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>The Trump administration may eliminate this secrecy, making numbers like the ones in these charts more common and easier to find. As The Wall Street Journal ha
by RcouF1uZ4gsC 8y ago
>The Trump administration may eliminate this secrecy, making numbers like the ones in these charts more common and easier to find. As The Wall Street Journal has reported, the administration has asked for comments on a proposal to require doctors and hospitals to publish negotiated prices.
I really hope this goes through. Right now, the opacity of prices for health care is a huge problem.
- michaelmrose 8y agoAny particular reason for not just fixing the current situation by declaring by fiat either - It costs exactly $20 - It costs not more than $30 allowing negotiation - You may only charge one price for all customers - You may not charge more than some n percentage over the national average in the last business quarter
- wtfrmyinitials 8y agoPrices set by fiat cannot possibly react quickly enough to changes in the market
- mbesto 8y agoPrecisely what changes in the market are you referring to? Prices negotiated between payer and provider today are already 1 + N year length contracts. Having one transparent national price list would 1000x easier than the hundreds of thousands of healthcare administrators that exist today whose sole job is to negotiate and determine price lists.
- bobdole12345 8y agoMedicine changes on the scale of multi-year adjustments. What exactly do you think is going to change in the market?
- roywiggins 8y agoMedicaid does okay.
- rootusrootus 8y agoMaybe it could just be as simple as one price for all customers, published.
- pishpash 8y agoThen you'll just get offered $1000 with some places offering secret $900 coupons. Hospital master sheets that nominally satisfy transparency are basically this.
- michaelmrose 8y agoWhich would be fixed by setting a legal maximum cost.
- deleted 8y ago[deleted]
- ars 8y agoThat would break Medicare, because it pays under costs for procedures, and hospitals make it up from private parties. I'm in favor of what you suggest, but it will come with increases in Medicare costs.
- r00fus 8y agoMedicare would be fixed by having all the healthy folks in the same risk pool. Right now privatized medicine are like charter schools - they can pick and choose their subscribers leading to lower costs and an obscene profit while Medicare gets the old folks who have multiple ER visits a year.
- ars 8y agoThat wouldn't help anything. At the end of the day even if you mixed them in, the same number of people would visit hospitals. So hospital utilization would not change. Remember I'm talking about the payment for any particular procedure, not the number of procedures an average person has.
- fromthestart 8y agoBecause markets need some degree of freedom to set prices to be efficient. The problem now is there is no downward price pressure from competition and transparency. Market controls are an extreme solution which will likely have unintended negative consequences.
- mbesto 8y agoYes this is true in markets where the consumer (1) is the actual person paying for the product/service (2) isn't restricted to comparable options and (3) prices across all available providers are known. None of these exist today in the market for US healthcare...but they do for fast food. Trying to compare the two would be extremely disingenuous.
- zip1234 8y agoDefinitely transparency is one of the main issues.
- tehlike 8y agoThis is one attempt: https://www.healthcare.gov/health-care-law-protections/rate-review/ https://www.healthcare.gov/health-care-law-protections/rate-... It is in medical providers best interest to raise prices. Efficient markets need more competition, but in healthcare the market is fragmented and once a provider or insurance gets big enough it gets acquired by another leading to larger duopolies.
- kevin_thibedeau 8y agoThe government never should have let mutual insurance privatize. That was the tipping point that started this whole mess. Rather, there should be incentives for for-profit insurance to switch a mutual ownership model.
- bsanr2 8y ago"Regulations are anti-American/evil/distort the market."
- tehlike 8y agoI sure hope so. We were getting a blood work for wifr, and when we checked pricing online we were shocked to learn that self pay price was around 300 and through insurance it would be 8k. Crazy, and no free market would function this way. Except when they are not free and have messed up regulations.
- reilly3000 8y agoTotally. A few years back I asked both my doctor and insurance company how much a procedure would cost in advance. They both knew this answer and both flat refused to tell me until I got the service. How would that possibly fly in any other sphere? A friend of mine that works in health care admin and IT described walking into a doctor’s office ‘like walking into a used car lot.’ It seems to be one of those few holdout areas where the information economy hasn’t affected. Maybe it’s even perverted it, by enabling data holders to optimize inefficiency for their own benefit.
- jrs235 8y agoWalking into a doctor’s office is like buying a timeshare. You have no idea or control over how much the fees will be.
- maxerickson 8y agoThey know how much a particular code costs in advance. They are less certain whether a particular course of treatment will be coded in one way or another. It's probably not a good payment model, it doesn't make any sense for the insurance company to be taking on risk that the provider should be bearing, but here we are.
- reilly3000 8y agoThat makes sense. ICD9/10 is certainly byzantine, and widely abused, but it seems reasonable to not quote something that isn't coded yet. I did some research for a company once on Medicare reimbursements. That data is all publicly available via data.gov, sorted by code and much more. The private insurance market could follow suit, and providers could also publish that information if agreements didn't forbid it. The data simply needs to be price per code per insurance policy. I understand providers may not want people bickering over what codes are used, but they ought to be able to produce that report easily.
- pauljurczak 8y agoThat's where it gets even more bizarre. Some states legally protect health insurance companies for not disclosing their price list. Highly paid lobbyists pushed that one through legislation on trade secret/proprietary data doctrine. You can't inconvenience the holy "free" enterprise in America.