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

New health insurance “transparency data” looks suspiciously wrong

dolthub.com

Post reply on HN
Print view View original

71–80 of 171 posts

Re: New health insurance “transparency data” looks suspiciously wrong

#71

Post by inetknght »

BoorishBears wrote: post #65
eftychis wrote: post #48

Earlier quoted context omitted.

My personal experience as a European citizen living in the U.S. is drastically different. I flee the U.S. to have all my medical related tests and work, out of pocket, in the E.U. And it is cheaper and much much better experience. (And I don't get different treatment compared to any members of my family that are insured in Europe for paying out of pocket.) First of all: I speak with a doctor. Not a nurse, an administ…

Not a solution for everyone... but I have to ask, since you have the time to go to the EU for routine medical work, why not move to somewhere in the US that has doctors? Also looking at a primary care wait time is fine, but what is broken in most single player systems is specialists and "non-emergency surgery"... which is often stuff that significantly affects your quality of life. https://worldpopulationreview.com/c…

> why not move to somewhere in the US that has doctors?

Do you have a suggestion where in the US that is? The US has many doctors but essentially all of them are gated behind insurances and especially hospitals.

Re: New health insurance “transparency data” looks suspiciously wrong

#72

Post by [deleted] »

iamerroragent wrote: post #18

Imagine a world where one entity received all the peoples medical bills and was incentived to negotiate for the lowest possible rate from each provider. Imagine the savings alone from reducing a massively overly bureaucratic and complicated system down to just one entity negotiating and paying the health service providers. Just imagine in that world this article would have never needed to have been written.

[deleted]

Re: New health insurance “transparency data” looks suspiciously wrong

#73

Post by dsfyu404ed »

nhinck2 wrote: post #52
Alupis wrote: post #47

Earlier quoted context omitted.

> There are plenty of countries which operate functioning public health systems with optional private care. You mean the US...? It's a quaint idea... but nobody likes the reality once it's implemented. Evidenced by the fact that the US is already the largest public health system in the world, and people do not even realize it.

No, functioning, so not like the US, universal public health care with costs covered by the government. I'm not sure why you're ignoring a lot of Europe, Canada, Australia and New Zealand.

The states that were well on their way to having public options before obamacare generally have ok public options at this point. Frankly they probably would have done better without the federal wrench being thrown into things.

Re: New health insurance “transparency data” looks suspiciously wrong

#74

Post by yamtaddle »

xupybd wrote: post #45
maxwell wrote: post #31

Earlier quoted context omitted.

And why federal governments make the best health insurance carriers. Brokers, medical billing staff, and other middlemen serve no purpose other than increasing cost (in order for an inefficient, openly colluding private cabal to invest premiums, deny claims, and collect profit) because everybody needs access to medical treatment.

I live with free healthcare. The last three trips to the emergency department have been over eight hour waits. My father's cancer treatment was not covered so the last year of his life cost him everything. On the other side my child's healthcare is amazing and all free. We get instant access to great services.

Last time I went to the ER with my dad it was about a 3-hour wait, and he really needed to get in. Saw a few people who looked like they definitely ought to get help, given the runaround and told it'd be hours and hours of waiting, until they left to try to find another ER with a shorter wait (in one case, the patient was delirious, sweating, and being guided around by a couple friends—I hope she got help somewhere), I assume because they looked like they couldn't pay and were probably uninsured (there was definitely a pattern to who got this treatment), so the staff were doing everything they could to discourage them. Some people who were there when we arrived, were still waiting when we got out, so they'd been there at least 4 hours.

US, and he's insured, and it's supposedly a pretty-good hospital.

I've been to the same ER within months of that, and it was empty and I was back in a room (well, cubby) within 15 minutes, with something just barely severe enough to merit an ER visit. Quick. Fucking expensive (think it was almost $3k by the time they were done sending bills, for 5 stitches and an x-ray—and that's with insurance), but quick.

It was mostly just timing and luck.

> My father's cancer treatment was not covered so the last year of his life cost him everything.

Sucks that it happens to anyone, but the final year(s) of healthcare finding a way to soak up every cent, before the end, is basically the norm here in the US. Everyone's retirement savings is just money the healthcare industry's lettings us hold temporarily.

Re: New health insurance “transparency data” looks suspiciously wrong

#75

Post by sbaiddn »

christophilus wrote: post #66
xupybd wrote: post #45

Earlier quoted context omitted.

I live with free healthcare. The last three trips to the emergency department have been over eight hour waits. My father's cancer treatment was not covered so the last year of his life cost him everything. On the other side my child's healthcare is amazing and all free. We get instant access to great services.

I live with private healthcare. The last few trips to the ER have been 8 hour waits, too. This is an under capacity thing. I live in a place that has boomed, and the mismanaged hospital hasn’t remotely kept up. They fired a bunch of folks during COVID, then shocked pikachu found themselves understaffed. The point is, the entire thing is broken nearly everywhere you look. I don’t know what a better alternative is, but…

I live in the US. Every trip to the ER has had 5).

So you millage may vary.

Re: New health insurance “transparency data” looks suspiciously wrong

#76

Post by Nition »

iamerroragent wrote: post #18

Imagine a world where one entity received all the peoples medical bills and was incentived to negotiate for the lowest possible rate from each provider. Imagine the savings alone from reducing a massively overly bureaucratic and complicated system down to just one entity negotiating and paying the health service providers. Just imagine in that world this article would have never needed to have been written.

https://pharmac.govt.nz/about/what-we-do/pharmac-history/

Re: New health insurance “transparency data” looks suspiciously wrong

#77

Post by ethbr0 »

candiddevmike wrote: post #3

Everyone assumed there would be malicious compliance here but it's definitely eye opening just how malicious they made it. Speaks volumes for the perceived risk releasing this data, IMO. Still waiting to hear about someone using this data to negotiate down a hospital bill, seems like it's just insurance companies that can weaponize this data for better rates.

> but it's definitely eye opening just how malicious they made it

As someone familiar with insurer, provider, and facility IT systems, I'd offer an alternate explanation -- the data is bad because healthcare IT is understaffed (and often incompetent).

These are businesses that have squeezed most costs out, and IT is definitely a cost.

Imagine banking... if there were much less competitive pressure and an inability to offer services across state lines without substantial additional effort.

They received a mandate.

They tried to respond in the way that required the least amount of effort.

From someone in the industry, it's entirely plausible this is the best they can do.

Which usually means it takes CMS threatening to drop them for them to launch a multi-year project to finally fix the issue (somewhat).

Re: New health insurance “transparency data” looks suspiciously wrong

#78

Post by medellin »

ethbr0 wrote: post #77
candiddevmike wrote: post #3

Everyone assumed there would be malicious compliance here but it's definitely eye opening just how malicious they made it. Speaks volumes for the perceived risk releasing this data, IMO. Still waiting to hear about someone using this data to negotiate down a hospital bill, seems like it's just insurance companies that can weaponize this data for better rates.

> but it's definitely eye opening just how malicious they made it As someone familiar with insurer, provider, and facility IT systems, I'd offer an alternate explanation -- the data is bad because healthcare IT is understaffed (and often incompetent). These are businesses that have squeezed most costs out, and IT is definitely a cost. Imagine banking... if there were much less competitive pressure and an inability to…

If this is the best they can do maybe capital markets don’t work best for insurance companies and they should be taken over.

Dealing with them right now feels like dealing with the government might as well just have the government run it

Re: New health insurance “transparency data” looks suspiciously wrong

#79

Post by lazide »

medellin wrote: post #78
ethbr0 wrote: post #77

Earlier quoted context omitted.

> but it's definitely eye opening just how malicious they made it As someone familiar with insurer, provider, and facility IT systems, I'd offer an alternate explanation -- the data is bad because healthcare IT is understaffed (and often incompetent). These are businesses that have squeezed most costs out, and IT is definitely a cost. Imagine banking... if there were much less competitive pressure and an inability to…

If this is the best they can do maybe capital markets don’t work best for insurance companies and they should be taken over. Dealing with them right now feels like dealing with the government might as well just have the government run it

Don’t take it too much at face value.

This is the best they can do when all their incentives align so that being as opaque and disingenuous as possible about costs (and understaffing and often screwing it up helps with that!) helps them.

Re: New health insurance “transparency data” looks suspiciously wrong

#80

Post by lazide »

maxwell wrote: post #31
JPws_Prntr_Fngr wrote: post #17

Earlier quoted context omitted.

> seems like it's just insurance companies that can weaponize this data for better rates. That’s because their negotiating power is mainly due to the size of their buying power, not special knowledge or skills. Health “insurance” is basically the lamest, most economically perverted form of collective bargaining ever.

And why federal governments make the best health insurance carriers. Brokers, medical billing staff, and other middlemen serve no purpose other than increasing cost (in order for an inefficient, openly colluding private cabal to invest premiums, deny claims, and collect profit) because everybody needs access to medical treatment.

Don’t bet on it.

There is enough (potential) money and incentive here that almost any system will be perverted eventually.

NHS is not known for speedy treatment, for instance.

It’s about ongoing oversight and a willingness and ability to cut through bullshit to fix things. That’s in short supply here and everywhere else.

The stories (first hand from relatives who use it) of blatant profiteering and abuse of the system in Medicare is mind boggling.

Post reply on HN