Live data from Hacker News

Hospital creates bidding war by posting pricing online

kfor.com

61–70 of 231 posts

Re: Hospital creates bidding war by posting pricing online

#61

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…

I generally agree with your sentiment. However, here's something to consider - medical practices mostly over-charge to avoid insurance fraud. Wait, what?? Yes, here's how it works: if they were to ask you, "what insurance do you have" and then charge you differently (i.e. one insurance pays them better than the other, so they'd charge more), they'd be committing a crime.

So, instead, they charge EVERYONE a crazy amount, and then they get X% of the amount billed from one insurance, Y% from another insurance, etc. Fair? Not really -- if you don't have insurance, you get hit with the FULL amount (since you don't have the negotiating power the insurance company has). So while company X paid $200 for an MRI, you'd pay out of pocket $2500 without insurance.

In reality, what happens? Normally, people without insurance are an underserved population. They send them letters, and they don't pay. At the end of the day, the hospital/private practice just ends up writing this amount off, and they call it a day. It ends up being a silly game where they bill knowing they won't get paid, and then spend more money on trying to collect rather than give more realistic prices.

I, therefore, welcome this transparency.

source: I work for one of the largest and prestigious medical/research institutions in the US, and I used to do Analytics for their financial data warehouse.

Re: Hospital creates bidding war by posting pricing online

#62
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…

Wow, this (along with the whole health care thing) makes me glad I live in the UK. Here renting property is very well regulated, you put down a security deposit when you move in (usually 1.5 months rent) and then any charges like this are taken from that. The best part is the security deposit legally has to be left with a third party (DPS), and then if the land lord wants to keep any of it, they have to go through th…

That is the standard in the Chicago, IL area as well and coincides from what I've heard of from friends around the states.

Re: Hospital creates bidding war by posting pricing online

#63
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…

> "As I prepare to move out of my apartment, I received an itemized list (hidden among a contract and various other documentation) "

You yourself have trouble with our fine-print-society and yet you still write off the missteps of others who fall into similarly-shaped potholes as a result of their running on impulse or having weak mathematical logic?

Re: Hospital creates bidding war by posting pricing online

#64
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/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-and-Systems/Stat... Dealing with Medicare/caid involves lots of additional overhead and billing oversight, but that graf is a political shot, not a fact related to transparent pricing.

Isn't this a recent development, like two months ago?

http://www.nytimes.com/2013/05/08/business/hospital-billing-...

Re: Hospital creates bidding war by posting pricing online

#65
I really like their footer section :)

"FREE MARKET-LOVING, PRICE-DISPLAYING, STATE-OF-THE-ART, AAAHC ACCREDITED, DOCTOR OWNED, MULTISPECIALTY SURGICAL FACILITY IN CENTRAL OK."

[Edit]: The footer of the hospital in the article: http://www.surgerycenterok.com/

Re: Hospital creates bidding war by posting pricing online

#66

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…

Adding to your comment: There's a lot that cannot be quantified as well. For example, some doctors I trust more than others because I think their diagnostic skills, empathy, listening skills and ability to absorb case knowledge are superior to the generalized level of their peers' abilities in the same area. However, I wouldn't want someone to make an Excel spreadsheet with every patient's assessment of his/her docto…

Of course this is quantifiable. In the simplest sense, there's no reason you couldn't allow patients to rate doctors/hospitals based on these factors. But in a broader sense, you have to assume that these factors in turn affect the issues highlighted in the comment (infection rates, re-admission rates, etc.). If the listening skills do not in turn lead to better, measurable care, then it's a non-factor. If it does, then it can be measured.

Now, the measurements may not (especially initially) be perfect. But at least you're creating data points that give you SOMETHING to work with.

Re: Hospital creates bidding war by posting pricing online

#67

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…

You and the article seem to be saying totally contradictory things. Was the article just outright lying, or is there some nuance I'm missing?

Re: Hospital creates bidding war by posting pricing online

#68
post #21

Earlier quoted context omitted.

How do you explain the fact that healthcare expenditures in the US are twice as high as in the rest of the Western world, and life expectancy is comparable?

Because while demand for healthcare is inelastic, more healthcare can actually be a bad thing. For example, old people (who are big customers) are often best if they are told to just go home, and look after themselves. Cutting up old people can be a waste of time (since they are unlikely to live a lot longer), and can actually reduce their life expectancy (since they don't always survive surgery). Also, the money the…

Someone's gotta sell the meth, work at McDonald's, mow the lawns (well, not mine... I mow it myself), make the firecrackers, clean the toilets, etc.

It's all about how we allocate this labor, I guess. Paying everyone the same salary leads to underperformance, so we encourage competition. I'm sure there's a better way, but it probably won't be a total reversal, only a modification, of what we have.

Re: Hospital creates bidding war by posting pricing online

#69
post #26

Earlier quoted context omitted.

All this is of course due to political circumstances: medicine is just too profitable. No. Medicine in inelastic. There is no such thing as a rational demand side, as you don't get to choose if you need healthcare or not. When demand is inelastic, and supply is limited, prices will rise accordingly with no relief in sight. The solution? Either set market prices (at the cost of stifling supply) or flood the market wit…

>There is no such thing as a rational demand side, as you don't get to choose if you need healthcare or not That's not true in many cases. I bump my head or get a sore throat, I can choose to seek medical treatment or not. There are also lots of things like "yearly checkups", etc...

Is that anything more than noise?

Assuming you have a reasonable doctor and let yourself be guided by his recommendations, your bump-on-the-head visits are going to be an hour of you waiting in the waiting room, and five minutes of a nurse taking your blood pressure and the doctor asking you a couple of questions. Billing their time at $240 / hour, you've used up $20 of medical resources, plus a few bucks for the gloves and popsicle sticks they use during the exam.

If every man, woman, and child in the US went into the doctor every month for a bump or a cough, the total cost would be significant in absolute terms -- $72 billion -- but insignificant in the grand scheme of things; $72 billion is less than 3% of current US healthcare spending.

Re: Hospital creates bidding war by posting pricing online

#70
post #46

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 fac…

> Where are the free market republicans supporting these practices?

Yes, where? You'd think they and the Ron Paul fans would be all over this.

Post reply on HN