4 ms·

I’m not sure it’s a lack of “care” and more a lack of ability to take action. If I have a broken arm I’m not going to price comparison shop amongst hospitals.

I’m not sure it’s a lack of “care” and more a lack of ability to take action. If I have a broken arm I’m not going to price comparison shop amongst hospitals. Anecdote: I attempted to comparison shop for an mri to diagnosis a potential rotator cuff injury. While I could get the actual scan fees I couldn’t get the fully burdened cost and during the visit it’s entirely opaque what things will be new line items on the bill.

PeterisP 7y ago
While urgent care is a significant part of total medical expenses, it's not that large part - the vast majority of really expensive procedures are scheduled well in advance, and doing price comparison would be quite feasible if the institutions would allow that.
- craftinator 7y ago
  In practice I've found that to be incorrect. Prices quoted to me are either wildly inaccurate, or end up being the minor percentage of the total cost.
  - PeterisP 7y ago
    That's the "if institutions would allow that" part. Or, more accurately, if institutions would get legally forced to allow that. We didn't get price transparency and limits for ridiculously lying advertising in other consumer markets just by sheer goodwill of merchants, it required legal mandate and enforcement of it.
count 7y ago
And if you're taken in to the ER, you're possibly not even ABLE to consent to charges. You're at the whim of the hospital staff! Did you know they charge for 'chaplain time' for having a chaplain stop by and say hi (you don't get to say yes or no, and this is obviously not medically necessary)?
- Consultant32452 7y ago
  Emergency care accounts for about 2% of total healthcare expenses. The issue you bring up about consent during an emergency is a real one, but it's not where all the money is going. https://www.politifact.com/truth-o-meter/statements/2013/oct/28/nick-gillespie/does-emergency-care-account-just-2-percent-all-hea/ https://www.politifact.com/truth-o-meter/statements/2013/oct...
  - sbov 7y ago
    Note that your article cites at least 1 other study that says 5-6% or even as high as 10%. It would be interesting to see a breakdown here - does this include prescription medication? It seems like if you're talking about provider regulation, you shouldn't include that. Unfortunately the article doesn't make it easy to figure this out.
    - filoleg 7y ago
      Even assuming that the 10% number is the right one, it still seems good enough in my book if, in the beginning, only 90% of the expenses get addressed successfully.
  - maxerickson 7y ago
    You don't need that long of a list of things that cost 2% before you've explained quite a lot.
jerkstate 7y ago
From your anecdote you indicate that people will comparison shop among hospitals but are unable to do so. I have a similar story about a broken ankle where I couldn't even get an estimate for an X-ray and a cast.
- sbov 7y ago
  I got an estimate once. After a total of about 20 hours on the phone. The day I arrived they told me it didn't include a bunch of stuff. They said it didn't matter though because insurance covered it. But they were wrong.
mixmastamyk 7y ago
> If I have a broken arm I’m not going to price comparison shop amongst hospitals. This gets mentioned in every healthcare thread. With transparent pricing we'll soon know which hospital costs 3x of the other, so we (or beforehand or family) can decide which one to go to for treatment.
- dlp211 7y ago
  This is a very urban/suburban mindset. There is a not insignificant portion of the population that has no choice and the one place they can get medical care is already over an hour away.
  - mixmastamyk 7y ago
    Most folks are moving to cities, the portion you mention is small and getting smaller. Don't let perfect be the enemy of the good. People can make their own decisions. There is no ethical position for keeping pricing information secret. Just because one can imagine a rare scenario where it wouldn't be useful is hardly a reason to continue hiding it.
    - dlp211 7y ago
      While true, 20% of a large number is still a large number. It's easy to disregard these people, but they should not be disregarded. They have suffered directly due to the privatization of hospitals and the requirement to satisfy stockholders. Also, I'm not against price transparency, but I'm highly skeptical that it will improve anything. The reasons should be quite apparent but price setters will settle on or near the highest prices since everyone in the system is incentivized to do so. It also doesn't solve the problem that many people pay a $N copay noatter what the price is due to insurance. And the third issue is the in and out of network problem. When you consider all these, along with the lack of choice for pretty much everyone, it isn't going to change anything.
      - jessaustin 7y ago
        Nobody wants to "disregard" rural patients. Rural patients would also like to know the price they'll be charged after driving 1.5 hours. Often we have a choice among several faraway towns to which we could drive. We've made our peace with the fact that living in the sticks requires driving further. This argument is too dumb to qualify as sophistry.

PeterisP 7y ago

While urgent care is a significant part of total medical expenses, it's not that large part - the vast majority of really expensive procedures are scheduled well in advance, and doing price comparison would be quite feasible if the institutions would allow that.

craftinator 7y ago
In practice I've found that to be incorrect. Prices quoted to me are either wildly inaccurate, or end up being the minor percentage of the total cost.
- PeterisP 7y ago
  That's the "if institutions would allow that" part. Or, more accurately, if institutions would get legally forced to allow that. We didn't get price transparency and limits for ridiculously lying advertising in other consumer markets just by sheer goodwill of merchants, it required legal mandate and enforcement of it.

count 7y ago

And if you're taken in to the ER, you're possibly not even ABLE to consent to charges. You're at the whim of the hospital staff! Did you know they charge for 'chaplain time' for having a chaplain stop by and say hi (you don't get to say yes or no, and this is obviously not medically necessary)?

Consultant32452 7y ago
Emergency care accounts for about 2% of total healthcare expenses. The issue you bring up about consent during an emergency is a real one, but it's not where all the money is going. https://www.politifact.com/truth-o-meter/statements/2013/oct/28/nick-gillespie/does-emergency-care-account-just-2-percent-all-hea/ https://www.politifact.com/truth-o-meter/statements/2013/oct...
- sbov 7y ago
  Note that your article cites at least 1 other study that says 5-6% or even as high as 10%. It would be interesting to see a breakdown here - does this include prescription medication? It seems like if you're talking about provider regulation, you shouldn't include that. Unfortunately the article doesn't make it easy to figure this out.
  - filoleg 7y ago
    Even assuming that the 10% number is the right one, it still seems good enough in my book if, in the beginning, only 90% of the expenses get addressed successfully.
- maxerickson 7y ago
  You don't need that long of a list of things that cost 2% before you've explained quite a lot.

jerkstate 7y ago

From your anecdote you indicate that people will comparison shop among hospitals but are unable to do so. I have a similar story about a broken ankle where I couldn't even get an estimate for an X-ray and a cast.

sbov 7y ago
I got an estimate once. After a total of about 20 hours on the phone. The day I arrived they told me it didn't include a bunch of stuff. They said it didn't matter though because insurance covered it. But they were wrong.

mixmastamyk 7y ago

> If I have a broken arm I’m not going to price comparison shop amongst hospitals. This gets mentioned in every healthcare thread. With transparent pricing we'll soon know which hospital costs 3x of the other, so we (or beforehand or family) can decide which one to go to for treatment.

dlp211 7y ago
This is a very urban/suburban mindset. There is a not insignificant portion of the population that has no choice and the one place they can get medical care is already over an hour away.
- mixmastamyk 7y ago
  Most folks are moving to cities, the portion you mention is small and getting smaller. Don't let perfect be the enemy of the good. People can make their own decisions. There is no ethical position for keeping pricing information secret. Just because one can imagine a rare scenario where it wouldn't be useful is hardly a reason to continue hiding it.
  - dlp211 7y ago
    While true, 20% of a large number is still a large number. It's easy to disregard these people, but they should not be disregarded. They have suffered directly due to the privatization of hospitals and the requirement to satisfy stockholders. Also, I'm not against price transparency, but I'm highly skeptical that it will improve anything. The reasons should be quite apparent but price setters will settle on or near the highest prices since everyone in the system is incentivized to do so. It also doesn't solve the problem that many people pay a $N copay noatter what the price is due to insurance. And the third issue is the in and out of network problem. When you consider all these, along with the lack of choice for pretty much everyone, it isn't going to change anything.
    - jessaustin 7y ago
      Nobody wants to "disregard" rural patients. Rural patients would also like to know the price they'll be charged after driving 1.5 hours. Often we have a choice among several faraway towns to which we could drive. We've made our peace with the fact that living in the sticks requires driving further. This argument is too dumb to qualify as sophistry.