7 ms·

> hospital price transparency, Wasn't this already put in place by the previous administration?

ytdytvhxgydvhh 5y ago
It was, but apparently we’re not there yet in terms of compliance: https://www.axios.com/hospitals-price-transparency-costs-regulations-noncompliance-ebf6bd21-5709-4298-b67a-74c8a90a1ec1.html https://www.axios.com/hospitals-price-transparency-costs-reg...
ryanSrich 5y ago
Of course it was, also see “value based care”. It’s all bullshit. Hospitals have zero incentive to be transparent, and all the incentives to be opaque. So long as you’re a non-Medicare/Medicaid patient you’ll continue to suffer. The American healthcare system is completely fucked (there’s no better word).
- o8r3oFTZPE 5y ago
  Is it fscked for physicians and various healthcare professionals (e.g., paid higher wages than other countries with different systems). Is it also fscked for wealthy patients who do not really care about costs.
  - adventured 5y ago
    > Is it fscked for physicians and various healthcare professionals It's an underappreciated point. The US healthcare system is one of the largest wealth transfer systems ever invented. It's a heavily protected cartel that plunders wealth from the top 2/3 and lines the pockets of a few million employees in the system. There is an excess cost bounty of $1.2 trillion (or more) being plundered and redistributed every year to the healthcare cartel. There are millions of people working artificially high paying jobs in the healthcare cartel in the US courtesy of the hyper inflated costs in the system. From nurses to doctors to pharma sales reps to scientists to management and everything inbetween. Nobody ever talks about the need to slash the pay of nurses & doctors though, it's far too unpopular of a subject, it's downright taboo. Just a notch below slashing the pay of teachers. They'd all go on strike tomorrow morning if a serious attempt were made to bring their pay in-line with other developed nations. The US has to remove a minimum of $1.2 trillion in cost from its healthcare system (which would produce an end cost structure still far above that of eg Britain). Only about 10-15% of that can come from slashing costs out of the pharma drug price side. The bulk of it has to come out of inflated salaries of millions of workers in healthcare across the board. When politicians talk about universal healthcare in the US, they always, without exception, go far out of their way to dodge this epic scale problem of inflated salaries in healthcare and of where to find $1.2 trillion in costs to slash (they primarily focus on high drug prices as a matter of political convenience; that segment by itself won't remotely cut it though). This is why every time a state decides it's going to look at doing universal healthcare, it immediately runs away after the cost study is completed, it's impossible until you remove a dramatic amount of cost from the system. Now someone go tell all the nurses and doctors in California they get to make 25%-35% less money (good luck).
    - AussieWog93 5y ago
      About 50% of that $1.2 trillion is in unnecessary admin.
    - FlyingLawnmower 5y ago
      Do you have some sources where I can read up more on this? I have always believed that the cost of front line worker salaries (Doctors/Nurses) was a relatively small % of the total cost of healthcare. Studies like this [1] led me to believe that massive rises in administration costs and inefficiencies due to insurance structure are bigger culprits than doctor/nurse salaries. But I am admittedly not very well informed in this area. [1] https://pubmed.ncbi.nlm.nih.gov/31905376/ https://pubmed.ncbi.nlm.nih.gov/31905376/
    - pininja 5y ago
      Do you have an example of a cost study? I’m curious, but don’t know how to find one.
    - borski 5y ago
      I see your point, but I will raise you that medical training in other countries doesn't also put you in hundreds of thousands of dollars of debt before you've even begun to practice. The cost of a medical education has a large impact on why salaries are "artificially" inflated.
      - hn_acc_2 5y ago
        Sure, high salaries are justified for this minority. The people mentioned specifically in the comment are of more concern; sales, admin, etc. salaries in this field are also inflated compared to other industries.
        borski 5y ago
        Got it. Thanks for the clarification. I think I agree on that.
    - hamandcheese 5y ago
giantg2 5y ago
Only for billing cost of procedures. It's still a mess. Did you know that hospitals make money by using name brand medications? They will get a contract with a brand, like Motrin, and charge you full price at $8 a pill. Then Motrin will will evaluate how much the hospital used and give them a big rebate to bring the hospital's cost down under $1 per pill. You can literally buy a bottle of ibuprofen for what they charge for a single pill, but of course in the name of safety (and really kickbacks too) they won't allow the cheaper outside medication. It's effectively an internal monopoly.
- revscat 5y ago
  I’m not sure what your point is. These contracts between seller and merchant were voluntary. There are other hospitals available should you choose, and if not then you have no one to blame but yourself.
  - alisonkisk 5y ago
    Are you trolling? A hospital has even more lock in than the App Store. They can literally legally lock you in.
    - raspasov 5y ago
      At least in the US, that would have to go through a court. I don't think a hospital can force you to stay in.
      - giantg2 5y ago
        They mean lock you in to their services only. Once you're in there you're forced to pay for whatever services they provide, which could be a lot in an emergency or if your unconscious. I think they were also referencing the idea that you are forced to pay a high amount for Motrin, when an alternate source would be much cheaper.
  - giantg2 5y ago
    Not everywhere has multiple hospitals to choose from. Even if there are multiple hospitals, your insurance might influence your choices too. And at the end of the day, if you're incapacitated, they will just take you to wherever is closest. The point was that the hospitals are doing things behind the scenes that are not well known that affect the pricing. In this example, they charge you more for using name brand medication and then get a kickback to make money for themselves.
sethammons 5y ago
A couple years past, def under Obama, I went in for a retina exam. They absolutely could not tell me the price for the appointment. "It depends on services rendered" - "what if it is a standard appointment with no extra services, how much (ball park) should I expect? $50? $500? $5k?" - "I couldn't tell you, I can't imagine that high." There is no price transparency. Sure would like it since I have a high deductible plan.
- bushbaba 5y ago
  Price transparency plus high deductible plans would drive the cost of health insurance down. Health insurance is supposed to cover you for catastrophic health issues that were previously unknown. For some reason it changed to also cover all your recurring or minor illnesses.
  - epistasis 5y ago
    I'm not so sure. There's a lot of waste in all of our health care system, and many areas are served by few care providers. Transparency on prices without effective competition won't change much.
    - spaetzleesser 5y ago
      You have to start somewhere. Knowable prices are the first prerequisite for markets.
      - epistasis 5y ago
        That's an excellent point! It can't hurt, and might help. I don't know why I felt negatively about it at first, anything to start disrupting the bad parts of the system should be welcome.
  - alasdair_ 5y ago
    Part of that is because it’s far cheaper to catch (say) cancer at an early stage and treat it than it is to catch it at stage 3 or 4 and spend potentially millions on a possibly preventable catastrophe. There is fairly strong evidence that if the cost of routine preventative care isn’t paid by insurance, quite a lot of people opt to skip it because they can’t afford it, leading to worse outcomes.
Black101 5y ago
yes... One of the good things Trump did
- cirrus3 5y ago
  no one took or will take that chump b*itch seriously
crawsome 5y ago
definitely not trump
- TheHypnotist 5y ago
  I actually think this was maybe one of the few things Trump's admin did that roundly was viewed as good.

It was, but apparently we’re not there yet in terms of compliance: https://www.axios.com/hospitals-price-transparency-costs-regulations-noncompliance-ebf6bd21-5709-4298-b67a-74c8a90a1ec1.html https://www.axios.com/hospitals-price-transparency-costs-reg...

ryanSrich 5y ago

Of course it was, also see “value based care”. It’s all bullshit. Hospitals have zero incentive to be transparent, and all the incentives to be opaque. So long as you’re a non-Medicare/Medicaid patient you’ll continue to suffer. The American healthcare system is completely fucked (there’s no better word).

o8r3oFTZPE 5y ago
Is it fscked for physicians and various healthcare professionals (e.g., paid higher wages than other countries with different systems). Is it also fscked for wealthy patients who do not really care about costs.
- adventured 5y ago
  > Is it fscked for physicians and various healthcare professionals It's an underappreciated point. The US healthcare system is one of the largest wealth transfer systems ever invented. It's a heavily protected cartel that plunders wealth from the top 2/3 and lines the pockets of a few million employees in the system. There is an excess cost bounty of $1.2 trillion (or more) being plundered and redistributed every year to the healthcare cartel. There are millions of people working artificially high paying jobs in the healthcare cartel in the US courtesy of the hyper inflated costs in the system. From nurses to doctors to pharma sales reps to scientists to management and everything inbetween. Nobody ever talks about the need to slash the pay of nurses & doctors though, it's far too unpopular of a subject, it's downright taboo. Just a notch below slashing the pay of teachers. They'd all go on strike tomorrow morning if a serious attempt were made to bring their pay in-line with other developed nations. The US has to remove a minimum of $1.2 trillion in cost from its healthcare system (which would produce an end cost structure still far above that of eg Britain). Only about 10-15% of that can come from slashing costs out of the pharma drug price side. The bulk of it has to come out of inflated salaries of millions of workers in healthcare across the board. When politicians talk about universal healthcare in the US, they always, without exception, go far out of their way to dodge this epic scale problem of inflated salaries in healthcare and of where to find $1.2 trillion in costs to slash (they primarily focus on high drug prices as a matter of political convenience; that segment by itself won't remotely cut it though). This is why every time a state decides it's going to look at doing universal healthcare, it immediately runs away after the cost study is completed, it's impossible until you remove a dramatic amount of cost from the system. Now someone go tell all the nurses and doctors in California they get to make 25%-35% less money (good luck).
  - AussieWog93 5y ago
    About 50% of that $1.2 trillion is in unnecessary admin.
  - FlyingLawnmower 5y ago
    Do you have some sources where I can read up more on this? I have always believed that the cost of front line worker salaries (Doctors/Nurses) was a relatively small % of the total cost of healthcare. Studies like this [1] led me to believe that massive rises in administration costs and inefficiencies due to insurance structure are bigger culprits than doctor/nurse salaries. But I am admittedly not very well informed in this area. [1] https://pubmed.ncbi.nlm.nih.gov/31905376/ https://pubmed.ncbi.nlm.nih.gov/31905376/
  - pininja 5y ago
    Do you have an example of a cost study? I’m curious, but don’t know how to find one.
  - borski 5y ago
    I see your point, but I will raise you that medical training in other countries doesn't also put you in hundreds of thousands of dollars of debt before you've even begun to practice. The cost of a medical education has a large impact on why salaries are "artificially" inflated.
    - hn_acc_2 5y ago
      Sure, high salaries are justified for this minority. The people mentioned specifically in the comment are of more concern; sales, admin, etc. salaries in this field are also inflated compared to other industries.
      - borski 5y ago
        Got it. Thanks for the clarification. I think I agree on that.
  - hamandcheese 5y ago

giantg2 5y ago

Only for billing cost of procedures. It's still a mess. Did you know that hospitals make money by using name brand medications? They will get a contract with a brand, like Motrin, and charge you full price at $8 a pill. Then Motrin will will evaluate how much the hospital used and give them a big rebate to bring the hospital's cost down under $1 per pill. You can literally buy a bottle of ibuprofen for what they charge for a single pill, but of course in the name of safety (and really kickbacks too) they won't allow the cheaper outside medication. It's effectively an internal monopoly.

revscat 5y ago
I’m not sure what your point is. These contracts between seller and merchant were voluntary. There are other hospitals available should you choose, and if not then you have no one to blame but yourself.
- alisonkisk 5y ago
  Are you trolling? A hospital has even more lock in than the App Store. They can literally legally lock you in.
  - raspasov 5y ago
    At least in the US, that would have to go through a court. I don't think a hospital can force you to stay in.
    - giantg2 5y ago
      They mean lock you in to their services only. Once you're in there you're forced to pay for whatever services they provide, which could be a lot in an emergency or if your unconscious. I think they were also referencing the idea that you are forced to pay a high amount for Motrin, when an alternate source would be much cheaper.
- giantg2 5y ago
  Not everywhere has multiple hospitals to choose from. Even if there are multiple hospitals, your insurance might influence your choices too. And at the end of the day, if you're incapacitated, they will just take you to wherever is closest. The point was that the hospitals are doing things behind the scenes that are not well known that affect the pricing. In this example, they charge you more for using name brand medication and then get a kickback to make money for themselves.

sethammons 5y ago

A couple years past, def under Obama, I went in for a retina exam. They absolutely could not tell me the price for the appointment. "It depends on services rendered" - "what if it is a standard appointment with no extra services, how much (ball park) should I expect? $50? $500? $5k?" - "I couldn't tell you, I can't imagine that high." There is no price transparency. Sure would like it since I have a high deductible plan.

bushbaba 5y ago
Price transparency plus high deductible plans would drive the cost of health insurance down. Health insurance is supposed to cover you for catastrophic health issues that were previously unknown. For some reason it changed to also cover all your recurring or minor illnesses.
- epistasis 5y ago
  I'm not so sure. There's a lot of waste in all of our health care system, and many areas are served by few care providers. Transparency on prices without effective competition won't change much.
  - spaetzleesser 5y ago
    You have to start somewhere. Knowable prices are the first prerequisite for markets.
    - epistasis 5y ago
      That's an excellent point! It can't hurt, and might help. I don't know why I felt negatively about it at first, anything to start disrupting the bad parts of the system should be welcome.
- alasdair_ 5y ago
  Part of that is because it’s far cheaper to catch (say) cancer at an early stage and treat it than it is to catch it at stage 3 or 4 and spend potentially millions on a possibly preventable catastrophe. There is fairly strong evidence that if the cost of routine preventative care isn’t paid by insurance, quite a lot of people opt to skip it because they can’t afford it, leading to worse outcomes.

Black101 5y ago

yes... One of the good things Trump did

cirrus3 5y ago
no one took or will take that chump b*itch seriously

crawsome 5y ago

definitely not trump

TheHypnotist 5y ago
I actually think this was maybe one of the few things Trump's admin did that roundly was viewed as good.