7 ms·

I am originally from India and came to the US 10 years ago. I still can't believe that you can not call up a doctor/clinic/hospital in US and get a price quote

I am originally from India and came to the US 10 years ago. I still can't believe that you can not call up a doctor/clinic/hospital in US and get a price quote for something routine. Chris's experience is representative of what one can expect from the Indian health care system. If you are a working, middle class person, the free market health care works extremely well.

itg 11y ago
Part of the problem is you can thank the stranglehold the AMA has around the US healthcare system to keep the number of doctors artificially low so their salaries remain ridiculously high. Here's another example: https://www.washingtonpost.com/business/economy/new-machine-could-one-day-replace-anesthesiologists/2015/05/11/92e8a42c-f424-11e4-b2f3-af5479e6bbdd_story.html https://www.washingtonpost.com/business/economy/new-machine-... "Anesthesiologists tried to stop Sedasys. They lobbied against it for years, arguing no machine could possibly replicate their skills or handle an emergency if something went wrong. Putting someone to sleep is an art, they said. Too little sedation, and the patient feels pain. Too much, and the patient dies. Anesthesiology requires four years of training after medical school, meaning careers might not launch until the doctors are in their 30s. It’s one reason the profession’s median salary is $277,000 a year, according to research firm Payscale."
- jjoonathan 11y ago
  Before we start squabbling over whether the fault lies with the AMA in particular (this topic has come up before) let me propose that instead we discuss the more general and more relevant claim "the USA overtrains its doctors, creating needless scarcity."
  - fluxquanta 11y ago
    >"the USA overtrains its doctors, creating needless scarcity." What about the increase in physicians assistants and nurse practitioners, who seem to be taking over in the scene of less serious, more routine healthcare?
- HarryHirsch 11y ago
  the stranglehold the AMA has around the US healthcare system to keep the number of doctors artificially low On the other hand, wages in IT suffer from an overabundance of indentured H1-B labourers, held on the very short leash of the US immigration system. This should demonstrate the importance of union representation, even at the high end of the qualification scale.
- pkaye 11y ago
  I read another article a long while back on how cardiologists used to be paid considerable amounts for their skills in open heart surgery. Then later non-evasive techniques were developed and some of them were not happy because it all became more routine that heroic skills were no longer needed. There is always some degree of thinking what is best for yourself instead of your patient.
- Symmetry 11y ago
  Other notable problems with our medical system would be the RBRVS[1] and Nixon's scheme to limit hospital competition[2]. [1]https://en.wikipedia.org/wiki/Resource-based_relative_value_scale https://en.wikipedia.org/wiki/Resource-based_relative_value_... [2]https://en.wikipedia.org/wiki/Certificate_of_need https://en.wikipedia.org/wiki/Certificate_of_need
  - HarryHirsch 11y ago
    Other people would think that fixed reimbursement rates are a feature - it's what they do in my country to hold down costs, and it works well. You can ask to be paid beyond published rates, but you better have a good case when you present the bill to the insurance company. As far as overbuilding hospitals goes, you'd think that physicians and administrators will try to fill those beds at any cost, cost that is billed to patients and the taxpayer. Hospital overcapacity is not like airline overcapacity.
    - squozzer 11y ago
      The Roemer Effect has never been proven, as no country has ever had the luxury of too many hospital beds. It's based on a certain plausible logic - similar to saying welfare makes people lazy - but no one has ever presented evidence to support either.
      - HarryHirsch 11y ago
        Looking through Pubmed (!) you find many papers that are in favour of the Roemer Effect.
- chimeracoder 11y ago
  > Part of the problem is you can thank the stranglehold the AMA has around the US healthcare system to keep the number of doctors artificially low so their salaries remain ridiculously high. The AMA is a common scapegoat, except that the AMA has literally nothing to do with the number of of doctors supply-side. You're probably thinking of the AAMC, which has nothing to do with the AMA, and is responsible for the number of medical students who graduate each year from the US. Except the AAMC has very deliberately and openly increased the number of medical student slots each year for over a decade, specifically with this goal in mind. But even this is a moot point, because the number of people gradating with MDs is not the bottleneck - the problem is that doctors can't practice medicine until they complete a residency program. We graduate more medical students every year than we have residency slots available, so increasing the number of graduates even further will have no effect. Increasing the number of residency slots is up to Medicare, because Medicare funds residency programs nationwide.
  - jessaustin 11y ago
    Does this mean there is an ever-growing population of "post-doc" physicians, stuck in labs or other non-patient-facing situations? What numbers are we talking about?
    - chimeracoder 11y ago
      > What numbers are we talking about? In 2015 there were 41,000+ applicants for ~30,000 residency positions[0]. I don't have the 2015 numbers for medical schools, but in 2014, there were 18,000 graduates in the US[1]. Increasing the number of medical school graduates in the US would mean that a larger percentage of residency slots are taken by people who went to school in the US but not the total number of residents. Ironically, this would actually be a bad thing cost-wise, since foreign medical schools are usually cheaper and students carry a lower debt load[2]. > Does this mean there is an ever-growing population of "post-doc" physicians, stuck in labs or other non-patient-facing situations? Yes. You are likely to see them take jobs in industry - e.g. at a pharmaceutical or insurance company, but on the business side, since they're not licensed to practice. (Nor are they even qualified - medical school teaches essential knowledge for doctors, but they receive basically no training on actual clinical practice. All of that happens during residency). It's worth noting that not all doctors want to practice medicine - for example, people in an MD/PhD program often go into research, and that's a good thing. But if we're talking about increasing the supply of practicing physicians, increasing the number of medical school applicants in the US makes literally zero difference. [0] http://www.nrmp.org/press-release-2015-residency-match-largest-on-record-with-more-than-41000-applicants-vying-for-over-30000-residency-positions-in-4756-programs/ http://www.nrmp.org/press-release-2015-residency-match-large... [1] https://www.aamc.org/download/321532/data/factstable27-2.pdf https://www.aamc.org/download/321532/data/factstable27-2.pdf [2] These aren't necessarily "foreign" students either; it's quite common for people in the US to go to medical school in the Caribbean and then come back for their residency.
- knughit 11y ago
  $277K/yr doesn't sound too bad, compared to lawyers and finance folks and business VPs. That's not why healthcare costs so much. Even if you booked 1 anesthesiologist for a whole day long massively intensive surgery, that's only about $2k of your cost
- Omniusaspirer 11y ago
  This comment is not only factually wrong (It's not the AMA) but misleading as well. The typical medical student today leaves med school $250k in debt at 8% interest then spends years in a residency where they make $50-60k working 80+ hours per week in a likely high cost of living area. If they started schooling immediately after high school they probably won't actually make that 270k (median, so many starting out are lower) until they're 30+ years old. Contrast that to a completely mediocre web dev who can pull 100k+ at 21 putting in 40-50 hours a week and do you really still think physicians are overpaid? Keep in mind the majority end up in family or internal medicine working 60+ hours a week for ~$175k/yr. Going to medical school is a massive financial risk with an incredibly uncertain future. If you want a human punching bag then turn your gaze towards hospital administrators, pharmaceutical executives, and exploitative vendors. The actual hospital employees are just as much victims of the healthcare shit show as members of the public are.
atom-morgan 11y ago
Exactly. Imagine how much of a hassle car repairs would be if your car insurance company handled an oil change or a tire balance/rotation.
- lbhnact 11y ago
  Imagine how much a hassle car repairs would be if cars were a staggeringly complex biological system where parts could not be replaced figuring out what was wrong was difficult and all work had to be done in while it was driving down the road and it was really easy for you to die if a mistake was made and other people had to pay for it.
  - kangman 11y ago
    That sounds like a modern car to me. sans biological
  - jerf 11y ago
    Are Indian humans made out of simpler parts, such that it's OK for them to have free market health care whereas it doesn't work for us?
    - s73v3r 11y ago
      No, it's that they don't care about people not being able to get care, whereas we at least try to care about it.
      - jerf 11y ago
        That ahem sort of racist snark would make a lot more sense if we weren't having this discussion in the context of a system that appears to be providing wildly cheaper service. My more subtle point is that when we are discussing an existing free-market based medical system, you can not just trot out all the standard arguments about why the US should not go free market, because they are all based on a discussion of a change in how we structure the system. Here we (appear to) have a free-market system, so, one must validate all the slurs actually apply before just flinging them at the existing system. If free-market health is so guaranteed to be so utterly disastrous, instead of flinging quasi-racist slurs at the Indians, why don't you actually go find the guaranteed-disasters in progress? Ought to be pretty easy if it's even one-tenth as bad as everyone always claims in the US context. (Though I'll warn you in advance I'm going to account for the situation on the ground; if the doctor's office in a far-flung village with a per-capita income of 50$/year isn't up to US standards, I'm not going to award you many points. India is not a wealthy country. Only the major medical centers are really that interesting. It's also generally invalid to complain about a government not providing services when they simply do not have the wherewithal to be providing them to everybody yet.)
pc86 11y ago
In addition to what itg said, another is that with various insurers the doctors and even the billing people do not actually know what you'll pay. They know what the service costs them to perform (irrelevant to what is charged to the consumer), they know what they're going to bill the insurer (a grossly inflated number that is a big cause of these massive 6-figure bills you see to uninsured folks), but they have no idea what the insurer will actually reimburse them, so they honestly can't tell you. It's a broken system and there's no excuse for it, but at least in the US it is not because they're being intentionally obtuse.
- secabeen 11y ago
  Many doctors don't even know what they'll bill, as it's different per-insurer, etc. Their back-office staff certainly can look it up, but docs don't know the numbers.
- r00fus 11y ago
  I went through this a few years back trying to get enough FSA to cover my portion of my daughter's long awaited eye operation. It was insane that I couldn't even be given an exact figure for my portion of the bill to plan for FSA - it's like it's all negotiated at time of operation or after the fact. Now some of that is that if a complication occurs, there will be additional cost, but I was just asking for a baseline, and all they could give me were guesses.
  - pc86 11y ago
    Disclaimer: It has been many years since I was involved in this professionally, pre-ACA. It may have changed since then. Depending on the arrangement with the insurer, and what the recovery period was like for that type of operation, nobody in the office probably had any idea (and I bet their guesses were pretty far apart, too). Some medication used in recovery is very expensive and can add five-figure variances if someone doesn't respond well to the procedure or is in an abnormal amount of pain. And as you mentioned any complications can double the cost in an instant. From the insurer side, they will decide after they receive the care provider's bill what they're covering and for how much. They may decide she only need five hydrocodone, not eight, so there's (3 * $n) out of your pocket (I am not googling the cost of hydrocodone at work :)). What's more is this "justification" is rarely given to the care providers. The insurer is billed $50,000, they pay $47,000 and that's that. The cynic in me wants to say it's so they don't actually have to justify partial payment, but who knows.
lbhnact 11y ago
>I still can't believe that you can not call up a doctor/clinic/hospital in US and get a price quote for something routine You can. Routine, profitable procedures are not hard to arrange in the US. I have personally worked in a clinic where the exact experience described in this post happens every day. >If you are a working, middle class person, the free market health care works extremely well. It's pretty easy in most places in the world to get people to do something that makes them money, like the discectomy discussed here. Managing a system where the poor and the unlucky get care is a little tougher. The US does it lousily, but so does most of the rest of the world. India doesn't do it at all. edit:copy error
- mikeg8 11y ago
  > You can. Routine, profitable procedures are not hard to arrange in the US. I have personally worked in a clinic where the exact experience described in this post happens every day. For the majority, this is simply not the case. I'm sure there are exceptions as our country is very large, but most people's experience would be very similar to the OPs. I'd suggest reading Healing of America by T.R. Reed if you're interested in the working of US compared to other systems.
- hospes 11y ago
  For vast majority of the procedures and surgeries you cannot get any quote. I tried to get quote for the standard procedure (that they have performed 100s of times) via phone and in person in Dr's office in 4 different hospitals. All of them told me that they do not know the price, since it depends on what my insurance will cover. They said that they need to do evaluation, schedule the procedure, submit paperwork to the insurance company and then I can get the quote, which is crazy, because to schedule the procedure you need to go through pretty expensive evaluation process. Basically just to know the price you may need to spend couple thousand dollars. This happened to most of the people that I know that needed some kind of quote from the hospital. The clinic you have worked was an exception.
Vivtek 11y ago
Ha. Back when our son was having regular lab exams, we were in the States. When we asked Bloomington Hospital for a price for one lab exam, the receptionist asked us, "Why? Don't you want the best for your child?" Yeah, lady, that includes not giving you all our money without asking how much you'll be taking.
crusso 11y ago
We have too many middle-men in US healthcare. They obscure costs and prices while preventing individuals from getting more involved with their own healthcare decisions. Rather than a one-size-fits-all approach to healthcare through single payer or other subsidies, my fondest wish for government intervention would be for laws that force doctors and hospitals to provide price and likely outcome information to the general public. Give healthcare consumers the data they need to make informed decisions and the ensuing competition could drive down prices while improving outcomes.
- maxxxxx 11y ago
  That would be my first step for health reform: Require publication of prices and outcomes. Also: Don't allow charging of one price to one group of people (uninsured) and 25% of that price for another group (insurers). One price for all. Maybe allow for 10% discount but not the huge discounts insurers get.
s73v3r 11y ago
"If you are a working, middle class person, the free market health care works extremely well." And if you're not?
xixi77 11y ago
You actually often can (or at least, could -- not sure how Obamacare might have changed this) -- you need to state that you are uninsured; you may very well get a lower price for your routine than you would have to pay out of pocket with insurance.
vadym909 11y ago
Yes- my friend goes to India and does his annual checkups/ dental checkups and fillings for a few hundred rupees which is cheaper than the deductible of his dental insurance here. Last time he had heart pain and went to a top heart specialty clinic and his bill was $11 to get checked out.

itg 11y ago

Part of the problem is you can thank the stranglehold the AMA has around the US healthcare system to keep the number of doctors artificially low so their salaries remain ridiculously high. Here's another example: https://www.washingtonpost.com/business/economy/new-machine-could-one-day-replace-anesthesiologists/2015/05/11/92e8a42c-f424-11e4-b2f3-af5479e6bbdd_story.html https://www.washingtonpost.com/business/economy/new-machine-... "Anesthesiologists tried to stop Sedasys. They lobbied against it for years, arguing no machine could possibly replicate their skills or handle an emergency if something went wrong. Putting someone to sleep is an art, they said. Too little sedation, and the patient feels pain. Too much, and the patient dies. Anesthesiology requires four years of training after medical school, meaning careers might not launch until the doctors are in their 30s. It’s one reason the profession’s median salary is $277,000 a year, according to research firm Payscale."

jjoonathan 11y ago
Before we start squabbling over whether the fault lies with the AMA in particular (this topic has come up before) let me propose that instead we discuss the more general and more relevant claim "the USA overtrains its doctors, creating needless scarcity."
- fluxquanta 11y ago
  >"the USA overtrains its doctors, creating needless scarcity." What about the increase in physicians assistants and nurse practitioners, who seem to be taking over in the scene of less serious, more routine healthcare?
HarryHirsch 11y ago
the stranglehold the AMA has around the US healthcare system to keep the number of doctors artificially low On the other hand, wages in IT suffer from an overabundance of indentured H1-B labourers, held on the very short leash of the US immigration system. This should demonstrate the importance of union representation, even at the high end of the qualification scale.
pkaye 11y ago
I read another article a long while back on how cardiologists used to be paid considerable amounts for their skills in open heart surgery. Then later non-evasive techniques were developed and some of them were not happy because it all became more routine that heroic skills were no longer needed. There is always some degree of thinking what is best for yourself instead of your patient.
Symmetry 11y ago
Other notable problems with our medical system would be the RBRVS[1] and Nixon's scheme to limit hospital competition[2]. [1]https://en.wikipedia.org/wiki/Resource-based_relative_value_scale https://en.wikipedia.org/wiki/Resource-based_relative_value_... [2]https://en.wikipedia.org/wiki/Certificate_of_need https://en.wikipedia.org/wiki/Certificate_of_need
- HarryHirsch 11y ago
  Other people would think that fixed reimbursement rates are a feature - it's what they do in my country to hold down costs, and it works well. You can ask to be paid beyond published rates, but you better have a good case when you present the bill to the insurance company. As far as overbuilding hospitals goes, you'd think that physicians and administrators will try to fill those beds at any cost, cost that is billed to patients and the taxpayer. Hospital overcapacity is not like airline overcapacity.
  - squozzer 11y ago
    The Roemer Effect has never been proven, as no country has ever had the luxury of too many hospital beds. It's based on a certain plausible logic - similar to saying welfare makes people lazy - but no one has ever presented evidence to support either.
    - HarryHirsch 11y ago
      Looking through Pubmed (!) you find many papers that are in favour of the Roemer Effect.
chimeracoder 11y ago
> Part of the problem is you can thank the stranglehold the AMA has around the US healthcare system to keep the number of doctors artificially low so their salaries remain ridiculously high. The AMA is a common scapegoat, except that the AMA has literally nothing to do with the number of of doctors supply-side. You're probably thinking of the AAMC, which has nothing to do with the AMA, and is responsible for the number of medical students who graduate each year from the US. Except the AAMC has very deliberately and openly increased the number of medical student slots each year for over a decade, specifically with this goal in mind. But even this is a moot point, because the number of people gradating with MDs is not the bottleneck - the problem is that doctors can't practice medicine until they complete a residency program. We graduate more medical students every year than we have residency slots available, so increasing the number of graduates even further will have no effect. Increasing the number of residency slots is up to Medicare, because Medicare funds residency programs nationwide.
- jessaustin 11y ago
  Does this mean there is an ever-growing population of "post-doc" physicians, stuck in labs or other non-patient-facing situations? What numbers are we talking about?
  - chimeracoder 11y ago
    > What numbers are we talking about? In 2015 there were 41,000+ applicants for ~30,000 residency positions[0]. I don't have the 2015 numbers for medical schools, but in 2014, there were 18,000 graduates in the US[1]. Increasing the number of medical school graduates in the US would mean that a larger percentage of residency slots are taken by people who went to school in the US but not the total number of residents. Ironically, this would actually be a bad thing cost-wise, since foreign medical schools are usually cheaper and students carry a lower debt load[2]. > Does this mean there is an ever-growing population of "post-doc" physicians, stuck in labs or other non-patient-facing situations? Yes. You are likely to see them take jobs in industry - e.g. at a pharmaceutical or insurance company, but on the business side, since they're not licensed to practice. (Nor are they even qualified - medical school teaches essential knowledge for doctors, but they receive basically no training on actual clinical practice. All of that happens during residency). It's worth noting that not all doctors want to practice medicine - for example, people in an MD/PhD program often go into research, and that's a good thing. But if we're talking about increasing the supply of practicing physicians, increasing the number of medical school applicants in the US makes literally zero difference. [0] http://www.nrmp.org/press-release-2015-residency-match-largest-on-record-with-more-than-41000-applicants-vying-for-over-30000-residency-positions-in-4756-programs/ http://www.nrmp.org/press-release-2015-residency-match-large... [1] https://www.aamc.org/download/321532/data/factstable27-2.pdf https://www.aamc.org/download/321532/data/factstable27-2.pdf [2] These aren't necessarily "foreign" students either; it's quite common for people in the US to go to medical school in the Caribbean and then come back for their residency.
knughit 11y ago
$277K/yr doesn't sound too bad, compared to lawyers and finance folks and business VPs. That's not why healthcare costs so much. Even if you booked 1 anesthesiologist for a whole day long massively intensive surgery, that's only about $2k of your cost
Omniusaspirer 11y ago
This comment is not only factually wrong (It's not the AMA) but misleading as well. The typical medical student today leaves med school $250k in debt at 8% interest then spends years in a residency where they make $50-60k working 80+ hours per week in a likely high cost of living area. If they started schooling immediately after high school they probably won't actually make that 270k (median, so many starting out are lower) until they're 30+ years old. Contrast that to a completely mediocre web dev who can pull 100k+ at 21 putting in 40-50 hours a week and do you really still think physicians are overpaid? Keep in mind the majority end up in family or internal medicine working 60+ hours a week for ~$175k/yr. Going to medical school is a massive financial risk with an incredibly uncertain future. If you want a human punching bag then turn your gaze towards hospital administrators, pharmaceutical executives, and exploitative vendors. The actual hospital employees are just as much victims of the healthcare shit show as members of the public are.

atom-morgan 11y ago

Exactly. Imagine how much of a hassle car repairs would be if your car insurance company handled an oil change or a tire balance/rotation.

lbhnact 11y ago
Imagine how much a hassle car repairs would be if cars were a staggeringly complex biological system where parts could not be replaced figuring out what was wrong was difficult and all work had to be done in while it was driving down the road and it was really easy for you to die if a mistake was made and other people had to pay for it.
- kangman 11y ago
  That sounds like a modern car to me. sans biological
- jerf 11y ago
  Are Indian humans made out of simpler parts, such that it's OK for them to have free market health care whereas it doesn't work for us?
  - s73v3r 11y ago
    No, it's that they don't care about people not being able to get care, whereas we at least try to care about it.
    - jerf 11y ago
      That ahem sort of racist snark would make a lot more sense if we weren't having this discussion in the context of a system that appears to be providing wildly cheaper service. My more subtle point is that when we are discussing an existing free-market based medical system, you can not just trot out all the standard arguments about why the US should not go free market, because they are all based on a discussion of a change in how we structure the system. Here we (appear to) have a free-market system, so, one must validate all the slurs actually apply before just flinging them at the existing system. If free-market health is so guaranteed to be so utterly disastrous, instead of flinging quasi-racist slurs at the Indians, why don't you actually go find the guaranteed-disasters in progress? Ought to be pretty easy if it's even one-tenth as bad as everyone always claims in the US context. (Though I'll warn you in advance I'm going to account for the situation on the ground; if the doctor's office in a far-flung village with a per-capita income of 50$/year isn't up to US standards, I'm not going to award you many points. India is not a wealthy country. Only the major medical centers are really that interesting. It's also generally invalid to complain about a government not providing services when they simply do not have the wherewithal to be providing them to everybody yet.)

pc86 11y ago

In addition to what itg said, another is that with various insurers the doctors and even the billing people do not actually know what you'll pay. They know what the service costs them to perform (irrelevant to what is charged to the consumer), they know what they're going to bill the insurer (a grossly inflated number that is a big cause of these massive 6-figure bills you see to uninsured folks), but they have no idea what the insurer will actually reimburse them, so they honestly can't tell you. It's a broken system and there's no excuse for it, but at least in the US it is not because they're being intentionally obtuse.

secabeen 11y ago
Many doctors don't even know what they'll bill, as it's different per-insurer, etc. Their back-office staff certainly can look it up, but docs don't know the numbers.
r00fus 11y ago
I went through this a few years back trying to get enough FSA to cover my portion of my daughter's long awaited eye operation. It was insane that I couldn't even be given an exact figure for my portion of the bill to plan for FSA - it's like it's all negotiated at time of operation or after the fact. Now some of that is that if a complication occurs, there will be additional cost, but I was just asking for a baseline, and all they could give me were guesses.
- pc86 11y ago
  Disclaimer: It has been many years since I was involved in this professionally, pre-ACA. It may have changed since then. Depending on the arrangement with the insurer, and what the recovery period was like for that type of operation, nobody in the office probably had any idea (and I bet their guesses were pretty far apart, too). Some medication used in recovery is very expensive and can add five-figure variances if someone doesn't respond well to the procedure or is in an abnormal amount of pain. And as you mentioned any complications can double the cost in an instant. From the insurer side, they will decide after they receive the care provider's bill what they're covering and for how much. They may decide she only need five hydrocodone, not eight, so there's (3 * $n) out of your pocket (I am not googling the cost of hydrocodone at work :)). What's more is this "justification" is rarely given to the care providers. The insurer is billed $50,000, they pay $47,000 and that's that. The cynic in me wants to say it's so they don't actually have to justify partial payment, but who knows.

lbhnact 11y ago

>I still can't believe that you can not call up a doctor/clinic/hospital in US and get a price quote for something routine You can. Routine, profitable procedures are not hard to arrange in the US. I have personally worked in a clinic where the exact experience described in this post happens every day. >If you are a working, middle class person, the free market health care works extremely well. It's pretty easy in most places in the world to get people to do something that makes them money, like the discectomy discussed here. Managing a system where the poor and the unlucky get care is a little tougher. The US does it lousily, but so does most of the rest of the world. India doesn't do it at all. edit:copy error

mikeg8 11y ago
> You can. Routine, profitable procedures are not hard to arrange in the US. I have personally worked in a clinic where the exact experience described in this post happens every day. For the majority, this is simply not the case. I'm sure there are exceptions as our country is very large, but most people's experience would be very similar to the OPs. I'd suggest reading Healing of America by T.R. Reed if you're interested in the working of US compared to other systems.
hospes 11y ago
For vast majority of the procedures and surgeries you cannot get any quote. I tried to get quote for the standard procedure (that they have performed 100s of times) via phone and in person in Dr's office in 4 different hospitals. All of them told me that they do not know the price, since it depends on what my insurance will cover. They said that they need to do evaluation, schedule the procedure, submit paperwork to the insurance company and then I can get the quote, which is crazy, because to schedule the procedure you need to go through pretty expensive evaluation process. Basically just to know the price you may need to spend couple thousand dollars. This happened to most of the people that I know that needed some kind of quote from the hospital. The clinic you have worked was an exception.

Vivtek 11y ago

Ha. Back when our son was having regular lab exams, we were in the States. When we asked Bloomington Hospital for a price for one lab exam, the receptionist asked us, "Why? Don't you want the best for your child?" Yeah, lady, that includes not giving you all our money without asking how much you'll be taking.

crusso 11y ago

We have too many middle-men in US healthcare. They obscure costs and prices while preventing individuals from getting more involved with their own healthcare decisions. Rather than a one-size-fits-all approach to healthcare through single payer or other subsidies, my fondest wish for government intervention would be for laws that force doctors and hospitals to provide price and likely outcome information to the general public. Give healthcare consumers the data they need to make informed decisions and the ensuing competition could drive down prices while improving outcomes.

maxxxxx 11y ago
That would be my first step for health reform: Require publication of prices and outcomes. Also: Don't allow charging of one price to one group of people (uninsured) and 25% of that price for another group (insurers). One price for all. Maybe allow for 10% discount but not the huge discounts insurers get.

s73v3r 11y ago

"If you are a working, middle class person, the free market health care works extremely well." And if you're not?

xixi77 11y ago

You actually often can (or at least, could -- not sure how Obamacare might have changed this) -- you need to state that you are uninsured; you may very well get a lower price for your routine than you would have to pay out of pocket with insurance.

vadym909 11y ago

Yes- my friend goes to India and does his annual checkups/ dental checkups and fillings for a few hundred rupees which is cheaper than the deductible of his dental insurance here. Last time he had heart pain and went to a top heart specialty clinic and his bill was $11 to get checked out.