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I love how everyone is susposed to be an expert in medical billing now. It’s hopeless. There’s no way people can beat the system on their own. Hospital chains,

I love how everyone is susposed to be an expert in medical billing now. It’s hopeless. There’s no way people can beat the system on their own. Hospital chains, private equity, billing software consultants, these people are gunning for you every day. There’s no way you can compete with that.

pan69 7y ago
It seems that that is what capitalism has become, the creation of many niche complex systems of which one can never be an expert.
- javagram 7y ago
  This is mainly an issue with healthcare in the US, not “capitalism”. The fact that providers can perform services on you without telling you up-front what the price will be is the problem. That isn’t how a lot of the rest of our capitalist society works - Amazon can’t raise the price of something I order from them after it’s shipped to me, my rent can’t change once I sign the lease contract which clearly states the charges up front, and so on...
  - pan69 7y ago
    > The fact that providers can perform services on you without telling you up-front what the price will be is the problem. Of course. In an unregulated for-profit health care system that is definitely the problem and the way we got there was because of; if there are multiple vendors then prices will automatically go down. I'm not anti-capitalism. It just doesn't work for certain parts of society but it seems that in the US everything needs to be capitalised and the government clearly doesn't want to regulate this industry.
    - javagram 7y ago
      This article itself is about someone who is on Medicare (government-run health insurance) getting a surprise bill because the hospital has mis-assigned his procedure to the wrong category to allow them to run up the bill. FTA: “In a feeble attempt to ameliorate the problem, Congress passed the Notice Act in 2015, which requires hospitals to inform patients of the implications of their observation status within 36 hours after observation services have been initiated. In other words, hospitals must advise patients of their observation status only after they have already incurred the expense of surgery and hospitalization.” This type of thing seems like the most immediate problem. It makes no sense that the price can be raised 36 hours after a procedure has already begun. How is anyone supposed to negotiate that properly? Just saying, I don’t think “capitalism” is necessarily the boogeyman here. The government itself is failing to negotiate properly with the providers when running its socialist healthcare system in this instance. (And non-government payers will run into the same problems, getting unfair bills that couldn’t be anticipated or negotiated before agreeing to the service)
  - AmericanChopper 7y ago
    One of the primary reasons healthcare is so expensive in the US is that so many of the factors that influence price are not constrained by competition. Fixing those problems is largely a political matter, not an economic one. The economics of capitalist systems do not make any claims about the functionality of markets that are allowed to exist without competition. Which is why all serious free market economists exclusively promote competitive free markets. A free market economist who doesn’t believe government has a role in ensuring markets are competitive is really just an extreme libertarian. Any market where the buyer is not the person who’s paying, or where the buyer has to make a purchasing decision before they know the price (or even what goods/services they’re agreeing to buy), cannot possibly be influenced by the laws of supply and demand. It’s the same reason that you can look at essentially any government spending project, and amaze yourself by how little the government manages to achieve with so much money. The payer doesn’t have any choice about how much taxes they pay, and the decision maker has a very poorly constrained supply of other people’s money to spend.
- tryptophan 7y ago
  Healthcare is literally the least "capitalistic" industry in the US. Posting prices is literally like a foundational concept. In many states, you still need to ask your local competitors for permission for if you can open up your own hospital. Perhaps the real issue is the lack of capitalist principles? Perhaps the issue is CMS trying to micromanage everything via billing in a very centrally planned manner? I think its interesting that the areas of the economy with the most government intervention are doing the worst... Healthcare, education, housing...etc. You could even throw in ISPs with their government guaranteed monopolies. Meanwhile tech had basically no regulation. What do we see? Many things are free (yes even to the poor! Without a government guarantee or people going around proclaiming that it is a human right! Insane!). The industry also has some of the highest paid (no tech minimum wage to bring it about, insane!) and best treated workers...
  - __s 7y ago
    Some survivorship bias: industries that are doing well without regulation are the least likely to be regulated
  - mnm1 7y ago
    Tech is enabling dictators, genocides, election tampering, massive theft, massive surveillance, addiction, etc. It's hardly doing well. Unless your definition of doing well is a few people profiting from the suffering of the masses. In that case, you're right tech is doing wonderful and we don't need government intervention. We could regulate tech to get this under control. Or we can deregulate medicine and forget about sanitizing surgical tools or sterilizing this and that. I'm sure the healthcare providers will do it themselves without being forced to. What could possibly go wrong with expecting healthcare providers to pay for necessary things they do not deem necessary for budget purposes? The plan is genius.
- underwater 7y ago
  It's not capitalist though, is it? The reason that hospitals can bill arbitrary amounts retroactively is because the government allows them to. The reason that there isn't strong competition between vendors is again because of government intervention.
  - JadeNB 7y ago
    > It's not capitalist though, is it? The reason that hospitals can bill arbitrary amounts retroactively is because the government allows them to. The reason that there isn't strong competition between vendors is again because of government intervention. I think it's the opposite–yes, the government does allow this sort of behaviour, but that's because the health-care-adjacent parasites lobby so furiously against any efforts to stop it. It's scarcely the government stepping in to ensure this sort of banditry (why would they, when government officials don't benefit from it?).
- refurb 7y ago
  Yes, the subject of the article, Medicare, a government created and run health system is a great example of capitalism run wild. What?
disabled 7y ago
Exactly. Also people should consult the Kaiser Family Foundation website and look into the statistics in general on Medicare. The data there is what you can expect to deal with once you are retired. If you have an exorbitantly expensive medicine that is covered under Medicare Part D (extremely, extremely likely), then you will face something called Medicare Part D catastrophic coverage. One should especially look into the data on that. It is really easy to be in the Medicare Part D catastrophic coverage situation. Even if you are sitting on a mountain of cash during retirement, it is profoundly wasteful to be paying anywhere from $20,000/year-$100,000/year for your medicine, which is usually a lifesaving medicine, and is life or death, whether you take it or not. Not to mention: The third leading cause of death in the United States in preventable medical errors. If you do not believe me then Google it. When a country has the third leading cause of death as preventable medical errors, they are almost always developing or third world countries. But, the US is an anomaly in that respect. You can go the the best hospitals and the best doctors in the United States, but you cannot evade a statistic like that. When that statistic is so high, these issues are so pervasive that they are definitely present in a completely unacceptable way, even with the best institutions, hospitals and doctors in the United States. If one was smart, they would investigate this further and decide to leave. Europe, especially West and Northern Europe, should be places one should by vying for. But anywhere in the European Union typically will be a step up from this chaos of a system.
- tbugrara 7y ago
  > The third leading cause of death in the United States in preventable medical errors. If you do not believe me then Google it. I googled it. The third leading cause of death is 'accidents.' Where are you seeing 'preventable medical errors'?
  - disabled 7y ago
    Here is the NPR news article about it: https://www.npr.org/sections/health-shots/2016/05/03/476636183/death-certificates-undercount-toll-of-medical-errors https://www.npr.org/sections/health-shots/2016/05/03/4766361... There has been a lot of research done about it. It would be foolish to underestimate the scale of the problem. Also, if you are concerned about getting the best possible care, or even just staying alive long-term, one should spend a lot of time examining http://healthdata.org http://healthdata.org Life expectancy can be a good start when it comes to just investigating things. The research from this site is very solid and all of it is open access. It was funded partly by the Bill & Melinda Gates Foundation too. A lot of this research comes from the University of Washington. They have a remarkable statistics department in general. They also have an phenomenal medical school. In terms of public medical schools, it is by far one of the best. Only UCLA and UCSF compete with it. Their allied health programs are great too. If you live in Seattle, the care tends to be fairly consistent. Anyways, I am basically affirming my allegiance to UW Medical School. They kept my grandmother alive for many more years than what we would have ever expected. Anyways, you can bet on it that their research is solid, even though I have deep respect for UW Medical School.
kjs3 7y ago
My wife is a medical billing expert (a billing executive at a mid-sized (multi-doctor) practice). You are correct. It took her two years of study (with full time job) to pass her medical coder exam, and she's only really an expert in her area of expertise. There are dozens of areas of expertise. It is virtually impossible to navigate the system without an insider to assist.

pan69 7y ago

It seems that that is what capitalism has become, the creation of many niche complex systems of which one can never be an expert.

javagram 7y ago
This is mainly an issue with healthcare in the US, not “capitalism”. The fact that providers can perform services on you without telling you up-front what the price will be is the problem. That isn’t how a lot of the rest of our capitalist society works - Amazon can’t raise the price of something I order from them after it’s shipped to me, my rent can’t change once I sign the lease contract which clearly states the charges up front, and so on...
- pan69 7y ago
  > The fact that providers can perform services on you without telling you up-front what the price will be is the problem. Of course. In an unregulated for-profit health care system that is definitely the problem and the way we got there was because of; if there are multiple vendors then prices will automatically go down. I'm not anti-capitalism. It just doesn't work for certain parts of society but it seems that in the US everything needs to be capitalised and the government clearly doesn't want to regulate this industry.
  - javagram 7y ago
    This article itself is about someone who is on Medicare (government-run health insurance) getting a surprise bill because the hospital has mis-assigned his procedure to the wrong category to allow them to run up the bill. FTA: “In a feeble attempt to ameliorate the problem, Congress passed the Notice Act in 2015, which requires hospitals to inform patients of the implications of their observation status within 36 hours after observation services have been initiated. In other words, hospitals must advise patients of their observation status only after they have already incurred the expense of surgery and hospitalization.” This type of thing seems like the most immediate problem. It makes no sense that the price can be raised 36 hours after a procedure has already begun. How is anyone supposed to negotiate that properly? Just saying, I don’t think “capitalism” is necessarily the boogeyman here. The government itself is failing to negotiate properly with the providers when running its socialist healthcare system in this instance. (And non-government payers will run into the same problems, getting unfair bills that couldn’t be anticipated or negotiated before agreeing to the service)
- AmericanChopper 7y ago
  One of the primary reasons healthcare is so expensive in the US is that so many of the factors that influence price are not constrained by competition. Fixing those problems is largely a political matter, not an economic one. The economics of capitalist systems do not make any claims about the functionality of markets that are allowed to exist without competition. Which is why all serious free market economists exclusively promote competitive free markets. A free market economist who doesn’t believe government has a role in ensuring markets are competitive is really just an extreme libertarian. Any market where the buyer is not the person who’s paying, or where the buyer has to make a purchasing decision before they know the price (or even what goods/services they’re agreeing to buy), cannot possibly be influenced by the laws of supply and demand. It’s the same reason that you can look at essentially any government spending project, and amaze yourself by how little the government manages to achieve with so much money. The payer doesn’t have any choice about how much taxes they pay, and the decision maker has a very poorly constrained supply of other people’s money to spend.
tryptophan 7y ago
Healthcare is literally the least "capitalistic" industry in the US. Posting prices is literally like a foundational concept. In many states, you still need to ask your local competitors for permission for if you can open up your own hospital. Perhaps the real issue is the lack of capitalist principles? Perhaps the issue is CMS trying to micromanage everything via billing in a very centrally planned manner? I think its interesting that the areas of the economy with the most government intervention are doing the worst... Healthcare, education, housing...etc. You could even throw in ISPs with their government guaranteed monopolies. Meanwhile tech had basically no regulation. What do we see? Many things are free (yes even to the poor! Without a government guarantee or people going around proclaiming that it is a human right! Insane!). The industry also has some of the highest paid (no tech minimum wage to bring it about, insane!) and best treated workers...
- __s 7y ago
  Some survivorship bias: industries that are doing well without regulation are the least likely to be regulated
- mnm1 7y ago
  Tech is enabling dictators, genocides, election tampering, massive theft, massive surveillance, addiction, etc. It's hardly doing well. Unless your definition of doing well is a few people profiting from the suffering of the masses. In that case, you're right tech is doing wonderful and we don't need government intervention. We could regulate tech to get this under control. Or we can deregulate medicine and forget about sanitizing surgical tools or sterilizing this and that. I'm sure the healthcare providers will do it themselves without being forced to. What could possibly go wrong with expecting healthcare providers to pay for necessary things they do not deem necessary for budget purposes? The plan is genius.
underwater 7y ago
It's not capitalist though, is it? The reason that hospitals can bill arbitrary amounts retroactively is because the government allows them to. The reason that there isn't strong competition between vendors is again because of government intervention.
- JadeNB 7y ago
  > It's not capitalist though, is it? The reason that hospitals can bill arbitrary amounts retroactively is because the government allows them to. The reason that there isn't strong competition between vendors is again because of government intervention. I think it's the opposite–yes, the government does allow this sort of behaviour, but that's because the health-care-adjacent parasites lobby so furiously against any efforts to stop it. It's scarcely the government stepping in to ensure this sort of banditry (why would they, when government officials don't benefit from it?).
refurb 7y ago
Yes, the subject of the article, Medicare, a government created and run health system is a great example of capitalism run wild. What?

disabled 7y ago

Exactly. Also people should consult the Kaiser Family Foundation website and look into the statistics in general on Medicare. The data there is what you can expect to deal with once you are retired. If you have an exorbitantly expensive medicine that is covered under Medicare Part D (extremely, extremely likely), then you will face something called Medicare Part D catastrophic coverage. One should especially look into the data on that. It is really easy to be in the Medicare Part D catastrophic coverage situation. Even if you are sitting on a mountain of cash during retirement, it is profoundly wasteful to be paying anywhere from $20,000/year-$100,000/year for your medicine, which is usually a lifesaving medicine, and is life or death, whether you take it or not. Not to mention: The third leading cause of death in the United States in preventable medical errors. If you do not believe me then Google it. When a country has the third leading cause of death as preventable medical errors, they are almost always developing or third world countries. But, the US is an anomaly in that respect. You can go the the best hospitals and the best doctors in the United States, but you cannot evade a statistic like that. When that statistic is so high, these issues are so pervasive that they are definitely present in a completely unacceptable way, even with the best institutions, hospitals and doctors in the United States. If one was smart, they would investigate this further and decide to leave. Europe, especially West and Northern Europe, should be places one should by vying for. But anywhere in the European Union typically will be a step up from this chaos of a system.

tbugrara 7y ago
> The third leading cause of death in the United States in preventable medical errors. If you do not believe me then Google it. I googled it. The third leading cause of death is 'accidents.' Where are you seeing 'preventable medical errors'?
- disabled 7y ago
  Here is the NPR news article about it: https://www.npr.org/sections/health-shots/2016/05/03/476636183/death-certificates-undercount-toll-of-medical-errors https://www.npr.org/sections/health-shots/2016/05/03/4766361... There has been a lot of research done about it. It would be foolish to underestimate the scale of the problem. Also, if you are concerned about getting the best possible care, or even just staying alive long-term, one should spend a lot of time examining http://healthdata.org http://healthdata.org Life expectancy can be a good start when it comes to just investigating things. The research from this site is very solid and all of it is open access. It was funded partly by the Bill & Melinda Gates Foundation too. A lot of this research comes from the University of Washington. They have a remarkable statistics department in general. They also have an phenomenal medical school. In terms of public medical schools, it is by far one of the best. Only UCLA and UCSF compete with it. Their allied health programs are great too. If you live in Seattle, the care tends to be fairly consistent. Anyways, I am basically affirming my allegiance to UW Medical School. They kept my grandmother alive for many more years than what we would have ever expected. Anyways, you can bet on it that their research is solid, even though I have deep respect for UW Medical School.

kjs3 7y ago

My wife is a medical billing expert (a billing executive at a mid-sized (multi-doctor) practice). You are correct. It took her two years of study (with full time job) to pass her medical coder exam, and she's only really an expert in her area of expertise. There are dozens of areas of expertise. It is virtually impossible to navigate the system without an insider to assist.