5 ms·

> In most realms, those with the least ability to pay should receive the biggest discounts. In health care, it is often the uninsured and indigent who receive b

by habosa 10y ago

> In most realms, those with the least ability to pay should receive the biggest discounts. In health care, it is often the uninsured and indigent who receive bills with the full “chargemaster” fee — the wildly inflated prices that nobody really pays — while large insurance companies get the biggest breaks. This bothers me more than almost any other piece of our system. It's corrupt from the start, with prices being presented that do not have any relation to the price that the parties in the transaction actually expect to pay/receive. So even if we had "price transparency" for medical procedures, it wouldn't really reflect reality. A few examples of the system at work: * I have a HSA so I don't put small medical expenses through my insurance. I went to a doctor for a strep throat check and was told that my 30m appointment would be $350 if put through my insurance (and I hadn't hit my deductible yet) or $150 if I paid in cash at the office. So I paid cash with my HSA. Why should there by these two wildly divergent prices? Even if I had no deductible and took the $350 option that just means my insurance company is paying $200 over what the doctor actually wants for the service, which means some other person in the insurance pool will receive $200 less in services down the road. * One time I got food poisoning in college and because it happened in a classroom and I was unable to really walk/balance the school said I could only leave in an ambulance. So an ambulance was called to drive me the 0.25mi to the university hospital. I waited a few hours in the ER, then a doctor saw me for 15 minutes and no medicine or care was actually administered since I was fine by then. I get a bill in the mail for $1000 a few weeks later, that's $700 for the drive and $300 for the doctor's time. My dad (a dentist) advised me to not pay the bill and let it go to collection. Then a few weeks later the bill collector called me and since I had my income listed as $0 (college student) they said I could pay the bill in installments or just make it all go away for a $300 lump sum (which I took). So just by waiting around suddenly the cost of treatment went down by 70%. Medicine should not be a negotation. There should be one price for everyone and you shouldn't have to know anyone or pull strange tricks to get the real price. If we don't even know what something costs, how can we begin to drive the cost down?

6e0prjs5fv 10y ago
Just letting you know, the monospace formatting appears as a single line and is unreadable on mobile.
- habosa 10y ago
  Fixed, thanks!
newjersey 10y ago
I do not believe for a single second that your insurance company "pays" their full share as demonstrated when they tell you you have to pay 20% of the cost. I have no evidence but I am strongly convinced that there is some sort of account reconciliation between an insurance company and an in network provider where they settle accounts in a ... more palatable manner. There is just no way Humana would pay over $7k for two hours of waiting for triage in the emergency room and eventually a rabies vaccine shot. You've hit the problem right in the head here. > Medicine should not be a negotation. There should be one price for everyone and you shouldn't have to know anyone or pull strange tricks to get the real price. If we don't even know what something costs, how can we begin to drive the cost down? From what I've read: Part of the problem is hospitals themselves don't know the exact cost. I think another part should be the introduction of death panels. There should be a point being which we will "put down" a suffering patient. We do this with dogs and cats all the time. If someone is suffering and very unlikely to make a good recovery, we should put them out of their misery. Or at least we shouldn't pour so much effort into keeping them alive.

by habosa 10y ago

6e0prjs5fv 10y ago

Just letting you know, the monospace formatting appears as a single line and is unreadable on mobile.

habosa 10y ago
Fixed, thanks!

newjersey 10y ago

I do not believe for a single second that your insurance company "pays" their full share as demonstrated when they tell you you have to pay 20% of the cost. I have no evidence but I am strongly convinced that there is some sort of account reconciliation between an insurance company and an in network provider where they settle accounts in a ... more palatable manner. There is just no way Humana would pay over $7k for two hours of waiting for triage in the emergency room and eventually a rabies vaccine shot. You've hit the problem right in the head here. > Medicine should not be a negotation. There should be one price for everyone and you shouldn't have to know anyone or pull strange tricks to get the real price. If we don't even know what something costs, how can we begin to drive the cost down? From what I've read: Part of the problem is hospitals themselves don't know the exact cost. I think another part should be the introduction of death panels. There should be a point being which we will "put down" a suffering patient. We do this with dogs and cats all the time. If someone is suffering and very unlikely to make a good recovery, we should put them out of their misery. Or at least we shouldn't pour so much effort into keeping them alive.