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Insured price $2,758, cash price $521

latimes.com

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Re: Insured price $2,758, cash price $521

#31

Post by Stratoscope »

alt_f4 wrote: post #26
Stratoscope wrote: post #9

Beyond opaque and variable pricing for the same service, there is also the question of whether something simpler would do the trick. Some years ago, I thought I might have broken my finger. I went to the doctor and it was actually the physician's assistant who saw me. I'd explained at the front desk that I had a high-deductible policy and I would be paying in full for the visit. The PA said "Usually we would send som…

great anecdote and when you're having heart arrhythmia, since it is too expensive to send you to a specialist and hook you up to one of those EKG devices, why not just do a series of 20 pushups and 20 squats and see if you'll collapse? alternatively, we could have a system where patients are entitled to some basic care, but hey..

I don't quite see the connection. It seems unlikely that my doctor and his assistant would treat heart arrhythmia the same as a sore finger.

And no one said I couldn't have an X-ray. They merely offered me a faster and less expensive diagnostic procedure at my own option.

Re: Insured price $2,758, cash price $521

#32

Post by pkaye »

dantheman wrote: post #5
devoply wrote: post #3

Earlier quoted context omitted.

Why? Why are insurance companies not demanding cash price and reducing premiums? There should be lawsuits against hospitals, this seems like something which is generally considered highly illegal at this sort of scale... charging different customers different prices -- especially when the ones paying more are more than capable of taking hospitals to court.

The 80/20 Rule could be one reason -- the more they spend on health care, the more they can spend on other things. https://www.healthcare.gov/health-care-law-protections/rate-...

I believe this rule came out of the ACA (Obamacare) however all the problems have existed well before that.

Re: Insured price $2,758, cash price $521

#33

Post by erikig »

I'll start by saying I agree with the premise of the article - transparency of pricing is not just helpful, it is necessary.

However...I can also understand why paying by cash should much cheaper Adding another company or companies into the transaction, trying to standardize the various medical procedures, invoicing and managing co-pays, deductibles etc adds a significant amount of overhead.

One would hope that the insurance companies would leverage the volume of transactions and the pools of clients to get price improvements but this is not the case.

Re: Insured price $2,758, cash price $521

#34

Post by alt_f4 »

Stratoscope wrote: post #31
alt_f4 wrote: post #26

Earlier quoted context omitted.

great anecdote and when you're having heart arrhythmia, since it is too expensive to send you to a specialist and hook you up to one of those EKG devices, why not just do a series of 20 pushups and 20 squats and see if you'll collapse? alternatively, we could have a system where patients are entitled to some basic care, but hey..

I don't quite see the connection. It seems unlikely that my doctor and his assistant would treat heart arrhythmia the same as a sore finger. And no one said I couldn't have an X-ray. They merely offered me a faster and less expensive diagnostic procedure at my own option.

eh, it's just a reductio ad absurdum argument

The underlying point is that it'd be nice if you are able to get first world care instead of "lifehacks" for a range of very common conditions, given that you're insured, and not have to pay a giant deductible.

Re: Insured price $2,758, cash price $521

#35

Post by point78 »

johnwheeler wrote: post #25

I took my 4 year old to the ER because he had a 103 fever. The doctor put an ear thermometer to him and told me to give him some childrens ibuprofen. The visit lasted all of 5 minutes. The cost: $756.00. I refused to pay it. It was the first time I did not pay a debt and the first time I was sent to collections. I refused based on principle, and not because I couldn’t afford it. Collections called me for about 3 mont…

Well as screwed up as the system is one little part of why prices are so high is to cover when people don't pay.

Re: Insured price $2,758, cash price $521

#36

Post by tareqak »

DaiPlusPlus wrote: post #24
rpmisms wrote: post #7

Earlier quoted context omitted.

I'm a generally anti-legislation kind of person, but as long as breaking up big tech is a hot topic, why not pass a bill requiring cash prices for any not-for-profit insurance providers and co-pay networks? There's a lot of interesting competition happening in those spaces, and making not-for-profit insurance a better deal seems like a great way to get capitalism grinding at the issue of overpriced healthcare.

That doesn’t work for emergency care - where the patient really doesn’t have the time to go window-shopping while having a cardiac arrest. And while greater transparency is good - not everyone in the public is able - or willing - to understand a medical price-sheet and might opt for a cheaper but medically-inappropriate procedure with similar-sounding-name to the procedure they actually need.

OK, how about mandatory cash prices for non-emergency care?

Re: Insured price $2,758, cash price $521

#37

Post by tdhoot »

Stratoscope wrote: post #31
alt_f4 wrote: post #26

Earlier quoted context omitted.

great anecdote and when you're having heart arrhythmia, since it is too expensive to send you to a specialist and hook you up to one of those EKG devices, why not just do a series of 20 pushups and 20 squats and see if you'll collapse? alternatively, we could have a system where patients are entitled to some basic care, but hey..

I don't quite see the connection. It seems unlikely that my doctor and his assistant would treat heart arrhythmia the same as a sore finger. And no one said I couldn't have an X-ray. They merely offered me a faster and less expensive diagnostic procedure at my own option.

I think it depends on the efficacy of the cheaper procedure. It's rare for the cheaper procedure to be as accurate as the more expensive one. If you knew the tuning fork was 80% accurate and an x-ray 100% accurate, would you still take it? I'd personally pay extra to make sure I was diagnosed correctly.

Re: Insured price $2,758, cash price $521

#39

Post by wrs »

minikites wrote: post #21

I don't see how mandating clear pricing is supposed to address medical inefficiency. If it threatens your life, you're going to pay no matter what, or in other words, demand is inelastic. Insulin is often used as an example of an inelastic good in Economics 101. I'm not sure how people are supposed to comparison shop for hospitals in an emergency situation and even for elective procedures, lots of hospitals in an are…

No. For the market to work, substitute goods would need to have transparent pricing so the customer can choose with price in mind. Most ultrasounds — indeed, most entire hospitals — are pretty close to identical goods. Everyone will die without food, but supermarkets don't take advantage of that fact to mark up food by 500%.

Re: Insured price $2,758, cash price $521

#40

Post by colbyh »

erikig wrote: post #33

I'll start by saying I agree with the premise of the article - transparency of pricing is not just helpful, it is necessary. However...I can also understand why paying by cash should much cheaper Adding another company or companies into the transaction, trying to standardize the various medical procedures, invoicing and managing co-pays, deductibles etc adds a significant amount of overhead. One would hope that the i…

Yeah I think the big problem here is related to the scale, not the fact that it's cheaper when you pay in cash. But that insurance would pay $500 (after negotiating the price down) and then push a > $1k charge to the patient when the clinic would have been ok with a $500 payment up front is just wrong.

It's also worth noting that many clinics, if not most, won't actually try to collect the balance here. They'll often go through the motions and forgive the balance after some number of attempts to collect.

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