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> doctors and hospitals don't want price transparency Well, I do want price transparency - IF it works the way they promise. It’s hard for me, as a programmer
by commandlinefan 7y ago
> doctors and hospitals don't want price transparency
Well, I do want price transparency - IF it works the way they promise. It’s hard for me, as a programmer, not to draw parallels to every employer’s expectation that I should be able to listen to them describe a software problem and quote them a timeframe on the spot (which, of course, they’ll then try to “negotiate” down). On the one hand, as a non-medical-professional outsider looking in, it seems to me that _of course_ they should be able to say ahead of time how much a cataract removal surgery should cost, they’ve done it hundreds of times (I hope). On the other hand, I know how much variability occurs in software projects and how little of that is trivially predictable.
On the other other hand, I can’t for the life of me imagine any possible reason why they can’t say EXACTLY how much an MRI will cost before they do it.
- umvi 7y agoYeah but come on. It's one thing to program something with nebulous requirements. The cost of the X-ray machine is known. The cost of collecting X-rays can be calculated deterministically. The only thing similar to programming is trying to diagnose a rare disease or tricky condition. But for run-of-the-mill deterministic procedures, the cost should absolutely be known.
- commandlinefan 7y agoWell, I think so too, but - just to play devil’s advocate - many of my former bosses would almost certainly say something like, “the cost of the web server is known. The cost of collecting the web traffic can be calculated deterministically. We’re just talking about a website here, the cost should absolutely be known.”
- umvi 7y agoWell are you asking me to setup infrastructure or to design you a website? The first is deterministic and I can certainly give you a fixed price/timeframe to set up your web servers/DNS/etc. Designing a website on the other hand, isn't deterministic. That mandates lots of requirements gathering and suffering through iterations where the peanut gallery criticizes every CSS choice and demands minor CSS tweaks until some arbitrary "feel" is achieved.
- carapace 7y agoThe prices don't change in a supermarket if you edit your shopping list, eh? A hospital can't predict everything a patient will need (their shopping list), but they should be able to account for the cost of each procedure/drug/test/bandage/etc... eh?
- Fomite 7y agoThe problem is a lot of that isn't deterministic. There's a lot of "If Then" statements that aren't easy to price ahead of time. Like, your procedure is very different if your doctor decides they could use a specialist consult.
- carapace 7y ago> your procedure is very different if your doctor decides they could use a specialist consult. The necessity of the specialist consult may be unexpected, but it doesn't follow that the cost of it should be secret or obscure, eh? The intrinsic unpredictability of health care isn't an excuse for additional unpredictability of cost.
- XG6 7y ago> parallels to every employer’s expectation that I should be able to listen to them describe a software problem and quote them a timeframe on the spot I don't agree with that parallel. It would be like a patient asking, "How much to cure my cancer?" Total cost will of course differ for each patient, but the doctor should be able to tell me the exact cost for a 20 minute office visit or a single session chemotherapy. I think that's all anyone could expect.
- zebrafish 7y agoAgreed. Procedures are like products. From a hospital administrator's perspective, you should have a good idea of your cost of goods sold for standard procedures. Lipid panel costs $X in materials (needles, vials, bandages), $Y in cost of the siemens equipment that does the test, $Z in labor cost to draw the blood, etc. If the administrator knows the COGS for each procedure, test, minute per consult per professional, etc. then quoting and billing should be much simpler than any type of hourly based quote work. The only time there would be a parallel would be if some doctor deliberated on a diagnosis for a long time. Most of the time though it's a quick collection of symptoms and then diagnosis or trial and error based on those symptoms. Maybe in some surgeries that have more complications than usual I could see a parallel to hourly work.