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Hospitals release lists of retail prices for services

modernhealthcare.com

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Re: Hospitals release lists of retail prices for services

#101

Post by jtbayly »

DanBC wrote: post #97
zeroname wrote: post #91

Earlier quoted context omitted.

> Source? This term was invented by Sarah Palin and was judged 2009’s Lie of the Year by PolitiFact.[1] The lie (or at least misrepresentation) was that Obamacare had a "death panel clause" in it. An argument could be made that it still does: https://www.washingtontimes.com/news/2017/jun/14/obamacare-d... For the equivalent in the UK: https://www.bbc.com/news/health-28983924 > You have no idea what you’re taking abou…

> For the equivalent in the UK: > https://www.bbc.com/news/health-28983924 What do you think this means? How are you understanding this article? Because I'm pretty sure it doesn't mean what you think it means. Are you honestly saying US insurance companies don't do exactly the same thing?

When the government decides it isn’t worth it, you don’t have the option of paying for it anyway if you disagree. Hence the high-profile cases of parents with money, begging the government to be allowed to take their baby someplace else willing to treat him.

Insurance companies cannot prohibit you leaving the country.

Re: Hospitals release lists of retail prices for services

#102

Post by zeroname »

DanBC wrote: post #97
zeroname wrote: post #91

Earlier quoted context omitted.

> Source? This term was invented by Sarah Palin and was judged 2009’s Lie of the Year by PolitiFact.[1] The lie (or at least misrepresentation) was that Obamacare had a "death panel clause" in it. An argument could be made that it still does: https://www.washingtontimes.com/news/2017/jun/14/obamacare-d... For the equivalent in the UK: https://www.bbc.com/news/health-28983924 > You have no idea what you’re taking abou…

> For the equivalent in the UK: > https://www.bbc.com/news/health-28983924 What do you think this means? How are you understanding this article? Because I'm pretty sure it doesn't mean what you think it means. Are you honestly saying US insurance companies don't do exactly the same thing?

> Are you honestly saying US insurance companies don't do exactly the same thing?

I certainly don't think it's "exactly the same", but that's not my point. I just wanted you to move the goalpost from "there are no death panels" to "okay, there are death panels, but they are everywhere, potato/patata!". Kinda like this guy:

https://www.dailykos.com/stories/2017/5/8/1660050/-Death-Pan...

Re: Hospitals release lists of retail prices for services

#103

Post by Peradine »

DanBC wrote: post #96
joshgel wrote: post #42

Earlier quoted context omitted.

I'm a doctor. I'm pretty sure I know what those things mean. But ya, wouldn't expect you to. Ultimately that's irrelevant, because you don't choose the services you get in a hospital, "I" do. If I come in and recommend this or that test, are you going to check the price? Of course not, because the issue is only partially hidden prices. Its also knowledge asymmetry and fear. I think most doctors only recommend tests t…

> I think most doctors only recommend tests they feel will be helpful Why are the rates of over-testing and over-diagnosis so high?

"helpful" may be defined as helpful in preventing the doctor from being sued

Re: Hospitals release lists of retail prices for services

#104

Post by ceejayoz »

rayiner wrote: post #95
temp231239 wrote: post #74

Earlier quoted context omitted.

I am hopeful of these changes, too. But market alone won't have any influence in deterring hospitals from charging arbitrary charges. Market works best when there are range of options available, but in case of hospitals in US only few big players are hoarding all medicinal resources leaving patients with no choice.

That doesn’t seem true. I live in a small city and have three major hospitals within a 20 minute drive, plus half a dozen urgent cares.

Most of the urgent cares in my area (Rochester, NY) are being taken over by the local university medical system. Those that aren’t are closing as a new URMC urgent care opens up across the street.

They own several hospitals in the city. They’ve also bought up several formerly independent hospitals in the surrounding more rural areas.

My understanding is that this approach is becoming increasingly common.

Re: Hospitals release lists of retail prices for services

#105

Post by ceejayoz »

jtbayly wrote: post #101
DanBC wrote: post #97

Earlier quoted context omitted.

> For the equivalent in the UK: > https://www.bbc.com/news/health-28983924 What do you think this means? How are you understanding this article? Because I'm pretty sure it doesn't mean what you think it means. Are you honestly saying US insurance companies don't do exactly the same thing?

When the government decides it isn’t worth it, you don’t have the option of paying for it anyway if you disagree. Hence the high-profile cases of parents with money, begging the government to be allowed to take their baby someplace else willing to treat him. Insurance companies cannot prohibit you leaving the country.

> Insurance companies cannot prohibit you leaving the country.

Neither will developed-world single-payer systems, in virtually all cases. It sounds like you're referencing the Alfie Evans case, which a) was unusual enough to receive international headlines and b) involved a terminal, untreatable minor incapable of making their own decisions.

Hell, even in the UK, you can opt for private treatment - they've got a dual private/public system, as do many single-payer systems.

Re: Hospitals release lists of retail prices for services

#106

Post by splintercell »

cdoxsey wrote: post #92
curiousgal wrote: post #79

I find this whole situation ironic because whenever I come across a news article online of some Third World country making an improvement, mostly in regards of human rights like Saudi Arabia allowing women to drive or Tunisia passing inheritance equality laws, the general response is "Meh, this shouldn't have been an issue to begin with". When it comes to the U.S., particularly with anything that involves its helathy…

Healthcare systems are not uniform. Canada or the UK's system is quite different from other systems. For example the Netherlands has a hybrid system that utilizes a competitive, private, for-profit insurance market (with subsidies from the government). I think a lot of first-world countries have systems like that. (they aren't publicly managed, single-payer systems) And given the rhetoric on this issue I was very sur…

> For example the Netherlands has a hybrid system that utilizes a competitive, private, for-profit insurance market (with subsidies from the government).

I am always skeptical of these claims. We have a hybrid system for higher education which utilizes a competitive, private, for-profit education market, with heavy subsidies from the govt (given to the students in the form of aid). Look what it looks like, ever increasing prices.

Take our K-12 schooling system, again the same problem, somehow it works great for other racially homogenous European and Asian countries, but in America, we spend far more on public education per students, and get worse results.

So why is the belief that our healthcare system is going to look like Netherland's when our education system doesn't look like that?

Re: Hospitals release lists of retail prices for services

#107

Post by Sir_Vival »

DanBC wrote: post #100
zeroname wrote: post #88

Earlier quoted context omitted.

> You don’t cite any evidence to support your claim. Most U.S. doctors graduate with >$100K in medical education debt. You posted a source yourself: https://news.harvard.edu/gazette/story/2018/03/u-s-pays-more... Salaries are almost twice as high. Those other countries also tend to have higher taxes and other salary deductions, so doctors earn less. > Other countries have better health outcomes, so that pretty much k…

Everyone knows that 5 year cancer survival rates in the US are high because the US over-tests so much. This is evidence that harm is being caused. It's not evidence of a good health care system. Why are male incontinence products so prevalent in the states? It's because men are pushed to get PSA and similar screening for prostate cancer. This means the US detects a lot of slow growing cancer that's unlikely to kill s…

It doesn't seem like "over testing" or "harm" if the end result is less people dying. The fact of the matter is that I was able to get an MRI the same day I went to the doctor with an issue twice in the US. One of those times was for severe recurrent headaches. The doctor didn't think it was a tumor (and it wasn't), but he did it to be sure. If I were in Canada chances are I would have waited months for that appointment. In the worst case that would mean the tumor had time to grow. In the best case that's months of unnecessary worry, which isn't healthy in itself.

Re: Hospitals release lists of retail prices for services

#108

Post by jrowley »

DanBC wrote: post #96
joshgel wrote: post #42

Earlier quoted context omitted.

I'm a doctor. I'm pretty sure I know what those things mean. But ya, wouldn't expect you to. Ultimately that's irrelevant, because you don't choose the services you get in a hospital, "I" do. If I come in and recommend this or that test, are you going to check the price? Of course not, because the issue is only partially hidden prices. Its also knowledge asymmetry and fear. I think most doctors only recommend tests t…

> I think most doctors only recommend tests they feel will be helpful Why are the rates of over-testing and over-diagnosis so high?

> Why are the rates of over-testing and over-diagnosis so high?

It is something health systems are aware of and working on, but if you go to the doctor with lower back pain and they say, get a better pair of shoes, take epsom salt baths, and deal with it, you might get frustrated. It doesn't cost the physician anything to order an MRI, but that procedure alone can costs $10k to your insurance, and may very well not reveal anything novel from the physical. But both the patient and physician feel more confident and there is no incentive against the physician for ordering the test. This particular example is such an issue, that a national quality measurement standards org has a measure dedicated to it:

https://www.ncqa.org/hedis/measures/use-of-imaging-studies-f...

And now that we are monitoring it (at some cases, down to the physician level), we can see awareness grow and individual physicians are changing their ordering habits. Very cool.

Re: Hospitals release lists of retail prices for services

#109

Post by alexhutcheson »

koolba wrote: post #64
maxerickson wrote: post #41

Earlier quoted context omitted.

The worst situation is to have high deductible insurance. Then you have to pay the prices the insurance negotiates out of pocket (at least if you want the costs to apply against that high deductible). If you don't have insurance the hospital will take what they can get.

Or just tell them you’re paying cash and ask for that price. It won’t count toward your deductible but it could be significantly cheaper. I’ve seen urgent care facilities that charge $50 for cash patients and $130 for those with insurance.

It can go both ways - often the insurance negotiated price is significantly cheaper.

Re: Hospitals release lists of retail prices for services

#110

Post by [deleted] »

DanBC wrote: post #100
zeroname wrote: post #88

Earlier quoted context omitted.

> You don’t cite any evidence to support your claim. Most U.S. doctors graduate with >$100K in medical education debt. You posted a source yourself: https://news.harvard.edu/gazette/story/2018/03/u-s-pays-more... Salaries are almost twice as high. Those other countries also tend to have higher taxes and other salary deductions, so doctors earn less. > Other countries have better health outcomes, so that pretty much k…

Everyone knows that 5 year cancer survival rates in the US are high because the US over-tests so much. This is evidence that harm is being caused. It's not evidence of a good health care system. Why are male incontinence products so prevalent in the states? It's because men are pushed to get PSA and similar screening for prostate cancer. This means the US detects a lot of slow growing cancer that's unlikely to kill s…

[deleted]
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