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New health insurance “transparency data” looks suspiciously wrong

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

#131

Post by heavyset_go »

aintgonnatakeit wrote: post #10

There are two problems here: 1) Hanlon’s razor 2) The author doesn’t understand health insurance data. I’m not trying to excuse the other bad behavior, but within the data itself, he’s experiencing a combination of health insurers’ incompetence, the kludged up data models they’ve had to build to represent the output of the multiple generations of claims processing systems and other administrative processes, and the g…

Hanlon's razor falls apart when there is money to be made by doing shitty things.

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

#132

Post by m463 »

joe_the_user wrote: post #97
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…

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. Assuming this is true for the sake of argument, saying that this sort of thing isn't malicious compliance is a sad kind apologistics for bad behavior that seems to regularly appear on HN.

I agree.

How can these kinds of companies optimize their charge codes to get the max for the procedures, optimize their taxes to pay the minimum possible, and then do a poor job on these existential crisis kinds of things? I think they know what they're doing in all cases.

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

#133

Post by logicallee »

axutio wrote: post #49
logicallee wrote: post #43

I've asked the author for a copy of a correct csv or xlsx file, I'll share it if the author responds. https://imgur.com/a/bTmfDEU

What does this mean? Having read the article, I don't understand what it is you're asking the author for.

Article says "contracted rates that are wrong, mislabeled, or missing" so I want to see what a correct, properly labelled example looks like according to the author. I want to see what they think correct data looks like.

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

#134

Post by lelanthran »

lostlogin wrote: post #61
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 have both, and the wait at the paid clinic is long, as is the wait at the free clinic. It’s not whether the cost is socialised or not that decides how long the wait will be. It also doesn’t help that the private system is incentivised to undermine the ‘free’ system at every turn.

> It also doesn’t help that the private system is incentivised to undermine the ‘free’ system at every turn.

By competing on ... what? Can't be price (because "free" wins). The only other option is competing on quality.

Your statement doesn't sound correct.

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

#136

Post by johngladtj »

The big problem with health insurance is that the people who buy it think that they are buying a health subscription.

The second big problem is that they are being forced to buy it.

So you have something that isn't what people want, but that they are legally obligated to "purchase"... Is it any wonder most people are dissatisfied with it?

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

#137

Post by Timon3 »

lelanthran wrote: post #134
lostlogin wrote: post #61

Earlier quoted context omitted.

I have both, and the wait at the paid clinic is long, as is the wait at the free clinic. It’s not whether the cost is socialised or not that decides how long the wait will be. It also doesn’t help that the private system is incentivised to undermine the ‘free’ system at every turn.

> It also doesn’t help that the private system is incentivised to undermine the ‘free’ system at every turn. By competing on ... what? Can't be price (because "free" wins). The only other option is competing on quality. Your statement doesn't sound correct.

Competition isn't the only way for a private system to have influence on a non-private system. You understand that, right?

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

#138

Post by refurb »

ChrisMarshallNY wrote: post #87
lazide wrote: post #86

Earlier quoted context omitted.

Well, it’s the same here for the existing healthcare system in the US. Even basic reforms (obamacare) get met with insane opposition.

The difference is who the opposition is from. In the UK, it's from the voters. In the US, it's from the Healthcare Industry.

It's not if one remembers the promise of "If you like your doctor you can keep your doctor" with Hilary's healthcare plan in the 90's.

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

#139

Post by relaxing »

TedDoesntTalk wrote: post #89
lostlogin wrote: post #61

Earlier quoted context omitted.

I have both, and the wait at the paid clinic is long, as is the wait at the free clinic. It’s not whether the cost is socialised or not that decides how long the wait will be. It also doesn’t help that the private system is incentivised to undermine the ‘free’ system at every turn.

> It’s not whether the cost is socialised or not that decides how long the wait will be If care is free, aren’t you more likely to go than if you had to pay even a minimal cost?

Yeah man I love spending my time in the hospital.

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

#140

Post by relaxing »

elzbardico wrote: post #57
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.

The reality is that both systems suck, and I say this having lived in systems with universal public healthcare. They just suck in different manners, different countries have different degrees of "suckness" and so on. And then there's the big problem beyond the question of who is paying: How much is being paid. Healthcare costs in the US are absurdly high both on relative terms (things are way more expensive) and on a…

> Healthcare costs in the US are absurdly high both on relative terms (things are way more expensive) and on absolute terms (more of the same things is needed because the American population is relatively too unhealthy for what you'd expect in a developed country with similar demographics). You need to ask why relatively inexpensive stuff like insulin is so much expensive in America than say, Germany or the UK.

Must be that law of economics that says the more you make of something the more expensive it gets.

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