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

Congress is set to ban most surprise medical bills

nytimes.com

Post reply on HN
Print view View original

181–190 of 440 posts

Re: Congress is set to ban most surprise medical bills

#181

Post by mindslight »

thowawayyy wrote: post #170
calvinmorrison wrote: post #154

Earlier quoted context omitted.

That's probably true but a lot of medical cost is scheduled like follow up or specialist visits, surgery and things of the less urgent nature.

How is that solving the car crash situation?

The same way you don't get super gouged when choosing a restaurant while hangry - non-urgent shoppers keep prices down across the board, even for urgent participants.

I'm not saying this makes for some total solution - just reacting to rejection of the market dynamic having any worth. It's foolish to cast aside entire paradigms of approaches because they don't fully solve every corner case. (The dual would be to ask how single payer healthcare solves purely elective procedures like cosmetic surgery. It doesn't.)

Obviously any market dynamic for urgent care needs to recognize that no contract has been formed, and so hospitals can't unilaterally set charges under a fallacious idea of contract. For instance when your car gets towed under duress (accident on the highway, expired papers, etc), the state sets the rates they're allowed to charge. They're still inflated, but at least within a factor of 2-3x the usual market.

(FWIW I think single payer is a good pragmatic way forward)

Re: Congress is set to ban most surprise medical bills

#182

Post by StreamBright »

StreamBright wrote: post #110
bfieidhbrjr wrote: post #57

Earlier quoted context omitted.

There's no "market" in healthcare in the US. Long ago, it became illegal to open a hospital without a 'certificate of need' from the State. That's why so many towns have only one hospital - it's a government granted monopoly like cable companies in the 80s. Differential pricing is also illegal. You fly cheap on Sunday at 3am, expensive on Monday at 9am. Healthcare providers are not allowed to charge less when it's ch…

Exactly. Many people think that free market healthcare is bad because the US healthcare system. Once you are pointing out it is not a free market system they are surprised. The 20% profit cap also not very open market like.

"Health care in the United States is provided by many distinct organizations. Health care facilities are largely owned and operated by private sector businesses. 58% of community hospitals in the United States are non-profit, 21% are government-owned, and 21% are for-profit."

Makes me wonder, why people think it is free market healthcare?

https://en.wikipedia.org/wiki/Health_care_in_the_United_Stat...

Re: Congress is set to ban most surprise medical bills

#183

Post by rayiner »

tehjoker wrote: post #178
rayiner wrote: post #142

Earlier quoted context omitted.

That's not true. Medicare can and does negotiate the cost of procedures and doctor's services. What the law says is that Medicare can't negotiate prescription drug prices. That's because Medicare doesn't directly pay for drugs, except what's used incidentally in the course of covered hospital stays. Medicare didn't provide coverage for prescription drugs until the adoption of Part D. That is structured differently th…

That's 1/10th of the military budget for drugs that can be often be manufactured for pennies (drugs with biological elements requiring glass column filtration and such are a different story but are far more rarely used). A point in case is the Hep C vaccine: https://www.medicalnewstoday.com/articles/323767#drug-types-...

And the Moderna vaccine was designed in two days: https://www.businessinsider.com/moderna-designed-coronavirus.... Is that all there is to it?

Re: Congress is set to ban most surprise medical bills

#184

Post by pxeboot »

ashtonkem wrote: post #152
iaw wrote: post #100

Earlier quoted context omitted.

> has turned me from a pure free market thinking into a believer in single payer healthcare The current trend in 'free-market economics' is to call captured markets free and then argue for the relatively lax regulation. Most markets are not free markets and the healthcare definitely isn't. There's very little true choice, participants are typically under duress when seeking expensive services, and prices are hidden.…

Price transparency would help, but it wouldn’t solve the duress problem. After a car crash we all want to go to the nearest hospital rather than the most price efficient one.

Emergency care seems to account for less than 10% of healthcare spending in the US [1].

[1] https://www.annemergmed.com/article/S0196-0644(13)00313-2/ab...

Re: Congress is set to ban most surprise medical bills

#185

Post by thesimon »

zaroth wrote: post #87

This essentially takes the patient out of the loop if one of the providers is not in-network / being directly reimbursed by insurance. Now the provider and insurance company have to work together to resolve the bill. Most importantly it would be charged against the patient’s in-network deductible. It’s really too bad that this bill was watered down in one particular way. The Senate version of the bill would have set…

I guess a version that would make them pay what Medicare would pay wouldn't fly?

Re: Congress is set to ban most surprise medical bills

#186

Post by flowerlad »

Another thing that is needed urgently is uniform pricing. Today healthcare providers charge different amounts to different insurers, and if you don't have insurance you pay list price. The list price is a arbitrary large number (often 3x the price insurers pay) that has no relation to reality. So if you don't have insurance, you are hit with a double whammy: You have to pay the bill yourself, and if that isn't bad enough, they charge you 300% of the "real" price, meaning what insurance companies pay for the same procedure.

Re: Congress is set to ban most surprise medical bills

#187

Post by OminousWeapons »

crazcarl wrote: post #135
OminousWeapons wrote: post #54

I was working on a health insurance related startup for awhile so I would say I know more than the average person about the space, and even I get surprised on a regular basis by the absurdity in this field. For example, I was finishing up an advanced degree program between September and January and my University decided to terminate my health insurance in September. Without telling me. In the middle of a pandemic. Wh…

Just as a heads up in case you or anyone else reading this is in this position. For the uninsured, if your treatment is directly related to Covid-19, you would be covered under the Covid-19 HRSA program described here. https://www.hrsa.gov/CovidUninsuredClaim

This is a huge relief; thank you for bringing this to my attention!

Re: Congress is set to ban most surprise medical bills

#189

Post by pmart123 »

ashtonkem wrote: post #152
iaw wrote: post #100

Earlier quoted context omitted.

> has turned me from a pure free market thinking into a believer in single payer healthcare The current trend in 'free-market economics' is to call captured markets free and then argue for the relatively lax regulation. Most markets are not free markets and the healthcare definitely isn't. There's very little true choice, participants are typically under duress when seeking expensive services, and prices are hidden.…

Price transparency would help, but it wouldn’t solve the duress problem. After a car crash we all want to go to the nearest hospital rather than the most price efficient one.

Pricing transparency through a public ally available database would at least help with more competitive or uniform drug/scheduled treatment costs?

Re: Congress is set to ban most surprise medical bills

#190

Post by cogman10 »

pxeboot wrote: post #184
ashtonkem wrote: post #152

Earlier quoted context omitted.

Price transparency would help, but it wouldn’t solve the duress problem. After a car crash we all want to go to the nearest hospital rather than the most price efficient one.

Emergency care seems to account for less than 10% of healthcare spending in the US [1]. [1] https://www.annemergmed.com/article/S0196-0644(13)00313-2/ab...

To me, that sort of proves a point.

Cancer and other disease are extremely expensive to treat and fairly common in the population. Yet, somehow, emergency care which is a minority of health costs, eats up 10% of the spending.

Anyone that's been to an emergency room knows how excessive the price gouging going on there is. Pills that cost $0.10 OTC (or less!) routinely see 100x markup. That same pill can cost anywhere from $10->$15.

Post reply on HN