Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

What Happens When Doctors Only Take Cash (2017)

time.com

Post reply on HN
Print view View original

31–40 of 177 posts

Re: What Happens When Doctors Only Take Cash (2017)

#31

Post by qubex »

t3rmi wrote: post #27
qubex wrote: post #21

> Setting and casting a basic leg Oh good God, I’d never thought of this... I’ve broken more bones than I care to count (wrist, triple torsion fracture in my ankle, two ribs twice, shoulder) and I’ve never paid a penny (here in Italy). I’d never even remotely contemplated it might be a cost beyond the annoyance.

How does one break so many bones?

By accident... but it’s pretty unusual because I’m a fairly inactive nerd. First was the ankle which I broke in torsion while skiing in a freak accident, the next year I decided not to ski and had to amuse myself somehow so I picked skating and that’s how I broke the wrist... two ribs when tossed in a ditch by a hunter that noticed we were in the unwitting line of fire of another hunter (I was just there to photograph the hunting dogs), another two ribs accidentally throwing myself out of a first-floor window while putting up Christmas decorations...

Re: What Happens When Doctors Only Take Cash (2017)

#32

Post by sethammons »

linsomniac wrote: post #24

My local mechanic is required by law to tell me how much something is going to cost me before they start work. Why is my doctor not held to the same standard. Ever tried calling a provider to find out how much something is going to cost? Sounds like the medical industry had better lobbyists.

Heh. I have tried to call to see the cost. I see a retina specialist twice a year. I recently changed to a high deductible plan with an HSA. I called to see what the cost of my appointment would be. They could not or would not tell me. Incall three separate times, talking to different people and different departments. I went in and continued asking the front desk. "It depends on the services you end up getting." Ok, sure, but for a standard appointment, what then? "I can't say." Listen lady, I'm looking for a ball park. $50? $100? $1000? $5000? "Oh, I can't imagine it will be that much." Which one? "We will have to just bill you after." So absolutely frustrating. It ended up being like $150. Without price transparency like a public menu, we won't get better.

Re: What Happens When Doctors Only Take Cash (2017)

#33

Post by cwbrandsma »

linsomniac wrote: post #24

My local mechanic is required by law to tell me how much something is going to cost me before they start work. Why is my doctor not held to the same standard. Ever tried calling a provider to find out how much something is going to cost? Sounds like the medical industry had better lobbyists.

Reality is they don't know. They know how much it will cost them...sort of. They have a log of how much they charge for each procedure, and then individual insurance providers will pay a percentage of that. Some of which the hospital will pass on you. Even then, it is up to insurance company to figure out how much they will pay.

"Adam Ruins Everything" had a really good segment on this.

Re: What Happens When Doctors Only Take Cash (2017)

#34

Post by everybodyknows »

SQL2219 wrote: post #2

Need surgery? Here are the prices: https://surgerycenterok.com/pricing/

From the web site:

"Expenses or fees resulting from complications subsequent to the completion of the surgery and discharge from the facility are also not included." https://surgerycenterok.com/pricing-disclaimer/

Complications e.g. infection can run up expenses almost without limit. And you're likely to be in no condition to get up and take your business elsewhere.

Re: What Happens When Doctors Only Take Cash (2017)

#35

Post by astura »

Feniks wrote: post #9

That would be a problem, I can't even withdraw more than €1000 from an ATM. Most of my transactions are plastic or digital, like 99%.

It would be silly for a doctors office to accept only suitcases full of $100 bills, not only would that be highly impractical for both parties, it would make them a prime target for robbery so they'd have to invest a ton in physical security.

"Cash only" means "not insurance claims" in this context - usually when you go to the doctor you give them your insurance information and your expected copay the doctor (actually their admin staff) then submits a claim to your insurance company for payment. If the company doesn't pay, or pays less than expected, they will bill you.

Large "cash" transactions aren't a problem.

Multi thousands of dollars+ "cash" transactions are done all the time (such as a down payment on a house), you go to the bank and get a cashier's check. There's no reason you couldn't take out cash instead of getting a cashier's check, but it wouldn't be secure or practical. And your payee may have an issue with accepting physical cash from a risk perspective.

Re: What Happens When Doctors Only Take Cash (2017)

#36

Post by maxerickson »

Clubber wrote: post #19
prostoalex wrote: post #14

Earlier quoted context omitted.

Hospital chargemasters are required to be public in California https://www.oshpd.ca.gov/Chargemaster/ Unfortunately, 1) The price agreements between hospitals and insurance companies are confidential, as both sides compete in their own industry and don't want to reveal their hands. 2) Consequently, chargemasters post some ridiculous price per procedure (with discounts available, naturally, to insurance carriers, who…

There is an Adam Ruins Everything episode about that. Basically hospitals were reasonable, then insurance companies came along and brought extra business to hospitals. For that, they felt they deserved a cut. Since the hospitals were mostly non-profits, or low profit, they didn't have anywhere to cut, so in response they raised their rates to provide a cut. There is more to it, but that's the origin of the charge mas…

The American Hospital Association tracks uncompensated care (bad debt and forgiven bills):

https://www.aha.org/system/files/2018-01/2017-uncompensated-...

It's around $40 billion per year in recent years (for all US hospitals). With hospital spending around $1 trillion, it's 4 or 5% across the industry. There are of course individual hospitals that face higher costs.

Re: What Happens When Doctors Only Take Cash (2017)

#37

Post by friedButter »

> If unforeseen complications arose during or after the procedure, the Surgery Center would cover those costs

Doesnt this expose the facility to additional risk? Overall healthy patients and those with sufficient insurance coverage do not have a reason to visit this place, while those without insurance coverage (who I assume are likely to be less healthy and hence have more complications) are more likely to visit the place.

If instead they accepted insurance, and charged people based on complications, they would have a more average risk profile while being able to maintain higher profits, and keeping a USP of transparent charges (which would apply to non insurance patients w/o complications)

Re: What Happens When Doctors Only Take Cash (2017)

#38

Post by IncRnd »

linsomniac wrote: post #24

My local mechanic is required by law to tell me how much something is going to cost me before they start work. Why is my doctor not held to the same standard. Ever tried calling a provider to find out how much something is going to cost? Sounds like the medical industry had better lobbyists.

The problem really isn't the doctors but the structure of insurance and how people treat health care and health insurance similarly. The worst part is that high costs aren't directly the fault of insurance companies but of government having driven the need for insurance. Health care used to be all cash, and people carried catastrophic health insurance policies only. We are moving back towards that. This isn't stating my preference, one way or the other, just the historical facts.

On the back end, there is the cost of lawsuits that also drives up prices systemically.

And, finally, not everyone pays their bills to their insurance companies. Everyone else has to pay those costs.

In these ways, insurance will always be an every increasing spiral of cost, eventually.

Re: What Happens When Doctors Only Take Cash (2017)

#39

Post by maxxxxx »

killjoywashere wrote: post #23
maxxxxx wrote: post #4

Earlier quoted context omitted.

A price list like this should be mandatory for all doctors.

Should software developers and lawyers also have upfront pricelists for all services? I will gladly develop a cure for cancer, for the low, low price of $20B.

When I hire a software developer or a lawyer I get an upfront price list. Would you hire a lawyer that either would not give you any price or told you "it costs between 2000 and 60000 depending on your insurance and some other factors we won't tell you"?

Re: What Happens When Doctors Only Take Cash (2017)

#40

Post by qubex »

Giacomot wrote: post #29
t3rmi wrote: post #27

Earlier quoted context omitted.

How does one break so many bones?

Free healthcare is a great incentive to be careless with your body. /s* edit: I was being sarcastic

You're getting voted down but you might actually be right... if I had ever suspected this I wouldn’t even leave the house.
Post reply on HN