Hospital creates bidding war by posting pricing online • Hacker News Board

Re: Hospital creates bidding war by posting pricing online

#101

Post by ahallock » Tue, Jul 09, 2013, 10:01 PM UTC

toomuchtodo wrote: post #74

ahallock wrote: post #51

Earlier quoted context omitted.

That's what insurance is for. Catastrophic situations. Or perhaps there's a way to pre-purchase emergency care at a discount. Or you set your emergency provider ahead of time based on price. I don't know. There must be creative ways to solve this problem rather than being all fatalist about it.

Counterpoint: At the time, we had insurance. Great insurance through Blue Cross Blue Shield. Also, had State Farm for auto. Our medical policy on our auto policy was exhausted solely from the hospital visit and ambulance ride, and the other at-fault party's coverage (also State Farm) barely covered the first few doctor visits for my wife. I've now had to pay several thousand dollars out of pocket for my wife's physic…

I'm deeply sorry for what you had to endure, and I didn't mean to trivialize your situation.

Re: Hospital creates bidding war by posting pricing online

#102

Post by kasey_junk » Tue, Jul 09, 2013, 10:04 PM UTC

javert wrote: post #89

> Dr. Smith said federal Medicare regulation would not allow for their online price menu. > They have avoided government regulation and control in that area by choosing not to accept Medicaid or Medicare payments. Obama, better close up that loophole! Wouldn't want people to find out that capitalism works in every. single. industry.

every. single. industry where efficiency and profit are the main concerns and externalities are captured accurately and true competition can exist. That is not always true. Off the top of my head the justice system and emergency service providers (think fire/hazmat etc) come to mind.

Lets not let the bizarre state of the US medical industry act as some sort of straw man to support some ultra libertarian viewpoint.

Re: Hospital creates bidding war by posting pricing online

#103

Post by pbreit » Tue, Jul 09, 2013, 10:06 PM UTC

Price transparency is a key part of Obamacare and is apparently beginning to work. For example, insurance companies in Oregon reduced premiums after seeing competitor prices [1].

1: http://www.oregonlive.com/health/index.ssf/2013/05/two_orego...

Re: Hospital creates bidding war by posting pricing online

#104

Post by kasey_junk » Tue, Jul 09, 2013, 10:12 PM UTC

Kapura wrote: post #46

Oh man I want this to be the new norm so bad . The American health care system really needs to be shaken up. Republican dissent in Congress blocked that when Obama was championing it; perhaps the Republican's stated goal of a free market is going to be what affects the change. Where are the free market republicans supporting these practices? Why are they so upset about people coming to work in America but not the fac…

Um, McCain ran on a platform that would encourage price transparency and insurance portability in 2008.

Also last I checked Obama's health care plan passed and it is all about access to and quality of health insurance. There is no evidence that it will improve price transparency from the providers.

Re: Hospital creates bidding war by posting pricing online

#105

Post by methehack » Tue, Jul 09, 2013, 10:12 PM UTC

alexholehouse wrote: post #57

Great story but "OKLAHOMA CITY – An Oklahoma City surgery center is offering a new kind of price transparency, posting guaranteed all-inclusive surgery prices online. The move is revolutionizing medical billing in Oklahoma and around the world." Around the world? Really?

By around the world I think they mean Canada :)

Re: Hospital creates bidding war by posting pricing online

#106

Post by EvanAnderson » Tue, Jul 09, 2013, 10:18 PM UTC

bengebre wrote: post #30

As someone with an High Deductible Healthcare Plan, I pay most medical costs out of pocket up to an annual limit. It's crazy that for such expensive services I NEVER know what my bill is going to be until months after the procedure has happened. I always try to guesstimate costs beforehand, but I've been off by an order of magnitude on more than one occasion. Having transparent pricing in the healthcare world, even i…

Same situation here.

I get looked-at like I'm crazy when I try to explain my insurance and that I'd like to know more about the cost of a procedure or prescription before I agree to it.

I've always tried to just pay cash for services. Increasingly, though, I'm finding that providers are being put under exclusive contracts which prevent them from allowing me to pay cash. As soon as they find out who my insurer is they clam up, explain that they're under contract w/ that insurer, and say they can't give me cash pricing. It's doubly frustrating because they usually won't talk to me at all if I don't tell them who my insurer is. Catch-22.

The provider ends up billing my insurer who doesn't pay because I haven't reached my deductible. Then I get a bill from the provider, 4 - 6 weeks later. Sometimes the provider allows me to pay the "negotiated price" my insurer would have paid, but other times I've had to pay the full non-discounted amount.

What a screwed-up mess.

Re: Hospital creates bidding war by posting pricing online

#107

Post by jessaustin » Tue, Jul 09, 2013, 10:22 PM UTC

abstractbill wrote: post #18

Scaevolus wrote: post #11

Earlier quoted context omitted.

Aggregate essentials (food, shelter) are generally inelastic. You don't choose if you need food or not. Being able to select what food you buy (based on price, etc) forces the prices to be competitive. Not being able to select healthcare based on price means nothing checks rising prices. Regulations have made healthcare into a cartel where members won't compete to be affordable.

Aggregate essentials (food, shelter) are generally inelastic. You don't choose if you need food or not. Right. And there were a lot of famines in the past. It's only by "flood[ing] the market with supply (using technology to both drive down costs and replace what people do)" that we've managed (in the West, at least) to ensure that most people no longer have to worry about food.

This is not a complete explanation. The most important factor is that Americans just have more resources than most humans in history. Transfer any but the absolute poorest Americans to anywhere on earth, at anytime in history, with their current income, and they'll be just as well-fed as they are here and now, even if the local farmers are driving oxen.

Another way of stating this, is that edible commodities are just as fungible as all other commodities. If Egyptians could afford to purchase enough wheat to feed themselves, they would.

Re: Hospital creates bidding war by posting pricing online

#108

Post by Shivetya » Tue, Jul 09, 2013, 10:26 PM UTC

showerst wrote: post #27

ChuckMcM wrote: post #22

I really salute these guys for doing this. It's freakin' awesome. This I've added to my next letter to my representatives in Congress: "Dr. Smith said federal Medicare regulation would not allow for their online price menu. They have avoided government regulation and control in that area by choosing not to accept Medicaid or Medicare payments." I've suggested that one non-controversial way in which Healthcare could b…

Copying my comment below. The government not only allows healthcare providers to reveal their prices, it encourages it. The graf about the government is a political statement, not a policy fact, and does not belong in a news story. ----- Medicare/caid prices are standardized and public. They also release data on what specific hospitals bill for the most common procedures. http://www.cms.gov/Research-Statistics-Data-a…

Part of the Affordable Care Act is a requirement for hospitals to bill cash payers no more than someone who has insurance must pay. So if insurance companies negotiate a rate for a procedure, stay, or the like, and you pay cash the hospital needs to charge you the same or less.

Re: Hospital creates bidding war by posting pricing online

#109

Post by drumdance » Tue, Jul 09, 2013, 10:27 PM UTC

refurb wrote: post #94

jljljl wrote: post #50

Earlier quoted context omitted.

Neither Lasik nor cosmetic surgeries tend to be major issues of life and death, nor do they tend to occur in emergency situations where an informed decision may not be possible. Free markets and transparent pricing that work require that there not be major information asymmetries between supplier and purchaser. If I'm in the hospital with an emergency or critical condition, I probably don't have the option of fully r…

You don't think people with cancer research which clinic to go to? I know if I had cancer I dam well would.

More to the point, you will spend a great deal of money to extend your life, and there is no less-expensive alternative (at least not published). Lasik has a very low-cost alternative: glasses.

Re: Hospital creates bidding war by posting pricing online

#110

Post by EvanAnderson » Tue, Jul 09, 2013, 10:28 PM UTC

Amadou wrote: post #78

rthomas6 wrote: post #67

Earlier quoted context omitted.

You and the article seem to be saying totally contradictory things. Was the article just outright lying, or is there some nuance I'm missing?

A couple of months ago, Time magazine (of all places) did a really good story about the lack of price transparency in healthcare and how that may well be the single largest contributor to the burgeoning healthcare costs in the US. I think it is behind a paywall, here is a starter though: http://www.time.com/time/magazine/article/0,9171,2136867,00.... In a stunning example of competence and efficiency, the US governme…

Fellow high deductible plan-holder here. Have you run into the circumstance yet where a provider is under an exclusive contract w/ your insurer and, once the provider finds out who your insurer is, is obligated to refuse to allow you to pay cash? I've had this happen 3 times in the last year and it's driving me mad. The providers were unwilling to talk to me unless I divulged my insurer, and when I did they were then unable to give me cash pricing. Maddening.