Our system is so byzantine. I prefer to go to Kaiser, if possible, for no other reason than everything is in-network by definition. The only reason I don't have Kaiser right this moment is my current company only has one Kaiser plan, and it's a Cadillac plan -- zero deductible, zero out of pocket maximum, and so it has a fairly high premium (whereas the PPO plan I'm using has a premium essentially zero, the company pays almost 100% of it). Which brings me to something else I loathe -- that my health coverage is related to my job. Dammit, I don't want to change doctors when I change jobs.
Hospitals lift curtain on prices, revealing giant swings in pricing by procedure
121–130 of 463 posts
Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure
#122Around 2012 before my wife and I were married, we both got pneumonia. I was insured through my employer, she was uninsured. We went to urgent care at the same time on the same day, saw the same doctor and got prescribed the same drugs. About a month later when the bills came, her bill with no insurance was somewhere in the $160 range. My bill after insurance was nearly $300. I'm still peaved about this.
Was there any difference in ability to sue the provider in case things went wrong? I heard that sometimes they ask the uninsured to sign away the ability to sue the doctor and get lower prices in return. I am not too sure about details, this is just hearsay.
I remember she did have to sign a lot of paperwork. I have no idea what it contained however.
Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure
#123I am one of the people responsible for making these lists. The fact that the general public as well as journalists think this data is accurate in anyway is really funny. This an exercise of futility that only increases the overall cost and provides job security for me :) No one working in a hospital knows how much do we acquire things for, or how much we get paid for doing things in advance. And only like 8 people ca…
>> Cost depends on: 1. Are you an outpatient/Obsveration v. inpatient v. ED? 2. Are you on Medicaid? 3. Is the hospital a part of GPO organization or not? 4. Is contractual obligations of GPO includes/excludes Aspirin? Those considerations aren't part of what anyone calls cost. How much does the hospital pay for aspirin? How much do they pay someone to administer it to a patient? That's cost. If it's very complicated…
The cost of the aspirin depends on these things lol. Look up 340B.
There is a drug called Oncaspar. It's >$16,000 for one patient, and 5 cents for another (acquisition cost). Same drug, widely different acquisition cost.
Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure
#124Seeing the price range you pay is interesting, but I'm not sure what we are supposed to do with it. My wife had her prenatal anatomy scan a few months ago at Stanford medical, $11000 for a 1 hour ultrasound. I personally was on the hook for around $500 and insurance paid $10500. End of the day, what say do we have as consumers? How did the insurance company negotiate a rate of $11,000? Does the insurance company real…
Holy shit, that's just insane!
Here in the UK we paid for a prenatal scan and NIPT a few years ago (this was in addition to free NHS scans at our local hospital), and IIRC it was £200!
Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure
#125I'm not sure how useful these lists are when hospitals are not in competition. In many areas that aren't a major metro, you may only have one hospital you can even choose, and the law prevents new hospitals from opening without permission. This 'market' is the very definition of inelastic.
Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure
#126Seeing the price range you pay is interesting, but I'm not sure what we are supposed to do with it. My wife had her prenatal anatomy scan a few months ago at Stanford medical, $11000 for a 1 hour ultrasound. I personally was on the hook for around $500 and insurance paid $10500. End of the day, what say do we have as consumers? How did the insurance company negotiate a rate of $11,000? Does the insurance company real…
The insurance most definitely did not pay $11,000 USD. They paid a percentage of an adjusted figure, and the balance was passed on to you. Billing and payment amounts usually differ by an order of magnitude.
Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure
#127Just spent last night in an Urgent Care watching my youngest child get stitches (closest thing around for miles). Can't wait to see how that bill plays out, hopefully one day I can see how their prices compare to larger hospitals and such.
Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure
#128Around 2012 before my wife and I were married, we both got pneumonia. I was insured through my employer, she was uninsured. We went to urgent care at the same time on the same day, saw the same doctor and got prescribed the same drugs. About a month later when the bills came, her bill with no insurance was somewhere in the $160 range. My bill after insurance was nearly $300. I'm still peaved about this.
Did you have a HDHP (high deductible plan)? In that case, you have no co-pay or anything until your deductible is used up. Employers typically contribute a good amount towards this deductible (or even more than) using an HSA.
It's still crazy that the bills were so completely divergent.
Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure
#129Earlier quoted context omitted.
There's police around hospitals constantly and if they get a whiff that you have a fake ID they're going to be talking to law enforcement sooner or later. Also this isn't going down to your corner liquor store and flashing your drivers license... that thing is going to get scanned etc. --- Actual protip: If you're uninsured and need care they legally can't turn you away at an ER. They have to provide the healthcare t…
I've often wondered what would happen if you went to the ER, carried no identifying documents, and just refused to identify yourself. Just hope nobody recognizes you there.
Giving a fake name is fraud, and people have been arrested for doing that at the ER. (Fuck America.) But I don't know that there's any legal obligation to give any name at all. If you don't give them a name, you're not lying to them, and oops, looks like they don't have a way to bill you. As you note, hospitals are legally required to provide emergency stabilization without regard to ability to pay.
I suppose the hospital could try to call the police, but AFAIK the police cannot compel you to identify yourself without reasonable suspicion that you have committed a crime.
Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure
#130Got three plates and a few screws put into my smashed hip last year, cost me 120 Euros for the stay.
I'm in Austria, obviously... The only thing wrong here in Austria is there's still more than one health care insurance (one of regular employees, quite a few on federal and state level and one of self-employed) and there's a separate one for accidents (AUVA) and almost all of them are just playthings to the power hungry and greedy government.