4 ms·

This was not in my radar, but strikes me as really good news for American healthcare. Are there any substantial downsides? I was not even close to being convinc

This was not in my radar, but strikes me as really good news for American healthcare. Are there any substantial downsides? I was not even close to being convinced by the arguments given by insurance companies in the article.

paul_f 6y ago
There are no downsides to the consumer. Hope the Biden administration doesn't reverse this.
- deleted 6y ago
  [deleted]
- musingsole 6y ago
  Are you aware that this statement cannot be true? It's like potheads holding marijuana up as a panacea. This will reduce income for some number of hospitals, and hospital administration gets a turn at the table too. If you make the business feel pain, they'll pass it on to their customers with some new policy of their own.
  - RickJWagner 6y ago
    If those hospitals are relying on hidden prices to protect their profitability, they are not well run. Period. It is time. There is no good reason for hiding the true costs. This is the beginning of a much-needed revival in the health-care industry.
- apta_ 6y ago
  What motives would they have to reverse it? Don't they claim they're "for the people"?
  - ormaba 6y ago
    > What motives would they have to reverse it? What part of "Orange Man Bad" did you not understand? Isn't it enough that Trump supported it?
- rbanffy 6y ago
  I hope they make the penalties prohibitively high.
parsimo2010 6y ago
It isn’t a bad thing, but it won’t affect many Americans. Most of the country has insurance coverage, and even a high copay is probably cheaper than paying cash for most things. However, it will hopefully lower prices for people that have no coverage for some procedures by exposing any gross differences between the negotiated rates with big insurance payers and the cash rates offered to individuals. It will benefit people that are uninsured or undercovered, if they do their homework. I have a feeling that while this is a step in the right direction, people can still be taken advantage of. Like, hospitals may offer a reasonable cash price for a baby delivery but still tack on all sorts of extra fees. Similar to the “underbody rust protection” scheme with car dealers. It’s supposed to be illegal but somehow the hospitals will figure it out.
- svieira 6y ago
  Having gone without insurance coverage, I have heard phrases like "our standard 85% discount" when notifying that I am paying cash instead of using insurance. (That said, I've also only received 30% discounts, so don't immediately jump ship :-) )
- ahelwer 6y ago
  I'm a young healthy dude and have a high-deductible healthcare plan, so I absolutely care about finding low prices for things (since I don't hit my deductible). I got strep throat in 2019 and had a hell of a time comparing prices for test + antibiotics between different clinics. I usually had to physically show up at the location before they'd give me a price. Prices varied between $20 and $250!!! Hopefully this will help.
  - SOLAR_FIELDS 6y ago
    There is a fabulous place in OKC called the surgery center that does not take insurance and lists the upfront cost for all of their procedures on their website. I live about 6 hours drive away from it but just having that resource available makes it worthwhile to check if it’s worth it to drive 6 hours if I need something done: https://surgerycenterok.com/ https://surgerycenterok.com/
- 6y ago
credit_guy 6y ago
I generally think this is a very good step in the right direction. The only negative that I've heard voiced by some people (here on HN) was that the penalty for non-compliance is negligible (if I remember correctly, something like a few hundred dollars; I don't remember if a few hundred dollars in all, or per day, but for a hospital both are a rounding error). Edit: The penalty is $300/day [1] [1] https://www.hhs.gov/about/news/2019/11/15/trump-administration-announces-historic-price-transparency-and-lower-healthcare-costs-for-all-americans.html https://www.hhs.gov/about/news/2019/11/15/trump-administrati...
- jerry1979 6y ago
  Do we know if this will expose physician fees? If not, I imagine physicians could charge the patients, then physicians and hospitals could settle the difference on the backend. In other words, a potential downside of partial sunlight could come from the fact that providers may want to move costs/charges around to obscure prices therefore making the system even more inefficient.
  - IG_Semmelweiss 6y ago
    that's not possible. At least not possible on a large scale. there are strict regulations (AKS and Stark) governing hospital <> Provider pay payments. Any pay in excess of medical services FMV will be toxic to pay out and could land both hospitals and providers in big trouble.
pmiller2 6y ago
It's a good thing, and one of the very few things I will happily stand up and commend the Trump administration for. Unfortunately, the impact on private individuals is likely to be very low, because those negotiated rates are extracted from hospitals by insurance companies by sheer weight of the number of policyholders they have. You and I won't be paying those rates, nor will we be able to negotiate anywhere near them. Our starting point as individuals is something called the "chargemaster rate," which is, theoretically, what the hospital might charge Joe Schmoe who's uninsured. In practice, even chargemaster rates aren't the real rates. Despite not being a huge insurance company, it is possible to negotiate with hospitals if you're either quite rich or quite poor. On the rich side, oftentimes just saying you're going to pay cash up front will get you a substantial discount. On the other end, hospitals frequently have entire departments theoretically devoted to helping poor and indigent patients afford medical care. What those departments actually do is sign people up for government benefits, or, sometimes, just writing off entire bills. Anyway, yes, it's a good thing. No, it probably won't make a difference to you.
- jtbayly 6y ago
  > it is possible to negotiate with hospitals if you're either quite rich or quite poor. It is possible to negotiate, no matter who you are. I can literally be described as both quite rich and quite poor using your criteria. Simply saying you don’t have insurance at one major hospital near us immediately reduces the bill by 49% (from the charge master rate, presumably).

paul_f 6y ago

There are no downsides to the consumer. Hope the Biden administration doesn't reverse this.

deleted 6y ago
[deleted]
musingsole 6y ago
Are you aware that this statement cannot be true? It's like potheads holding marijuana up as a panacea. This will reduce income for some number of hospitals, and hospital administration gets a turn at the table too. If you make the business feel pain, they'll pass it on to their customers with some new policy of their own.
- RickJWagner 6y ago
  If those hospitals are relying on hidden prices to protect their profitability, they are not well run. Period. It is time. There is no good reason for hiding the true costs. This is the beginning of a much-needed revival in the health-care industry.
apta_ 6y ago
What motives would they have to reverse it? Don't they claim they're "for the people"?
- ormaba 6y ago
  > What motives would they have to reverse it? What part of "Orange Man Bad" did you not understand? Isn't it enough that Trump supported it?
rbanffy 6y ago
I hope they make the penalties prohibitively high.

parsimo2010 6y ago

It isn’t a bad thing, but it won’t affect many Americans. Most of the country has insurance coverage, and even a high copay is probably cheaper than paying cash for most things. However, it will hopefully lower prices for people that have no coverage for some procedures by exposing any gross differences between the negotiated rates with big insurance payers and the cash rates offered to individuals. It will benefit people that are uninsured or undercovered, if they do their homework. I have a feeling that while this is a step in the right direction, people can still be taken advantage of. Like, hospitals may offer a reasonable cash price for a baby delivery but still tack on all sorts of extra fees. Similar to the “underbody rust protection” scheme with car dealers. It’s supposed to be illegal but somehow the hospitals will figure it out.

svieira 6y ago
Having gone without insurance coverage, I have heard phrases like "our standard 85% discount" when notifying that I am paying cash instead of using insurance. (That said, I've also only received 30% discounts, so don't immediately jump ship :-) )
ahelwer 6y ago
I'm a young healthy dude and have a high-deductible healthcare plan, so I absolutely care about finding low prices for things (since I don't hit my deductible). I got strep throat in 2019 and had a hell of a time comparing prices for test + antibiotics between different clinics. I usually had to physically show up at the location before they'd give me a price. Prices varied between $20 and $250!!! Hopefully this will help.
- SOLAR_FIELDS 6y ago
  There is a fabulous place in OKC called the surgery center that does not take insurance and lists the upfront cost for all of their procedures on their website. I live about 6 hours drive away from it but just having that resource available makes it worthwhile to check if it’s worth it to drive 6 hours if I need something done: https://surgerycenterok.com/ https://surgerycenterok.com/
6y ago

credit_guy 6y ago

I generally think this is a very good step in the right direction. The only negative that I've heard voiced by some people (here on HN) was that the penalty for non-compliance is negligible (if I remember correctly, something like a few hundred dollars; I don't remember if a few hundred dollars in all, or per day, but for a hospital both are a rounding error). Edit: The penalty is $300/day [1] [1] https://www.hhs.gov/about/news/2019/11/15/trump-administration-announces-historic-price-transparency-and-lower-healthcare-costs-for-all-americans.html https://www.hhs.gov/about/news/2019/11/15/trump-administrati...

jerry1979 6y ago
Do we know if this will expose physician fees? If not, I imagine physicians could charge the patients, then physicians and hospitals could settle the difference on the backend. In other words, a potential downside of partial sunlight could come from the fact that providers may want to move costs/charges around to obscure prices therefore making the system even more inefficient.
- IG_Semmelweiss 6y ago
  that's not possible. At least not possible on a large scale. there are strict regulations (AKS and Stark) governing hospital <> Provider pay payments. Any pay in excess of medical services FMV will be toxic to pay out and could land both hospitals and providers in big trouble.

pmiller2 6y ago

It's a good thing, and one of the very few things I will happily stand up and commend the Trump administration for. Unfortunately, the impact on private individuals is likely to be very low, because those negotiated rates are extracted from hospitals by insurance companies by sheer weight of the number of policyholders they have. You and I won't be paying those rates, nor will we be able to negotiate anywhere near them. Our starting point as individuals is something called the "chargemaster rate," which is, theoretically, what the hospital might charge Joe Schmoe who's uninsured. In practice, even chargemaster rates aren't the real rates. Despite not being a huge insurance company, it is possible to negotiate with hospitals if you're either quite rich or quite poor. On the rich side, oftentimes just saying you're going to pay cash up front will get you a substantial discount. On the other end, hospitals frequently have entire departments theoretically devoted to helping poor and indigent patients afford medical care. What those departments actually do is sign people up for government benefits, or, sometimes, just writing off entire bills. Anyway, yes, it's a good thing. No, it probably won't make a difference to you.

jtbayly 6y ago
> it is possible to negotiate with hospitals if you're either quite rich or quite poor. It is possible to negotiate, no matter who you are. I can literally be described as both quite rich and quite poor using your criteria. Simply saying you don’t have insurance at one major hospital near us immediately reduces the bill by 49% (from the charge master rate, presumably).