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Show HN: I mapped US medical prices. Save thousands by driving a few miles

bestmedicareprice.com

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Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles

#151

Post by adamlett »

x0054 wrote: post #142
matwood wrote: post #113

Earlier quoted context omitted.

Dispute all of it and the bill will likely be way less than 20k. I had mallet finger once and I got a bill of thousands of dollars and charge for a broken finger, then a set, and multiple check up visits. In reality I went to the doctor once, got an xray, he gave me a splint and said don't take it off for 8 weeks. I never went back for a second visit because it wasn't needed assuming I followed the treatment of did n…

This is exactly why I get so pissed about the Affordable Care Act! We are not solving the problem of why medical care in USA is so outrageously expensive, we instead are solving the problem of how to pay for it. The problem is, once most people have insurance, there will be no political will to solve the much more complex and important problem of reducing the healthcare costs for everyone. Incidentally, totally agree…

> We are not solving the problem of why medical care in USA is so outrageously expensive, we instead are solving the problem of how to pay for it.

Perhaps, but to the individual, the first problem is by far the gravest. One can feel outraged if the taxpayers are paying too much in general, but that is not exactly a life or death situation like not being able to pay for medical aid.

Also: Why can't you fix both problems?

Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles

#152

Post by netrus »

x0054 wrote: post #142
matwood wrote: post #113

Earlier quoted context omitted.

Dispute all of it and the bill will likely be way less than 20k. I had mallet finger once and I got a bill of thousands of dollars and charge for a broken finger, then a set, and multiple check up visits. In reality I went to the doctor once, got an xray, he gave me a splint and said don't take it off for 8 weeks. I never went back for a second visit because it wasn't needed assuming I followed the treatment of did n…

This is exactly why I get so pissed about the Affordable Care Act! We are not solving the problem of why medical care in USA is so outrageously expensive, we instead are solving the problem of how to pay for it. The problem is, once most people have insurance, there will be no political will to solve the much more complex and important problem of reducing the healthcare costs for everyone. Incidentally, totally agree…

Hope is that when big entities like the state or insurances have to pay the big bill, they have far superior means to enforce lower prices. That's not everything that needs to be done, but it is still useful.

Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles

#155

Post by _delirium »

gaadd33 wrote: post #106
frenchman_in_ny wrote: post #97

Earlier quoted context omitted.

No. This is wrong, yet people keep citing this. EMTALA [0] requires the hospital to stabilize the patient, ie, make it so that it is no longer an emergency (the "E" in "ER"). If you "really can't pay" and it's not an emergency, you likely will find yourself in collections from the hospital. [0] http://en.wikipedia.org/wiki/Emergency_Medical_Treatment_and...

So if you go and say you are seizing, they will just stabilize you till you are done seizing then kick you out? Or at that point they will attempt to collect for the emergency care and prohibit further care until you can prove you can pay for it?

Generally yes. This comes up occasionally with cancer patients; if they have an acute issue the hospital must stabilize them, but the hospital doesn't have to actually treat their cancer.

If they are very poor, they should in theory be covered by Medicaid, which will then pay for treatment. But this requires them to actually be in a condition (mentally/physically/education-wise) to figure out how to sign up and be approved for it, since coverage isn't automatic. Afaik, even if the hospital is able to determine the person should be eligible, they can't just treat the person and then sign them up on their behalf; the person has to do it themselves, and be approved before seeking treatment.

This is one area that I think the U.S. lags behind many other developed countries in: assigning a social worker to help people in bad situations navigate the system. I've noticed that with an uncle of mine who has MS, is on SSI disability, and can't really take care of himself. If he didn't have a family member who was willing to accept power of attorney and file all sorts of paperwork and make phone calls on his behalf, he would have huge problems, because he isn't able to do that himself, and the state has not assigned a social worker to help him out.

Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles

#156

Post by _delirium »

netrus wrote: post #152
x0054 wrote: post #142

Earlier quoted context omitted.

This is exactly why I get so pissed about the Affordable Care Act! We are not solving the problem of why medical care in USA is so outrageously expensive, we instead are solving the problem of how to pay for it. The problem is, once most people have insurance, there will be no political will to solve the much more complex and important problem of reducing the healthcare costs for everyone. Incidentally, totally agree…

Hope is that when big entities like the state or insurances have to pay the big bill, they have far superior means to enforce lower prices. That's not everything that needs to be done, but it is still useful.

They are actually pretty good at driving the prices down to something reasonable in most cases. While the headline prices are absurd, the prices actually paid by public and private insurers, whether Medicare or Blue Cross or Aetna, are much more reasonable. Not as reasonable as in much of the rest of the developed world, but the gap is not as gigantic as it initially seems.

The really big gap between the U.S. and the rest of the developed world on medical costs isn't the cost of individual procedures (once you've taken into account what insurers actually pay), but the much larger amount the U.S. spends on last-6-months-of-life "heroic care". If that were brought more in line with international norms, the overall cost-per-person numbers would be much better.

Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles

#157

Post by rschmitty »

This is a great start, however a key thing that is missing (at no fault of the authors) is patient outcomes.

Just because a service is cheaper does not mean you should shop by the lowest bidder.

BetterDoctor's Pricemaps also include US News Rank and score which gives you a place to start: http://health.usnews.com/health-news/best-hospitals/articles...

Please please please do not shop strictly by the lowest price when it comes to your family's health. Research both the hospital and the doctor who will be doing the procedure when it comes to complex procedures.

Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles

#158

Post by dilipd »

rogerbinns wrote: post #32
codex wrote: post #11

Earlier quoted context omitted.

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 vi…

According to the site, for the 'Certificate of need', the main arguments seems to be following: "A number of factors spurred states to require certificates of need in the health care industry. Chief among these was the concern that the construction of excess hospital capacity would cause competitors in an oversaturated field to cover the costs of a diluted patient pool by over-charging, or by convincing patients to accept hospitalization unnecessarily."

I couldn't understand this argument. Something seems to be wrong.

Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles

#159

Post by mathnode »

thrownaway2424 wrote: post #93

This is cute, but it is based on a flawed premise. There are not "prices" for medical procedures and even the providers don't know what they are going to charge. Anecdata: when my wife was pregnant I asked the hospital what are the basic charges for normal obstetric delivery, since we were paying out of pocket. I got a reply in writing that it was $20k, a suspiciously round number without itemization. The baby comes…

woh woh woh hold on....20k to give birth? I am amazed the US is still breeding.

Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles

#160

Post by lovskogen »

klausjensen wrote: post #147
lovskogen wrote: post #134

Earlier quoted context omitted.

It's also free in Norway.

It certainly is not. It is paid for by one of the highest tax rates in the world. I currently work in Norway and pay more than 50% in income tax and social contributions - and that does not even include other taxes and excise duties like the 25% VAT, the 9USD/gallon gas price (mostly tax) or the new car tax of something like 150-200%, property taxes, road taxes, vehicle taxes, alchold and tobacco taxes... So no, it i…

The norm is 36%, if you earn a lot you'll get taxed more. But your income never has a say in you wanting to have a child or not.
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