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The article already states that these online prices will be meaningless to most people, as they are the 'list prices' that no insurance company or individual wo

The article already states that these online prices will be meaningless to most people, as they are the 'list prices' that no insurance company or individual would actually end up paying. So it will still be nearly impossible to find out what a treatment will cost before having it.

sigmar 9y ago
>It may still prove to be confusing to consumers, since standard rates are like list prices and don't reflect what insurers and government programs pay. Does not mean "meaningless." And the purpose of shopping around is comparing between hospitals. List prices should be a good relative predictor for comparing cost.
- txcwpalpha 9y ago
  > And the purpose of shopping around is comparing between hospitals. List prices should be a good relative predictor for comparing cost. When is the last time you dealt with any healthcare bills? This is almost universally untrue. Hospital A's list price for an MRI might be $1000, but your insurance has a deal with them where you only pay $100 out of pocket. Meanwhile Hospital B's list price for the same MRI is $500, but your insurance doesn't have a deal with them, so your OOP cost is $500. This is very common, and in many cases is impossible to know if it will happen until after you have had the procedure and are billed.
  - sigmar 9y ago
    I mean, yea, you check with your insurer first? How could the hospital possibly have information about how much each insurer would cover considering there are literally hundreds? This seems like a "perfect is the enemy of good" situation
    - txcwpalpha 9y ago
      > I mean, yea, you check with your insurer first? If you're checking with your insurer to find the price, then that makes the hospital's listed prices meaningless, which is the entire point of this comment chain.
      - sigmar 9y ago
        The insurer doesn't know what each hospital charges. Posting costs online is just to make it more convenient to find the information. In the perfect world, everyone would sit down with the hospital, look at the likely range of costs of a procedure, call the HMO/PPO to check how each outcome would be covered, and then repeat that process at several locations. But that is arduous and people don't have the time or patience.
        txcwpalpha 9y ago
        >The insurer doesn't know what each hospital charges. Yes they do. Providers are already required to make their list prices publicly available, and insurance companies have it (they are already available to the general public as well, but they're probably going to be hard to find/understand for a layperson). Many insurance companies already have cost lookup tools specifically for this purpose. Posting the hospital's list price online like the article is talking about is purely for the consumption of the patient. It is not of use to the insurer. >In the perfect world In a perfect world, I'd contest that you wouldn't have to worry about healthcare costs at all, but I digress. >everyone would sit down with the hospital, look at the likely range of costs of a procedure, call the HMO/PPO to check how each outcome would be covered Except you already can do this even without looking at the list prices from a hospital. Your insurance can already tell you exactly how much you will be charged by any provider. They do not need these online 'list prices' to do so.
        chimeracoder 9y ago
        > The insurer doesn't know what each hospital charges. Posting costs online is just to make it more convenient to find the information. Every hospital charges more than the maximum reimbursable amount for the insurer. If they don't, that's because they've made a mistake - their goal is literally to set a bill that's high enough that it will generate a reimbursement for the maximum amount each time.
  - jwineinger 9y ago
    Isn't it standard practice to find out which facilities/providers are in your network so you can judge this? I always check before we go somewhere new
    - bluGill 9y ago
      Yes, but that is the only thing I check. If I have a choice between two in-network providers I don't even ask about price.
  - matz1 9y ago
    So at least you know what the maximum amount you have to pay, regardless what amount your insurance will pay.
- refurb 9y ago
  List prices should be a good relative predictor for comparing cost. The problem is it's not a good predictor. I'm sure you've seen articles that say the cost of an MRI can vary between $500 and $5000. Those are the list prices. For a given insurer, the contracted rate is probably pretty similar with the $500 rate being only marginally discounted and the $5000 rate heavily discounted.
  - matz1 9y ago
    So at least I can compare the price, regardless what insurance I have.
  - sigmar 9y ago
    Sure, predictions aren't always right. People should still check with the health insurance of where they should seek treatment. None of that doesn't makes list prices "meaningless"
bufferoverflow 9y ago
It's not meaningless. Because you know if the procedure costs X, and your insurance covers 80%, you know you will only pay 0.2X at most. There will be no random charge for thousands of dollars for something trivial. And it will introduce price competition.
- txcwpalpha 9y ago
  >It's not meaningless. Because you know if the procedure costs X, and your insurance covers 80%, you know you will only pay 0.2X at most. There will be no random charge for thousands of dollars for something trivial. That's not how insurance works, though. You would pay 20% of your insurance's negotiated cost, not the list price. So you could still end up paying more at a hospital that has "lower prices", based on how well your insurance negotiates with them. >And it will introduce price competition. This is not universally a good thing.
  - nopinsight 9y ago
    In what ways would price competition be worse than no price competition, given that other relevant information like quality of care is available as well?
    - txcwpalpha 9y ago
      > given that other relevant information like quality of care is available as well? Well first off, that's not a given. The article only mentions Medicare using price and electronic medical records as a way of 'rating' providers. I can't find anything similar about Medicare rating providers based on quality of care. Second, look up the situation with Lasik eye clinics. Another user in this thread suggested it as a "great example of a highly functional healthcare market" driven by price competition. In reality, price competition in the Lasik market has caused eye clinics to operate more like car salesmen (complete with sales commissions, aggressive/pushy sales tactics, and deceptive marketing), and not like someone who actually has your best medical interests in mind. I'm not saying that simply introducing price competition to hospitals will lead to something like that, but it's certainly an example of price competition not being a good thing.
poulsbohemian 9y ago
I think this is the issue that should push us all toward a single-payer, government-backed system. The fact that we all (or our employers) pay a ridiculous amount for health insurance each month, PLUS end up paying out of pocket a high amount anyway as our health insurance really only kicks in once there is an extreme situation (emergency, chronic illness). And as a consumer I am stuck in the middle of it, with there being no competition but no recourse either.

sigmar 9y ago

>It may still prove to be confusing to consumers, since standard rates are like list prices and don't reflect what insurers and government programs pay. Does not mean "meaningless." And the purpose of shopping around is comparing between hospitals. List prices should be a good relative predictor for comparing cost.

txcwpalpha 9y ago
> And the purpose of shopping around is comparing between hospitals. List prices should be a good relative predictor for comparing cost. When is the last time you dealt with any healthcare bills? This is almost universally untrue. Hospital A's list price for an MRI might be $1000, but your insurance has a deal with them where you only pay $100 out of pocket. Meanwhile Hospital B's list price for the same MRI is $500, but your insurance doesn't have a deal with them, so your OOP cost is $500. This is very common, and in many cases is impossible to know if it will happen until after you have had the procedure and are billed.
- sigmar 9y ago
  I mean, yea, you check with your insurer first? How could the hospital possibly have information about how much each insurer would cover considering there are literally hundreds? This seems like a "perfect is the enemy of good" situation
  - txcwpalpha 9y ago
    > I mean, yea, you check with your insurer first? If you're checking with your insurer to find the price, then that makes the hospital's listed prices meaningless, which is the entire point of this comment chain.
    - sigmar 9y ago
      The insurer doesn't know what each hospital charges. Posting costs online is just to make it more convenient to find the information. In the perfect world, everyone would sit down with the hospital, look at the likely range of costs of a procedure, call the HMO/PPO to check how each outcome would be covered, and then repeat that process at several locations. But that is arduous and people don't have the time or patience.
      - txcwpalpha 9y ago
        >The insurer doesn't know what each hospital charges. Yes they do. Providers are already required to make their list prices publicly available, and insurance companies have it (they are already available to the general public as well, but they're probably going to be hard to find/understand for a layperson). Many insurance companies already have cost lookup tools specifically for this purpose. Posting the hospital's list price online like the article is talking about is purely for the consumption of the patient. It is not of use to the insurer. >In the perfect world In a perfect world, I'd contest that you wouldn't have to worry about healthcare costs at all, but I digress. >everyone would sit down with the hospital, look at the likely range of costs of a procedure, call the HMO/PPO to check how each outcome would be covered Except you already can do this even without looking at the list prices from a hospital. Your insurance can already tell you exactly how much you will be charged by any provider. They do not need these online 'list prices' to do so.
      - chimeracoder 9y ago
        > The insurer doesn't know what each hospital charges. Posting costs online is just to make it more convenient to find the information. Every hospital charges more than the maximum reimbursable amount for the insurer. If they don't, that's because they've made a mistake - their goal is literally to set a bill that's high enough that it will generate a reimbursement for the maximum amount each time.
- jwineinger 9y ago
  Isn't it standard practice to find out which facilities/providers are in your network so you can judge this? I always check before we go somewhere new
  - bluGill 9y ago
    Yes, but that is the only thing I check. If I have a choice between two in-network providers I don't even ask about price.
- matz1 9y ago
  So at least you know what the maximum amount you have to pay, regardless what amount your insurance will pay.
refurb 9y ago
List prices should be a good relative predictor for comparing cost. The problem is it's not a good predictor. I'm sure you've seen articles that say the cost of an MRI can vary between $500 and $5000. Those are the list prices. For a given insurer, the contracted rate is probably pretty similar with the $500 rate being only marginally discounted and the $5000 rate heavily discounted.
- matz1 9y ago
  So at least I can compare the price, regardless what insurance I have.
- sigmar 9y ago
  Sure, predictions aren't always right. People should still check with the health insurance of where they should seek treatment. None of that doesn't makes list prices "meaningless"

bufferoverflow 9y ago

It's not meaningless. Because you know if the procedure costs X, and your insurance covers 80%, you know you will only pay 0.2X at most. There will be no random charge for thousands of dollars for something trivial. And it will introduce price competition.

txcwpalpha 9y ago
>It's not meaningless. Because you know if the procedure costs X, and your insurance covers 80%, you know you will only pay 0.2X at most. There will be no random charge for thousands of dollars for something trivial. That's not how insurance works, though. You would pay 20% of your insurance's negotiated cost, not the list price. So you could still end up paying more at a hospital that has "lower prices", based on how well your insurance negotiates with them. >And it will introduce price competition. This is not universally a good thing.
- nopinsight 9y ago
  In what ways would price competition be worse than no price competition, given that other relevant information like quality of care is available as well?
  - txcwpalpha 9y ago
    > given that other relevant information like quality of care is available as well? Well first off, that's not a given. The article only mentions Medicare using price and electronic medical records as a way of 'rating' providers. I can't find anything similar about Medicare rating providers based on quality of care. Second, look up the situation with Lasik eye clinics. Another user in this thread suggested it as a "great example of a highly functional healthcare market" driven by price competition. In reality, price competition in the Lasik market has caused eye clinics to operate more like car salesmen (complete with sales commissions, aggressive/pushy sales tactics, and deceptive marketing), and not like someone who actually has your best medical interests in mind. I'm not saying that simply introducing price competition to hospitals will lead to something like that, but it's certainly an example of price competition not being a good thing.

poulsbohemian 9y ago

I think this is the issue that should push us all toward a single-payer, government-backed system. The fact that we all (or our employers) pay a ridiculous amount for health insurance each month, PLUS end up paying out of pocket a high amount anyway as our health insurance really only kicks in once there is an extreme situation (emergency, chronic illness). And as a consumer I am stuck in the middle of it, with there being no competition but no recourse either.