3 ms·

Most providers have a pretty good idea what the lower bound will be, its the upper 5% they may have no idea about. Pathology maybe usually $100 for a tissue ex

by sgent 5y ago

Most providers have a pretty good idea what the lower bound will be, its the upper 5% they may have no idea about. Pathology maybe usually $100 for a tissue exam, but I've seen a routine mole biopsy need $1,500+ (wholesale) exams after referral to an academic center because there was something off that required further workup. This happened 1 time in 10 years. Anesthesia knows that a breast augmentation will usually be no less than $X, but if the patient has an anesthesia reaction and decompensates and needs 4 hours of one on one time with an MD its going to be a lot more. Very, very rare. You get the idea, its often not possible to know until you do the procedure. Even more when surgery is involved because imaging is not 100% and you may wind up with a much more complex procedure than you bargained for once you cut someone open, or a complication like a perforated bowel during colonoscopy, etc. Finally, most of these people don't talk to each other -- so the pathologist has no idea what the surgeon is charging and neither of them the hospital nor radiologist.

prepend 5y ago
That makes sense that there’s variability, many products have this. Not every single transaction needs to be profitable, only the aggregate. If pathology is normally $100 and yet some cost $1500 then factor that into the cost based on the probability. Or insure against it. Etc etc. These aren’t novel problems to the medical space, it’s just that there aren’t normal pressures forcing them to handle it. Apple charges $79 for an insurance claim to replace my iPhone whether it costs them $1 or $1000 to correct. Imagine if they had an asterisk that sometimes it cost lots more than $79. Someone else linked to the Surgery Center of OK [0] that has “solved” this problem. There’s a great episode of econtalk with Keith Smith [1] where they talk about this. Including examples almost exactly like how you call out. [0] https://surgerycenterok.com/ https://surgerycenterok.com/

by sgent 5y ago

prepend 5y ago

That makes sense that there’s variability, many products have this. Not every single transaction needs to be profitable, only the aggregate. If pathology is normally $100 and yet some cost $1500 then factor that into the cost based on the probability. Or insure against it. Etc etc. These aren’t novel problems to the medical space, it’s just that there aren’t normal pressures forcing them to handle it. Apple charges $79 for an insurance claim to replace my iPhone whether it costs them $1 or $1000 to correct. Imagine if they had an asterisk that sometimes it cost lots more than $79. Someone else linked to the Surgery Center of OK [0] that has “solved” this problem. There’s a great episode of econtalk with Keith Smith [1] where they talk about this. Including examples almost exactly like how you call out. [0] https://surgerycenterok.com/ https://surgerycenterok.com/