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Hospitals still not fully complying with federal price-disclosure rules
- stevesearer 5y agoHow about starting a non-profit that paid people $X to upload an redacted image of their medical bill? Or maybe it could be where you get discounts at participating local businesses when you upload. Kind of like a weird proof of work concept.
- maxwell 5y agoHow about simply holding non-compliant hospitals accountable with appropriate fines?
- nescioquid 5y agoI know. Every time I see one of these "mutual aid" solutions, I can only see evidence of the utter betrayal of our government and society.
- Ekaros 5y agoJust have them pay double the difference to reporter in fines.
- stevesearer 5y agoI agree with you. My original thought was to help people better negotiate at the local hospital/health system by knowing what other people pay. Perhaps like financial and tech firms, paying fines would just get rolled into the ledger as a cost of operating.
- spaetzleesser 5y agoUnfortunately hospitals are in the same category as banks that allows them to get away with breaking rules and criminal behavior with a slap on the wrist. If there ever has been as sector that needs price transparency it's hospital and medical in general. It's really hard to understand that people are putting up with insanity.
- MBCook 5y agoThere’s one difference, and that’s Medicare/Medicaid. The government could easily decide that they will stop paying hospitals for Medicare/Medicaid patients until this gets implemented. I bet it would happen pretty fast. There isn’t something quite as direct on banks.
- nradov 5y agoThat's not something that could be easily implemented by a new CMS regulation. They lack the statutory authority to make Medicare payments conditional on price transparency compliance. Changing that would require an Act of Congress.
- arwhatever 5y agoSome healthcare systems post incomplete pricing data or nothing at all, with no penalties yet from the Biden administration.
- spaetzleesser 5y agoIt's pretty sad that there is basically nobody in DC who wants to improve the healthcare system. Certainly not Biden.
- redis_mlc 5y ago
- ren_engineer 5y agonon-paywall link - https://archive.is/LQUkO https://archive.is/LQUkO this seems like something that should actually be able to be handled in bipartisan fashion, you need price transparency for a free market to function properly so Republicans should support because lower costs would stunt demands for universal healthcare.
- themaninthedark 5y agoFirst off, law/rule is passed. So who is in charge of enforcement. Second, came into existence 01/2021. That was under Trump and Republicans, so ostensibly they support it. Third, the only concern I have is being able to ensure that the procedures are the same and also outcome statistics. There are a couple different hip replacement surgeries that you can have. One is trickier to perform but has better outcome and recovery time, if both are listed as hip replacement and customers don't know there are differences then you create a race to the bottom.
- kevin_thibedeau 5y agoThe vaccine came from his brilliant scientific mind so there should be no objections there either.
- felipellrocha 5y ago> so Republicans should support because lower costs would stunt demands for universal healthcare. Oh, my sweat summer child...!
- dang 5y agoPlease don't do this here.
- ghufran_syed 5y agoThe article is about the Biden administration failing to enforce the rules - how does that make Republicans responsible?
- Day1 5y ago> “Some hospitals … don’t believe consumers would find [price transparency] useful” Is saying that consumers are too stupid to understand the benefits of price transparency an adequate defense?
- b9a2cab5 5y agoNo, the article says exactly why: > Texas-based Christus Health early this year said on its website it planned to defy the rules because its comprehensive list of prices “will only be useful for our competitors.” Because publishing prices leads to actual competition.
- mc32 5y agoPrice transparency in medical care should have been a thing since the 80s when we deregulated telecomms and aviation. There should be price transparency and WYSIWYG billing, no hidden fees, or bait and switch, etc. No $50 tylenols and such shenanigans.
- koolba 5y agoI’d take it a step further and mandate a single price for everybody. Let insurance cover whatever the actual is going to be for paying in cash and not some voodoo accounting that generates a cash price backwards from the maximum negotiated rates. Insurance should be to cover unforeseen events. Baking in the cost of trivial things like a “fee flu shot” just acts as a way to obscure the true costs.
- spaetzleesser 5y agoTotally agree. Charge the same price for everybody no matter how they are paying.
- JumpCrisscross 5y agoWhat would be the difficult-to-foresee challenges this, for practitioners and consumers, would raise?
- trembonator 5y ago
- mindslight 5y agoStraightforward healthcare reform would start with eliminating this unprecedented and nonsensical ability for hospitals to engage in arbitrary post facto billing, require well-defined contracts for non-emergency care, and require providers to publish a uniform all-payer rate schedule for emergency/urgent care. Any deviation should result in a non-enforceable invalid bill, with easily claimable punitive damages if such fraudulent charges end up being mistakenly paid. When I walk into a grocery store, buy some items, and leave there is absolutely no chance that I will later get a bill in the mail from the cashier for their bagging services. If I were to, it would be laughably unenforceable. And yet, this is precisely what the medical establishment feels entitled to do when they refuse to answer basic questions about prices or "network" status of providers, and then send you multiple bills for a single engagement! While this would do little to help healthcare affordability for those who truly cannot pay, it is a necessary step to creating a functioning market regardless of who is paying. The point we're at now, where even people with the ability to pay have no clue how exactly the system will attempt to screw them, is utterly untenable. For what it's worth, this is the kind of reform the Republican party could be loudly and persistently pushing if weren't primarily interested in dysfunction. As it stands the only popular avenue for reform I've seen is to punt the whole thing to the government, which I'm forced to reluctantly support even though it feels like giving up on actually solving the problem and letting the organizational cancer metastasize and feed on taxpayer money.
- AtlasBarfed 5y agoSo as you fly through the air after being ejected in a car crash, make sure to pull out your phone and negotiate upfront pricing with your providers before you hit the ground and are rendered unconscious. While I agree after the fact billing is stupid, your scheme implies people choose their hospital based on rates as they are flying through the air after being ejected from a car in a crash. Make sure to choose wisely before you black out! Or, every doctor visit has an attending billing assistant to explain costs of care to both the doctor and the patient. Because the doctors don't know and don't have time to know. In the end this is all Republican laissez faire fantasies. We need socialized medicine, like ever other civilized and (by our standards) uncivilized country has. I have no clue when the Republican party would have been able to push any coherent reform to the health care system. 50 years ago? The modern Republican party exists solely to defend entrenched oligarchies and anticompetitive cartel dominated markets. That's what campaign finance rules reward. The Democrats also perform the same function, but at least with some attempts at reform around the edges, because that's what their voting block demands.
- deleted 5y ago[deleted]
- 14 5y agoMeanwhile in Canada I have had multiple trips to my doctor, multiple tests, x-rays, ct-scan, blood work, and probably a couple others I am forgetting and my bill has been zero dollars. There is no such thing as a bill. I guess I pay taxes but that is it. As a non American it is so hard to see this and understand how it is allowed to happen. You guys must have to choose between doctors or financial uncertainty and I can't understand how a country as good as USA has allowed this to happen for so long.
- eagsalazar2 5y ago
- 14 5y agoI called my doctors office, had an appointment 2 weeks later. He ordered tests, about 1 month later got them. The blood work was as soon as I went to the lab and stood in line for half an hour so a few days later. About 5 days after I took the blood tests my doctor called me personally to tell me all negative. In the end I had a pinched nerve from a bit of scoliosis and chiro really helped. Chiro is not covered by our health care completely, I paid $80 then $40 for follow up visits. Chiro took my pain away with an exercise routine. All is well and the system worked fast and I was happy with how it all went.
- nradov 5y agoI'm not sure what you heard on Fox News but the average time for a Canadian to go from initial consultation to actual treatment by a specialist was 3 months in 2020. https://www.fraserinstitute.org/studies/waiting-your-turn-wait-times-for-health-care-in-canada-2020 https://www.fraserinstitute.org/studies/waiting-your-turn-wa... It's common for Canadians who can afford it to travel to the US (and other countries) for more rapid treatment. https://www.usnews.com/news/best-countries/articles/2016-08-03/canadians-increasingly-come-to-us-for-health-care https://www.usnews.com/news/best-countries/articles/2016-08-... Since demand for healthcare is effectively unlimited, all healthcare systems have to ration care. The US system primarily rations based on ability to pay. The Canadian system rations by restricting supply and forcing less urgent cases to wait.
- outside1234 5y agoFine them - nothing is going to change until the fines are larger than the competitive impact
- jedberg 5y agoThe fine is only $110,000 a year. They make more doing nothing.
- tempestn 5y agoI expect the main difficulty this presents to hospitals isn't that their customers will be informed, or even that their competitors will be advantaged, but that they will be unable to engage in price discrimination (charging different amounts to different customers, based on their willingness and ability to pay). Or at least, they'll need to do so transparently.
- bredren 5y agoMany, many medical bills go unpaid. Calculation of likelihood of payment based on customer attributes is being used to consider offering discounts to pay quickly. I don’t know how this wouldn’t act as de facto price discrimination but it is happening.
- joenathanone 5y ago>Many, many medical bills go unpaid. Several years ago I ended up in the ICU, no insurance, got a ridiculous bill that would have taken the majority of my lifetime to pay down. In the end I decided not to even attempt to pay because it was so ridiculously high, decided to just wait the seven years for it to fall off my credit. If the price had been reasonable I would have paid outright or gotten on a payment plan.
- MathCodeLove 5y agoWhat was the impact on your credit score? I imagine that had an effect on other parts of your life no?
- joenathanone 5y agoIt hurt my credit score(as in the number quite a bit), but not as much as I thought it would, I was really worried I wouldn’t get approved for things, but I was informed that when underwriters are reviewing credit reports, medical debt doesn’t carry much weight, as ‘everyone’ has it and it doesn’t reflect on how responsible or impulsive the debtor is.
- torbTurret 5y agoHospitals are unbelievably corrupt and it’s truly despicable. The worst bit is that this is often learned during trying times in ones life, when stress makes it easier to overlook.
- russdill 5y agoI had a hospital call me recently and inform me that the cash price for an upcoming procedure would be much lower than the price they would bill the insurance company. Since I wasn't going to meet my deductible this year, they suggested I accepted the cash price to save money. I asked them if the insurance price was the price billed to the insurance company or the negotiated price that actually gets paid. They could not give me a straight answer. I had them stay on the line while I added my insurance company to the call. The agent at the hospital communicated the necessary information to the insurance company (there's a ton of stuff that effects the price, down to which radiologist happens to be scheduled that day). And of course, the negotiated price for the insurance company was lower than the cash price the hospital was offering. I really don't think this attempt at getting me to pay the cash price was some accidental mix up. I think someone at the business side has figured out not only can they convince people to pay a higher rate, but that then they don't need to deal with billing the insurance. A double savings. I wonder what percentage of people they successfully scam with these calls. To anyone outside the US reading this who is really confused, I'll see if I can start a GoFundMe to explain the US healthcare system to foreigners
- quartz 5y agoThis specific con really ought to be illegal and it's becoming incredibly common to the point that I see it every time I'm at any medical facility now. The exact statement you described is used: "Oh you won't hit your deductible yet so pay this lower cash price" and you are spot-on that it's a sly way for the facility to get more for the procedure by hoping the patient doesn't understand negotiated billing. And it works... almost every time I've seen it offered it's accepted. Not to even mention the secondary effect that this causes the patient to not make progress towards burning their deductible so if they have more medical events that year they'll basically pay that amount AGAIN.
- neonate 5y agohttps://archive.is/LQUkO https://archive.is/LQUkO
- onetimemanytime 5y agodoes anyone know if they are forced to list complete procedures? example: hernia will cost $4200 or will they be able to list dozens of other charges that may or may not be added to the procedure?
- hestefisk 5y agoMaybe it’s time to get a proper publicly funded universal healthcare system. Then these problems would go away. My hypothesis is it could be funded if we increased federal taxes by 100-200 basis points.
- droopyEyelids 5y agoI believe a functional universal healthcare system can only be created without interference from the existing insurance companies and healthcare networks, but they have a strong lobbying engine that cultivates both sides of the political spectrum. If we make a universal healthcare system now, it could be a slight improvement for us, but it can only be written and passed in a way that will funnel an even larger portion of GDP to health insurance companies and hospital networks.
- loonster 5y agoA post about price transparency wouldn't be complete without the "Surgery Center of Oklahoma"[0]. If one for profit hospital can figure out how to publish prices in advance of surgery (for a lower price), than all hospitals should be able to do so too. [0] https://surgerycenterok.com/pricing/ https://surgerycenterok.com/pricing/
- deleted 5y ago[deleted]
- PaulDavisThe1st 5y agoThis seems like an area where the federal government could take a leaf out of Texas' new found love for citizen-driven lawsuits: allow individuals rather than CMS to sue hospitals for the damages (up to US$2M starting tomorrow). My guess is that you'd see the hospital IT and pricing infrastructure do a reasonable impression of faster-than-light travel and the information would be available by January 3rd.
- pg_1234 5y agoOr just say "if the price isn't published in advance it's free".