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

Re: Hospital creates bidding war by posting pricing online

#111

Post by Amadou » Tue, Jul 09, 2013, 10:36 PM UTC

EvanAnderson wrote: post #110

Amadou wrote: post #78

Earlier quoted context omitted.

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…

I have not had that happen, but it is rare for me to see a new doctor. I would be super pissed though. I'd be writing to my state attorney general if it happened to me.

Re: Hospital creates bidding war by posting pricing online

#112

Post by verelo » Tue, Jul 09, 2013, 10:37 PM UTC

Healthy people can work and be productive.

When progressive startups say things like "We want you to work, and not worry about your income, so we're trying to pay you a salary that allows you to do just that" we all respect that, right?

Why can we not do the same with healthcare and just say its "free" (aka paid by our pseudo-employer - the Government) so we can all be productive and contribute to making the country/world a better place. Plain and simple...

Re: Hospital creates bidding war by posting pricing online

#113

Post by jessaustin » Tue, Jul 09, 2013, 10:42 PM UTC

antitrust wrote: post #70

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…

> Where are the free market republicans supporting these practices? Yes, where? You'd think they and the Ron Paul fans would be all over this.

What, you think they'll schedule some elective surgery when they learn of this? People all over the political map have been complaining about healthcare for a long time. I'm surprised you haven't heard any of that.

Seriously, political solutions to this sort of complex problem in the USA are very difficult. Blaming any particular political group for a lack of same is kind of dumb.

If this Dr. Smith is improving the state of healthcare as most comments here seem to indicate, then you'll be scandalized by the Gustave de Molinari quote on his blog. It's more Ron-Paulian than Ron Paul.

Re: Hospital creates bidding war by posting pricing online

#114

Post by sanderjd » Tue, Jul 09, 2013, 10:45 PM UTC

badclient wrote: post #92

lettergram wrote: post #79

Earlier quoted context omitted.

I worked in a billing office for 5 years, there are literally thousands of codes for EACH insurance company, again EACH insurance company. The reason the cost of healthcare is so high is because medicare pays roughly 15% of a bill, others are somewhere between 20-50% of a bill depending. That is to say if the doctor charges you $40,000 you pay your 10% co-pay of $4,000 and the insurance then only pays maybe another $…

Also, just so everyone knows, it's pretty easy to negotiate down your bill. The reason healthcare is so expensive is so many people don't pay it. If you are willing to pay say 40% of your bill it's already 25% better than medicare. This. My Dad is a surgeon and the stories I hear are incredible. Once he operated on a child whose insurance was out of network. So the insurance company writes the parents a check to give…

This is the part I'm always curious about in these discussions: how do people get away with not paying? Is it a debt that is often discharged in bankruptcy or is there some other mechanism by which the debt is erased?

Re: Hospital creates bidding war by posting pricing online

#115

Post by pekk » Tue, Jul 09, 2013, 10:47 PM UTC

showerst wrote: post #77

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?

I don't think the article was exactly _lying_ as putting a spin on the truth to make a political point. What they did is totally cool, and more providers should post their pricing transparently. There are complicated, sensible reasons not in the current world, which I hope will change. The government does not obviously stop them from providing pricing information about how much they charge for medicare/medicaid, hell…

When you knowingly, intentionally mislead people, that is usually known as lying.

Re: Hospital creates bidding war by posting pricing online

#116

Post by pekk » Tue, Jul 09, 2013, 10:52 PM UTC

antitrust wrote: post #70

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…

> Where are the free market republicans supporting these practices? Yes, where? You'd think they and the Ron Paul fans would be all over this.

They want the government to play less of a role, not more of one. Regulation of corporations is not something they want. They are mainly for moving power from the federal government to state governments.

Re: Hospital creates bidding war by posting pricing online

#117

Post by toomuchtodo » Tue, Jul 09, 2013, 10:54 PM UTC

ahallock wrote: post #101

toomuchtodo wrote: post #74

Earlier quoted context omitted.

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.

No need to be sorry. I just wanted to demonstrate that even with insurance, healthcare is hard.

Re: Hospital creates bidding war by posting pricing online

#118

Post by cschneid » Tue, Jul 09, 2013, 10:55 PM UTC

redler wrote: post #71

crusso wrote: post #31

Earlier quoted context omitted.

The free market in medicine is plain weird Says you. Time and again, Lasik surgery and cosmetic surgeries not covered by insurance or hindered by over-regulation have shown us that transparent pricing and competition work to make those procedures more affordable -- just like these forces work in other markets. The State has perverted the medical market for more than half a century and you're just used to seeing it in…

It's also important to consider that Lasik and cosmetic surgeries are elective procedures characterized by elastic demand. Having a trauma surgeon remove a ruptured spleen, or being treated for a heart attack, are situations where demand is completely inelastic. One might shop around for the best way to spend a spare $10,000 for an eye lift, but who can be expected to shop for an economically satisfying deal while in…

While emergency care needs to be taken into account, most medical issues are just not emergencies, they are merely pressing. Even super expensive, life threatening ones (ie, a cancer diagnosis) allow for a bit of shopping around, second opinions and such.

So if most surgery, and near all outpatient procedures are not-pressing and possible to shop around for, why can't I know how much it costs ahead of time?

Re: Hospital creates bidding war by posting pricing online

#119

Post by me2i81 » Tue, Jul 09, 2013, 11:00 PM UTC

Shivetya wrote: post #108

showerst wrote: post #27

Earlier quoted context omitted.

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.

Do you have a citation for that?

Re: Hospital creates bidding war by posting pricing online

#120

Post by tracker1 » Tue, Jul 09, 2013, 11:13 PM UTC

sanderjd wrote: post #114

badclient wrote: post #92

Earlier quoted context omitted.

Also, just so everyone knows, it's pretty easy to negotiate down your bill. The reason healthcare is so expensive is so many people don't pay it. If you are willing to pay say 40% of your bill it's already 25% better than medicare. This. My Dad is a surgeon and the stories I hear are incredible. Once he operated on a child whose insurance was out of network. So the insurance company writes the parents a check to give…

This is the part I'm always curious about in these discussions: how do people get away with not paying? Is it a debt that is often discharged in bankruptcy or is there some other mechanism by which the debt is erased?

Well, you can hire a collection agency (who usually gets X% of the collected amount with an $X as a minimum acceptable ammount, usually around 50%).

You, or an agency on your behalf can then have the unpaid amount due as a collection account appear on their credit report, and after that (7 years of no activity) it is supposed to come off. Some unscrupulous collection companies will modify the last account change date to keep it on, but that can be challenged.

You can also take the person to court and have a declaratory judgement, which will stick around on said credit report until paid.

There are also specific laws regarding where the involved parties are as local state laws apply too. It gets a little complicated.

I have two bills on my credit report with agencies that refused to negotiate... and I had an auto loan that was charged off (they repossessed my truck after they broke the payment arrangements that were made when I lost my job, and I refused to pay), after 8 years the collection company had changed the dates several times, I pointed out to the credit reporting agencies that the amount was the charged off amount for over 8 years, and had it successfully removed.

YMMV.