A petabyte of health insurance prices per month • Hacker News Board

Re: A petabyte of health insurance prices per month

#261

Post by drekk » Wed, Jul 12, 2023, 4:26 PM UTC

slotrans wrote: post #242

tiffanyg wrote: post #41

Because our (US) system is at Monty Python levels of absurdity. We waste more money with this "system" than most other countries spend as a total, and with worse outcomes on average [1]. Fundamentally, there are two factors, IMO, that have been conclusively proven (repeatedly, and for decades - much more strongly, recently) to be incompatible with delivering quality healthcare with some level of efficiency: 1) For-pr…

> 1) For-profit entities (particularly, publicly-traded / with "fiduciary responsibility" to shareholders) Then why is laser eye surgery so efficient? Answer: it's not covered by insurance, so there's an actual market. The problem isn't for-profit entities, it's for-profit entities operating in the absence of markets. Rent-seeking, in short.

You're talking about the ticket price for the service when that really shouldn't be the consideration. It doesn't matter how affordable it is when most US citizens can't cover a $500 emergency with savings. It's a shameful, political choice to have people walking around with curable blindness. Or to have people rationing insulin. The body is a temple but the temple is made of meat. It's inevitable at some point that you'll be sick. We may as well bake that assumption into the social contract than try to treat it as any other good or service. Can't exactly shop around hospitals when you're in an ambulance, unconscious.

Re: A petabyte of health insurance prices per month

#262

Post by paulddraper » Wed, Jul 12, 2023, 4:31 PM UTC

yardie wrote: post #260

paulddraper wrote: post #199

Earlier quoted context omitted.

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.

Oscar is a new-age insurance startup, which is why people here may have heard it.

There are quite a few regional insurance companies. Like here in Utah a big name is Selecthealth, but no one else will have heard it.

National carriers are a safer/easier choice for employers who have a distributed workforce.

Re: A petabyte of health insurance prices per month

#263

Post by paulddraper » Wed, Jul 12, 2023, 4:55 PM UTC

orangepurple wrote: post #238

paulddraper wrote: post #189

Earlier quoted context omitted.

> Where is the incentive to deny legitimate claims? Because they want to be competitive and gain customers. Which would you sign up for? Insurance that costs $800/month or $1200/month?

I have only ever had the chance to sign up for United Healthcare plans in my last 3 jobs

To be clear, I mean the employer not the employee as the customer deciding between competing providers.

Re: A petabyte of health insurance prices per month

#264

Post by MichaelZuo » Wed, Jul 12, 2023, 5:27 PM UTC

CogitoCogito wrote: post #249

petsfed wrote: post #201

Earlier quoted context omitted.

I've spent a lot time around people doing statistics for environmental science, especially regulatory compliance around accidentally killing birds and bats. The unfortunate reality for the statisticians is that every tech thinks they're Henry David Thoreau or something. Like, nobody cares if it was a particular large exemplar of a given species, or that it had magnificent plummage, just write down the species of the…

> The billing codes exist explicitly to limit the amount of independent thought that can be applied to something that is adequately summarized as "bit by a duck, third visit". None of this explains why these codes are needed for billing though. We simply don't need to bill differently for these pieces of information. The visit might have all these tags for informational purposes, but the bill should be for "visit to…

That doesn't make sense, it's easy to imagine that subsequent visits will cost slightly different amounts in terms of resources, labour, etc... and require somewhat different procedures in terms of treatment.

Re: A petabyte of health insurance prices per month

#265

Post by MichaelZuo » Wed, Jul 12, 2023, 5:30 PM UTC

nradov wrote: post #255

willcipriano wrote: post #228

Earlier quoted context omitted.

They are consumers

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

Corporate entities consume administrative hours, paperwork, procedures, etc... of the healthcare system, which have many interested parties that benefit from that, they are consumers in a broader sense.

Re: A petabyte of health insurance prices per month

#266

Post by petsfed » Wed, Jul 12, 2023, 5:31 PM UTC

CogitoCogito wrote: post #249

petsfed wrote: post #201

Earlier quoted context omitted.

I've spent a lot time around people doing statistics for environmental science, especially regulatory compliance around accidentally killing birds and bats. The unfortunate reality for the statisticians is that every tech thinks they're Henry David Thoreau or something. Like, nobody cares if it was a particular large exemplar of a given species, or that it had magnificent plummage, just write down the species of the…

> The billing codes exist explicitly to limit the amount of independent thought that can be applied to something that is adequately summarized as "bit by a duck, third visit". None of this explains why these codes are needed for billing though. We simply don't need to bill differently for these pieces of information. The visit might have all these tags for informational purposes, but the bill should be for "visit to…

The application is so misunderstood that I called them billing codes, when these are in fact diagnosis codes. They exist primarily to simplify records transfer when you go to a new clinic/hospital/doctor/whatever, and secondarily to allow the NIH to track how a given health risk develops over time.

Re: A petabyte of health insurance prices per month

#267

Post by NoMoreNicksLeft » Wed, Jul 12, 2023, 6:25 PM UTC

lotsofpulp wrote: post #257

NoMoreNicksLeft wrote: post #251

Earlier quoted context omitted.

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

Like, I dunno... filling the entire system with so much garbage, that the insurance company is unable to determine exactly how much a reasonable price might be?

Yeh, I said something about that.

Re: A petabyte of health insurance prices per month

#268

Post by nradov » Wed, Jul 12, 2023, 7:11 PM UTC

MichaelZuo wrote: post #265

nradov wrote: post #255

Earlier quoted context omitted.

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

Corporate entities consume administrative hours, paperwork, procedures, etc... of the healthcare system, which have many interested parties that benefit from that, they are consumers in a broader sense.

You're really missing the point. The word "consumer" has a specific meaning in the health insurance industry, which is what this article covers. What you're describing is irrelevant and off topic.

Re: A petabyte of health insurance prices per month

#269

Post by Reptur » Wed, Jul 12, 2023, 8:15 PM UTC

karaterobot wrote: post #206

Reptur wrote: post #24

They'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.

What? No. This isn't user facing. And they are following a schema created as a result of regulation. It sounds like the schema sucks. It sucks because it implies a lot of redundancy, and allows you to remove some of that redundancy, but does not require it, resulting in a foreseeable and unfortunate amount of redundancy.

It doesn't matter if its user facing. This mass of data must be filtered through and understood by the medical coders, the confusion and mass amount of data can lead to overcharging. 80% of medical bills contain an error and usually not in the patient's favor.

https://www.healthline.com/health-news/80-percent-hospital-b...

Re: A petabyte of health insurance prices per month

#270

Post by CogitoCogito » Wed, Jul 12, 2023, 9:34 PM UTC

MichaelZuo wrote: post #264

CogitoCogito wrote: post #249

Earlier quoted context omitted.

> The billing codes exist explicitly to limit the amount of independent thought that can be applied to something that is adequately summarized as "bit by a duck, third visit". None of this explains why these codes are needed for billing though. We simply don't need to bill differently for these pieces of information. The visit might have all these tags for informational purposes, but the bill should be for "visit to…

That doesn't make sense, it's easy to imagine that subsequent visits will cost slightly different amounts in terms of resources, labour, etc... and require somewhat different procedures in terms of treatment.

Your position is kind of ridiculous. That applies to every single business ever and yet magically hospitals can't get by without itemizing _everything_? Of course not. Besides nowhere but in the US is this normal, which alone demonstrates your claim that somewhat different procedures _require_ this to be totally false.

The only reason that hospitals in the US get away with it is because of the ludicrous agreements that you sign when arriving (you agree to pay whatever magical amounts we decide to bill you...). If those contracts were unenforceable (as they should be), hospitals wouldn't come up with this idiocy and would charge things simpler and would tell you ahead of time what your cost will be.