Hospital creates bidding war by posting pricing online • Hacker News Board

Re: Hospital creates bidding war by posting pricing online

#31

Post by crusso » Tue, Jul 09, 2013, 8:35 PM UTC

HarryHirsch wrote: post #25

ambiate wrote: post #14

I dream of a day when I can walk into an area which offers 'services' and be offered a pricing chart. From hospitals, banks, loan officers, home loans, cars, etc. A cryptic itemized list, such as a mortgage's Good Faith Estimate (GFE), which falls short of describing the items in the list still fails my test. This hope is not for me. Its for the misfortunate who run on impulse and have weak mathematical logic. Many p…

> I dream of a day when I can walk into an area which offers 'services' and be offered a pricing chart. I don't want to be offered a pricing chart when I have a kidney stone or get violently mugged. When that happens I don't want to have to deal with that sort of thing. The free market in medicine is plain weird. Everyone needs the doctor on occasion, and everyone needs tyres on their car. Both things are pretty stan…

The free market in medicine is plain weird

Says you. Time and again, Lasik surgery and cosmetic surgeries not covered by insurance or hindered by over-regulation have shown us that transparent pricing and competition work to make those procedures more affordable -- just like these forces work in other markets.

The State has perverted the medical market for more than half a century and you're just used to seeing it in its current screwed up state.

Re: Hospital creates bidding war by posting pricing online

#32

Post by possibilistic » Tue, Jul 09, 2013, 8:40 PM UTC

HarryHirsch wrote: post #25

ambiate wrote: post #14

I dream of a day when I can walk into an area which offers 'services' and be offered a pricing chart. From hospitals, banks, loan officers, home loans, cars, etc. A cryptic itemized list, such as a mortgage's Good Faith Estimate (GFE), which falls short of describing the items in the list still fails my test. This hope is not for me. Its for the misfortunate who run on impulse and have weak mathematical logic. Many p…

> I dream of a day when I can walk into an area which offers 'services' and be offered a pricing chart. I don't want to be offered a pricing chart when I have a kidney stone or get violently mugged. When that happens I don't want to have to deal with that sort of thing. The free market in medicine is plain weird. Everyone needs the doctor on occasion, and everyone needs tyres on their car. Both things are pretty stan…

> Yet on TV you see many many more ads for the local hospital or medication for condition X that you see for tyres. How come?

Tires are a simple, well-known product, whereas medicine is not. Drug discovery happens to be a billion dollar process that often results in failure. All of the low-hanging fruit have been taken, and the remaining solutions all require intense research. Though a compound or antibody or whatever might be cheap to replicate once elucidated, you still have to pay the price for the process.

Marketing then directs dollars to product. Drugs often target a very specific healthcare niche, which requires massive education campaigns. Everybody knows that they need tires. Not everybody knows about the existence of a novel drug that solves a medical problem that only a subset of the population encounters.

Re: Hospital creates bidding war by posting pricing online

#33

Post by muyuu » Tue, Jul 09, 2013, 8:41 PM UTC

hcarvalhoalves wrote: post #15

The article uses the term "bidding war" like it's a race to the bottom. Isn't clear pricing supposed to be a good thing? Shouldn't it be actually enforced by law?

This is the kind of wording the medical industry has set. The reasoning goes like this: clear prices => competition => iron law of wages for specialised professionals => corners being cut.

Crony capitalism only believes in competition for others. Competition in their own sector suddenly brings doom and the Iron Law of Wages.

The US is one of the countries with the highest expenditure per capita in healthcare and the results simply don't match that. See the graph here: http://www.forbes.com/sites/toddhixon/2012/03/01/why-are-u-s...

Re: Hospital creates bidding war by posting pricing online

#34

Post by easyfrag » Tue, Jul 09, 2013, 8:41 PM UTC

One thing to keep in mind is that there's more to good medical care than a fair price:

Post-op infection rate - do all clinical employees regularly wash their hands before and after each patient encounter?

Re-admission rate - does the institution or surgeon do enough cases of a particular procedure to be proficient?

Error Rate - Are pre-op checklists ALWAYS used?

Post-op care - Are supportive therapies like Physiotherapy available?

It bugs me to see medical interventions treated like a commodity, these "products" don't always follow generally accepted market principles - a price cut in colonoscopies will not significantly increase demand.

Re: Hospital creates bidding war by posting pricing online

#35

Post by mikeyouse » Tue, Jul 09, 2013, 8:44 PM UTC

crusso wrote: post #31

HarryHirsch wrote: post #25

Earlier quoted context omitted.

> I dream of a day when I can walk into an area which offers 'services' and be offered a pricing chart. I don't want to be offered a pricing chart when I have a kidney stone or get violently mugged. When that happens I don't want to have to deal with that sort of thing. The free market in medicine is plain weird. Everyone needs the doctor on occasion, and everyone needs tyres on their car. Both things are pretty stan…

The free market in medicine is plain weird Says you. Time and again, Lasik surgery and cosmetic surgeries not covered by insurance or hindered by over-regulation have shown us that transparent pricing and competition work to make those procedures more affordable -- just like these forces work in other markets. The State has perverted the medical market for more than half a century and you're just used to seeing it in…

Lasik and Cosmetic surgeries are minimally invasive elective procedures that can be researched months ahead of time, it doesn't make much sense to compare them to major surgeries or even severe infections.

Re: Hospital creates bidding war by posting pricing online

#36

Post by showerst » Tue, Jul 09, 2013, 8:44 PM UTC

pdx wrote: post #2

They have avoided government regulation and control in that area by choosing not to accept Medicaid or Medicare payments. I don't understand how the government itself is causing lack of price transparency, but this should be addressed by any president or congressman who imagines he's going to do something about healthcare costs. If you don't have price transparency, you have no chance at cost cutting.

Medicare and Medicaid pay less than the private insurers (usually), and far less than the (wholly insane) charges to the uninsured. Generally the government pays a standardized cost plus some set profit margin, which is usually less profitable per procudure

It's very easy to do the accounting to make the government look very efficient and reasonable, or look like it requires a bankruptcy-inducing level of loss, depending on your politics and the field of medicine.

What I _think_ this statement is really inferring is that they refuse to take medicare/aid and pay the government's lower rates, and thus raised their margins and bottom line, allowing for better care.

This is a pretty standard conservative view of health care provisioning, and I'm surprised that it was allowed into a news story. The whole piece here reeks of being a politically slanted press release, which is embarrassing since it's actually an interesting story, and an editor could've just changed a few sentences to keep a more neutral POV.

Re: Hospital creates bidding war by posting pricing online

#37

Post by djcapelis » Tue, Jul 09, 2013, 8:44 PM UTC

stephengillie wrote: post #12

HarryHirsch wrote: post #3

This happens only now ? In more civilized countries like Germany, prices for procedures have been set since time immorial. There is a provision for surcharges from the physician, but these aren't common, and the physician will have to have a good cause or the insurer will not pay it. Same thing for new medications: they are not permitted in the clinic unless there is a genuine advantage for the patient. All this is o…

If a person in Germany without insurance goes to a hospital emergency room for treatment, who pays for it?

The uninsured rate in Germany is so low (.2%) that it seems like most of the time that's not even a big deal. But it's generally billed to the patient from what I understand.

See:

* https://en.wikipedia.org/wiki/Healthcare_in_Germany

* http://www.npr.org/templates/story/story.php?storyId=9196396...

Re: Hospital creates bidding war by posting pricing online

#38

Post by Afforess » Tue, Jul 09, 2013, 8:45 PM UTC

HarryHirsch wrote: post #25

ambiate wrote: post #14

I dream of a day when I can walk into an area which offers 'services' and be offered a pricing chart. From hospitals, banks, loan officers, home loans, cars, etc. A cryptic itemized list, such as a mortgage's Good Faith Estimate (GFE), which falls short of describing the items in the list still fails my test. This hope is not for me. Its for the misfortunate who run on impulse and have weak mathematical logic. Many p…

> I dream of a day when I can walk into an area which offers 'services' and be offered a pricing chart. I don't want to be offered a pricing chart when I have a kidney stone or get violently mugged. When that happens I don't want to have to deal with that sort of thing. The free market in medicine is plain weird. Everyone needs the doctor on occasion, and everyone needs tyres on their car. Both things are pretty stan…

I hear this complaint often, but it's rather short-sighted. The majority of medical procedures are not 'critical' operations, as in dealing with unexpected and urgent medical conditions (car accident injury, broken bones, gunshot wounds). Most are scheduled operations planned days, or weeks in advance. These operations are the ones being targeted for shopping around for the best price. The unexpected, extreme injuries are why people need to have a high-deductible insurance policy, to cover such cases.

Re: Hospital creates bidding war by posting pricing online

#39

Post by forgingahead » Tue, Jul 09, 2013, 8:45 PM UTC

systematical wrote: post #19

In Singapore it's required for all hospitals to post their prices and they have some of the lowest health care costs around. This should be mandatory in the United States.

Re: Hospital creates bidding war by posting pricing online

#40

Post by Daishiman » Tue, Jul 09, 2013, 8:45 PM UTC

stephengillie wrote: post #12

HarryHirsch wrote: post #3

This happens only now ? In more civilized countries like Germany, prices for procedures have been set since time immorial. There is a provision for surcharges from the physician, but these aren't common, and the physician will have to have a good cause or the insurer will not pay it. Same thing for new medications: they are not permitted in the clinic unless there is a genuine advantage for the patient. All this is o…

If a person in Germany without insurance goes to a hospital emergency room for treatment, who pays for it?

Health care in Germany is socialized. Some small items are left to the patient but for the most part nothing is paid out of pocket.