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

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

#221

Post by jules »

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...?

You can take quite a long vacation for 20k.

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

#222

Post by ianbicking »

It's unclear how accurate this is. I searched my area for a random item (something respiratory) and there was one hospital that was $10k and another that was $30k. The $30k hospital probably has inflated prices, but not by 3x – it's also the hospital that takes harder cases. It's the hospital other hospitals send patients to. When we looked at hospitals for the birth of our daughter we looked at C-section rates. Almost all hospitals were the same, there was one good hospital, and then there was this hospital which had twice the C-sections of any other. But it's the hospital that gets the hard cases, a friend later delivered there (I think by C-section) after barely avoiding premature labor from 20 weeks to 35 weeks. Because people go there when they have medical challenges they have a high C-section rate, and generally high rates for everything.

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

#224

Post by ada1981 »

phillmv wrote: post #201
3pt14159 wrote: post #166

Earlier quoted context omitted.

My question is how are they not criminally charged with fraud when this happens? I could understand if this only happens once in a while, that it isn't done intentionally, but it happens all the fucking time, so someone is clearly intentionally doing it. If you hold a man hostage for a month or a year you go to jail for a year or two. If you intentionally overbill a man so that he must work an extra year worst case s…

WELL, if we're talking about INTENTIONALITY then yes the american medical bureaucratic system as evolved obviously singles out the uninsured and proceeds to screw them over. If we're talking about mens rea, then I doubt it; my wager is tied to how it's in no one's incentive to care that leads to these outcomes. Medical providers are clueless and totally disconnected from administrative functions, hospital billing sys…

My father is close friends with someone who runs a large hospital in Texas -- he told us that it is quite routine to overbill, and that they allow for up to 5% over billing. It's a line item in their balance sheet and they actually rely in this as a predictable revenue source.

For an industry of people who have had to spend over a decade jumping through academic hoops, and whose job seems to require a great deal of precision, it is unbelievable they lack competence in something most high school drop outs master McDonalds - namely, standardized pricing and itemized billing (not to mention customer service).

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

#225

Post by novalis78 »

mneedham wrote: post #205
clarebear wrote: post #173

Earlier quoted context omitted.

Next time, try a midwife if you and your wife are comfortable with home birth. In the Denver area it runs about $3k for parental care, the birth, and post birth check ups. Also, you don't have to deal with hospitals. I had one of my kids at home with a midwife and I wish it would have been both. If you actually need one, then the midwife will take you to a hospital.

Unless you have one of dozens (hundreds?) of potential complications that can happen during childbirth and you don't make it to the hospital in time. They you've got a dead or severely brain damaged baby and a potentially dead mom. Totally worth it. And the odds of making it to the hospital in time if you need an emergency c-section or start bleeding out are pretty slim.

Obviously you haven't done your research on this topic yet. The midwives are state registered and are legally bound to only serve woman who are in perfect health condition, with no complication during pregnancy whatsoever and prefer woman who had previous births without complications. Still, hospital is on standby and yes, it makes more sense if you are not 100 miles away from one.

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

#226

Post by neilsharma »

ada1981 wrote: post #224
phillmv wrote: post #201

Earlier quoted context omitted.

WELL, if we're talking about INTENTIONALITY then yes the american medical bureaucratic system as evolved obviously singles out the uninsured and proceeds to screw them over. If we're talking about mens rea, then I doubt it; my wager is tied to how it's in no one's incentive to care that leads to these outcomes. Medical providers are clueless and totally disconnected from administrative functions, hospital billing sys…

My father is close friends with someone who runs a large hospital in Texas -- he told us that it is quite routine to overbill, and that they allow for up to 5% over billing. It's a line item in their balance sheet and they actually rely in this as a predictable revenue source. For an industry of people who have had to spend over a decade jumping through academic hoops, and whose job seems to require a great deal of p…

Wow, I always figured that many hospitals would overbill because they could get away with it, though I'd imagine many would go much past 5%.

I don't think it's incompetence that makes pricing variable; rather, its lack of accountability. It's hard to find out where the price tag comes from, so why not charge as much as you think you could get from each patient? If you ask your doctor for an itemized breakdown of your bill, they (may eventually) give it to. The prices are often exorbitant and arbitrary.

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

#227

Post by GFischer »

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...?

Doesn't need to be free - the very best healthcare in my country (Uruguay) would cost about five thousand dollars per year of coverage, and we're talking about something better than the average US hospital - www.hospitalbritanico.org.uy .

Those five thousand would cover 90% of the expenses involved in all steps of pregnancy (prenatal care and checkups, 4D ultrasound imaging, etc) and the delivery itself.

And living here a few months would cost way less than 15.000 dollars :)

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

#229

Post by clarebear »

mneedham wrote: post #205
clarebear wrote: post #173

Earlier quoted context omitted.

Next time, try a midwife if you and your wife are comfortable with home birth. In the Denver area it runs about $3k for parental care, the birth, and post birth check ups. Also, you don't have to deal with hospitals. I had one of my kids at home with a midwife and I wish it would have been both. If you actually need one, then the midwife will take you to a hospital.

Unless you have one of dozens (hundreds?) of potential complications that can happen during childbirth and you don't make it to the hospital in time. They you've got a dead or severely brain damaged baby and a potentially dead mom. Totally worth it. And the odds of making it to the hospital in time if you need an emergency c-section or start bleeding out are pretty slim.

Actually, experienced mid-wives are very good at recognizing problems before they become serious problems. At some point, I was running out of energy and starting to struggle. They have monitoring equipment for the baby, and checked on her first to make sure she was fine. They talked about transporting me, but decided to give me a tablespoon of honey first. It worked, and we were done with a healthy, happy outcome shortly after that.

With midwives, you actually have human attention on you during a birth, rather than doctors and nurses that drop in occasionally and can miss stuff. My hospital birth came closer to having problems because there was another emergency on the floor and no one paid attention to me for hours (when perhaps they should have).

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