Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

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

medtechdive.com

Post reply on HN
Print view View original

151–160 of 283 posts

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

#151

Post by sircastor »

fineIllregister wrote: post #146
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…

I'm not following your example. I don't want to end up in the ER requiring another surgery. If the provider can do something such that I can avoid that, I feel that's healthier. So the provider "hammers" me with reminders which makes that less likely to happen. Sure, they might not be doing it out of the kindness of their hearts (I've worked in a hospital and many people definitely do want patients to be healthier, b…

I think the point being made is that a patient’s health is a adjacent to the effort the hospital administration is putting in. The incentive isn’t “keep the patient healthy”, it’s “keep the patient from costing us money”

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

#152

Post by wbl »

throw123123123 wrote: post #115
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.

Kaiser promptly volunteered to perform several minor surgeries I would have spent months hunting down preauthorization for other places. It was almost scary how efficiently they bumped me up to the right person with me having to do almost nothing to arrange it.

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

#153

Post by Judgmentality »

bitdizzy wrote: post #135
RIDDLERTHIS wrote: post #132

Earlier quoted context omitted.

I worked on the tech-side of healthcare informatics with researchers and healthcare economists. What you say is correct. The cost/benefit ratio of hospital admittance and hospital stays has been quantified to an alarming degree. Not that we shouldn't be looking at such costs, but I feel as though it should involve some level of humanity. The other, often overlooked angle of healthcare in the U.S. is the dynamic at pl…

It won't be a great person who saves us.

Can you elaborate?

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

#154

Post by gregsq »

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…

My mother lives in country australia and had pancreatitis it seemed. Hospital, cat and mri’s, spent a week in hospital, sent home, returned after pain returned. More tests, it was decided she should be sent to a larger regional hospital for biopsy. Flew by Lear jet, drove by road home I guess about three hundred miles. Advise was a Whipple procedure. I wasn’t inclined to agree for reasons I won’t go into. I declined before second opinion from brisbane world class surgeon. He agreed. Flown commercial to brisbane. More mri’s and cat scans. Acinar cell carcinoma suspected. No need for full duodenectomy. Hospital stay and operation. After care and so on. Total cost zero. I live in the US. Healthcare here is a grift. The wife did medical billing, mostly reconciling and working all the codes. It’s a complete mess

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

#155

Post by 1996 »

ArtDev wrote: post #54
davidw wrote: post #29

When I lived in Italy, I once went with private care for a thing I wanted taken care of same day. I called, and they told me all the prices. I think I paid something like 120 euros out of pocket for a chest X-ray and consultation with an ENT specialist. The US health care system is so screwed up.

In Thailand, the hospital lobby has printed brochures with all the prices. It reads like a menu. I can't wait to return there and be a medical tourist again! The facilities and level of care was superior to my local dive of a hospital that is chronically understaffed. The hospital president make $980k while currently the nurses are on strike.

The US healthcare quality is bad, regardless of how much you pay, period.

For knee problems, like you I went to SE Asia as a medical tourist. I was provided with a taxi waiting for me at the airport, a translator who stayed with me at all times, a dedicated hospital administrative assistant for more complex issues like obtaining a copy of my exams, having them send to the doctor of my choice, obtaining the CV of the doctors so I could decide on the best one etc.

But the best was the fine dining options, as I do not like hospital food.

And when I was tired of the hospital and decided an hotel would be better for my mood, the doctor I had selected visited me in my suite, every day - with a nurse. If I wanted anything, I still had the translator the rest of the time.

It's not even a question of costs - that quality of service is just not available in the US, except maybe outside of some VIP setting where it may be shiny but the healthcare is mediocre (friends strongly recommended against such options)

Years later, I no longer have to care about costs, but I still won't go to a US hospital.

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

#156

Post by jollofricepeas »

Judgmentality wrote: post #153
bitdizzy wrote: post #135

Earlier quoted context omitted.

It won't be a great person who saves us.

Can you elaborate?

Politicians are often not great especially Teddy Roosevelt - a war-mongering, braggard focused on making a name for the himself and furthering the ‘forward race’.

Change if it comes at all will come by... 1. a populist demagogue with unchecked power

2. Or when the market wills it more than likely via technological disruption of some kind

Things must get worse before they get better as with all major advancements in human history.

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

#157

Post by astrange »

uniqueid wrote: post #145
astrange wrote: post #137

Earlier quoted context omitted.

Someone said something somewhere is not actually evidence of anything. Also, the answer is "yes", because new patients are always being born.

Try a web search for the most profitable drugs in pharma. They're not one-off cures. They're drugs the same patient takes repeatedly for decades: insulin, statins, pain-killers, etc.

That's not the only factor, though. If someone else is avoiding selling a cure to do something more profitable, you can compete with them by selling the cure and still make enough.

There simply isn't a "cure for pain" to replace painkillers, but statins and co could be avoided if we taught people actual good diet advice.

The worst problem with statins is the personality changes: https://www.bbc.com/future/article/20200108-the-medications-... …which doctors wouldn't admit existed because they aren't taught that "evidence of absence is not absence of evidence".

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

#158

Post by 1996 »

joshspankit wrote: post #95
tornato7 wrote: post #67

Earlier quoted context omitted.

That's awful. I hit my head in Thailand and went to the hospital, excellent experience I was in and out in 2 hours, got CT scanned and fully examined by a specialist, then left with a USB drive of my brain scans all for $180 out of pocket.

That’s awesome. Up here in Canada I have not gotten a bill yet (including when my daughter had to get brain scans), but one thing is it’s very hard to get the actual scans. I had to no joke steal my own chest xrays to get a copy.

> one thing is it’s very hard to get the actual scans. I had to no joke steal my own chest xrays to get a copy.

unacceptable. In Asia, you have the personal email and cellphone of your dedicated administrative assistant (you won't ever have to talk to another one) who takes care of things like that. You just tell her to obtain your CT and fedex it to your doctor, and they call you back when it's done.

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

#159

Post by jjeaff »

Black101 wrote: post #78
avgDev wrote: post #11

The US healthcare system is just a completely broken mess. When things go smooth, you are lucky! However, when you have a major procedure, life event or sickness things can get messy quick. We had a child 10 months ago, billing was screwed up by the hospital, then by insurance and we are still in process of getting it resolved. I have now spent at least 8 hours on the phone. I had a surgery, called insurance and veri…

> The US healthcare system is just a completely broken mess. That's why I got hospitalization-only insurance as soon as Trump allowed it... Obama-care was a joke... except for the pre-existing condition clause, maybe.

There is a very valid reason that hospitalization only insurance was not allowed.

The whole point of requiring everyone to get insurance is so that you don't have just the sickliest and oldest people getting insurance. Insurance is meant to spread the risk amongst everyone who pays premiums.

Additionally, not having insurance for primary and non-emergency care will make it much less likely that people will even end up in the emergency room. (No checkups, no outpatient)

Even worse, having emergency room coverage only encourages people to use the emergency room more often than they should.

Though I wouldn't expect our last president to have much of a handle on economics and business, considering his track record. Either that, or he was purposely trying to destroy the program (he was, but it was probably both reasons).

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

#160

Post by ironmagma »

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.

To say they work is a bit doubtful. Because they are both the insurance and the doctor, there is an incentive for them to find nothing wrong with you.
Post reply on HN