For reference, here is the Israeli Ministry of Health price list as of July 1st 2023:
https://www.gov.il/BlobFolder/dynamiccollectorresultitem/moh...
Edit: Direct link to an Excel spreadsheet.
A petabyte of health insurance prices per month
91–100 of 275 posts
Re: A petabyte of health insurance prices per month
#92It’s interesting that so many commentators are blaming the insurers here. The whole article is about how insurers use rules engines and lookups to define these prices and that the data explosion was a result of the legislation requiring price lists instead of an open standard for describing rules and lookups.
Re: A petabyte of health insurance prices per month
#93Earlier quoted context omitted.
Because, like it or not, a doctor's discretion can sometimes be self-serving. The more treatments a doctor gives, the more they get paid, and there is an enormous information imbalance between doctor and patient. (As in, they went to medical school, and you didn't.) Unfortunately, some doctors are willing to take advantage of this.
It's kinda ridiculous that because it costs x billion in doctors overcharging, we'll spend 100x on administration to control costs. Cutting off one's nose to spite one's face and all that.
Actually if you think about it insurance is forced investment in a fund where the amount they make is driven as much by the amount they can get you to pay in as much as efficiency. It is only beneficial not to be so obviously egregious that nobody will touch you in an environment full of people who are tacitly collaborating to increase prices so that the pie gets bigger for everyone.
Everyone is actually collaborating against you which is why in the US we only provide free health care for a small fraction of the populace but still manage to pay for THOSE folks as much as some other developed nations pay to cover their entire population.
Re: A petabyte of health insurance prices per month
#94They are making it impossible to handle the data so everyone gives up trying so they can go on screwing people over.
While there are huge problems, I think the majority of the problem is people expect their health insurance plan to be like a prepaid maintenance plan.
If you crash your car today without insurance, you understand it won't be covered by getting insurance tomorrow.
Why people think they can finally get healthy "insurance" at 45 from company xyz, knowing they need this pill or that pill, and expect the new insurance company to pay for it I will never understand.
Re: A petabyte of health insurance prices per month
#95There are separate charge codes for everything , and all of those codes need to be reflected in the pricing data. There's a price to slap on a bandaid. There's a price to give someone a Tylenol. Hell, W61.61XA is the medical code for "Bitten by duck, initial encounter." Presumably, this means there's also a code for "Bitten by duck, again." Medical billing is broken , and it's no surprise that the amount of data is o…
Medical billing is broken
Is it?
Seriously - how do you know? More specifically: broken compared to what? What would you replace it with?
Be specific, please.
Keeping in mind that it's like, an extremely complex domain and all, you know.
Re: A petabyte of health insurance prices per month
#96Earlier quoted context omitted.
I wonder if bitten by duck is more expensive that bitten by chicken.
Not even ironically, this all smells of insurers wanting sufficient data to raise rates on different types of farmers and breeders. It might be scandalous if they didn’t collect the data and then were biased against, say, chicken farmers. But if they do collect the data, they can say they analyzed it, whether or not they did, to support any kind of tactic they desired.
You are smelling something that is not there because, in the US, health insurers are only allowed a few factors to determine someone’s premium.
https://www.healthcare.gov/how-plans-set-your-premiums
> Five factors can affect a plan’s monthly premium: location, age, tobacco use, plan category, and whether the plan covers dependents.
Re: A petabyte of health insurance prices per month
#97There are separate charge codes for everything , and all of those codes need to be reflected in the pricing data. There's a price to slap on a bandaid. There's a price to give someone a Tylenol. Hell, W61.61XA is the medical code for "Bitten by duck, initial encounter." Presumably, this means there's also a code for "Bitten by duck, again." Medical billing is broken , and it's no surprise that the amount of data is o…
A friend of mine started a substack of all the kind of broken ICD10 codes, as recited by chatgpt: https://icdstories.substack.com/
Re: A petabyte of health insurance prices per month
#98Lol Cardiac Services ---- 44.8% of billed rate This screams pads and buffers. As in, the administrator adds random line-items to things as long as the name of the service is "similar enough" so that they can justify whatever amount they want in the end. It reminds me of the auto industry. I've been replacing transmission selonoids, serpentine belts, brakes, fluids, etc... last 3 years ( I bought a dodge ram 3500 and…
Insurers paying a negotiated X% of the original bill is a common feature of the bizarre US health care market. This has all the knock-on effects you would expect, like the original bill being then massively inflated so that the healthcare provider doesn't go out of business when they're only paid 44.8% of it.
Re: A petabyte of health insurance prices per month
#99Earlier quoted context omitted.
[flagged]
Bitten by a communist just yesterday. I wonder how it is coded.
Looks like it's W50.3XXA if it was accidental. Or Y04.8XXA if it was intentional. If you were the communist and bit yourself on the upper right arm it would be S40.871A or S41.151A depending on how deep the bite went.
Re: A petabyte of health insurance prices per month
#100Because our (US) system is at Monty Python levels of absurdity. We waste more money with this "system" than most other countries spend as a total, and with worse outcomes on average [1]. Fundamentally, there are two factors, IMO, that have been conclusively proven (repeatedly, and for decades - much more strongly, recently) to be incompatible with delivering quality healthcare with some level of efficiency: 1) For-pr…
> We waste more money with this "system" than most other countries spend as a total, and with worse outcomes on average [1] Oh sure, if you don't measure what is obviously the most important outcome: freedom
I value the freedom to not die because medical care is too expensive over the freedom to profit off of the sick.