4 ms·

I'm personally I the camp of, why the hell can I not know how much stuff costs up front, why can I not tell them no I dont an unnecessary x-ray, and why am I n

I'm personally I the camp of, why the hell can I not know how much stuff costs up front, why can I not tell them no I dont an unnecessary x-ray, and why am I not told cost owed by me until after the procedure only to find out it's just an absurd amount of money Private insurance blows cause we're all basically required to have it but it's worse than a tax because we barely ever know how much we owe.

EpicEng 7y ago
>why the hell can I not know how much stuff costs up front Prices should be publicized, I agree, but you can ask to get something pre-authorized. It just takes longer. >why can I not tell them no I dont an unnecessary x-ray You can ask your doctor why you need an x-ray, why they deem it necessary, and refuse if you like >and why am I not told cost owed by me until after the procedure only to find out it's just an absurd amount of money Again, you can ask for pre-auth.
- ridewinter 7y ago
  This doesn't seem to be something that's common knowledge. Can you point to information on how to use private health insurance like this?
  - EpicEng 7y ago
    You just ask the front desk to pre-authorize the prescribed treatment. They work with the insurance carrier and let you know what your cost will be.
- roland35 7y ago
  Pre-authorization sounds good, but unfortunately a lot of the time it isn't possible. For example, when I was in the ER they gave me a few choices on how they could do stiches on a big cut... But there is definitely no way I could compare the costs! I just ended up paying a $500 bill a few months later.
  - EpicEng 7y ago
    Yes, emergency situations are different. Not much of a chance to wait and shop around.
  - refurb 7y ago
    Lack of pricing information is ridiculous in the US. You can’t base a system on the “free market” then prevent consumers from having pricing information. It certainly wouldn’t fix everything in the US, but it would be a huge help. To be honest, I’m not sure why hospitals in the US haven’t taken the lead on this. If I had a choice between two hospital of similar quality, but one provided price transparency and maybe even a price guarantee (your procedure will cost $X, guaranteed), I would certainly go to that hospital.
enraged_camel 7y ago
Price transparency is a tremendously difficult problem because healthcare is a multi-layered bureaucracy. Even then though, making prices transparent wouldn’t address the primary scenario that results in personal bankruptcy, which is emergency care. You can’t exactly shop around for the cheapest ER facility if you’re bleeding from a gunshot wound.
- caseysoftware 7y ago
  What types of injuries/illnesses are the leading cause of personal bankruptcy?
- mattkrause 7y ago
  Information asymmetries are a huge problem in "market solutions" and there's a huge one here: doctors have 8+ years of medical training and most patients....don't. It's going to be very hard for many people to second-guess a doctor's recommendation or estimate the expected value of decisions. In a non-emergency situation, you can certainly try to read up on your own, but the medical literature is not always easy to interpret. A friend of mine asked for advice after he was diagnosed with Parkinson's Disease. Despite having a PhD in neuroscience and working as a researcher in a PD Center of Excellence, I had a really hard time making a recommendation. (Neuro conditions are particularly hard, but this is also possibly the best-case match with my experience).
- refurb 7y ago
  I had a good friend who worked in a leadership role at a major health system in CA. He readily admitted that the hospital has a very poor grasp on their own costs. At a high-level, they just charge as much as they can - sometimes they lose money, sometimes they make a 90% profit. They pool it all together (usually by line of business) and hope it all works out as a profit. That’s why specialized, stand alone clinics (e.g. MRI clinic) have some of the best prices. They know exactly what things cost and can make sure prices reflect it.
deleted 7y ago
[deleted]
unishark 7y ago
There's plenty cash-only doctors and clinics out there. There's also companies that handle healthcare for their employees via personal accounts (they put more cash in your account each year, and you spend or don't as you see fit). People on such plans do a lot more shopping around. And as the other poster said, you always have the right to refuse treatment, up to your death if you like (unless it is some kind of involuntary commitment where you are put there because you are supposedly dangerous). Many terminally ill people choose to go this way.
- Joe-Z 7y ago
  Oh sounds like everything is fine then! Seriouy doesn‘t your hair stand up in horror when you re-read this?! „You can always choose to die when you can‘t afford treatment“. WTF?!
Talanes 7y ago
It's so ridiculous. I had Kaiser for a period, because I was under the impression the bundle of insurer and healthcare provider would avoid these issues. It worked that way for a bit, but then I got some X-Rays. Paid up front, and then a few months later got an additional bill.
- newnewpdro 7y ago
  > I was under the impression the bundle of insurer and healthcare provider would avoid these issues. It gets worse, bundling those two is the epitome of conflict of interests when you find yourself the victim of the hospital's negligence and expect your insurer to act in your best interest. Nope!
- winrid 7y ago
  Interesting. Kaiser paid for a 4 hour ambulance ride for me from one hospital to another for immediate surgery. I think I remember paying like $100.

EpicEng 7y ago

>why the hell can I not know how much stuff costs up front Prices should be publicized, I agree, but you can ask to get something pre-authorized. It just takes longer. >why can I not tell them no I dont an unnecessary x-ray You can ask your doctor why you need an x-ray, why they deem it necessary, and refuse if you like >and why am I not told cost owed by me until after the procedure only to find out it's just an absurd amount of money Again, you can ask for pre-auth.

ridewinter 7y ago
This doesn't seem to be something that's common knowledge. Can you point to information on how to use private health insurance like this?
- EpicEng 7y ago
  You just ask the front desk to pre-authorize the prescribed treatment. They work with the insurance carrier and let you know what your cost will be.
roland35 7y ago
Pre-authorization sounds good, but unfortunately a lot of the time it isn't possible. For example, when I was in the ER they gave me a few choices on how they could do stiches on a big cut... But there is definitely no way I could compare the costs! I just ended up paying a $500 bill a few months later.
- EpicEng 7y ago
  Yes, emergency situations are different. Not much of a chance to wait and shop around.
- refurb 7y ago
  Lack of pricing information is ridiculous in the US. You can’t base a system on the “free market” then prevent consumers from having pricing information. It certainly wouldn’t fix everything in the US, but it would be a huge help. To be honest, I’m not sure why hospitals in the US haven’t taken the lead on this. If I had a choice between two hospital of similar quality, but one provided price transparency and maybe even a price guarantee (your procedure will cost $X, guaranteed), I would certainly go to that hospital.

enraged_camel 7y ago

Price transparency is a tremendously difficult problem because healthcare is a multi-layered bureaucracy. Even then though, making prices transparent wouldn’t address the primary scenario that results in personal bankruptcy, which is emergency care. You can’t exactly shop around for the cheapest ER facility if you’re bleeding from a gunshot wound.

caseysoftware 7y ago
What types of injuries/illnesses are the leading cause of personal bankruptcy?
mattkrause 7y ago
Information asymmetries are a huge problem in "market solutions" and there's a huge one here: doctors have 8+ years of medical training and most patients....don't. It's going to be very hard for many people to second-guess a doctor's recommendation or estimate the expected value of decisions. In a non-emergency situation, you can certainly try to read up on your own, but the medical literature is not always easy to interpret. A friend of mine asked for advice after he was diagnosed with Parkinson's Disease. Despite having a PhD in neuroscience and working as a researcher in a PD Center of Excellence, I had a really hard time making a recommendation. (Neuro conditions are particularly hard, but this is also possibly the best-case match with my experience).
refurb 7y ago
I had a good friend who worked in a leadership role at a major health system in CA. He readily admitted that the hospital has a very poor grasp on their own costs. At a high-level, they just charge as much as they can - sometimes they lose money, sometimes they make a 90% profit. They pool it all together (usually by line of business) and hope it all works out as a profit. That’s why specialized, stand alone clinics (e.g. MRI clinic) have some of the best prices. They know exactly what things cost and can make sure prices reflect it.

deleted 7y ago

[deleted]

unishark 7y ago

There's plenty cash-only doctors and clinics out there. There's also companies that handle healthcare for their employees via personal accounts (they put more cash in your account each year, and you spend or don't as you see fit). People on such plans do a lot more shopping around. And as the other poster said, you always have the right to refuse treatment, up to your death if you like (unless it is some kind of involuntary commitment where you are put there because you are supposedly dangerous). Many terminally ill people choose to go this way.

Joe-Z 7y ago
Oh sounds like everything is fine then! Seriouy doesn‘t your hair stand up in horror when you re-read this?! „You can always choose to die when you can‘t afford treatment“. WTF?!

Talanes 7y ago

It's so ridiculous. I had Kaiser for a period, because I was under the impression the bundle of insurer and healthcare provider would avoid these issues. It worked that way for a bit, but then I got some X-Rays. Paid up front, and then a few months later got an additional bill.

newnewpdro 7y ago
> I was under the impression the bundle of insurer and healthcare provider would avoid these issues. It gets worse, bundling those two is the epitome of conflict of interests when you find yourself the victim of the hospital's negligence and expect your insurer to act in your best interest. Nope!
winrid 7y ago
Interesting. Kaiser paid for a 4 hour ambulance ride for me from one hospital to another for immediate surgery. I think I remember paying like $100.