Gotta wonder how other countries with functional healthcare store and calculate pricing. There has to be a better way. This looks like denormalizing a huge number of small tables such that the resulting list of prices is like n^n growth for any possible addition.
A petabyte of health insurance prices per month
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Re: A petabyte of health insurance prices per month
#22They are making it impossible to handle the data so everyone gives up trying so they can go on screwing people over.
Hanlon's razor maybe applies. I have no way to know if they're trying to do what you say, but the article explains what's going on and it's not hard to see how a flawed schema and implementors going by the letter and not putting any effort into minimising the data volumes could result in this without any malice. Any individual company is presumably producing a fraction of the petabyte total and people are as astonishingly lazy with data sizes now as computers are astonishingly capable of handling them. I'm routinely seeing multi-gigabyte executables these days (don't get me started).
Also the article says the schema is published in github and CMS is responsive to feedback on it, so things will hopefully improve.
I thought this was a really good article. I wasn't expecting to read all the way through a blog about something that doesn't affect me in the slightest but I did.
Re: A petabyte of health insurance prices per month
#23They are making it impossible to handle the data so everyone gives up trying so they can go on screwing people over.
Hanlon's razor. Never attribute to malice what can be explained by stupidity. The US healthcare system is a mess, but I don't think it's intentionally malicious. It is just a mash of a thousand different systems, creating one big stupid system.
I don't think the billing system is malicious. But at the end of the day, each "provider" is given incentives to bill. They get promotions based on this. So the maliciousness is a distributed system that does not get codified at all.
It's the exact same thing as cops getting incentives for speeding tickets. Then you start getting more speeding tickets for 5 over instead of 10 over.
Re: A petabyte of health insurance prices per month
#24They're using information overload tactic. This approach leverages a psychological principle that suggests when people are given too many choices or too much information, they can become overwhelmed and struggle to make decisions. The point is to overwhelm, the consumer, the people trying to fix this system etc.
Re: A petabyte of health insurance prices per month
#25There are separate charge codes for everything , and all of those codes need to be reflected in the pricing data. There's a price to slap on a bandaid. There's a price to give someone a Tylenol. Hell, W61.61XA is the medical code for "Bitten by duck, initial encounter." Presumably, this means there's also a code for "Bitten by duck, again." Medical billing is broken , and it's no surprise that the amount of data is o…
My personal favorite is V97.33XD "Sucked into jet engine, subsequent encounter."
Re: A petabyte of health insurance prices per month
#26There are separate charge codes for everything , and all of those codes need to be reflected in the pricing data. There's a price to slap on a bandaid. There's a price to give someone a Tylenol. Hell, W61.61XA is the medical code for "Bitten by duck, initial encounter." Presumably, this means there's also a code for "Bitten by duck, again." Medical billing is broken , and it's no surprise that the amount of data is o…
Here's the full list of codes for "Bitten by ____, _____ encounter" https://www.icd10data.com/ICD10CM/Codes/V00-Y99/W50-W64/W61- The hierarchy looks like this: W61.6 Contact with duck = W61.61 Bitten by duck == W61.61XA …… initial encounter == W61.61XD …… subsequent encounter == W61.61XS …… sequela = W61.62 Struck by duck == W61.62XA …… initial encounter == W61.62XD …… subsequent encounter == W61.62XS …… sequela = W6…
Beagle Boys health records probably have a lot of W61.6... on their files.
Re: A petabyte of health insurance prices per month
#27Gotta wonder how other countries with functional healthcare store and calculate pricing. There has to be a better way. This looks like denormalizing a huge number of small tables such that the resulting list of prices is like n^n growth for any possible addition.
In England, the procedure costs for the entire healthcare system fit in one Excel sheet: https://www.england.nhs.uk/costing-in-the-nhs/national-cost-...
Re: A petabyte of health insurance prices per month
#28Gotta wonder how other countries with functional healthcare store and calculate pricing. There has to be a better way. This looks like denormalizing a huge number of small tables such that the resulting list of prices is like n^n growth for any possible addition.
That's exactly what it is, because as another comment pointed out the legislation currently doesn't allow them to just publish a [human,machine]-readable rules engine for calculating price, so they must publish this asinine amount of data every month in perpetuity until someone who's taken a math class in the last 70 years ends up in Congress.
Re: A petabyte of health insurance prices per month
#29There are separate charge codes for everything , and all of those codes need to be reflected in the pricing data. There's a price to slap on a bandaid. There's a price to give someone a Tylenol. Hell, W61.61XA is the medical code for "Bitten by duck, initial encounter." Presumably, this means there's also a code for "Bitten by duck, again." Medical billing is broken , and it's no surprise that the amount of data is o…
Here's the full list of codes for "Bitten by ____, _____ encounter" https://www.icd10data.com/ICD10CM/Codes/V00-Y99/W50-W64/W61- The hierarchy looks like this: W61.6 Contact with duck = W61.61 Bitten by duck == W61.61XA …… initial encounter == W61.61XD …… subsequent encounter == W61.61XS …… sequela = W61.62 Struck by duck == W61.62XA …… initial encounter == W61.62XD …… subsequent encounter == W61.62XS …… sequela = W6…
I wonder if bitten by duck is more expensive that bitten by chicken.
Re: A petabyte of health insurance prices per month
#30There are separate charge codes for everything , and all of those codes need to be reflected in the pricing data. There's a price to slap on a bandaid. There's a price to give someone a Tylenol. Hell, W61.61XA is the medical code for "Bitten by duck, initial encounter." Presumably, this means there's also a code for "Bitten by duck, again." Medical billing is broken , and it's no surprise that the amount of data is o…
IIRC the "initial encounter" refers to the first visit between the patient and doctor about the duck bite, and "subsequent encounter" means a follow-up visit about the issue, not a second maiming by the duck.
It makes for a fun first impression though