Hospitals release lists of retail prices for services • Hacker News Board

Re: Hospitals release lists of retail prices for services

#61

Post by jldugger » Sun, Jan 13, 2019, 5:10 AM UTC

nonbel wrote: post #11

Those are not the real prices. Those are "chargemaster" prices, they are pretty much entirely irrelevant. The true price is usually going to be somewhere between 10-50% of the chargemaster: https://en.wikipedia.org/wiki/Chargemaster http://selfpaypatient.com/2014/01/03/insured-patients-can-sa...

Seems to me that the first step in getting chargemaster prices to closer reflect reality would be to publish them, so that someone (consumers, journalists, cyber activists, hospital administrators) can compare hospital prices to ones near by. Likely not sufficient, but a required step.

Re: Hospitals release lists of retail prices for services

#62

Post by zeroname » Sun, Jan 13, 2019, 5:13 AM UTC

TylerE wrote: post #52

zeroname wrote: post #50

Earlier quoted context omitted.

Medicare for all would easily bankrupt hospitals. The money needs to come from somewhere. Either force people to buy insurance or raise taxes massively. Pick your poison.

Firing all of those billing specialists and insurance people would save a LOT of money.

They are nevertheless a small part of the total bill.

Re: Hospitals release lists of retail prices for services

#63

Post by RHSeeger » Sun, Jan 13, 2019, 5:14 AM UTC

kbsletten wrote: post #9

I love the passive aggressive stab at Sutter. "Modern Healthcare decided to see how long it would take to present the data in a more consumer-friendly format. It took less than two hours - with a break for lunch - to create the 29 PDF files linked below."

I liked how they described it as "a blob of incomprehensible script.". It's JSON, which is a data format, not an incomprehensible script. If you're looking for a machine readable format, it's a pretty solid choice for this type of data on the web.

Re: Hospitals release lists of retail prices for services

#64

Post by koolba » Sun, Jan 13, 2019, 5:18 AM UTC

maxerickson wrote: post #41

40four wrote: post #31

This is very exciting to me. I have been wanting this for a long time, and I belive it's a small step towards improving the healthcare system in the United States. It shouldn't matter these aren't he "real" prices, as so many folks have been quick to point out. But it's the starting point for what ever you think the "real" price is, and it's information that has never been easily accessible to the public until now. A…

The worst situation is to have high deductible insurance. Then you have to pay the prices the insurance negotiates out of pocket (at least if you want the costs to apply against that high deductible). If you don't have insurance the hospital will take what they can get.

Or just tell them you’re paying cash and ask for that price. It won’t count toward your deductible but it could be significantly cheaper. I’ve seen urgent care facilities that charge $50 for cash patients and $130 for those with insurance.

Re: Hospitals release lists of retail prices for services

#65

Post by zeroname » Sun, Jan 13, 2019, 5:19 AM UTC

EamonnMR wrote: post #56

zeroname wrote: post #50

Earlier quoted context omitted.

Medicare for all would easily bankrupt hospitals. The money needs to come from somewhere. Either force people to buy insurance or raise taxes massively. Pick your poison.

Another possibility is to reduce the cost of care.

Below market rate? That will be a shortage then.

Re: Hospitals release lists of retail prices for services

#66

Post by beatgammit » Sun, Jan 13, 2019, 5:20 AM UTC

jtbayly wrote: post #40

40four wrote: post #38

Earlier quoted context omitted.

Fair enough, so still maybe not actual price without insurance. In that case at least. Makes me wonder if all facilities do this or something similar? Maybe that facility is particularly generous, or in the financial position to do that without the patient having to negotiate themselves. Maybe this could be an interesting app to make where people could report what that paid in the end :)

No, it's not normal. But being able to get a discount if you are uninsured is normal. I've wondered whether the facility is particularly generous or whether it just starts with insanely high list prices. Now I guess I can find out. :) But I still won't know what the final bill would be for the same procedure at a different hospital. I want to see that app.

I really wish routine procedures had fixed prices so you know exactly what you're in for. Obviously there should be some limits, but you should know what you're in for with a low chance of surprises.

If prices were fixed, you could shop around if your procedure wasn't urgent. This ability to shop around means that prices should stay competitive, which will benefit people who don't have that luxury.

Re: Hospitals release lists of retail prices for services

#67

Post by sadris » Sun, Jan 13, 2019, 5:21 AM UTC

abalone wrote: post #53

zeroname wrote: post #50

Earlier quoted context omitted.

Medicare for all would easily bankrupt hospitals. The money needs to come from somewhere. Either force people to buy insurance or raise taxes massively. Pick your poison.

Literally every other industrialized country has a Medicare For All type system and somehow the hospitals manage to stay open. And you can’t mention a tax increase without mentioning the savings of not having to pay for private insurance.

literally every other country has "death panels" in which they deny care based on cost/benefit ratio. In America, everyone gets every treatment; we have the best cancer survival rates, but we pay for it. 90% of all health Care spending is spent on people within the last two years of their life: because in America we try to keep people alive for as long as possible. They have different goals in Europe. There's a reason private health insurance is big on Germany: because they don't have guaranteed coverage for everyone and everything at all ages.

Re: Hospitals release lists of retail prices for services

#68

Post by beatgammit » Sun, Jan 13, 2019, 5:23 AM UTC

maxerickson wrote: post #41

40four wrote: post #31

This is very exciting to me. I have been wanting this for a long time, and I belive it's a small step towards improving the healthcare system in the United States. It shouldn't matter these aren't he "real" prices, as so many folks have been quick to point out. But it's the starting point for what ever you think the "real" price is, and it's information that has never been easily accessible to the public until now. A…

The worst situation is to have high deductible insurance. Then you have to pay the prices the insurance negotiates out of pocket (at least if you want the costs to apply against that high deductible). If you don't have insurance the hospital will take what they can get.

No, the worst situation is to have no insurance and develop a super expensive condition. A high deductible insurance is way better for most people than either expensive insurance (you're paying for care you're not receiving most of the time) or no insurance (bankrupt by bad luck).

If you have a high deductible insurance plan (mines pretty high at >$10k for my family), keep cash in your HSA so you're not put out if you max it.

Re: Hospitals release lists of retail prices for services

#69

Post by beatgammit » Sun, Jan 13, 2019, 5:27 AM UTC

joshgel wrote: post #42

abalone wrote: post #39

> Modern Healthcare decided to see how long it would take to present the data in a more consumer-friendly format. It took less than two hours Having been through several hundred thousand dollars of chargemaster charges with one of the hospitals on this list I can confidently say this info is not consumer-friendly at all. First of all, did anyone look at the damn PDFs? Do you have any idea what a "HCHG SP EVAL MTN FLU…

I'm a doctor. I'm pretty sure I know what those things mean. But ya, wouldn't expect you to. Ultimately that's irrelevant, because you don't choose the services you get in a hospital, "I" do. If I come in and recommend this or that test, are you going to check the price? Of course not, because the issue is only partially hidden prices. Its also knowledge asymmetry and fear. I think most doctors only recommend tests t…

I thought doctors had to be a but conservative due to lawsuit concerns and insurance requirements. I hear about concern over doctors misdiagnosing, so I'm guessing that doctors order more tests than strictly necessary to cover themselves.

Re: Hospitals release lists of retail prices for services

#70

Post by beatgammit » Sun, Jan 13, 2019, 5:28 AM UTC

zeroname wrote: post #65

EamonnMR wrote: post #56

Earlier quoted context omitted.

Another possibility is to reduce the cost of care.

Below market rate? That will be a shortage then.

Find cheaper options for people who don't want to pay as much. Innovate.

That's what I'm hoping for by making procedure prices transparent.