We did a similar thing at BetterDoctor a few weeks ago:
Show HN: I mapped US medical prices. Save thousands by driving a few miles
31–40 of 229 posts
Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles
#32Earlier quoted context omitted.
Is there evidence of correlation?
If you were a doctor, would you rather charge more, or less? What keeps you from charging the highest fees in the world? Your reputation. If you're not the best, you cannot charge the most. All of capitalism works this way.
You forgot things like consumers needing information and having a choice. Those need to be present for capitalism to work.
For fun I ask how much it is going to cost when going to my doctor. They refuse to tell me. They can't even make an estimate (tens? hundreds? thousands?) Even after seeing the doctor they can't. I pull out my card and say "I would like to pay now". I get told I have to wait for the bill. It is virtually impossible to find prices. Things are more complicated because the patient is often not the one paying directly due to the "insurance" that goes on.
This doesn't only apply for doctor visits/procedures, but even for labs where it is a known consistent product with little variability. http://www.rogerbinns.com/blog/gplus/the-first-rule-of-the-a...
A few years ago I had a ride to the emergency room. There was only one ambulance company and only one relevant hospital. The morphine in the ambulance was $27. At the hospital it was $129 plus another $75 fee to add it to the drip. Capitalism is not at play there.
Also did you know that if in most states you were going to open a hospital to lower costs you won't be allowed to? https://en.wikipedia.org/wiki/Certificate_of_Need
Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles
#33Earlier quoted context omitted.
Is there evidence of correlation?
If you were a doctor, would you rather charge more, or less? What keeps you from charging the highest fees in the world? Your reputation. If you're not the best, you cannot charge the most. All of capitalism works this way.
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Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles
#34We did a similar thing at BetterDoctor a few weeks ago: http://pricemaps.betterdoctor.com/
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Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles
#35What's the consumer use for this? Is it for people without insurance? From what I understand this is the rate that Medicare has negotiated from these providers. But I assume this isn't for people with Medicare, since those people are covered with Medicare. I assume the dollar values don't have much relation to the reality that an uninsured individual would be billed, since Medicare negotiates pretty aggressively for…
Even with insurance your coinsurance could be up to 20%. So, for complex procedures, it is very useful to see if you can get it done some place cheaper. First example of intracranial hemorrhage, price ranges from $9,540 - $234,913. Certainly gives a lot of input to make an appropriate decision. Very unlikely that without medicare negotiation, prices will magically converge to some middle point for all of them.
Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles
#36Would it be useful to have a 'show me the cheapest' button? The range in cost hints at the massive variance. The US is crazy. How does a procedure costing 4k in one place cost 120k in another?
It doesn't. The price is set by a Chargemaster list that is drawn up by a committee. Hospitals are free to charge whatever they want above that, without any downward market forces.
Paying more sometimes means better outpatient treatment (and sometimes lower readmittance rates), but it's not a guarantor.
Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles
#37What's the consumer use for this? Is it for people without insurance? From what I understand this is the rate that Medicare has negotiated from these providers. But I assume this isn't for people with Medicare, since those people are covered with Medicare. I assume the dollar values don't have much relation to the reality that an uninsured individual would be billed, since Medicare negotiates pretty aggressively for…
Even with insurance your coinsurance could be up to 20%. So, for complex procedures, it is very useful to see if you can get it done some place cheaper. First example of intracranial hemorrhage, price ranges from $9,540 - $234,913. Certainly gives a lot of input to make an appropriate decision. Very unlikely that without medicare negotiation, prices will magically converge to some middle point for all of them.
The issue is that if you have insurance, you're not paying the charge master rate or the Medicare rate, you're paying the negotiated (and likely non-public) rate for your insurer. The 20% co-insurance you pay is based on the negotiated rate.
Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles
#38Who cares? My insurance co-pay is the same either way, which is exactly the problem. There is zero incentive to shop on price. Btw, nice work :)
Yes, in the short term. But in the long term, your insurance premiums are decided based on the cost of your health care. So if everyone spent wisely, the premiums would go down or stop rocketing the way they have been.
Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles
#39Would it be useful to have a 'show me the cheapest' button? The range in cost hints at the massive variance. The US is crazy. How does a procedure costing 4k in one place cost 120k in another?
Thanks for the feedback. My next goal is to look more into why the price varies so much.
The price spread is pretty crazy. Some hospitals have higher fixed costs or salaries depending on the geography. Also, if a hospital is more research-oriented, R&D funds are normally tacked onto the price (one of the reasons why Stanford's Hospital is really expensive).
It's hard to find quantifiable data on the breakdown of bills, but based on a great article in Time a few months ago, prices are almost entirely arbitrarily defined: http://swampland.time.com/2013/05/08/an-end-to-medical-billi...
Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles
#40What's the consumer use for this? Is it for people without insurance? From what I understand this is the rate that Medicare has negotiated from these providers. But I assume this isn't for people with Medicare, since those people are covered with Medicare. I assume the dollar values don't have much relation to the reality that an uninsured individual would be billed, since Medicare negotiates pretty aggressively for…
Even with insurance your coinsurance could be up to 20%. So, for complex procedures, it is very useful to see if you can get it done some place cheaper. First example of intracranial hemorrhage, price ranges from $9,540 - $234,913. Certainly gives a lot of input to make an appropriate decision. Very unlikely that without medicare negotiation, prices will magically converge to some middle point for all of them.
Your point is a good one, but maybe a different procedure would be a better example- most people suffering from an intracranial hemorrhage aren't in a position to do a whole of of comparison shopping on where to have it taken care of.