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Hospitals lift curtain on prices, revealing giant swings in pricing by procedure

healthcaredive.com

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Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure

#161

Post by lolpython »

loeg wrote: post #100
lolpython wrote: post #43

Earlier quoted context omitted.

That is not a useful statistic here. We are talking about an individual’s financial obligations in a medical emergency. A $10,000 bill is not 2% of an individual’s yearly spending.

You’re missing the bigger picture. It’s worthwhile improving transparency around the vast majority of healthcare needs/spending. ER costs are also a problem, but it’s an orthogonal issue. Don’t let the perfect be the enemy of the good.

No, I don't oppose hospital price transparency. My comment was basically a procedural one. Saying that ER visits are 2% of nationwide costs does not meaningfully address the toplevel poster's concerns.

> ER costs are also a problem, but it’s an orthogonal issue.

It's natural to want to discuss this orthogonal issue, and the solutions to the two issues are not mutually exclusive.

Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure

#162

Post by fidesomnes »

peterangular wrote: post #72
mabub24 wrote: post #59

Earlier quoted context omitted.

> Best insurance here is "don't get sick" Recent New Yorker article looking at the "Costa Rica model"[0] raised this point as well. America, by contrast to Costa Rica, has a very weak public health sector and infrastructure, and this leads to a real weakness when focusing on preventable illnesses and issues. [0]: https://www.newyorker.com/magazine/2021/08/30/costa-ricans-l...

Yeah I read that too - just cherry picking here: > All adults have tests and follow-up visits to prevent and treat everything from iron deficiency to H.I.V. It’s all free. If people don’t show up for their appointments, she makes sure their team finds out why and figures out what can be done. It's common sense why they have better results and outcomes than we do here... Our system is optimized for capitalistic profit…

> Our system is optimized for capitalistic profit.

We got a real astute analyst here. I am curious what your first hint of such a fact was?

Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure

#163

Post by [deleted] »

slownews45 wrote: post #154
avs733 wrote: post #58

Earlier quoted context omitted.

You inspired me to look at the local hospital we just delivered our first child at. They release 'standard charges' which as far as I can tell means 'the range of charges for this particular diagnosis based on past data' as an excel file. But the price list is a text file delimited by pipes (vertical bars... |) which just seems unnecessary. They also do nothing to define the variables or column names they use...so th…

God, I used to work in medical billing, and people would think these file format issues were some kind of scheme. NO they are not. They deal with the obvious problem that clinicians are NOT always programmer friendly, and will put things like tabs in case notes, will use commas etc. At some point you use a delimiter that is much less likely to be used - | - is one of those, not a lot of clinicians use it and you can…

[deleted]

Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure

#164

Post by EForEndeavour »

jonathan-adly wrote: post #123
phkahler wrote: post #96

Earlier quoted context omitted.

>> 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.

The more I read about US healthcare, the more confused I am about how it's grown this perverse for this long. Prices are hidden (until the government forces them into the open), but they're badly distorted anyway by perverse incentives, which all seem to ladder up to the root cause of providing healthcare for profit.

Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure

#165

Post by pessimizer »

lotsofpulp wrote: post #75
jjoonathan wrote: post #45

Earlier quoted context omitted.

Every head of the insurance/drug/provider dog points at the other two heads when somebody accuses it of being the problem.

Voters not wanting to pay for comprehensive care for everyone is a 4th head. The current system of healthcare is great for allocating different amounts of healthcare to different classes of people, so that it is great for 20 to 30% of people, okay for 20%, and not good for 50%, and that is why it persists. There is no reason Medicare should be restricted to those over 65, or why Medicaid is implemented differently (a…

> Voters not wanting to pay for comprehensive care for everyone is a 4th head.

M4A is overwhelmingly popular, at points taking majorities of Republicans. Also, the US government already spends as much on healthcare as Britain and the NHS; US healthcare is just allowed to cost twice as much.

Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure

#166

Post by lotsofpulp »

long_time_gone wrote: post #153
lotsofpulp wrote: post #75

Earlier quoted context omitted.

Voters not wanting to pay for comprehensive care for everyone is a 4th head. The current system of healthcare is great for allocating different amounts of healthcare to different classes of people, so that it is great for 20 to 30% of people, okay for 20%, and not good for 50%, and that is why it persists. There is no reason Medicare should be restricted to those over 65, or why Medicaid is implemented differently (a…

==We have at least 3 different taxpayer funded healthcare programs specifically so not everyone can get access to equal care== Add in CHIP and the VA (Tricare). We've taken every vulnerable part of society (older, poor people, poor children, injured veterans) and given them government-paid, universal healthcare. This is around 100 million people. Everyone left over is thrown into the private insurance pool. These peo…

>given them government-paid, universal healthcare

This is meaningless if the quality of healthcare is not the same. There are numerous hurdles placed for various different people to get the healthcare, effectively restricting access to healthcare itself.

Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure

#167

Post by jonathan-adly »

IMTDb wrote: post #140
jonathan-adly wrote: post #63

I 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…

The spirit is here is that you should fully open all those factors and fully open how they influence the cost paid by the patient. Make an excel sheet, a web app, an API, whatever. But let people know and simulate the cost - include all required factors. If the prices you charge differ from the prices provided by your open data platform, or if some factors are omitted from the open platform, you should get a lawsuit…

There is no internal reliable system. Healthcare in the US uses faxes.

People here thinks that their local hospital is Google, while in reality it's a badly managed/badly funded 100 year old non-profit organization full of middle managers who just learned how to use their email.

Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure

#168

Post by AptSeagull »

There are 6000 hospitals, 20% for profit businesses, 17 of which are publicly traded. They write off procedure costs to some degree. The amount written off is so widely variable and lopsided, the IRS or the SEC would have a nearly impossible task of determining what is true. I'm curious, do hospital CFOs sweat the risk of IRS discovery that write offs are artificially inflated if/when the data becomes easily known and calculable? How many years and how many procedures were written off to which extent? To what end did asymmetric data play in avoiding taxes or violating SEC regs?

Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure

#169

Post by joshAg »

monocasa wrote: post #134
ipaddr wrote: post #99

Earlier quoted context omitted.

Aren't insurance rates regulated meaning if they payout a smaller amount than expected the rates will go down next year?

So that encourages greater payouts more or less synced with greater premiums in order to increase year over year real profits. And given that the payouts are very nearly a function of how hard the insurance company can negotiate, they can simply choose to call off the negotiations when they reach their target amount.

Only to a degree because policies basically always have an upper limit on coverage.

If the payouts are dropping because there's a massive reduction in claims, then there's a pretty decent chance that paying the policy maximum on each claim still won't be enough.

Plus, profits don't come directly from the premiums anyway. They come from the investments the insurer makes with the premiums. So sure, they can try to convince policy holders to increase coverage which allows them to charge a higher premium, or they can work on their loss modeling and investment strategy to better predict their actual loss ratio (which means they can have less money in reserve and more money in investments) or get better returns on the investments. And those 2 are usually a better use of resources since increasing coverage means an individual conversation with each policy holder. That's a lot of human-hours compared to the modeling and investing.

Re: Hospitals lift curtain on prices, revealing giant swings in pricing by procedure

#170

Post by twofornone »

pulse7 wrote: post #107

Imagine the most advanced country in the world can not get their healthcare in order... Imagine one of the most Christian countries in the world (>75% are believers) yet they are not "good Samaritans" to their own people...

>yet they are not "good Samaritans" to their own people

The state of the secular healthcare system is unrelated to the religiosity of the population. Further, in some states (like TN), there are in fact christian organizations that do take on a substantial portion of the social safety net, especially for the homeless. Critics will say that the time limit on food and housing is unethical but I think its important not to create a permanent dependence.

I'm not a religious person but the disdain which people commonly speak of [white] Christianity online is really offputting and, frankly, ignorant.

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