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Hospital creates bidding war by posting pricing online

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Re: Hospital creates bidding war by posting pricing online

#211

Post by sseveran »

mbreese wrote: post #209
bradleyjg wrote: post #191

Earlier quoted context omitted.

Sheer and utter nonsense. First there are a huge number of students who wish to go to medical school and don't get in. There's no shortage of applicants at all. Second the incredibly high compensation for speciality doctors quickly overcomes both opportunity cost and tuition costs as compared to almost any other profession. I encourage you to run the numbers. You will find that $250k/year catches up very quickly to $…

I encourage you to talk to some doctors. No one makes $250k per year, except maybe a few surgery specialists (and maybe ER). Primary care doctors (the ones that where there actually is a shortage) can can easily start at under $100k and the max can be below $200k. And if you are a pediatrician or a pediatric specialist, expect to take a cut in pay relative to your adult colleagues.

Some specialties do. Its called the ROAD to success. Radiology, Ophthalmology, Anesthesiology and Dermatology. I know many radiologists who make between $500K and $1M. That being said residency spots in these specialties are extremely competitive.

Re: Hospital creates bidding war by posting pricing online

#213

Post by sseveran »

fizzbar wrote: post #207
lettergram wrote: post #79

Earlier quoted context omitted.

I worked in a billing office for 5 years, there are literally thousands of codes for EACH insurance company, again EACH insurance company. The reason the cost of healthcare is so high is because medicare pays roughly 15% of a bill, others are somewhere between 20-50% of a bill depending. That is to say if the doctor charges you $40,000 you pay your 10% co-pay of $4,000 and the insurance then only pays maybe another $…

Re: negotiating your bill: It blows my mind that in America you would approach paying for healthcare the same way you would purchase an expensive car. I don't consider my health to be a luxury good... But in the USA it is priced as such?!

The vast amount of technology available is turning healthcare into a luxury good. There are newer and better technologies for treating many things available. How much is that worth?

Re: Hospital creates bidding war by posting pricing online

#214

Post by sp332 »

refurb wrote: post #147
badclient wrote: post #121

Earlier quoted context omitted.

It is a combination. First, healthcare debt isn't weighted as heavily on credit reports. Second, healthcare is one of the few businesses where it is illegal to deny services before payment. You can't walk into a walmart, grab a candy bar and just walk out. With emergency healthcare, you can do just that and sadly, too many people take advantage of it.

To give you an idea of how big of a problem not paying is, I'll relate a story I heard from a small business owner in California: In an effort to provide his blue collar workers with a decent benefits package, he setup a health insurance plan. After 6 months or so, his HR person came back and said "none of the employees have used the insurance at all!" This was weird since these workers had families and obviously chi…

That seems odd... I've heard from several sources that insurance companies negotiate prices, while individuals get stuck with even larger bills.

Re: Hospital creates bidding war by posting pricing online

#215

Post by sseveran »

horacio wrote: post #162
lostlogin wrote: post #93

Earlier quoted context omitted.

Medicine doesn't really follow supply and demand. If you install more CT or MRI scanners, you do more scanning. Demand follows supply. This is not helped by it only rarely being the patient who pays directly (usually insurance or taxpayer). People tend to do what their doctors suggest and go where their doctors say to go. There was a great article on this I read about a year ago. I thought it was in the Economist, bu…

I believe the article you're referring to is Steven Brill's 26,000 word opus "Bitter Pill - Why Medical Bills Are Killing Us", which appeared in the U.S. edition of Time Magazine in March of this year. In it, he makes a specific criticism that not only do hospitals that purchase diagnostic scanners tend to make greater use of it, but that quite often, an above-average count of referrals to diagnostic imaging centers…

Not only that but my observation after working for 10 years in radiology is that many other departments either outsource diagnosis to radiology or at least want a study done. That way in case there is a lawsuit the finger can be pointed somewhere else. While this effect is hard to quantify it is definitely encouraged by hospital executives since radiology can be a highly profitable department.

Re: Hospital creates bidding war by posting pricing online

#216

Post by sseveran »

refurb wrote: post #148
lostlogin wrote: post #81

Earlier quoted context omitted.

This must a a US thing - I have never seen an advert on TV for a healthcare clinic of any sort that I can recall. I saw a poster at a cinema recently for a medical clinic, which I remember as it was so unusual.

They are actually quite common in the US. You'll often drive by billboards on the freeway where hospitals claim "No more than a 30 min wait in our emergency rooms!" I personally think it's a good thing.

Its also quite common in Hong Kong.

Re: Hospital creates bidding war by posting pricing online

#217

Post by wisty »

antitrust wrote: post #68
wisty wrote: post #21

Earlier quoted context omitted.

Because while demand for healthcare is inelastic, more healthcare can actually be a bad thing. For example, old people (who are big customers) are often best if they are told to just go home, and look after themselves. Cutting up old people can be a waste of time (since they are unlikely to live a lot longer), and can actually reduce their life expectancy (since they don't always survive surgery). Also, the money the…

Someone's gotta sell the meth, work at McDonald's, mow the lawns (well, not mine... I mow it myself), make the firecrackers, clean the toilets, etc. It's all about how we allocate this labor, I guess. Paying everyone the same salary leads to underperformance, so we encourage competition. I'm sure there's a better way, but it probably won't be a total reversal, only a modification, of what we have.

I heard the employment rate for young black high-school dropouts is something like 5%. I doubt the employment rate for white high-school dropouts is fantastic, either. So it seems we don't need that many people to flip burgers, mow lawns, make firecrackers, clean toilets, etc. Or that a high-school dropout isn't even qualified to do those jobs.

And we don't need more crime.

Re: Hospital creates bidding war by posting pricing online

#218

Post by bradleyjg »

mbreese wrote: post #209
bradleyjg wrote: post #191

Earlier quoted context omitted.

Sheer and utter nonsense. First there are a huge number of students who wish to go to medical school and don't get in. There's no shortage of applicants at all. Second the incredibly high compensation for speciality doctors quickly overcomes both opportunity cost and tuition costs as compared to almost any other profession. I encourage you to run the numbers. You will find that $250k/year catches up very quickly to $…

I encourage you to talk to some doctors. No one makes $250k per year, except maybe a few surgery specialists (and maybe ER). Primary care doctors (the ones that where there actually is a shortage) can can easily start at under $100k and the max can be below $200k. And if you are a pediatrician or a pediatric specialist, expect to take a cut in pay relative to your adult colleagues.

Why would I solicit anecdotes, when there is data available?

Median compensation for all physicians is above $200,000/yr for every region of the country.[1] The highest averge earning speciality is not surgery but radiology at $315,000. [2]

Focusing on primary care doctors is a goalpost shift. Your original talking about the extensive opportunity costs for all doctors and specifically mentioned the additional time needed to specialize. Furthermore foreign born and educated doctors, who faced very different trade-offs, make up a disproportionate percentage of primary care physicians.[3] Finally, primary care is the area most suitable for less expensive medical professions, if only doctors quit engaging in anti-competitive lobbying.

In any event, medical school applications alone put lie to any sort of overall compensation-driven doctor shortage, which was your original complaint.

Maybe it's because I'm not a Christian, but I'm puzzled as to how a profession can be plagued simultaneously with God complexes and Martyr complexes.

[1] http://www.medscape.com/features/slideshow/compensation/2012... pg 5 [2] ibid pg 2 [3] http://www.nytimes.com/2010/08/12/health/12chen.html

Re: Hospital creates bidding war by posting pricing online

#219

Post by refurb »

sp332 wrote: post #214
refurb wrote: post #147

Earlier quoted context omitted.

To give you an idea of how big of a problem not paying is, I'll relate a story I heard from a small business owner in California: In an effort to provide his blue collar workers with a decent benefits package, he setup a health insurance plan. After 6 months or so, his HR person came back and said "none of the employees have used the insurance at all!" This was weird since these workers had families and obviously chi…

That seems odd... I've heard from several sources that insurance companies negotiate prices, while individuals get stuck with even larger bills.

There are many hospitals (often inner-city) that serve a large population of the uninsured. They are quite used to not billing patients for procedures.

Re: Hospital creates bidding war by posting pricing online

#220

Post by TeMPOraL »

refurb wrote: post #168
lawnchair_larry wrote: post #163

Earlier quoted context omitted.

This isn't true. They only have to provide emergency services, and they still charge for them, just not up front. If anyone did that, they would still receive bills in the mail and have derogatory information on their credit report. Otherwise, please tell me which hospital is giving away free service to the uninsured.

Exactly, these employees would take their children to the emergency room/urgent care. They weren't getting check-ups, but if the kid had a high fever, they would bring them in, get them seen by a doctor, then be on their way. When asked about billing they simply said "I don't have insurance". Many hospitals, including the DSH (disproportionate share hospitals) write these things off all the time. The hospital just do…

> The hospital just doesn't bother following up. Are you going to spend $200 to chase down a $100 hospital bill?

I think I would. Do it few times at random and get the offenders to pay $1k+, and soon people will stop scamming hospitals. For what I can tell, similar system (random ticket checks + penalties 10x the ticket price) works quite well for public transit in many cities worldwide.

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