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A petabyte of health insurance prices per month

blog.turquoise.health

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Re: A petabyte of health insurance prices per month

#251

Post by NoMoreNicksLeft »

lotsofpulp wrote: post #117
NoMoreNicksLeft wrote: post #74

Earlier quoted context omitted.

A simpler and more rational explanation, is that they're trying to overwhelm the adversary. The insurance company, its claims department. If you can't ever compare two medical treatments because they're never similar, let along identical, then any price at all might be attached to these. The consumer hands over a laminated card and says "I have insurance". No one's overwhelming him. He's not even really a party to th…

An even more rational explanation is that the human body is one of the most complex machines there is, and we barely have an understanding of it. Those who do have some understanding of it spend decades learning about it, and so a layperson will simply never have the expertise to make informed purchasing decisions. That is why the insurance company (ideally) can serve as an informed agent (employing doctors and pharm…

Yes. Your explanation totally makes sense for why there's a billing code for "bitten by duck, initial encounter". I see it now. Disregard my first comment.

Re: A petabyte of health insurance prices per month

#253

Post by [deleted] »

thomascgalvin wrote: post #15

There 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…

[deleted]

Re: A petabyte of health insurance prices per month

#254

Post by dodslaser »

thomascgalvin wrote: post #15

There 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…

There's also V97.33XD - Sucked into jet engine, subsequent encounter.

For when you're sucked into a jet engine, ejected on the other side, only to be sucked into another jet engine.

Re: A petabyte of health insurance prices per month

#255

Post by nradov »

willcipriano wrote: post #228
nradov wrote: post #211

Earlier quoted context omitted.

Employers and other group buyers want to control costs.

They are consumers

Employers are customers, not consumers. That word has a specific meaning in the industry and you are using it incorrectly.

Re: A petabyte of health insurance prices per month

#256

Post by Workaccount2 »

lotsofpulp wrote: post #127
AnthonyMouse wrote: post #123

Earlier quoted context omitted.

> So, if you’re an insurer who wants to increase nominal profits, then you’re ok with spiraling healthcare costs. Not just okay, but actively incentivized to cause it, because then you get 20% of a bigger number. Laws like that are some of the most expensive of the perverse incentives created by naive idealists (or cynical opportunists, since the lobbyists for the medical providers know exactly what that would do).

In reality, there is sufficient competition such that the 7 largest publicly listed health insurance companies have 4% or less profit margins, and one has 6%. I always find it funny when people on this forum act like a certain business is so powerful when it can only earn low single digit profit margins, yet tech company employees work for companies so powerful they can earn 20%+ and 30%+ profit margins for years and…

It's like when people complain about "greedflation" and point to grocery stores gouging food prices, but then you look at the books for grocery stores and realize that they are basically running a charity the margins suck so bad.

Re: A petabyte of health insurance prices per month

#257

Post by lotsofpulp »

NoMoreNicksLeft wrote: post #251
lotsofpulp wrote: post #117

Earlier quoted context omitted.

An even more rational explanation is that the human body is one of the most complex machines there is, and we barely have an understanding of it. Those who do have some understanding of it spend decades learning about it, and so a layperson will simply never have the expertise to make informed purchasing decisions. That is why the insurance company (ideally) can serve as an informed agent (employing doctors and pharm…

Yes. Your explanation totally makes sense for why there's a billing code for "bitten by duck, initial encounter". I see it now. Disregard my first comment.

That is probably explained by the attempt to use an existing system developed for a different purpose to also accomplish the billing task.

https://news.ycombinator.com/item?id=36686754

Re: A petabyte of health insurance prices per month

#258

Post by TheJoeMan »

secabeen wrote: post #196
elcritch wrote: post #128

Earlier quoted context omitted.

There's a similar issue in academia. Tuition costs have risen far faster than inflaction but the number of professors per student is roughly similar. Where does all the extra go? Administrators and bureaucracy!

There's two things here. First, payment for the cost of education has two major parts: tuition, and state allocations to higher ed. When tuition goes up, it can mean that education costs have risen, that state allocations have gone down, or both. Although there have been some understandable increases in the cost of education, the main driver in the increase in the nameplate tuition is the decreases in state allocatio…

I paid MORE to sit at home on zoom during Covid, through a "distance learning fee". And that money didn't even go towards buying the professors decent internet.

Re: A petabyte of health insurance prices per month

#259

Post by treeman79 »

thomascgalvin wrote: post #15

There 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…

Yep. Was involved in medical billing software. Health companies do everything they can to “upgrade” billing to more expensive codes. Lots of AI and such.

Especially if it’s government funded.

Re: A petabyte of health insurance prices per month

#260

Post by yardie »

paulddraper wrote: post #199
yardie wrote: post #194

Earlier quoted context omitted.

Competitive? In every job I've had it was basically the same 3-4 HMOs: Aetna, Bluecross, Cigna, and United Healthcare. If you are getting employer provided healthplans, as most Americans are, those are your options, 4. With so few options you aren't choosing the most competitive, you're choosing the lease worst.

Humana, Kaiser, Oscar. But yes, there is an intense economy-of-scale that produces relatively few insurance companies. (Maybe eventually only one.)

Oscar I've never heard of but appears to be only available in NY/NJ and is operated by Cigna in other states. Kaiser operates primarily in the west coast. And Humana doesn't have much presence in Florida. They primarily do Medicare Advantage, AFAICT.
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