5 ms·

> They need to compete for our business. No, they don't. When you're out of breath with pain running down your left arm and are about to collapse, you're going

> They need to compete for our business. No, they don't. When you're out of breath with pain running down your left arm and are about to collapse, you're going to try to get to the nearest hospital, not first shop around to see which one has the most competitive rates like you're buying a new car or something.

tehlike 7y ago
Emergency is one thing. For others you could have time to shop.
- Broken_Hippo 7y ago
  Ok. So when you have flu complications? Gall bladder issues? When you fell and twisted your ankle but don't need emergency services even though you can't really walk? When you need a stint put in? Or how about when you've been diagnosed with an autoimmune disorder? Sure, you technically have time to shop, but it seems to me that this is just an excuse and makes sick people suffer more.
  - kgantchev 7y ago
    In all of those cases you can: 1. Take 30 mins to find the most affordable option. 2. Ask for a lower price.
    - TheOtherHobbes 7y ago
      1. The most affordable option may be a complete waste of money, and you have no way to tell ahead of time. 2. Ditto. You also could just live in a country with a good single payer health service, and know that you'll be treated without any bullshit. The fact that anyone would seriously suggest shopping around for treatment, as if there is a convincing and credible reason why anyone should even have to consider this, is beyond astonishing to me.
      - tehlike 7y ago
        I think this is the part where i use "could". This is simply not possible today. Doctors dont really know or care how much "you" will be charged vs how much they get paid. If there was more transparency, you could imagine doctors and patients working their way out. People would see the inefficiency, and yake counter measures, both as care giver and care taker. I have heard multiple stories now whete independent practices now just want cash, without insurance, payments for much cheaper, and they get paid more in the end.
    - tehlike 7y ago
      2 is interesting. We are expecting a baby, and one of the tests we had to get done early in the pregnancy was NIPT. There was 2-3 companies we could go with, and when we asked for the price they responded some number between >2.7K - I don't really recall - it could even be 8K. When asked for the cash price, they said 250$. Crazy.
- mattkrause 7y ago
  Have you ever actually tried to do this? It is hard. A family friend, a very smart guy himself, was recently diagnosed with Parkinson’s Disease. Since I’m a neuroscientist, he asked me for advice. I work on brain stimulation, one of the better treatments for Parkinson’s Disease. My institute is a Parkinson’s Centre of Excellence, and I collaborate with movement disorders specialists. I have easy access to experts and tons of relevant training and literature. Nevertheless, I found it very hard to make a recommendation, even between the options his doctor had laid out—-and I wasn’t even considering price, since he has excellent insurance. This decision was smack in the middle of my wheelhouse too; helping with, say, a decision about kidneys would have been even worse. There’s no way people, especially people in vulnerable situations, can reasonably be expected to catch up with experts that have a decade of advanced training and then second-guess them.
  - tehlike 7y ago
    i was mostly saying "it should be possible", not that it is possible/easy today.

tehlike 7y ago

Emergency is one thing. For others you could have time to shop.

Broken_Hippo 7y ago
Ok. So when you have flu complications? Gall bladder issues? When you fell and twisted your ankle but don't need emergency services even though you can't really walk? When you need a stint put in? Or how about when you've been diagnosed with an autoimmune disorder? Sure, you technically have time to shop, but it seems to me that this is just an excuse and makes sick people suffer more.
- kgantchev 7y ago
  In all of those cases you can: 1. Take 30 mins to find the most affordable option. 2. Ask for a lower price.
  - TheOtherHobbes 7y ago
    1. The most affordable option may be a complete waste of money, and you have no way to tell ahead of time. 2. Ditto. You also could just live in a country with a good single payer health service, and know that you'll be treated without any bullshit. The fact that anyone would seriously suggest shopping around for treatment, as if there is a convincing and credible reason why anyone should even have to consider this, is beyond astonishing to me.
    - tehlike 7y ago
      I think this is the part where i use "could". This is simply not possible today. Doctors dont really know or care how much "you" will be charged vs how much they get paid. If there was more transparency, you could imagine doctors and patients working their way out. People would see the inefficiency, and yake counter measures, both as care giver and care taker. I have heard multiple stories now whete independent practices now just want cash, without insurance, payments for much cheaper, and they get paid more in the end.
  - tehlike 7y ago
    2 is interesting. We are expecting a baby, and one of the tests we had to get done early in the pregnancy was NIPT. There was 2-3 companies we could go with, and when we asked for the price they responded some number between >2.7K - I don't really recall - it could even be 8K. When asked for the cash price, they said 250$. Crazy.
mattkrause 7y ago
Have you ever actually tried to do this? It is hard. A family friend, a very smart guy himself, was recently diagnosed with Parkinson’s Disease. Since I’m a neuroscientist, he asked me for advice. I work on brain stimulation, one of the better treatments for Parkinson’s Disease. My institute is a Parkinson’s Centre of Excellence, and I collaborate with movement disorders specialists. I have easy access to experts and tons of relevant training and literature. Nevertheless, I found it very hard to make a recommendation, even between the options his doctor had laid out—-and I wasn’t even considering price, since he has excellent insurance. This decision was smack in the middle of my wheelhouse too; helping with, say, a decision about kidneys would have been even worse. There’s no way people, especially people in vulnerable situations, can reasonably be expected to catch up with experts that have a decade of advanced training and then second-guess them.
- tehlike 7y ago
  i was mostly saying "it should be possible", not that it is possible/easy today.