11 ms·

I'm one of the co-founders of Turquoise Health, mentioned in the article here. We've been downloading and parsing this data all day. It's a really big deal in t

I'm one of the co-founders of Turquoise Health, mentioned in the article here. We've been downloading and parsing this data all day. It's a really big deal in the industry that the prices that insurance companies pay doctors are now being shared publicly. It will have all sorts of positive impacts over time, hopefully making rate negotiations more consistent and fair between different insurance plans. Right now, 10x differences in prices paid for the same healthcare service from the same doctor between insurance plans is not uncommon.

WFHRenaissance 4y ago
What do you serve to gain from scraping all of this information?
- jjoonathan 4y ago
  The information on their landing page was immediately relevant to me https://turquoise.health/ https://turquoise.health/ I hope they have a good business plan and manage to stick around!
  - ageitgey 4y ago
    Thanks! So far, so good. We don't sell anything to consumers. Our products are aimed at the healthcare industry which lets us post information for consumers for free and we have pretty good product-market fit. Obligatory "if anyone is interested in joining a fast growing, series A company doing impactful work, hit up our careers page!"
    - atlasunshrugged 4y ago
      Interesting, I'm curious since you're in the industry, why do you think medical tourism has never taken off in a big way in the U.S.? I feel like I saw more people willing to go to Poland or Ukraine for things like dental work when I lived in Europe than people in the U.S. willing to go to Mexico or some other destination.
      - Red_Leaves_Flyy 4y ago
        Not the person you asked. I want my medical providers to be local to me so they’re liable to my local community. I also want to keep my organs and have insurance cover the costs.
      - ageitgey 4y ago
        The US is really, really large and many people living there have never left it. There's also a belief that US healthcare is the gold standard (which is probably true at the very high end, but not necessarily on average). In other words, it's a hard sell to convince a factory worker to travel 5-10 hours on a plane to a place they have no familiarity with to get what they believe to be inferior treatment. They might not even have a passport. This is much less of an issue in Europe where countries are tiny and almost everyone travels between them on a regular basis. Also, medical tourism is mostly limited to what the industry calls Shoppable Services - outpatient treatments that are not emergent/not life threatening. There is a bit of a cottage industry in Mexico for some services, like bariatric surgery for obesity or dental work, but it isn't a huge volume. The really expensive stuff in the US is emergency treatment which you can't shop for anyway. All that said, I think the interest in buying prescriptions from overseas has never been higher.
      - rootusrootus 4y ago
        Anecdotally, most of the people in my circle of friends and family are perfectly satisfied with what we get locally. If you have adequate insurance and no major medical issues, you don't save much by flying down to Mexico. I do have some extended family that have gone to Mexico for treatment, however, mostly of the dental variety. But it was major reconstruction, so it was worth the effort. I do remember reading a story a couple years back where an insurance company paid for their customer to fly to Mexico, flew down a US orthopedic surgeon, and paid him pretty well for his services. The cost of the flights, surgeon, and medical facility in Mexico were significantly less than it would cost them in the US, so everybody won except the US hospital. As I recall, the hospital in Mexico was collocated with a resort, so it was a nice place to recuperate as well. Not sure how common that really is, though, stories like that make the news for a reason. Edit: Pretty sure this is the story I was thinking about: https://www.advisory.com/daily-briefing/2019/08/13/cancun https://www.advisory.com/daily-briefing/2019/08/13/cancun
    - wildrhythms 4y ago
      How does the healthcare industry use this data typically?
- ageitgey 4y ago
  Our industry-focused products are based on knowing how much every service costs at every healthcare provider. It's the underpinning of our products. We also post a lot of the rates publicly in a consumer-friendly searchable format, but we don't charge any money for that. But this data will let us greatly expand the scope of that free service.
- dugmartin 4y ago
  I was guessing it was this bit at the bottom of their landing page: > Are you a transparent provider or payer? > There is a market for transparency. Let patients find you by claiming > your provider page and listing your services. It only takes 10 minutes. But following through that link says it is a free program.
  - ageitgey 4y ago
    We build products that help healthcare providers and insurance companies broker contracts between themselves based on actual market information instead of guessing at prices. The goal is to drive down prices by making the market more efficient. Part of that is assuming that prices will be public, so we encourage them to claim their own page and take control of the rates listed there.
nullfield 4y ago
Where is the - if it exists - list of locations where different entities have published their machine-readable files?
elromulous 4y ago
Could this backfire - similarly to how publicly traded companies' CEOs disclosing their pay caused their pay to skyrocket?
- huitzitziltzin 4y ago
  This is a good question and the answer is absolutely yes. It could raise prices. Consumers have some incentive to care how much they are spending on health care, but they aren't generally the claimant on savings they realize for their insurance plans. (Obviously the incentives for uninsured or self-insured patients (to the extent that there's anyone in the latter category) are quite different, but those populations are small.) On the other hand, every hospital has a strong, strong incentive to care a lot about how much their competitors are getting for the same procedures. (Much more than consumers, for example.) It's possible that these disclosures lead to prices falling as hospitals seek to undercut each other. However, most US hospital markets feature a small number of competing hospital systems in an oligopoly. The price-cutting pressures in such markets are much, much weaker. There is a "mutually assured destruction" aspect to price competition in such markets which may keep prices from falling. The latter incentive can raise prices too. IF you know your competitors across town are getting an extra $5,000 for a knee replacement and you know that the two of you are the only game in town for hospitals, you may raise your prices rather than lowering them. On balance I think this is the right policy, in part because I want this data myself as a researcher. But it is not unambiguous that this will lead to price reductions. Source: am a health economist.
- marricks 4y ago
  Can you support that claim? I couldn't find when CEO pay went public but it sounds very likely like one of those causes were correlation definitely doesn't imply causation.
  - zeruch 4y ago
    All CEO pay for public companies is exposed in the 10Ks. What I suspect the person was referring to is the change where compensation became more tied to equity valuation.
sinab 4y ago
Where are health providers hosting these data? Could you give an example? Thank you.
treeman79 4y ago
A few times I’ve seen a 10x price decrease when I asked to pay cash before. Sometimes the co-pay alone is more then cash for procedure. Weekly injections and MRIs is the worst offenders I’ve seen.
snarf21 4y ago
We really need to move to reference based pricing. We can cut so much waste out of the current system including brokers. Reference based pricing also get rids of the loopholes for things like anesthesiologists being "out of network" at a hospital/facility that is "in network". It also gets rid of the situation where if you offer cash you get one price but if you submit for the same code, it could be 3x or 10x or even more.
- whatshisface 4y ago
  What's reference-based pricing?
  - antisthenes 4y ago
    It's basically price-controls. A regulatory body looks at how much something "should" cost based on its history of reimbursement and the cost of its inputs and then sets a cap of say, cost + 20%. The problem is having an independent body that is free of influence of health insurance companies and hospitals, both of which have perverse incentives to continue profiteering.
    - db48x 4y ago
      Not to mention the fact that it will eventually cause a supply shortage.
      - alxhill 4y ago
        Germany has reference pricing for their drugs system and doesn't seem to have a supply issue. Genuine question, is there something that makes you think that wouldn't be true for the US?
        whatshisface 4y ago
        How would anyone notice a shortage when shortages came in the from of it not being standard practice to prescribe a medicine in a certain situation?
tomrod 4y ago
Very cool work! The article mentions that yall are working on hospital data. Is insurer data beginning to roll in?
baby 4y ago
Another proof that more transparency decreases corruption and improves efficiency?
- BurningFrog 4y ago
  Once it's been shown to work it may be proof. The track record of healthcare reforms intended to cut costs is rather abysmal.
  - epgui 4y ago
    Does it really need to be proved? I'd argue that it's a mathematical/logical truth in principle, and that the only thing that requires proof is whether this particular implementation is successful at what it aims to do.
  - spaetzleesser 4y ago
    That may be true but the first prerequisite for functioning markets is price transparency for participants. Without that it will never work. There may be other problems but you absolutely need to know prices.
antisthenes 4y ago
Are you guys hiring?
- missedthecue 4y ago
  Look like it https://turquoise.health/careers https://turquoise.health/careers
jerry1979 4y ago
How do you account for case-based charges?
codegeek 4y ago
I appreciate what you all are doing. We need people to try and really fix our Healthcare Industry. However, I do have a question. Are you trying to get rid of Insurance mafia at all for at least some things like basic preventive care etc because I am sure that drives costs up a lot if Insurance companies are always between a doctor and a patient. I really hope something can be done where I can just go to a doctor/hospital, ask how much and pay for it out of pocket instead of crazy premiums and all the other BS we have to go through everytime.
- nradov 4y ago
  Most healthcare providers are happy to accept cash payments from patients. You can sometimes even negotiate a discount. If you have a medical plan subject to the Affordable Care Act then most preventive care is already fully covered at no cost to the patient. https://www.healthcare.gov/coverage/preventive-care-benefits/ https://www.healthcare.gov/coverage/preventive-care-benefits...
  - indymike 4y ago
    > Most healthcare providers are happy to accept cash payments from patients. You can sometimes even negotiate a discount. Actually, if you don't have insurance, you get the special cash price of $Maximum. /been there //tried that.
    - adventured 4y ago
      I have also been there and tried that, extensively. That's the opposite experience of what I encountered in paying by cash for more than a decade. Typically I'd pay around half price via cash for healthcare services (routine doctor visits, scans, et al.) versus what they charged if you had insurance. I never ran into a situation where they wouldn't negotiate steep discounts for paying by cash.
      - indymike 4y ago
        Yes, it works for routine stuff, but don't try to pay cash for abdominal surgery. You will get a very terrible, high price. After all, it's agree to our low price or die of appendicitis.
FollowingTheDao 4y ago
Sorry, but the only thing that will help is Medicare for all. We need to get rid of insurance companies completely.
- KyeRussell 4y ago
  Non-American here: your healthcare system is so abysmal that you could stop short of implementing Medicare for all and still have a significantly improved system. You should obviously have Medicare for all, but let’s not kid ourselves about how far from that you are.
- Steko 4y ago
  Lots of countries have great systems that aren't single payer.
- refurb 4y ago
  Should Europe get rid of their insurers too?
  - hansel_der 4y ago
    as european i am not entirely convinced that it makes sense to have hundreds of companies providing the same heavily regulated service. if there were too few of those i would probably also object. idk about the situation where there are no private companies involved at all and the government takes over healthcare top to bottom because on the one hand i see a massive problem with for profit healtcare as it is and on the other hand i can see how incentives would wither away if there is no drive for efficiency at all.
spaetzleesser 4y ago
“Right now, 10x differences in prices paid for the same healthcare service from the same doctor between insurance plans is not uncommon.” Makes me wonder how things got to this point. How can a business perform any planning if they sell their services with such big differences between prices charged to customers?
- pc86 4y ago
  Over time the higher paying ones subsidize the lower ones. Due to this we'll see some people's insurance premiums increase, some decrease, and some insurance providers probably go out of business (all good IMO).
- 29athrowaway 4y ago
  Short answer is: because they can. And they can because there's a lack of transparency that makes people believe this is OK.
- refurb 4y ago
  The honest answer is because that’s what insurer negotiation had led to with hospitals having using their negotiating position. If you’re a hospital in an area with standalone MRI clinics the negotiation pressure is high, insurers can say “ill send patients elsewhere”, so you give on price, maybe below cost. But that same hospital is the only cath lab in 100 miles. Great! We’ll just tell the insurer “we’re charging 300% the normal cost of a cath procedure, take it or leave it”. So the insurer takes it because how can you offer insurance and tell customer they have to drive 100 miles for a heart procedure? Hospital is happy because they’re profitable overall. Insurer just lives with paying 3x for cath procedures in that area.
  - datavirtue 4y ago
    Hospitals don't let you obtain imaging elsewhere. They force you to use their imaging services--full stop.
    - refurb 4y ago
shostack 4y ago
My dentist dropped my insurer (Delta Dental) because they claim they did not cover things as reliably as they should. When I saw a comparison bill of what it would be in and out of network for a recent service it looked like the 60% increase in price was purely because my dentist billed more, which they then claimed is due to the discount The insurer provides. None of this makes sense to me. How can I leverage this new data access to my advantage?
- Akronymus 4y ago
  > When I saw a comparison bill of what it would be in and out of network for a recent service it looked like the 60% increase in price was purely because my dentist billed more, which they then claimed is due to the discount The insurer provides. Well, rebates kinda DO end up working like that. https://www.youtube.com/watch?v=uPa-RHVh97k https://www.youtube.com/watch?v=uPa-RHVh97k https://www.youtube.com/watch?v=_4_WNFPnmO8 https://www.youtube.com/watch?v=_4_WNFPnmO8
- neycoda 4y ago
  People keep complaining government is too complicated and too expensive and bafoonish, yet they don't see how corporations are no different except their priority is maximizing profit not providing cost-efficient quality.
  - janekm 4y ago
    The point (in theory) is that in efficient markets you can choose between different companies offering a product/service and that competition drives down prices / costs. The healthcare market in the US is very much not a competitive market (in part due to transparency issues which this is trying to address, in part because of the perverse incentives in the health insurance system). It's not so easy to have a competitive marketplace for government services (though I would not be surprised if the US saw the emergence of private police forces now, for those parents who actually want police officers that have a duty to protect their kids...)
    - feet 4y ago
Zenst 4y ago
How well will their data be audited and enforced? For example if they charge one price and yet their public data purports another price? More so will they cut the drug prices internally and shift the difference onto an administration fee? That is one aspect I'm very mindful of.

WFHRenaissance 4y ago

What do you serve to gain from scraping all of this information?

jjoonathan 4y ago
The information on their landing page was immediately relevant to me https://turquoise.health/ https://turquoise.health/ I hope they have a good business plan and manage to stick around!
- ageitgey 4y ago
  Thanks! So far, so good. We don't sell anything to consumers. Our products are aimed at the healthcare industry which lets us post information for consumers for free and we have pretty good product-market fit. Obligatory "if anyone is interested in joining a fast growing, series A company doing impactful work, hit up our careers page!"
  - atlasunshrugged 4y ago
    Interesting, I'm curious since you're in the industry, why do you think medical tourism has never taken off in a big way in the U.S.? I feel like I saw more people willing to go to Poland or Ukraine for things like dental work when I lived in Europe than people in the U.S. willing to go to Mexico or some other destination.
    - Red_Leaves_Flyy 4y ago
      Not the person you asked. I want my medical providers to be local to me so they’re liable to my local community. I also want to keep my organs and have insurance cover the costs.
    - ageitgey 4y ago
      The US is really, really large and many people living there have never left it. There's also a belief that US healthcare is the gold standard (which is probably true at the very high end, but not necessarily on average). In other words, it's a hard sell to convince a factory worker to travel 5-10 hours on a plane to a place they have no familiarity with to get what they believe to be inferior treatment. They might not even have a passport. This is much less of an issue in Europe where countries are tiny and almost everyone travels between them on a regular basis. Also, medical tourism is mostly limited to what the industry calls Shoppable Services - outpatient treatments that are not emergent/not life threatening. There is a bit of a cottage industry in Mexico for some services, like bariatric surgery for obesity or dental work, but it isn't a huge volume. The really expensive stuff in the US is emergency treatment which you can't shop for anyway. All that said, I think the interest in buying prescriptions from overseas has never been higher.
    - rootusrootus 4y ago
      Anecdotally, most of the people in my circle of friends and family are perfectly satisfied with what we get locally. If you have adequate insurance and no major medical issues, you don't save much by flying down to Mexico. I do have some extended family that have gone to Mexico for treatment, however, mostly of the dental variety. But it was major reconstruction, so it was worth the effort. I do remember reading a story a couple years back where an insurance company paid for their customer to fly to Mexico, flew down a US orthopedic surgeon, and paid him pretty well for his services. The cost of the flights, surgeon, and medical facility in Mexico were significantly less than it would cost them in the US, so everybody won except the US hospital. As I recall, the hospital in Mexico was collocated with a resort, so it was a nice place to recuperate as well. Not sure how common that really is, though, stories like that make the news for a reason. Edit: Pretty sure this is the story I was thinking about: https://www.advisory.com/daily-briefing/2019/08/13/cancun https://www.advisory.com/daily-briefing/2019/08/13/cancun
  - wildrhythms 4y ago
    How does the healthcare industry use this data typically?
ageitgey 4y ago
Our industry-focused products are based on knowing how much every service costs at every healthcare provider. It's the underpinning of our products. We also post a lot of the rates publicly in a consumer-friendly searchable format, but we don't charge any money for that. But this data will let us greatly expand the scope of that free service.
dugmartin 4y ago
I was guessing it was this bit at the bottom of their landing page: > Are you a transparent provider or payer? > There is a market for transparency. Let patients find you by claiming > your provider page and listing your services. It only takes 10 minutes. But following through that link says it is a free program.
- ageitgey 4y ago
  We build products that help healthcare providers and insurance companies broker contracts between themselves based on actual market information instead of guessing at prices. The goal is to drive down prices by making the market more efficient. Part of that is assuming that prices will be public, so we encourage them to claim their own page and take control of the rates listed there.

nullfield 4y ago

Where is the - if it exists - list of locations where different entities have published their machine-readable files?

elromulous 4y ago

Could this backfire - similarly to how publicly traded companies' CEOs disclosing their pay caused their pay to skyrocket?

huitzitziltzin 4y ago
This is a good question and the answer is absolutely yes. It could raise prices. Consumers have some incentive to care how much they are spending on health care, but they aren't generally the claimant on savings they realize for their insurance plans. (Obviously the incentives for uninsured or self-insured patients (to the extent that there's anyone in the latter category) are quite different, but those populations are small.) On the other hand, every hospital has a strong, strong incentive to care a lot about how much their competitors are getting for the same procedures. (Much more than consumers, for example.) It's possible that these disclosures lead to prices falling as hospitals seek to undercut each other. However, most US hospital markets feature a small number of competing hospital systems in an oligopoly. The price-cutting pressures in such markets are much, much weaker. There is a "mutually assured destruction" aspect to price competition in such markets which may keep prices from falling. The latter incentive can raise prices too. IF you know your competitors across town are getting an extra $5,000 for a knee replacement and you know that the two of you are the only game in town for hospitals, you may raise your prices rather than lowering them. On balance I think this is the right policy, in part because I want this data myself as a researcher. But it is not unambiguous that this will lead to price reductions. Source: am a health economist.
marricks 4y ago
Can you support that claim? I couldn't find when CEO pay went public but it sounds very likely like one of those causes were correlation definitely doesn't imply causation.
- zeruch 4y ago
  All CEO pay for public companies is exposed in the 10Ks. What I suspect the person was referring to is the change where compensation became more tied to equity valuation.

sinab 4y ago

Where are health providers hosting these data? Could you give an example? Thank you.

treeman79 4y ago

A few times I’ve seen a 10x price decrease when I asked to pay cash before. Sometimes the co-pay alone is more then cash for procedure. Weekly injections and MRIs is the worst offenders I’ve seen.

snarf21 4y ago

We really need to move to reference based pricing. We can cut so much waste out of the current system including brokers. Reference based pricing also get rids of the loopholes for things like anesthesiologists being "out of network" at a hospital/facility that is "in network". It also gets rid of the situation where if you offer cash you get one price but if you submit for the same code, it could be 3x or 10x or even more.

whatshisface 4y ago
What's reference-based pricing?
- antisthenes 4y ago
  It's basically price-controls. A regulatory body looks at how much something "should" cost based on its history of reimbursement and the cost of its inputs and then sets a cap of say, cost + 20%. The problem is having an independent body that is free of influence of health insurance companies and hospitals, both of which have perverse incentives to continue profiteering.
  - db48x 4y ago
    Not to mention the fact that it will eventually cause a supply shortage.
    - alxhill 4y ago
      Germany has reference pricing for their drugs system and doesn't seem to have a supply issue. Genuine question, is there something that makes you think that wouldn't be true for the US?
      - whatshisface 4y ago
        How would anyone notice a shortage when shortages came in the from of it not being standard practice to prescribe a medicine in a certain situation?

tomrod 4y ago

Very cool work! The article mentions that yall are working on hospital data. Is insurer data beginning to roll in?

baby 4y ago

Another proof that more transparency decreases corruption and improves efficiency?

BurningFrog 4y ago
Once it's been shown to work it may be proof. The track record of healthcare reforms intended to cut costs is rather abysmal.
- epgui 4y ago
  Does it really need to be proved? I'd argue that it's a mathematical/logical truth in principle, and that the only thing that requires proof is whether this particular implementation is successful at what it aims to do.
- spaetzleesser 4y ago
  That may be true but the first prerequisite for functioning markets is price transparency for participants. Without that it will never work. There may be other problems but you absolutely need to know prices.

antisthenes 4y ago

Are you guys hiring?

missedthecue 4y ago
Look like it https://turquoise.health/careers https://turquoise.health/careers

jerry1979 4y ago

How do you account for case-based charges?

codegeek 4y ago

I appreciate what you all are doing. We need people to try and really fix our Healthcare Industry. However, I do have a question. Are you trying to get rid of Insurance mafia at all for at least some things like basic preventive care etc because I am sure that drives costs up a lot if Insurance companies are always between a doctor and a patient. I really hope something can be done where I can just go to a doctor/hospital, ask how much and pay for it out of pocket instead of crazy premiums and all the other BS we have to go through everytime.

nradov 4y ago
Most healthcare providers are happy to accept cash payments from patients. You can sometimes even negotiate a discount. If you have a medical plan subject to the Affordable Care Act then most preventive care is already fully covered at no cost to the patient. https://www.healthcare.gov/coverage/preventive-care-benefits/ https://www.healthcare.gov/coverage/preventive-care-benefits...
- indymike 4y ago
  > Most healthcare providers are happy to accept cash payments from patients. You can sometimes even negotiate a discount. Actually, if you don't have insurance, you get the special cash price of $Maximum. /been there //tried that.
  - adventured 4y ago
    I have also been there and tried that, extensively. That's the opposite experience of what I encountered in paying by cash for more than a decade. Typically I'd pay around half price via cash for healthcare services (routine doctor visits, scans, et al.) versus what they charged if you had insurance. I never ran into a situation where they wouldn't negotiate steep discounts for paying by cash.
    - indymike 4y ago
      Yes, it works for routine stuff, but don't try to pay cash for abdominal surgery. You will get a very terrible, high price. After all, it's agree to our low price or die of appendicitis.

FollowingTheDao 4y ago

Sorry, but the only thing that will help is Medicare for all. We need to get rid of insurance companies completely.

KyeRussell 4y ago
Non-American here: your healthcare system is so abysmal that you could stop short of implementing Medicare for all and still have a significantly improved system. You should obviously have Medicare for all, but let’s not kid ourselves about how far from that you are.
Steko 4y ago
Lots of countries have great systems that aren't single payer.
refurb 4y ago
Should Europe get rid of their insurers too?
- hansel_der 4y ago
  as european i am not entirely convinced that it makes sense to have hundreds of companies providing the same heavily regulated service. if there were too few of those i would probably also object. idk about the situation where there are no private companies involved at all and the government takes over healthcare top to bottom because on the one hand i see a massive problem with for profit healtcare as it is and on the other hand i can see how incentives would wither away if there is no drive for efficiency at all.

spaetzleesser 4y ago

“Right now, 10x differences in prices paid for the same healthcare service from the same doctor between insurance plans is not uncommon.” Makes me wonder how things got to this point. How can a business perform any planning if they sell their services with such big differences between prices charged to customers?

pc86 4y ago
Over time the higher paying ones subsidize the lower ones. Due to this we'll see some people's insurance premiums increase, some decrease, and some insurance providers probably go out of business (all good IMO).
29athrowaway 4y ago
Short answer is: because they can. And they can because there's a lack of transparency that makes people believe this is OK.
refurb 4y ago
The honest answer is because that’s what insurer negotiation had led to with hospitals having using their negotiating position. If you’re a hospital in an area with standalone MRI clinics the negotiation pressure is high, insurers can say “ill send patients elsewhere”, so you give on price, maybe below cost. But that same hospital is the only cath lab in 100 miles. Great! We’ll just tell the insurer “we’re charging 300% the normal cost of a cath procedure, take it or leave it”. So the insurer takes it because how can you offer insurance and tell customer they have to drive 100 miles for a heart procedure? Hospital is happy because they’re profitable overall. Insurer just lives with paying 3x for cath procedures in that area.
- datavirtue 4y ago
  Hospitals don't let you obtain imaging elsewhere. They force you to use their imaging services--full stop.
  - refurb 4y ago

shostack 4y ago

My dentist dropped my insurer (Delta Dental) because they claim they did not cover things as reliably as they should. When I saw a comparison bill of what it would be in and out of network for a recent service it looked like the 60% increase in price was purely because my dentist billed more, which they then claimed is due to the discount The insurer provides. None of this makes sense to me. How can I leverage this new data access to my advantage?

Akronymus 4y ago
> When I saw a comparison bill of what it would be in and out of network for a recent service it looked like the 60% increase in price was purely because my dentist billed more, which they then claimed is due to the discount The insurer provides. Well, rebates kinda DO end up working like that. https://www.youtube.com/watch?v=uPa-RHVh97k https://www.youtube.com/watch?v=uPa-RHVh97k https://www.youtube.com/watch?v=_4_WNFPnmO8 https://www.youtube.com/watch?v=_4_WNFPnmO8
neycoda 4y ago
People keep complaining government is too complicated and too expensive and bafoonish, yet they don't see how corporations are no different except their priority is maximizing profit not providing cost-efficient quality.
- janekm 4y ago
  The point (in theory) is that in efficient markets you can choose between different companies offering a product/service and that competition drives down prices / costs. The healthcare market in the US is very much not a competitive market (in part due to transparency issues which this is trying to address, in part because of the perverse incentives in the health insurance system). It's not so easy to have a competitive marketplace for government services (though I would not be surprised if the US saw the emergence of private police forces now, for those parents who actually want police officers that have a duty to protect their kids...)
  - feet 4y ago

Zenst 4y ago

How well will their data be audited and enforced? For example if they charge one price and yet their public data purports another price? More so will they cut the drug prices internally and shift the difference onto an administration fee? That is one aspect I'm very mindful of.