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

Re: Hospital creates bidding war by posting pricing online

#41

Post by clarkm » Tue, Jul 09, 2013, 8:46 PM UTC

ChuckMcM wrote: post #22

I really salute these guys for doing this. It's freakin' awesome. This I've added to my next letter to my representatives in Congress: "Dr. Smith said federal Medicare regulation would not allow for their online price menu. They have avoided government regulation and control in that area by choosing not to accept Medicaid or Medicare payments." I've suggested that one non-controversial way in which Healthcare could b…

If you're looking for some more information, you can see the pricing on their website here: http://www.surgerycenterok.com/pricing/

Reason also did a story and short video on the Surgery Center of Oklahoma last year that I think is worth watching:

http://reason.com/reasontv/2012/11/15/the-obamacare-revolt-o...

The center was started by Dr. Keith Smith, who is very much a free-market guy. Even if you don't agree with a lot of his libertarian stuff, you have to admit that he's very well read and knowledgeable of economics, especially for a physician. He runs an active blog at: http://surgerycenterofoklahoma.tumblr.com/

Re: Hospital creates bidding war by posting pricing online

#42

Post by [deleted] » Tue, Jul 09, 2013, 8:46 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?

[deleted]

Re: Hospital creates bidding war by posting pricing online

#43

Post by rayiner » Tue, Jul 09, 2013, 8:47 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…

I'd look at good old supply and demand before reaching for "over-regulating is distorting the market." Demand for Lasik and cosmetic surgery is much more elastic because they're not life-saving or otherwise necessary procedures. Meanwhile, supply is relatively higher because they're relatively cheap procedures to provide. They can be done in outpatient centers instead of hospitals, usually don't require general anesthesia, etc.

Re: Hospital creates bidding war by posting pricing online

#44

Post by jerf » Tue, Jul 09, 2013, 8:48 PM UTC

easyfrag wrote: post #34

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 Physiothe…

There's more to everything than a "fair price". People who want to explain why Microecon 101 doesn't hold in the medical arena really should take care to not accidentally explain too much and end up proving that Microecon 101 never holds, which is demonstrably false.

(And yes, there's more to the world than Microecon 101, just as there's more to physics than Newtonian mechanics or thermodynamics, but I still get to assume that glorious theories that somehow fail to conform to such basics are probably in error.)

Re: Hospital creates bidding war by posting pricing online

#45

Post by pdx » Tue, Jul 09, 2013, 8:48 PM UTC

showerst wrote: post #27

ChuckMcM wrote: post #22

I really salute these guys for doing this. It's freakin' awesome. This I've added to my next letter to my representatives in Congress: "Dr. Smith said federal Medicare regulation would not allow for their online price menu. They have avoided government regulation and control in that area by choosing not to accept Medicaid or Medicare payments." I've suggested that one non-controversial way in which Healthcare could b…

Copying my comment below. The government not only allows healthcare providers to reveal their prices, it encourages it. The graf about the government is a political statement, not a policy fact, and does not belong in a news story. ----- Medicare/caid prices are standardized and public. They also release data on what specific hospitals bill for the most common procedures. http://www.cms.gov/Research-Statistics-Data-a…

Pricing transparency, for whatever reason, does not exist as a rule in the medical industry. The "charge masters", are a joke that the hospitals themselves admit are useless as indicators of actual prices paid unless you're out of pocket, and then you get to pay them. Even then, the charge masters, as useless as they are, are still kept well hidden from all but the most inquisitive.

I hope you're right about the government not hindering medical pricing transparency. Now we need to get them to mandate it.

Re: Hospital creates bidding war by posting pricing online

#46

Post by Kapura » Tue, Jul 09, 2013, 8:49 PM UTC

Oh man I want this to be the new norm so bad. The American health care system really needs to be shaken up. Republican dissent in Congress blocked that when Obama was championing it; perhaps the Republican's stated goal of a free market is going to be what affects the change. Where are the free market republicans supporting these practices? Why are they so upset about people coming to work in America but not the fact that hospitals are able to use the insurance system to gouge consumers?

The cited $30,000 surgery costing a fifth of that at the centre makes it well worth the effort to fly from out of state to get your operation on. The old system of charging whatever you can get away with because the patient doesn't have options needs to die a horrible death.

Re: Hospital creates bidding war by posting pricing online

#47

Post by roc » Tue, Jul 09, 2013, 8:49 PM UTC

ChuckMcM wrote: post #22

I really salute these guys for doing this. It's freakin' awesome. This I've added to my next letter to my representatives in Congress: "Dr. Smith said federal Medicare regulation would not allow for their online price menu. They have avoided government regulation and control in that area by choosing not to accept Medicaid or Medicare payments." I've suggested that one non-controversial way in which Healthcare could b…

There's a very large amount of medicaid/medicare practice (and 'obamacare' practice) that was written by insurance and hospital lobbyists with a financial incentive to perpetuate the status quo, if not outright extend regulatory capture and stymie any actual market competition.

Given that something as simple as allowing Medicare to negotiate with care providers and suppliers as any other insurer is massively controversial, I think you would be amazed just how controversial seemingly-straightforward reforms actually are. Particularly those things that would increase competition and thus threaten the status quo.

Re: Hospital creates bidding war by posting pricing online

#48

Post by steveplace » Tue, Jul 09, 2013, 8:50 PM UTC

Some other techniques off the top of my head:

-- offer a "price match guarantee" against any procedures versus in-network hospitals

-- offer a discount for low-risk patients (non-diabetic non-obese) who need to have surgery done

-- do "bundle deals" with local hotels and/or attractions like they do with plane flights, so if you are travelling to the hospital you would have something for the family to do

-- free 1-month nurse concierge where you can call a hotline to followup after any procedure (would be great for baby deliveries)

-- discount on 3-months of physical training, along with a bundle deal at a local gym

-- offer a "retainer" that would lockin a price of any procedure for 5 years. Good for those who are family planning or have a low-priority surgery

It just seems like there's a market for something-that-doesn't-suck in healthcare.

Re: Hospital creates bidding war by posting pricing online

#49

Post by petermonsson » Tue, Jul 09, 2013, 8:50 PM UTC

easyfrag wrote: post #34

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 Physiothe…

Does your current hospital show you these statistics?

Re: Hospital creates bidding war by posting pricing online

#50

Post by jljljl » Tue, Jul 09, 2013, 8:51 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…

Neither Lasik nor cosmetic surgeries tend to be major issues of life and death, nor do they tend to occur in emergency situations where an informed decision may not be possible.

Free markets and transparent pricing that work require that there not be major information asymmetries between supplier and purchaser. If I'm in the hospital with an emergency or critical condition, I probably don't have the option of fully researching or understanding my options.