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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.

#91

Post by lostlogin »

beagle3 wrote: post #81
lostlogin wrote: post #58

Earlier quoted context omitted.

What’s the logic in that? If the cost is socialised surely you’d expect more people to seek care than if they were paying?

What’s the logic in that? Am I going to get a quad bypass just because it is cheaper? People seek care because they need it. The kind of care that people use more because it is cheaper/available is maintenance care (which reduces overall costs because things are often treated before they become critical). The first time I heard “I am feeling sick / cut my hand / need stitches but I cannot afford to go to the doctor”…

I think I didn’t make my point clearly. The post I replied to was suggesting that Americans seek care more than others and that’s why costs are higher. I didn’t think that likely, and argue that direct exposure to the cost would lead to people seeking care less often.

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

#92

Post by grey-area »

AmericanChopper wrote: post #24
cazum wrote: post #20

Earlier quoted context omitted.

You're implying that both the quality of care and the amount of medical research done is a result of the profits of the medical companies. I'm not sure that this is the case.

Profit is the only thing that drives investment in care and research. You’re asserting that you can reduce profits via price fixing and still deliver the same outcomes in both care and research.

Profit is the only thing that drives investment in care and research

This is manifestly untrue in so many domains, including medicine. Most research is heavily government funded, particularly pure research, and most academics are not interested in profit. The only orgs motivated by profit (drug companies, insurance companies) are the ones who push this misconception, because they profit from it. As one example, the UK runs large trials comstantly to improve care, without a profit motive.

Nobody has to postulate that price fixing (as you call it), or single payer healthcare without insurers works better, because the rest of the developed world outside the US uses that system and delivers very similar outcomes for radically lower cost. The facts are clear.

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

#93

Post by breatheoften »

lostlogin wrote: post #69
alexis_fr wrote: post #46

Earlier quoted context omitted.

and require the same price for lone customers as what is negociated with insurances.

Is this right though? Surely buying 20k knee joint replacements should earn a discount? Just setting it such that it wasn’t taking the piss would seem a vast improvement.

How does prepaying for treatment help with costs at all? Either you _can_ forecast accurately how many knee replacements you are going to do in which case prepaying won’t help you plan better — or you “prebill” for knee replacements and then incentivize doctors to push people into knee replacements to maximize their payouts ...

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

#94

Post by dakom »

trevyn wrote: post #57
dakom wrote: post #40

How about transparency of medical records - i.e. if I provide some credentials, can I definitively get a copy of my medical history so that I can easily take it with me to another country/hospital? By definitively I mean within some federal regulation or system that doesn't depend on an employee at a particular hospital getting around to it on their coffee break.

You certainly can under HIPAA, and I’ve done this several times without unreasonable delay. If you’ve had issues, I’m sure the “sternly worded letter from a lawyer” approach would get the gears turning.

Thanks! Are they all interconnected, so that if I use a service like https://www.medicare.gov/manage-your-health/medicares-blue-b... I will get the collected records from different doctor visits at different hospitals?

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

#95

Post by benj111 »

homero wrote: post #83
throwaway12iii wrote: post #60

Earlier quoted context omitted.

Most doctors in the US actually do know how pricing works.

They know how it works but not the exact price of an aspirin. They can't exactly tell you to go to the pharmacy out of your hospital bed to get a $2 bottle vs a $50 pill from them.

Is it not reasonable for them to ask, if they don't know? Also should they not have a general ballpark idea? I'm British and would expect Drs to be aware of costs before advising treatment (ruling out cheaper to rule out things etc).

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

#96

Post by JamesBarney »

throwaway12iii wrote: post #60
tehlike wrote: post #56

Earlier quoted context omitted.

most doctors in the US actually do not know about the prices of treatments as it changes based on insurance administrator/insurer, and then what the patient pays also have huge variability based on insurance administrator/insurer.

Most doctors in the US actually do know how pricing works.

95% of the time if ask a doctor the cost of a procedure they have more idea what the cash price is, not to mention whatever my copay will be calculated to be based on my insurance and its agreements with the service providers.

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

#97

Post by Sacho »

tehlike wrote: post #56
mikedilger wrote: post #21

I actually stiffed a doctor once because he refused to give a price up front and when I got the bill it was outlandish. I also made a huge scene in the intake/waiting room about this. I was leaving the United States at the time so I didn't really care about my credit record. To be slightly more honest: he wasn't the doctor assigned to me on intake, he was another doctor from another hospital across the street as a co…

most doctors in the US actually do not know about the prices of treatments as it changes based on insurance administrator/insurer, and then what the patient pays also have huge variability based on insurance administrator/insurer.

I get why they might not be able to tell you how much you'll pay because of your specific insurer, but why would the overall price of the treatment change with it? That seems bizarre.

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

#98

Post by setr »

feanaro wrote: post #71
huac wrote: post #63

Earlier quoted context omitted.

> all prices need to be +\- 50% of what Medicare pays. This is actually close to what happens with private insurers- they negotiate with a hospital to pay n-times what Medicare pays for some set of treatments. So why does Medicare pay the least? Because they have the most patients covered of any insurance network in the US. That's a hell of a bargaining factor. More patients = cheaper prices. The logical conclusion i…

That still doesn't explain how prices of medical services in many other countries turn out several order of magnitudes smaller than commonly encountered prices in the US.

I've discussed this before, but I think there's quite a bit of funny money in hospital bills -- a 10k bill rarely actually materializes in 10k transferred across all parties involved.

Doctors bill $10k to your insurance, the insurance decides its too much, lawyers are on-hire to negotiate and take a 30% cut of the outcome, and finally 2k is paid out; the absurd bill naturally accounts for the absurd process, and I don't think anyone except the consumer ever expects 10k to really be 10k. And ofc, the insured consumer only ever pays $500 of it from his deductible.

This was basically Shkreli's defense as well -- the insured patient doesn't pay anything close to the bill given; and I'm pretty sure, neither does the insurance. If you want to raise the price be $10, you add $1000 to the bill.

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

#99

Post by philtar »

peteretep wrote: post #73
feanaro wrote: post #71

Earlier quoted context omitted.

That still doesn't explain how prices of medical services in many other countries turn out several order of magnitudes smaller than commonly encountered prices in the US.

Are the prices that Medicare pay orders of magnitude different? ISTR that Medicare and the VA both pay about $10k per patient per year, which I think is comparable with the NHS. No sources as this is half-remembered.

We would also need to know the average number of visits per patient before this data means anything otherwise it's just data without context or meaning.

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

#100

Post by lovemenot »

mtgx wrote: post #77
throwaway12iii wrote: post #61

Earlier quoted context omitted.

Median and average are not good representations of a distribution.

Also even media leaves out the poor who can't afford expensive procedures. It's why Obamacare is ultimately doomed to fail too.

Just looking at your first sentence. I assume you meant median, not media since that is what your parent was talking about.

Median actually does a better job of including the poor than does mean. The reason is that median counts the number of affected people, whereas mean counts the amount of spending. Clearly the latter skews more towards the rich, for whom spending may approach infinity.

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