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

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

#111

Post by danaris »

fractionalhare wrote: post #93
danaris wrote: post #26

Earlier quoted context omitted.

Framing it this way is probably inaccurate, and if inaccurate, unhelpful. From decades of observing the system, it seems extremely unlikely to me that it was deliberately engineered to be this way. Rather, different parts of it grew and changed organically and the parts and changes that benefitted moneyed interests in power stayed, while those that did not were discarded. It does not take a deliberate will behind som…

You say this: > It does not take a deliberate will behind something for it to be pulled toward this sort of inequality, and presenting it as if that's what's happened suggests that if we could only defeat the Evil People who "engineered" it this way, we could make it better. ...but then also this: > ...to inhibit the flow of money upward from the 99% to the 1%. It's hard, it will take a long time, the people with the…

There can be "evil" people who will work to prevent the dismantling of a system, even if those people did not deliberately design and build that system. All that is required is that they recognize that the status quo benefits them, and that's a very common situation for those among the elite.

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

#113

Post by throw123123123 »

joshspankit wrote: post #98
0xmohit wrote: post #80

Earlier quoted context omitted.

The mess is by design. Goldman Sachs asks in biotech research report: ‘Is curing patients a sustainable business model?’ https://www.cnbc.com/2018/04/11/goldman-asks-is-curing-patie... >

The providers should get paid every month that you’re in excellent health. Imagine how many cheap cures we would “suddenly discover”.

That would lead to a model where healthcare spending is directed to attracting healthy patients and refusing unhealthy patients.

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

#114

Post by primitivesuave »

I'm the technical cofounder of a mid-sized healthcare startup, and when I start explaining hospital administration to people, I start with this - every person working in your hospital or clinic has no incentive whatsoever for you to emerge healthier. The only goal is to maximize the ratio between the amount your insurance is willing to pay, and the amount of care that is provided.

In the case of joint replacement, each insurance provider has negotiated a fixed block payment for all costs related to the surgery. If the surgeon makes a mistake, or the patient doesn't follow along with physical therapy, or something goes wrong for whatever reason, the care provider is financially responsible for any corrective actions on the procedure. This means any complaint in a follow-up visit is usually met with some kind of platitude to make you go away, like "here is a prescription for some pain medication, let us know if the problem persists". There is no incentive to do any scans or tests, since this would eat into the profits that the hospital has made on this patient.

For certain GI surgeries, patients are instructed not to eat solid food for a week or two after surgery. A certain percentage of people ignore these instructions and end up in the hospital ER requiring another surgery. In the last couple years, providers of these treatments have learned how to bring that percentage down by hammering post-op patients with daily email/SMS messages to ensure they are educated about their procedure. These systems were not put in place by someone at the hospital who wanted patients to be better informed, they were put in place because someone noticed that percentage and calculated how much money the hospital could be saving for each percentage point in reduced readmission.

I have heard good arguments against Medicare-for-all, but I have never heard any logical argument to defend the status quo.

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

#115

Post by throw123123123 »

narrator wrote: post #84

Kaiser is the only non-broken part of the U.S healthcare system. They have never sent me a bill for a surprise out of network anything. Out of network doctors don't work there. All doctors are on salary. You get one bill from one company. No wonder they have been growing like crazy in California.

Kaiser is popular and 'a' model of care, but do note that it is extremely limited in coverage and is one of the most draconian in respect to providers.

They hire people right out of medschool with the offer to pay their entire student debt if they stay with them for 8 years. They have massive burn out.

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

#117

Post by Spooky23 »

primitivesuave wrote: post #114

I'm the technical cofounder of a mid-sized healthcare startup, and when I start explaining hospital administration to people, I start with this - every person working in your hospital or clinic has no incentive whatsoever for you to emerge healthier. The only goal is to maximize the ratio between the amount your insurance is willing to pay, and the amount of care that is provided. In the case of joint replacement, ea…

In helping with a family member struggling with a very serious medical condition, the only incentive I’ve been work is the stick.

The Medicare incentives to kick patients out of rehab is very effective, to the point that it’s a cruel game for families operating under the mistaken assumption that healing is a goal.

In the hospital, the only urgency outside of acute/intensive care that I saw was when my family member was readmitted due to incompetence on the part of the hospital, and ended up costing them thousands of unremimbursed dollars.

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

#119

Post by maxerickson »

benlivengood wrote: post #85

Healthcare is such an asymmetric market that there will never be enough information for patients to price things accurately. It's like if every road we drove on had a different toll every time we travelled on it, and we didn't quite know what the total would be (or what construction projects you might encounter along the way) at the end. It's made worse by the high value people put on their health and their low knowl…

CT scans in India cost ~$100.

US prices for imaging aren't based on the cost.

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

#120

Post by hoka-one-one »

wdn wrote: 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.

According to the law they have to provide a price list, you're probably just asking for the wrong thing. No one's going to go through the price list and translate what you're looking for into medical jargon. My experience has been that you can usually find a list of direct-to-consumer prices online.
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