by accepting everyone with a 3.5+ and decent MCAT instead of requiring that you have a 3.95, volunteering experience, clinical experience, and near perfect MCATs. The path is unattractive because it's filled with bullshit requirements that don't matter. I for one am glad that it s hard for doctors to get into med school - allowing less qualified people to practice medicine sure doesn't…

I would take a smart doctor motivated by money over a dumber one motivated by caring for people.

The reality is all of the top surgeons, cardiologists, etc. didn't become those professions just because they were "well rounded", they were smart and they wanted prestige/money. It would be good for medicine to have more smart and ambitious people.

Well rounded is just a euphemism to discriminate against Asians through affirmative action.

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

#490

Post by kasey_junk » Wed, Sep 07, 2022, 3:26 PM UTC

qzw wrote: post #482

kasey_junk wrote: post #455

Earlier quoted context omitted.

“Most” Americans do not skip procedures due to cost. About 1/3 have ( https://www.kff.org/health-costs/issue-brief/americans-chall... ) and that is mostly dental procedures. That is an atrocious number and something that needs fixing but we don’t need to exaggerate it to make that true.

Good link there, but assuming I’m looking at the same section as you, it seems like the 1/3 figure is for skipping or delaying tests and treatments recommended by their doctors , which doesn’t really tell us how many people forego seeing a doctor altogether due to cost concerns.

Technically it was 1/3 had or had family members, which means the number is actually much better than 1/3 but I was being generous.

We don’t know how many people skip healthcare because a doctor is inconvenient (in the states or in other regimes) either. So it seemed the most appropriate comparison to make.