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Hospital prices are about to go public in the U.S.

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Re: Hospital prices are about to go public in the U.S.

#121

Post by namdnay »

beagle3 wrote: post #81
lostlogin wrote: post #58

Earlier quoted context omitted.

What’s the logic in that? If the cost is socialised surely you’d expect more people to seek care than if they were paying?

What’s the logic in that? Am I going to get a quad bypass just because it is cheaper? People seek care because they need it. The kind of care that people use more because it is cheaper/available is maintenance care (which reduces overall costs because things are often treated before they become critical). The first time I heard “I am feeling sick / cut my hand / need stitches but I cannot afford to go to the doctor”…

I think there's a balance to be found. Here in France people will go to the doctor for a common cold, and immediately load up on unnecessary medicine at the pharmacy. I'm sure that if they were asked to pay even 5E out of their pocket it would significantly reduce the shortage of GPs and the lower costs.

Re: Hospital prices are about to go public in the U.S.

#122

Post by arethuza »

QuantumGood wrote: post #120
mastef wrote: post #114

Earlier quoted context omitted.

The differences in the prices you mentioned are astronomical... I'm already getting angry here to be charged $50 instead of $25 when the doctor "touches" you during some basic evaluation. But at least they tell you about any massive amounts coming up before any treatment happens.

It's not sane. With insurance, was hospitalized for a heart condition. ~$45,000. Found no problem in testing, so they kept ordering more tests, sending in more cardiologists. Kept hearing "I know you've said this several times already, but please repeat for me...". Each time I repeated the story to a different doctor there was a large bill. Clearly the hospital new how to pad the bill. I eventually left "against doct…

"With insurance, was hospitalized for a heart condition. ~$45,000"

Please tell me you didn't have to pay the ~$45,000 personally?

Re: Hospital prices are about to go public in the U.S.

#123

Post by QuantumGood »

arethuza wrote: post #117
QuantumGood wrote: post #110

Earlier quoted context omitted.

Had new insurance and a sore shoulder. Was billed ~$1,400 for a physical therapist to examine it ("evaluation"). No treatment. Very little covered by insurance. The next day had a chiropractor treat it and shoulder was fine. $25 with coupon. Funny part is, as it was new insurance, I spent over 30 minutes with insurance rep in advance on phone going over options and trying to get an idea of likely costs. When I had a…

So you have insurance but it doesn't cover stuff when you are actually ill? Does your insurance policy actually spell stuff out so that you can predict what will or won't be covered? Note: I'm from the UK and find the stories about US healthcare insurance grimly fascinating....

On the phone in advance, was given some hint of what could go wrong.

Basically, it depends on how the provider "codes" the treatment. You can contest the code, i.e. say you should have been billed for something other than what they are calling it. There is apparently a very wide range of things similar visits could be coded as.

Re: Hospital prices are about to go public in the U.S.

#124

Post by conductr »

grecy wrote: post #43
noja wrote: post #30

Earlier quoted context omitted.

Please. You cannot be serious. Are you really saying that pricing in the US healthcare system is so broken that the only way to set prices is to take other countries prices and convert them?

It would certainly be a good start. In fact, the US could improve a lot of basic services if it looked at what other developed countries (OECD) are delivering, and for how much, and made those targets for the next lets say ~10 years. After those 10 years of bringing the US more into line with the best countries in the world, it should strive to do even better. Or, alternatively, the US can keep falling further behind…

“The US” is not a entity unless you’re saying we should convert to a single payor system, then set prices based on rest of world pricing.

I can tell from first hand experience. Healthcare companies, set prices by market. Specifically, by what price that market will sustain. It just so happens that the US can sustain the highest prices. You know being unregulated and rich af and all.

This is how all industries/companies set prices btw. What you’re saying, It’s kind of like saying, I want New York City to base real estate prices off median home prices in the Midwest because as a buyer I like those prices better.

Re: Hospital prices are about to go public in the U.S.

#125

Post by randomacct3847 »

yodsanklai wrote: post #116

Some anecdotes related in the comments are scary. I'm wondering, how is the situation for a software engineer working in a big company (say GAFA in silicon valley). Suppose you broke a leg skiing, and need surgery and various medical exams. How much are you expected to pay? what's the administrative overhead? same question for dental care.

completely depends on your insurance plan...something like this will definitely be covered, but how much you will pay depends on your deductible, how much you’ve already contributed to your deductible, what copay or coinsurance you need to pay once you meet it, and your out of pocket max (max you will pay for anything in a given year)

I have supplemental “accident insurance” since I’m relatively young and healthy and the biggest reason why I’d end up in the ER is due to a physical accident. With this insurance it covers more of what I would pay in this situation than my insurance would alone.

Re: Hospital prices are about to go public in the U.S.

#126

Post by alkonaut »

grecy wrote: post #43
noja wrote: post #30

Earlier quoted context omitted.

Please. You cannot be serious. Are you really saying that pricing in the US healthcare system is so broken that the only way to set prices is to take other countries prices and convert them?

It would certainly be a good start. In fact, the US could improve a lot of basic services if it looked at what other developed countries (OECD) are delivering, and for how much, and made those targets for the next lets say ~10 years. After those 10 years of bringing the US more into line with the best countries in the world, it should strive to do even better. Or, alternatively, the US can keep falling further behind…

This applies to quite a lot. Banking, legal, infrastructure, political systems etc.

It amazes me how the US is still arguing how archaic districting laws should work, how to have elections with integrity or manage without paper checks or fax machines.

I realize there are politicsl/historical and cultural differences but there is a combination of exceptionalism (“the US is so special we can’t just look at France and imitate”) and resignation (“yeah we want that but we cant have that because it would never work because X”) surrounding each of these discussions. The US is pushing boundaries in so many areas but when it comes to evolving society in a way that requires broad agreements, there isn’t much to report on

Re: Hospital prices are about to go public in the U.S.

#127

Post by iamgopal »

randomacct3847 wrote: post #125
yodsanklai wrote: post #116

Some anecdotes related in the comments are scary. I'm wondering, how is the situation for a software engineer working in a big company (say GAFA in silicon valley). Suppose you broke a leg skiing, and need surgery and various medical exams. How much are you expected to pay? what's the administrative overhead? same question for dental care.

completely depends on your insurance plan...something like this will definitely be covered, but how much you will pay depends on your deductible, how much you’ve already contributed to your deductible, what copay or coinsurance you need to pay once you meet it, and your out of pocket max (max you will pay for anything in a given year) I have supplemental “accident insurance” since I’m relatively young and healthy and…

How much I would pay is depend on insurance plan. How much is payable can be stated. Even insurance needs to publish their payouts for each of published data of hospitals.

Re: Hospital prices are about to go public in the U.S.

#128

Post by [deleted] »

QuantumGood wrote: post #120
mastef wrote: post #114

Earlier quoted context omitted.

The differences in the prices you mentioned are astronomical... I'm already getting angry here to be charged $50 instead of $25 when the doctor "touches" you during some basic evaluation. But at least they tell you about any massive amounts coming up before any treatment happens.

It's not sane. With insurance, was hospitalized for a heart condition. ~$45,000. Found no problem in testing, so they kept ordering more tests, sending in more cardiologists. Kept hearing "I know you've said this several times already, but please repeat for me...". Each time I repeated the story to a different doctor there was a large bill. Clearly the hospital new how to pad the bill. I eventually left "against doct…

[deleted]

Re: Hospital prices are about to go public in the U.S.

#129

Post by QuantumGood »

arethuza wrote: post #122
QuantumGood wrote: post #120

Earlier quoted context omitted.

It's not sane. With insurance, was hospitalized for a heart condition. ~$45,000. Found no problem in testing, so they kept ordering more tests, sending in more cardiologists. Kept hearing "I know you've said this several times already, but please repeat for me...". Each time I repeated the story to a different doctor there was a large bill. Clearly the hospital new how to pad the bill. I eventually left "against doct…

"With insurance, was hospitalized for a heart condition. ~$45,000" Please tell me you didn't have to pay the ~$45,000 personally?

We had to pay our ~$8,000 deductible, everything above that was covered. We paid by negotiating a one lump sum payment and got 25% off. Had a relative with more cash flow make the payment all at once then paid them in installments. Was told by a doctor later that they only get paid 75% of what they bill by the insurance company, and that considering that, the 25% discount made sense. Tried for a 30% discount but 25% was the best we could do. I pre-negotiated 25%, then had the relative with more experience in negotiating close the deal and try for 30%.

There was a substantial upside. The cardiac event happened early in the year, and everything covered by insurance for the rest of the year was 100% free. We were able to pursue some things we probably wouldn't have otherwise. Simple things like having more cough syrup on hand became a no-brainer as cost of visit and prescription was guaranteed to be $0

Re: Hospital prices are about to go public in the U.S.

#130

Post by lotsofpulp »

randomacct3847 wrote: post #125
yodsanklai wrote: post #116

Some anecdotes related in the comments are scary. I'm wondering, how is the situation for a software engineer working in a big company (say GAFA in silicon valley). Suppose you broke a leg skiing, and need surgery and various medical exams. How much are you expected to pay? what's the administrative overhead? same question for dental care.

completely depends on your insurance plan...something like this will definitely be covered, but how much you will pay depends on your deductible, how much you’ve already contributed to your deductible, what copay or coinsurance you need to pay once you meet it, and your out of pocket max (max you will pay for anything in a given year) I have supplemental “accident insurance” since I’m relatively young and healthy and…

Also if someone out of network walks into the room.
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