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Hospitals lift curtain on prices, reveals giant swings for hips, knees and more

medtechdive.com

11–20 of 283 posts

Re: Hospitals lift curtain on prices, reveals giant swings for hips, knees and more

#11
The US healthcare system is just a completely broken mess. When things go smooth, you are lucky! However, when you have a major procedure, life event or sickness things can get messy quick.

We had a child 10 months ago, billing was screwed up by the hospital, then by insurance and we are still in process of getting it resolved. I have now spent at least 8 hours on the phone.

I had a surgery, called insurance and verified it was pre-approved and in-network. After procedure I receive $22k bill. I was young and did not care about my credit back then and never paid. 5 years later I received a new bill, for $300 as the provider sued the insurance company.

I hate going to the hospital and AWAITING a shower of bills. This grinds my gears SO hard. Every hospital stay and bills just keep coming for a few months.

As someone who likes to budget and plant expenses, I just cannot stand the US medical system. I never know how much a simple wart removal my cost. $100 or $2000? I'm happy to have good insurance, don't require to use the medical system a lot and have enough money. However, if you are extremely ill you seriously need to move to a "FIRST" world nation or have a good insurance with low max out of pocket. However, you still are going to deal with bills like its your full time job.

Re: Hospitals lift curtain on prices, reveals giant swings for hips, knees and more

#12
post #9

I thought "free markets" where supposed to facilitate fair value discovery?

Look at Canada, we're spending tax $ on health care per capita each year, yet wait times & outcome success has plateued.

This is about more than 'free markets', it's arguably more about regulatory capture by the major entities in health care.

The health care industry is hand in hand with education as top of the 'scam index' industries.

Yet criticism of health care is relatively 'off limits', and there's low competitive incentive to correct/draw attention to this.

'e.g. you're evil for wanting more efficient health care: why? doctors/nurses are already overworked & efficiency will mean jobs cuts of those at the lowest rung'

Re: Hospitals lift curtain on prices, reveals giant swings for hips, knees and more

#13
post #9

I thought "free markets" where supposed to facilitate fair value discovery?

It does for less regulated markets, which is why you get those promotional mailers with promotional prices on LASIC or teeth whitening.

Medical lobby benefits from high barriers to entry, suppressed competition (from foreign doctors or medical tourism companies able to fly their customers abroad) and opaque pricing. Uninformed consumer forced to shop locally is rarely able to extract best pricing.

You can look at the annual fear-mongering fairs where medical lobby has been attempting to insert itself as a rent-seeker into kidney dialysis services in California. It's not like those industries are run by altruists, but on TV concerned serious faces in white coats would tell you in alarmist tones how those centers are run without professional supervision and people with no medical training, but when you vote properly, some [highly paid] individual with medical credentials would make things so much better [albeit more expensive in the long run].

Re: Hospitals lift curtain on prices, reveals giant swings for hips, knees and more

#14
post #11

The US healthcare system is just a completely broken mess. When things go smooth, you are lucky! However, when you have a major procedure, life event or sickness things can get messy quick. We had a child 10 months ago, billing was screwed up by the hospital, then by insurance and we are still in process of getting it resolved. I have now spent at least 8 hours on the phone. I had a surgery, called insurance and veri…

It is not a 'broken mess'. It is an 'engineered mess'. The difference is in intent.

Re: Hospitals lift curtain on prices, reveals giant swings for hips, knees and more

#15

Earlier quoted context omitted.

They will outright REFUSE to give you a quote...forget out-of-network, even IN network?! This is so astonishing cause you would assume they have NEGOTIATED the rate given its in network so there is little variability in what can be charged by the doctor and what can be thrust upon the customer. ex. if you charge $100K more than other in-network doctors, good luck, cause the insurance company is only paying the doctor…

They bill based on the procedures done and might not have that information until after the fact. I'm not saying it's a good way to do things. Opening a price list, it looks like one hospital charges ~$5000 for a knee replacement without major complications, and then the matching price for one with complications is $30000. So how do they quote that when the complications can be unpredictable? Which of course just says…

> So how do they quote that when the complications can be unpredictable?

Then they should be ones buying “price insurance” to compensate them potentially exceeding the quoted costs. That also has the pleasant effect of aligning incentives so they can keep their costs accurate.

Re: Hospitals lift curtain on prices, reveals giant swings for hips, knees and more

#16
post #2

Only in US that we don’t know the price of the health service we are redeeming. When I go get my car fix and I would go around to get an estimate for multiple body shop even if it is under insurance. But when it come to health care, you ask them for a cash price, they said they don’t know.

They will outright REFUSE to give you a quote...forget out-of-network, even IN network?! This is so astonishing cause you would assume they have NEGOTIATED the rate given its in network so there is little variability in what can be charged by the doctor and what can be thrust upon the customer. ex. if you charge $100K more than other in-network doctors, good luck, cause the insurance company is only paying the doctor…

They have to reveal their prices now. It's part of a bill that the Trump administration passed in 2019: https://www.cnbc.com/2019/11/15/trump-releases-rule-requirin...

From the article:

> As of Jan. 1, hospitals must publicly reveal the negotiated rates reached with insurers for services, a landmark shift in the sector notoriously opaque when it comes to pricing. The data offer a peek behind the curtain, exposing prices long kept a secret.

The catch is that they can't guarantee what services you'll receive. If you have complications after your inpatient surgery, the price is going to be higher than the estimate due to additional services.

Re: Hospitals lift curtain on prices, reveals giant swings for hips, knees and more

#18
post #3

In other countries you can see prices before making a decision. Funny that this a (sticker) shocker to us still today.

That's what this article is about. The prices must be revealed now:

> As of Jan. 1, hospitals must publicly reveal the negotiated rates reached with insurers for services, a landmark shift in the sector notoriously opaque when it comes to pricing. The data offer a peek behind the curtain, exposing prices long kept a secret.

Re: Hospitals lift curtain on prices, reveals giant swings for hips, knees and more

#19

Isn't one of the problems that the price of the total procedures are so different from the component parts / equipment / time, because different providers (and insurers) lump in different categories of cost with different methodologies of billing for overhead items? Or allow different costs to come in? Such that even if you tried to comparison shop across 2 hospitals, you can't really tell whether that is the "all in…

Yes to all of this. That's the problem.
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