4 ms·

it's actually a little more nuanced than that. Hospitals/providers have what they call charge master. it is probably the cash price you are mentioning. Even un

by tehlike 10y ago

it's actually a little more nuanced than that. Hospitals/providers have what they call charge master. it is probably the cash price you are mentioning. Even uninsured can end up negotiating the bill, albeit after the fact. Sometimes, insurance might negotiate lower prices than what a certain procedure/treatment costs, i believe that's not uncommon. They make up for it from other procedures in general. 1. The lack of health care cost transparency reduces price competition. 2. people not asking for price in advance, or not caring because the are already past their 1. deductible 2. out of pocket maximum makes healthcare expensive[a]. Similar to reference pricing, high-deductible health plans (with added HSA benefit) makes people think twice before going to doctors. I also felt a lot of people are not price conscious about healthcare - just yesterday a friend mentioned "i picked the most expensive plan so i don't have to think about it". Completely reasonable, but one reason why prices get higher each year. [a: reference pricing] http://www.nytimes.com/2016/08/09/upshot/how-common-procedures-got-20-percent-cheaper-for-many-californians.html http://www.nytimes.com/2016/08/09/upshot/how-common-procedur...

mirimir 10y ago
> Even uninsured can end up negotiating the bill, albeit after the fact. Yes. One could say something like "I know that you're billing me three times what you get from insurance companies, and I know that you'd pay at least 50% to a collection agency, so will you accept 40% now?" > Sometimes, insurance might negotiate lower prices than what a certain procedure/treatment costs, i believe that's not uncommon. They make up for it from other procedures in general. True. Also from payers with less negotiating strength.
- FireBeyond 10y ago
  "Yes. One could say something like "I know that you're billing me three times what you get from insurance companies, and I know that you'd pay at least 50% to a collection agency, so will you accept 40% now?"" Unfortunately, this misses another pertinent point, that the provider/facility will be able to charge off and deduct as a loss either that 50% of the original amount they're going to charge you, as well as getting 50% from collections, or 100% if they're... 'creative'. This can often reduce incentive to negotiate.
  - tehlike 10y ago
    that's still a hassle, though. there is a point, but it probably works better with individual practices than large hospitals.
  - mirimir 10y ago
    Maybe so. But wouldn't that increase the incentive to negotiate?
mikepurvis 10y ago
How practical would it be to recreate the charge master through crowd sourcing? If everyone scanned their invoices and submitted the hospital name and insurer, a picture would very quickly emerge that might allow consumers to get a reasonably accurate view of what line items are typically in a certain procedure and what it all costs. There's nothing which prevents the sharing of this information, is there?

by tehlike 10y ago

mirimir 10y ago

> Even uninsured can end up negotiating the bill, albeit after the fact. Yes. One could say something like "I know that you're billing me three times what you get from insurance companies, and I know that you'd pay at least 50% to a collection agency, so will you accept 40% now?" > Sometimes, insurance might negotiate lower prices than what a certain procedure/treatment costs, i believe that's not uncommon. They make up for it from other procedures in general. True. Also from payers with less negotiating strength.

FireBeyond 10y ago
"Yes. One could say something like "I know that you're billing me three times what you get from insurance companies, and I know that you'd pay at least 50% to a collection agency, so will you accept 40% now?"" Unfortunately, this misses another pertinent point, that the provider/facility will be able to charge off and deduct as a loss either that 50% of the original amount they're going to charge you, as well as getting 50% from collections, or 100% if they're... 'creative'. This can often reduce incentive to negotiate.
- tehlike 10y ago
  that's still a hassle, though. there is a point, but it probably works better with individual practices than large hospitals.
- mirimir 10y ago
  Maybe so. But wouldn't that increase the incentive to negotiate?

mikepurvis 10y ago

How practical would it be to recreate the charge master through crowd sourcing? If everyone scanned their invoices and submitted the hospital name and insurer, a picture would very quickly emerge that might allow consumers to get a reasonably accurate view of what line items are typically in a certain procedure and what it all costs. There's nothing which prevents the sharing of this information, is there?