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Show HN: I mapped US medical prices. Save thousands by driving a few miles

bestmedicareprice.com

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Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles

#211

Post by huherto »

bambax wrote: post #145
ulfw wrote: post #102

Earlier quoted context omitted.

WOW just wow. Would have been cheaper to fly first class to any other country in the world and get the baby there. It's really time for significant overhaul of the health care system here in the US

Yes, if I had to pay 20k to just have a baby and could fly somewhere else where it's free, I'd chance it. There might be a problem that many airlines won't let pregnant women fly past a certain number of months, for fear they will deliver the baby in the air; so maybe you have to move to the target country months in advance, significantly adding to the total cost...?

If flying is a problem, you may drive to Canada or Mexico. Mexico has a pretty good private system that is used by the local middle and upper classes. This is from my hometown...http://www.chihuahuamedicalcity.com/

Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles

#212

Post by thyrsus »

I'm in the midst of a heart attack, and I'm supposed to optimize cost/benefit of the area hospitals according to available data on expenses and outcomes. I invite those in favour of market solutions to propose practical responses. If Siri gives me bad advice, is Apple liable? Was I not under duress when agreeing to the 50 page (or minute) disclaimer?

Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles

#213

Post by alnafie »

lovskogen wrote: post #134
galenko wrote: post #126

Earlier quoted context omitted.

Come to the UK, it's free.

It's also free in Norway.

Comparisons between countries like Norway and the US are a bit misguided IMO. It's hard to imagine that an oil rich country with a homogeneous society of 5 million people at the edge of the world can be fairly compared to the leader of the world's current Pax-Americana with a population of 300 million. Norway enjoys the benefits of being an almost-city-state as described in Antifragile by Nassim Taleb.

Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles

#214

Post by anoncowherd »

potatolicious wrote: post #204
anoncowherd wrote: post #195

Earlier quoted context omitted.

It's an important point to make that even "free" healthcare is not actually free - the money has to come from somewhere, and most of it comes from forcefully confiscating it from people. Not only that, but if you're using money, it's much easier to use someone else's money instead of your own, you just won't be too careful about how you spend it. In fact, if you've got a "limitless" supply of other people's money , y…

> "Not only that, but if you're using money, it's much easier to use someone else's money instead of your own, you just won't be too careful about how you spend it." Sounds logical on paper but doesn't bear out in reality - just about every country where health care is provided via "confiscated funds" pays dramatically less for better outcomes than the USA where people are responsible for spending their own money. Th…

>> Sounds logical on paper but doesn't bear out in reality - just about every country where health care is provided via "confiscated funds" pays dramatically less for better outcomes than the USA where people are responsible for spending their own money.

The US healthcare system is truly fucked, but serves as another great example of how people use someone else's money. That's why healthcare is so absurdly expensive there. Patients generally aren't using their own money to pay for medical services, and so, insurance companies get charged ridiculous prices behind the scenes, and the customer doesn't care. Businesses are forced to buy insurance, right?

Well, without the "forced middlemen" of insurance companies, and with customers paying for whatever services they use, you can bet your ass that health care would be massively cheaper. Competition drives quality up, and prices down.

>> The Parasite(tm) is more bedtime-story boogeyman than observed reality

I hadn't even heard of that "theory". But I bet I would have, if I were still watching Bill Maher's show.

You're right in that some parasite patients are not the problem. The whole system is.

Think about it. If you're running a hospital on a "limitless" supply of other people's money (as in, "public healthcare"), you're just not that concerned with efficiency, nor the quality of your services, because you don't have to be. It doesn't matter if your customers are unhappy, because you'll still be getting your money! .. It's blindingly obvious that this kind of system is doomed, but of course, healthcare is not socialized in order to make it better. It's socialized to make the masses dependent on the State.

Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles

#215

Post by neilsharma »

refurb wrote: post #48
neilsharma wrote: post #39

Earlier quoted context omitted.

Thanks for the feedback. My next goal is to look more into why the price varies so much. The price spread is pretty crazy. Some hospitals have higher fixed costs or salaries depending on the geography. Also, if a hospital is more research-oriented, R&D funds are normally tacked onto the price (one of the reasons why Stanford's Hospital is really expensive). It's hard to find quantifiable data on the breakdown of bill…

The cost adjustments you're talking about are MS-DRG adjustments (the amount the hospital actually gets paid by CMS). From what I can gather, the numbers on the website, are cost numbers, i.e. what the hospital tells CMS it costs them (which is a number they are free to make whatever). If you want to know why costs vary so much, starting looking at reimbursement. Hospitals are incentivized to raise their list prices…

I thought medicare reimbursement is relatively fixed, with minor fluctuations based on geography and some hospital-specific practices? Based on a rough glance at the data, it seems like medicare reimbursement is only loosely correlated with the cost numbers, so I don't know how much raising prices would increase their Medicare revenue.

Also, from what I've learned about elderly care, Medicare reimburses a care center a fixed amount ($5000/mon/patient in California) regardless of the severity of the case. I'm assuming this number varies a bit too even in the same region.

As a side note, if you click on any of the prices in the map, it'll show you medicare's reimbursement rates too. Should've made that feature more clear--it's rather important.

Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles

#216

Post by neilsharma »

doorty wrote: post #6

Great first step. And pretty soon we'll have quality of care reviews--from patient questionnaires thanks to ACA/Obama Care.

I'm anxious to see those reviews. Quality of care is highly subjective and difficult to measure. Patient reviews are probably the best thing, but may be skewed on short-term or trivial aspects of the treatment, like how nice a doctor is or the wait-time. It'd need to be more on how a patient recovers over a 3, 6, etc. month period and whether or not they need to be re-treated

Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles

#217

Post by netrus »

nimble wrote: post #199
_delirium wrote: post #156

Earlier quoted context omitted.

They are actually pretty good at driving the prices down to something reasonable in most cases. While the headline prices are absurd, the prices actually paid by public and private insurers, whether Medicare or Blue Cross or Aetna, are much more reasonable. Not as reasonable as in much of the rest of the developed world, but the gap is not as gigantic as it initially seems. The really big gap between the U.S. and the…

Where do you find a breakdown of the costs? Anyone have links?

This looks interesting:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361028/

If I get table 4 right, people who manage to live past 85 years will have 1/3 of their health care spending after their 85th birthday (not entirely accurate, but a reasonable simplification).

Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles

#219

Post by moocowduckquack »

jmadsen wrote: post #175
pseingatl wrote: post #150

Earlier quoted context omitted.

It is utterly unfair to complain about errors made by non-native speakers who are making a good faith effort to communicate in English.

Why not? It's not an attack on him personally, but ...why not? Read the rest of his posts. He clearly has a very high level of English, and can state his ideas and opinions clearly. Yet he fell into the same shit-English trap that his friends are all in. My complaint isn't that someone made a mistake. My complaint is that someone who knows better couldn't give a fuck to say it correctly. This is about standards, not…

Your own writing style is hardly something to use as an example of correct English. Your usage and placement of ellipsis and commas is fairly non-standard, you repeatedly use semicolons where a full stop would seem more suitable and the liberal use of dashes to form compound swear words seems a somewhat crude and overused device. On first impressions I would say that it is you who gives a less professional impression through your writing and you really are in no position to scream so shrilly from such a very high and ridiculous horse.

Re: Show HN: I mapped US medical prices. Save thousands by driving a few miles

#220

Post by hydrologie »

I made a similar app at http://healthcostnegotiator.com/

I took the approach of targeting under/un-insured patients with the goal of assisting them in negotiating their health care costs to levels more similar to the Medicare payments. It is pretty difficult to shop for medical care in the event of an emergency, so my tool gives nearby, regional, and national prices for selected procedures so that the patient go into price negotiations with their care provider and hopefully get charged a lower price.

Edit: I also made a visualization of the CMS Provider Charge Data here: http://labs.coseppi.com/cms/

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