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Hospitals lift curtain on prices, reveals giant swings for hips, knees and more

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Re: Hospitals lift curtain on prices, reveals giant swings for hips, knees and more

#91

Post by techrat »

maerF0x0 wrote: post #33
techrat wrote: post #28

Earlier quoted context omitted.

Funny how it's only when regulation is involved that it begins to pull back the curtain.

Consider that regulation makes a certain tier of solution effectively illegal. See https://www.youtube.com/watch?v=elq2mnHTFUY I know this may look a little dystopian, but solutions of this sort would be illegal in the US and then folks would have no choice but to just go without any help at all. (Save for if charity/gov't step in). Same story with housing. Part of the reason we have homeless ness (or more realistica…

Deregulation of telecoms.

Now we have monopolies with no regulatory requirements to provide service to customers. Read: Verizon refusing to rebuild landline areas affected by severe storms.

Removal of regulations for ISPs.

Data caps. Throttling. Zero metering. Deep packet inspection. Data injection. Opt out (if you even can) tracking.

Removal of oversight for agriculture and removal of animal welfare regulations.

More contaminated products. More waste being dumped improperly.

Like the argument about minimum wage. Wages aren't going to go up if they remove minimum wage as companies are already paying the least they can get away with.

The "free market" simply cannot be trusted to regulate itself. The argument that this wouldn't happen in a "true free market" doesn't hold water. Nor that less regulations would make it easier for newer companies to compete: We've only seen the actual reality of such a policy. Less regulations make it easier for existing companies to fuck the consumer over.

Regulations are written in blood. There is a reason they existed in the first place.

Re: Hospitals lift curtain on prices, reveals giant swings for hips, knees and more

#92

Post by Geezus_42 »

avgDev wrote: post #11

The US healthcare system is just a completely broken mess. When things go smooth, you are lucky! However, when you have a major procedure, life event or sickness things can get messy quick. We had a child 10 months ago, billing was screwed up by the hospital, then by insurance and we are still in process of getting it resolved. I have now spent at least 8 hours on the phone. I had a surgery, called insurance and veri…

Like when you go for a normal doctor's appointment, pay on your way out the door and the other get three bills in the mail "because they didn't know how much the insurance would cover when you paid". I have great insurance, this is pure bullshit.

Re: Hospitals lift curtain on prices, reveals giant swings for hips, knees and more

#93

Post by fractionalhare »

danaris wrote: post #26
kshacker wrote: post #14

Earlier quoted context omitted.

It is not a 'broken mess'. It is an 'engineered mess'. The difference is in intent.

Framing it this way is probably inaccurate, and if inaccurate, unhelpful. From decades of observing the system, it seems extremely unlikely to me that it was deliberately engineered to be this way. Rather, different parts of it grew and changed organically and the parts and changes that benefitted moneyed interests in power stayed, while those that did not were discarded. It does not take a deliberate will behind som…

You say this:

> It does not take a deliberate will behind something for it to be pulled toward this sort of inequality, and presenting it as if that's what's happened suggests that if we could only defeat the Evil People who "engineered" it this way, we could make it better.

...but then also this:

> ...to inhibit the flow of money upward from the 99% to the 1%. It's hard, it will take a long time, the people with the most wealth and power will fight us every step of the way...

So maybe there are "evil" people and deliberation at work, and it's not just emergent complexity?

Re: Hospitals lift curtain on prices, reveals giant swings for hips, knees and more

#94

Post by datavirtue »

axlee wrote: post #9

I thought "free markets" where supposed to facilitate fair value discovery?

Because it was not a free market. Hospitals had the insurers by the balls, set the price, and forced them into secrecy contractually. It WAS a huge factor in Healthcare prices.

Re: Hospitals lift curtain on prices, reveals giant swings for hips, knees and more

#95

Post by joshspankit »

tornato7 wrote: post #67
banana_giraffe wrote: post #48

Earlier quoted context omitted.

I have good insurance through a major company. My SO tripped, and hit their head on a curb on a busy road. I wasn't there, but by happenstance an EMT was there, witnessed the event, and came to offer aid. The EMT was concerned enough my SO ended up going to the hospital. Several scans, and a few hours later, my SO was discharged. I then got to spend something like 30 hours on the phone over the course of a couple of…

That's awful. I hit my head in Thailand and went to the hospital, excellent experience I was in and out in 2 hours, got CT scanned and fully examined by a specialist, then left with a USB drive of my brain scans all for $180 out of pocket.

That’s awesome.

Up here in Canada I have not gotten a bill yet (including when my daughter had to get brain scans), but one thing is it’s very hard to get the actual scans. I had to no joke steal my own chest xrays to get a copy.

Re: Hospitals lift curtain on prices, reveals giant swings for hips, knees and more

#96

Post by mindslight »

dumpsterdiver wrote: post #82
mindslight wrote: post #50

Earlier quoted context omitted.

I feel like 80% of the healthcare logjam would be fixed if providers were required to 1. charge uniform prices for all payers and 2. present patients with written estimates based on said price schedule ahead of any non-emergency services, thus forming an actual contract. Note that mechanics don't particularly know what they're going to have to do to any given car before they really get into working on it. Yet the mar…

I'm not disagreeing at all (I'm not familiar enough with the system to disagree), just curious about your reasoning on uniform pricing for all payers? The reason I'm curious is because using your car analogy, if I was a barely competent mechanic then management would probably be fine letting me perform oil changes, but when a classic Rolls Royce comes in with all original parts, management isn't going to let me touch…

The reasoning is to make pricing transparent and grokkable as in every other industry, end the severity of this in-network out-network divide, and eliminate this ridiculous dance based around providers sending fraudulent bills to patients.

In the car analogy, there are natural differentiators between levels of service, namely completely different shops that Rolls Royce owners go to. Even so, the same shop could have a price list specifically for Rolls Royces, using Rolls Royce certified mechanics.

And the residual where a shop is willing to pay for damage caused by barely competent mechanics on less expensive cars, but only becomes concerned when that liability grows? It seems like that should fall on the business.

Re: Hospitals lift curtain on prices, reveals giant swings for hips, knees and more

#97

Post by jjoonathan »

cptskippy wrote: post #71
danaris wrote: post #26

Earlier quoted context omitted.

Framing it this way is probably inaccurate, and if inaccurate, unhelpful. From decades of observing the system, it seems extremely unlikely to me that it was deliberately engineered to be this way. Rather, different parts of it grew and changed organically and the parts and changes that benefitted moneyed interests in power stayed, while those that did not were discarded. It does not take a deliberate will behind som…

No one argues that the California or Texas power grids were geared to be unreliable and fail, but they were deliberately engineered over the years in specific ways for specific reasons. Our medical system is no different. Insurers developed byzantine claims departments and custom plans as a way to make medical coding complicated and error prone for the purpose of denying claims due to error. They setup private panels…

There are three heads to this beast: hospitals, insurance companies, and drug companies. Each swears it is innocent and points to the other two and calls them the problem, but they are all guilty.

You've covered the evil tactics of insurers, but providers absolutely engage in intentional opaqueness, overbilling, and as much screwball behavior as the market will bear. No, the insurance company did not force them to charge $500 for an aspirin and "accidentally" bill in full for a procedure that was discussed as a hypothetical but never actually happened. "Look over there!" isn't going to cut it as an excuse forever.

Re: Hospitals lift curtain on prices, reveals giant swings for hips, knees and more

#98

Post by joshspankit »

0xmohit wrote: post #80
avgDev wrote: post #11

The US healthcare system is just a completely broken mess. When things go smooth, you are lucky! However, when you have a major procedure, life event or sickness things can get messy quick. We had a child 10 months ago, billing was screwed up by the hospital, then by insurance and we are still in process of getting it resolved. I have now spent at least 8 hours on the phone. I had a surgery, called insurance and veri…

The mess is by design. Goldman Sachs asks in biotech research report: ‘Is curing patients a sustainable business model?’ https://www.cnbc.com/2018/04/11/goldman-asks-is-curing-patie... >

The providers should get paid every month that you’re in excellent health.

Imagine how many cheap cures we would “suddenly discover”.

Re: Hospitals lift curtain on prices, reveals giant swings for hips, knees and more

#99

Post by missedthecue »

kshacker wrote: post #14
avgDev wrote: post #11

The US healthcare system is just a completely broken mess. When things go smooth, you are lucky! However, when you have a major procedure, life event or sickness things can get messy quick. We had a child 10 months ago, billing was screwed up by the hospital, then by insurance and we are still in process of getting it resolved. I have now spent at least 8 hours on the phone. I had a surgery, called insurance and veri…

It is not a 'broken mess'. It is an 'engineered mess'. The difference is in intent.

Who is making the profits? Most health insurance orgs, mine included, are not for profit. BCBS, Kaiser, Wellmark, etc

Re: Hospitals lift curtain on prices, reveals giant swings for hips, knees and more

#100

Post by CGamesPlay »

narrator wrote: post #84

Kaiser is the only non-broken part of the U.S healthcare system. They have never sent me a bill for a surprise out of network anything. Out of network doctors don't work there. All doctors are on salary. You get one bill from one company. No wonder they have been growing like crazy in California.

They have sent me a bill for non-preventive services which should have been billed as preventive (aka free), but to their credit I was able to get them to refill with a not-too-tedious phone call.
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