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Hospital prices are about to go public in the U.S.

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Re: Hospital prices are about to go public in the U.S.

#381

Post by Rotten194 »

madengr wrote: post #287
cmiles74 wrote: post #214

Earlier quoted context omitted.

This was my experience when my partner received treatment and the insurance company refused to cover the anesthesia charges (they claimed anesthesia was optional for the procedure and thus wasn't covered). The anesthesiologist's office was surprised that it wasn't covered and waived the charges. It was the only bright spot in a prolonged battle with the insurance company and the hospital.

Optional anesthesia may be a new trend. Restraints and a bite belt are cheaper, but the hospital would figure out a way to milk that too.

Bite belt sanitation fee: $300

Re: Hospital prices are about to go public in the U.S.

#382

Post by AmericanChopper »

mikestew wrote: post #229
lostlogin wrote: post #59

Earlier quoted context omitted.

This weird argument pops up regularly. In relation to New Zealand (where I am) it’s argued that the US is subsidising the cost of drug scripts. It’s beyond me quite how NZs drug buying agency is running roughshod over the rights of drug companies that have multiple insurance companies in the US that are bigger customers. What’s the agenda behind this argument?

The U. S. is the last place drug companies can get away with it, is what the agenda is. Americans are suckers for a good capitalist argument. “U. S. customers pay more because they have to subsidize those filthy socialists.” Imma gonna have to call bullshit. You’re telling me you sell to NZ at a loss because...New Zealand tanks will roll up to your doorstep if you don’t? Does New Zealand even own a tank? No, you sell…

>No, you sell to NZ because you somehow figured out how to profit from doing so.

The incremental cost of selling drugs you’ve already developed is quite low, so of course they can still profit from them in less profitable markets. But it’s the US that’s paying for them to be developed. This isn’t even up for debate, R&D in the US dwarfs everywhere else.

Re: Hospital prices are about to go public in the U.S.

#383

Post by HillRat »

vec wrote: post #307
cryptonector wrote: post #295

Earlier quoted context omitted.

Doctors don't know the prices, and neither do the customers (not without doing a lot of homework that can't be done during emergencies). Even when you know the list prices, the actual prices your insurance negotiates are almost certainly different, so asking for list prices isn't enough. Basically, in the U.S. the healthcare system is not exactly a free market as pricing signals are unclear, and most consumers have n…

My wife owns and operates a private medical practice (she's an audiologist), and it's insane the way she has to do billing and accounts receivable. When a patient asks about prices she quotes them her standard price for the necessary services and calls their insurance company to confirm that the patient is covered and check what kind of copay the patient needs to pay. Assuming the patient is satisfied with the result…

The counterexample is Medicare and Medicaid, which (CMS particularly) are exhaustively transparent (to provider and patient alike) regarding what they cover, pricing schedules, etc. Having architected revenue cycle platforms, I can say that Medicare was almost ridiculously easy to work compared to private carriers.

Re: Hospital prices are about to go public in the U.S.

#384

Post by dennis_jeeves »

peteretep wrote: post #357
mmirate3 wrote: post #349

Earlier quoted context omitted.

Well that is socialism. (As is our conflation of insurance and charity.) Being a form of price control, it also happens to not work very well. EDIT: and if anyone can explain why forcing doctors and hospitals to provide their services at a loss, is not socialism, then feel free to reply; as that will be assuredly more enlightening than a simple downvote.

I didn't downvote you, but I'll take a stab at this! > Well that is socialism As indeed is provision of roads, fire trucks, police, military and so on. For some reason, people rarely call those out > Being a form of price control, it also happens to not work very well I think there's a strong strong case that it works very well in every rich country, because they're all doing it to some degree? > forcing doctors and…

>As indeed is provision of roads, fire trucks, police, military and so on. For some reason, people rarely call those out

Personally I would call out. But hey, so what if I did? As you rightly pointed out most people are convinced that they need the govt in their _many_ aspects of their lives. I'm outnumbered by people who think, that they can decide what is good for me as an individual.

Re: Hospital prices are about to go public in the U.S.

#385

Post by conanbatt »

bborud wrote: post #367
conanbatt wrote: post #271

Earlier quoted context omitted.

Medicare reimbursements are below cost of care. If all insurance lowered to Medicare reimbursements, you will reduce supply.

I was referring to private healthcare without reimbursements or insurance. And mind you: Norway has a pretty high cost of living so it isn't like this is a low cost country. Which suggests to me that prices do not reflect actual cost, but rather inflated profit margins.

> Which suggests to me that prices do not reflect actual cost, but rather inflated profit margins.

There are lots of healthcare companies that are public. Healthcare insurance companies are amongst the lowest earnings of any insurance, contrary to the argumentational of Bernie Sanders. Also, one of the biggest health insurance companies, blue cross, is a non-profit.

Furthermore, 60% of hospitals are non-profit. And hospitals are 30% of the national healthcare spending.

If we are theorizing at random on what changes could impact the cost-effectiveness of healthcare, it is the increase of profits, not the decrease, that would be a more significant change.

Re: Hospital prices are about to go public in the U.S.

#386

Post by bborud »

conanbatt wrote: post #385
bborud wrote: post #367

Earlier quoted context omitted.

I was referring to private healthcare without reimbursements or insurance. And mind you: Norway has a pretty high cost of living so it isn't like this is a low cost country. Which suggests to me that prices do not reflect actual cost, but rather inflated profit margins.

> Which suggests to me that prices do not reflect actual cost, but rather inflated profit margins. There are lots of healthcare companies that are public. Healthcare insurance companies are amongst the lowest earnings of any insurance, contrary to the argumentational of Bernie Sanders. Also, one of the biggest health insurance companies, blue cross, is a non-profit. Furthermore, 60% of hospitals are non-profit. And h…

So how do you explain that getting treated at private hospitals (on your own dime) in Norway is cheaper than in the US?

Re: Hospital prices are about to go public in the U.S.

#387

Post by conanbatt »

bborud wrote: post #386
conanbatt wrote: post #385

Earlier quoted context omitted.

> Which suggests to me that prices do not reflect actual cost, but rather inflated profit margins. There are lots of healthcare companies that are public. Healthcare insurance companies are amongst the lowest earnings of any insurance, contrary to the argumentational of Bernie Sanders. Also, one of the biggest health insurance companies, blue cross, is a non-profit. Furthermore, 60% of hospitals are non-profit. And h…

So how do you explain that getting treated at private hospitals (on your own dime) in Norway is cheaper than in the US?

That private healthcare in the us is heavily and negatively affected by regulation.

US has.. - a very low doc/population count, due to the artificial constraints of medical licensing and immigration law.

- a draconian FDA process for drugs and an unreasonable patent application to drugs.

- An incredibly distortive public service implementation (Medicare) that provokes cost-shifting (by paying below cost), that creates heavy admin burden (fee-for-service), and that overpays specialties and punishes primary care (fix reimbursement fees in multiples for specialties, giving a very low primary care doc count)

- An incredibly distortive tax credit for the wealthier to spend on healthcare (the richer you are, the more tax effective it is to get better insurance through your employer)

- A free-market abolishing regulation requirement: tying healthcare provider to employer.

Re: Hospital prices are about to go public in the U.S.

#388

Post by conanbatt »

Holybeds wrote: post #373
conanbatt wrote: post #370

Earlier quoted context omitted.

If the government has a final say, then it has to restrict supply to keep costs down. It cant say yes to everything.

Doctors are expected to give the proper amount of care so they do that. Doctors doesn't care about what this will eventually cost for the government. The doctors work for private companies so the have no incentive to limit the care. They also have no big incentive to provide more care than needed. Anyone can go to a doctor to get an appropriate level of treatment. If you want more than that, to the degree that you wa…

I don't think its a solved problem at all. Healthcare costs are an issue in terms of spending per capita in the whole world. And the "whole world" depends in great amounts on the pharma and medical research that is developed in the U.S., and exported for very little in return. Furthermore, countries have varying levels of care based on the countries budget.

When the rich people in europe get sick, they go to the U.S..

Re: Hospital prices are about to go public in the U.S.

#389

Post by karmelapple »

dfxm12 wrote: post #225
karmelapple wrote: post #195

I was in a hospital in Singapore recently, and the prices for doctor consultation fees, staying in a room, and even certain tests were listed right at the front of the emergency room desk. After the patient I was with was stabilized, the nurse confirmed with us verbally what the rough cost should be for the rest of what the doctor prescribed, and asked if we wished to proceed. We could have said no and gone elsewhere…

We could have said no and gone elsewhere if we wanted, since the patient at least was relatively stable and we knew what was wrong. Next question, if the patient did go elsewhere, would they get to keep all the test results/would the hospital share the test results with the new facility? Or would the new place have to rerun all those tests?

I believe so. We specifically asked if we could take our results with us, although I didn’t specifically ask what would happen if we rejected further treatment. I think it would have been fine, though, and likely they would have charged us at least a small amount (maybe around $100 USD).

Re: Hospital prices are about to go public in the U.S.

#390

Post by cryptonector »

Sir_Vival wrote: post #356
cryptonector wrote: post #338

Earlier quoted context omitted.

In a world of pre-1990s, high-deductible, 80/20 insurance, this would happen less as the insurance company might not do the 800lb gorilla thing until the patient maxes their deductibles, and high deductibles give the consumer a strong incentive to negotiate directly with the provider.

It's insane more people haven't realized this. All you need to do to fix our healthcare system is bring transparency to prices and have insurance actually be insurance again instead of health plans. I have multiple anecdotes from my own life where I didn't care about the cost of something due to my insurance paying for it (and in some instances not being able to be informed of the price beforehand). When you have a w…

Piecemeal. First require more price transparency. Then stop incentivizing the HMO/PPO type of insurance.
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