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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.

#131

Post by lotsofpulp »

feanaro wrote: post #71
huac wrote: post #63

Earlier quoted context omitted.

> all prices need to be +\- 50% of what Medicare pays. This is actually close to what happens with private insurers- they negotiate with a hospital to pay n-times what Medicare pays for some set of treatments. So why does Medicare pay the least? Because they have the most patients covered of any insurance network in the US. That's a hell of a bargaining factor. More patients = cheaper prices. The logical conclusion i…

That still doesn't explain how prices of medical services in many other countries turn out several order of magnitudes smaller than commonly encountered prices in the US.

Because doctors in the US can easily make $300k+.

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

#132

Post by randomacct3847 »

lotsofpulp wrote: post #130
randomacct3847 wrote: post #125

Earlier quoted context omitted.

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.

Yeah that’s a big one. Also if you have an emergency and go to a in network facility your doctor might be out of network. Most decent insurance plans do say that in emergencies they treat in network and out of network care equally, but definitely not all plans work like that.

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

#133

Post by mwerd »

This won't help consumers. The prices (both charges and what Medicare pays) are already effectively public: https://data.cms.gov/Medicare-Physician-Supplier/Medicare-Pr...

The problem, as some other comments point out, is that they're way too complicated. The link I posted, for example, is just the provider charges. A hospital visit typically has a facility claim and at least one provider claim. Depending on the type of service received and the agreement between insurance and facility, the facility fees can be billed a variety of ways (diagnosis related groups, ambulatory payment classifications, or HCPCS). Each provider that sees you or performs labs, x-rays, etc can bill separately, and each could have a separate or no contract with your insurance. The latter is how surprise 'out of network' bills happen.

It's a total mess and hopelessly complex for the average consumer.

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

#134

Post by lotsofpulp »

redisman wrote: post #79
alexis_fr wrote: post #46

Earlier quoted context omitted.

and require the same price for lone customers as what is negociated with insurances.

and then strangle the parasitic insurance companies that are paid handsomely by the consumer to build pointless bureaucracy and safeguard their market position

Considering the patients have no idea what is going on and therefore no way to tell if what they are being sold by medical care providers is appropriate or not, insurance (who also have doctors reviewing the cases) is actually the only entity that is auditing the work of the medical providers to make sure they’re following the proper procedure and prevent overcharging.

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

#135

Post by QuantumGood »

mwerd wrote: post #133

This won't help consumers. The prices (both charges and what Medicare pays) are already effectively public: https://data.cms.gov/Medicare-Physician-Supplier/Medicare-Pr... The problem, as some other comments point out, is that they're way too complicated. The link I posted, for example, is just the provider charges. A hospital visit typically has a facility claim and at least one provider claim. Depending on the type…

As I noted below ($25 vs. $1400 for my sore shoulder), the range of ways providers can "code" what they charge you for is not sane. And how my inpatient bill in a different situation reached ~$45,000 was clearly because the hospital knew how to pad the bill.

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

#136

Post by pjc50 »

AmericanChopper wrote: post #38
torgian wrote: post #34

Earlier quoted context omitted.

I disagree about quality/availability. In Japan, Taiwan, Mainland China, Thailand; I’ve had amazing health care for the fraction of the price. Shit, a full cancer check only cost me 90 dollars in Japan. Getting my eyes fully checked for retinal tears cost me nothing due to national insurance in China. In some cases, maybe the US has better care. But the cost of that is just way too damn high. Yes, medical research in…

In the developed world, the price of routine checkups are not what people would generally be referring to when discussing _quality_ of healthcare. Generally speaking, the US has the best facilities, technology, expertise and pharmaceuticals available. Which is why people come from all over the world for procedures that simply aren’t available elsewhere. Again, I’m not talking about the problems with accessibility, me…

The flaw in this is that for-profit medical research optimises ... for profit, that is, the treatments for which most can be charged.

So they focus on illnesses of the rich gerontocracy while diseases of the developing world have to be addressed by public funding. Additionally, there's no real incentive to work on cost reduction.

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

#137

Post by Cthulhu_ »

mwerd wrote: post #133

This won't help consumers. The prices (both charges and what Medicare pays) are already effectively public: https://data.cms.gov/Medicare-Physician-Supplier/Medicare-Pr... The problem, as some other comments point out, is that they're way too complicated. The link I posted, for example, is just the provider charges. A hospital visit typically has a facility claim and at least one provider claim. Depending on the type…

> It's a total mess and hopelessly complex for the average consumer.

But not for insurance companies; it's in their interest to compare hospitals and get the best care for the lowest price.

I for one hope this will trigger competition. On the other hand, it'll probably end up shafting the personnel instead of the ridiculous profit margins.

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

#138

Post by DanBC »

AmericanChopper wrote: post #32
mikeash wrote: post #25

Earlier quoted context omitted.

Medical research in the US comes out to something like $500/year per capita. It’s doesn't come anywhere close to accounting for the cost differences between the US and other first-world countries.

I didn’t say research alone did. I said that when you compare investment in research, as well as the quality of care, you’d expect the cost of healthcare in the US to be higher. As much higher as they are? I don’t think so. But if you want to fix the accessibility issues without impacting innovation and quality of care, then you’re going to need a solution slightly more thought out than hamfisted price fixing.

> as well as the quality of care, you’d expect the cost of healthcare in the US to be higher

If the quality of care is so amazing I'd expect Americans to have longer life expectancy, and they don't.

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

#139

Post by bborud »

conductr wrote: post #109
huac wrote: post #63

Earlier quoted context omitted.

> all prices need to be +\- 50% of what Medicare pays. This is actually close to what happens with private insurers- they negotiate with a hospital to pay n-times what Medicare pays for some set of treatments. So why does Medicare pay the least? Because they have the most patients covered of any insurance network in the US. That's a hell of a bargaining factor. More patients = cheaper prices. The logical conclusion i…

No. Medicare pays the least because the don’t negotiate. They just set prices. As a hospital/doctor you can choose to accept Medicare patients or not. Most providers lose money on Medicare patients, or so the like to say.

What do they mean by "lose money"?

Even if I turn up at a private hospital here in Norway, I pay nowhere near what you would pay in the US. Which tells me that either hospitals are run extremely inefficiently in the US (orders of magnitude worse than here) or there are layers of pretty substantial profit margins.

I may be a bit peculiar, but I think a healthcare sector that is set up to mainly benefit execs and shareholders is a bit immoral.

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

#140

Post by m1sta_ »

mwerd wrote: post #133

This won't help consumers. The prices (both charges and what Medicare pays) are already effectively public: https://data.cms.gov/Medicare-Physician-Supplier/Medicare-Pr... The problem, as some other comments point out, is that they're way too complicated. The link I posted, for example, is just the provider charges. A hospital visit typically has a facility claim and at least one provider claim. Depending on the type…

> It's a total mess and hopelessly complex for the average consumer.

Sounds like something the people on this forum can help improve.

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