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

As Hospital Prices Soar, a Single Stitch Tops $500

nytimes.com

Post reply on HN
Print view View original

71–80 of 97 posts

Re: As Hospital Prices Soar, a Single Stitch Tops $500

#71

Post by jonah »

beagle3 wrote: post #22
jonah wrote: post #13

And how much of that is "profit"?

Amortized over the uninsured people who don't eventually pay list price, and the insured people whose insurance only pays 20% of the list price? (oh, and over the billing department that is 10 to 100 times bigger than it is anywhere else in the world) - not much profit.

I did a quick look following your response. It seems that many hospital's profits aren't terribly bad.

"Forbes found 24 hospitals with more than 200 beds make 25 cents or more for every dollar of patient revenue they take in." http://thehill.com/blogs/healthwatch/corporate-news/116745-h... http://www.forbes.com/2010/08/30/profitable-hospitals-hca-he...

Bloomberg ran a lengthy story on how hospital consolidations are running up prices for all manner of procedures. http://www.bloomberg.com/news/2010-08-20/hospital-monopolies...

Re: As Hospital Prices Soar, a Single Stitch Tops $500

#73

Post by techsupporter »

mortyseinfeld wrote: post #21
davidbanham wrote: post #6

How on earth can you think a free market solution is appropriate for emergency medical care? For elective procedures, sure. For the ER? How do you expect the consumer to have perfect knowledge, rationality and freedom of choice in that scenario? If your kid is gushing blood, you call an ambulance to take them wherever they can get patched up the fastest. To expect someone to shop around until they find an equilibrium…

Wrong. There are choices and not everybody is spastically out of control like apparently you would be for a few stitches. You people have such a hard time with simple concepts, such as an ideologically disagreement on the role of government. Your first world government did a good job of indoctrinating you.

When we (note: "we" is defined as the set of individuals located on plant Earth who are legally able to cast a vote in the political unit known as the United States of America) can have an ideological disagreement on the role of government that no longer includes one major participant in the debate being able to effect that participant's desired outcome (little-to-no government) by simply standing on the side and refusing to debate, I think we'll then be ready to debate the relative merits of the system we currently have versus any other system in the world.

Until then, best of luck with your trolling.

Re: As Hospital Prices Soar, a Single Stitch Tops $500

#74

Post by Aloisius »

refurb wrote: post #12
rdtsc wrote: post #3

> Orla’s forehead was sealed with a dab of skin glue for $1,696. On Reddit, where this stuff is discussed more, I just urge people if they can get away with it (they are conscious and can hide their wallet, for ex), to just give them a fake name. Almost $2k for a dab of skin glue? No! I don't care what complicated politico-economical factor lead to that. Free market, over-regulated market,expensive doctor's education…

Have you seen the profit margins for the hospitals with these high prices? They certainly aren't raking it in. I agree that's stupid, but that's how the system works for paying for medical care in the US. From the perspective of the hospital, it makes perfect sense.

Have you seen the profit margins for the hospitals with these high prices? They certainly aren't raking it in.

These hospital are almost exclusively non-profits. Measuring the profit margins of non-profits is folly. They funnel the excess money into salaries, marketing, equipment and expansion (often unnecessary).

Re: As Hospital Prices Soar, a Single Stitch Tops $500

#75

Post by techsupporter »

maratd wrote: post #70
davidbanham wrote: post #6

How on earth can you think a free market solution is appropriate for emergency medical care? For elective procedures, sure. For the ER? How do you expect the consumer to have perfect knowledge, rationality and freedom of choice in that scenario? If your kid is gushing blood, you call an ambulance to take them wherever they can get patched up the fastest. To expect someone to shop around until they find an equilibrium…

> How on earth can you think a free market solution is appropriate for emergency medical care? You could say the same thing about funeral services. Yet it is a free market. And it works well. Because people buy plots ahead of time and negotiate services well in advance. Nothing is stopping you from walking into an emergency room at your local hospital and negotiating a fair hourly or daily rate for care. Well, nothin…

> You could say the same thing about funeral services. Yet it is a free market. And it works well. Because people buy plots ahead of time and negotiate services well in advance.

Well, except that when I die, my corpse only goes one place: the ground or the incinerator. And, as an added bonus, I get to choose that destination in advance. Oh, for the joys of only ever potentially needing emergency (or even urgent) care in a single location.

> Nothing is stopping you from walking into an emergency room at your local hospital and negotiating a fair hourly or daily rate for care.

I'm pretty sure that this is called insurance.

> until your premium is thousands per month and you run to some halfwit politician to fix it.

Or until you buy insurance on the open, free market and then have that insurance canceled for some obscure reason usually related to your suddenly becoming too expensive for your insurance carrier. Or knowing in advance that actually going to the doctor for that pain in your side will mark you as having a preexisting condition (even if the insurance doesn't pay for it and never even sees a bill) thus previously making you uninsurable or only able to receive coverage for a staggeringly high premium.

I could go on but I don't want to bore you with my real life tales of navigating our so-called health care system.

Re: As Hospital Prices Soar, a Single Stitch Tops $500

#76

Post by gorbachev »

refurb wrote: post #12
rdtsc wrote: post #3

> Orla’s forehead was sealed with a dab of skin glue for $1,696. On Reddit, where this stuff is discussed more, I just urge people if they can get away with it (they are conscious and can hide their wallet, for ex), to just give them a fake name. Almost $2k for a dab of skin glue? No! I don't care what complicated politico-economical factor lead to that. Free market, over-regulated market,expensive doctor's education…

Have you seen the profit margins for the hospitals with these high prices? They certainly aren't raking it in. I agree that's stupid, but that's how the system works for paying for medical care in the US. From the perspective of the hospital, it makes perfect sense.

That's because if the hospital submits that $2K bill to an insurance company, they get paid somewhere around $300 - $500 for it.

The sucker without health insurance goes bankrupt trying to pay the full price.

Re: As Hospital Prices Soar, a Single Stitch Tops $500

#77

Post by HorizonXP »

xerophtye wrote: post #61
HorizonXP wrote: post #51

As a Canadian, I think it would be really cool if every doctor/hospital visit you went to in Canada, you got an e-mail copy of the invoice showing how much it cost, and how much was covered, just so people would start to understand: a) how much they're costing themselves in taxes b) so they could see how awesome we have it compared to others. I should build this. I have the connections to make it happen. Hmm...

Go for it! (Btw you DON'T get bills? as in not ACTUAL bills stating how much it cost you? The bill just goes to the insurance/govt?)

Sure, we do get billed. But as a patient, I never see it. The only bill I've ever seen is for ambulance rides, if I ever need to take one. That's ~$35-45. I've never received charges for anything else.

When I used to volunteer at the ER, I saw patients come in to pay some bills related to wheelchair rentals or crutches. Sometimes they had their prescriptions filled at the pharmacy, and they had to pay for that. But again, that's the extent of the bills that patients would see.

I once saw a guy come in via ambulance, screaming in pain. The paramedics rushed him in, and yelled to the staff that they needed a Resusc room immediately, since the guy had no detectable pulse or pressure, and she suspected he had a triple-A (I found out later that this was an abdominal aortic aneurysm.). The nurses fumbled to clear a room for them, but they eventually did. A quick ultrasound by the ER Dr. to confirm, and he was wheeled off to surgery.

That "bill" likely cost the taxpayers of Ontario upwards of $50k by my uninformed guess. Not sure if he survived or not, AAAs typically have extremely high mortality rates and have to be addressed within 30 minutes. In any case, I do appreciate the fact that him and his family don't have to worry about a thing, except getting better and appreciating life. However, I'm not sure what value it would provide for them to know the financial cost. shrug Something worth thinking about.

(Recounting this story makes me somewhat regret not continuing along the path to medical school. shrug Guess I have to contribute in a different way.)

Re: As Hospital Prices Soar, a Single Stitch Tops $500

#80

Post by ctdonath »

PeterisP wrote: post #53
ctdonath wrote: post #5

Both my kids required a few stitches near their eyes. Did I opt for the $30 suture kit and do it myself? or did I opt for on-demand (there & ready, patients or not) doctor analysis (risks of fractured skull or aggressive infection), sedatives (both wriggled & screamed as I held them still, how much worse without?), experienced threading, and whatever other ideals applied? "Sure you can buy a hamburger for a dollar. B…

Half an hour job for a $200.000/year professional is $50; doubling for overhead is a roughly $100 cost for that service. Doubling it again for profit&stuff is $200 reasonable price. Charging $2000 for a $200 service is the problem here, especially since that is not an informed market price, but an ultimatum set without a market negotiation or possibility for competition. In most countries, including first world count…

Same service? Remember, your kid. And it's not just the service; you could go to the urgent care clinic instead of the hospital[1] and pay less; you could go to your regular doctor and pay even less; heck, I know people who just keep sutures & glue on hand and just patch the kid up themselves. There's also the matter of demand & supply: are you confident you'll get immediate treatment if needed? that an ER staff is on hand if that small cut suddenly proves itself a skull fracture and whatever unseen complications ensue?

I'm not going to argue that the pricing is perfect; I am going to argue that there's a whole lot more behind that price than just overcharging. I've looked both my kids in the eyes while holding them still while being stitched up for one injury or another, thought thru a range of what-ifs, and had no problem paying the bill knowing there was more to it than just a little sewing. When both the doctor and urgent care clinic take one look at the injury and say "not here, she needs a hospital for this" and pass on billable treatment, there's a reason.

[1] - seems different cultures have different notions of what the term "hospital" entails. Methinks this confuses the discussion a great deal.

Post reply on HN