4 ms·

While I'm sure the transparency is a good idea, I'm guessing is only important because US hospitals mostly charge individuals rather than health insurance provi

While I'm sure the transparency is a good idea, I'm guessing is only important because US hospitals mostly charge individuals rather than health insurance providers / healthcare provider organizations ("sick funds") - and thus people are surprised by exorbitant fees and hospitals have a motivation to overcharge, rather than the fees being negotiated and agreed in bulk.

manv1 4y ago
A discussion of healthcare pricing would take hours, but here's a TL;DR: Most insurers pay negotiated rates, which have no real relationship to list price (uninsured pricing). The law is supposed to (1) make it easier to compare costs, and (2) shame providers into lowering their list prices. Obviously the industry has been fighting these regulations for years. The annoying thing is al the games they're playing. Everyone already has a list of prices by CPT code, because it's what billing uses. Just list all prices by CPT codes. The industry refuses.
- einpoklum 4y ago
  And IIRC, the insurers are for-profit, right? What about the hospitals? Are they mostly for-profit or non-profit entities?
  - deleted 4y ago
    [deleted]
lotsofpulp 4y ago
>I'm guessing is only important because US hospitals mostly charge individuals rather than health insurance providers / healthcare provider organizations ("sick funds") No, they charge the insurance, but US healthcare providers are still required to show individuals the billing details. This is important because people still pay for amounts up to their deductible and out of pocket maximum, so for non emergency healthcare, a patient still has incentive to compare healthcare prices from different providers.
- einpoklum 4y ago
  > This is important because people still pay for amounts up to their deductible and out of pocket maximum In many world states, if you have health insurance, and are referred to hospitalization, or come in with a wound or other obviously serious condition, your deductible/out-of-pocket for being in the hospital is exactly 0. Israel is in this category for example. This doesn't cover 100% of hospitals but all the big ones and your "sick fund"'s hospital-grade facilities. In other countries (e.g. the Netherlands), a lot of health care expenses are charged through to you from the get-go, but - your annual out-of-pocket maximum is low, e.g. 500 EUR or 700 EUR or something like that (EUR ~= 1.05 USD right now, was higher when I was in the Netherlands). So, you might be interested in what hospitals charge, but it's not like you would save all that much anyway.
insane_dreamer 4y ago
Hospitals charge insurers negotiated prices. So these prices mostly impact: - what insured persons pay until they reach their deductible (and how high that is depends on the insurance plan they have, cheaper plans have higher deductibles) - uninsured persons
yamtaddle 4y ago
Perhaps confusingly, they charge both. Most insurance requires substantial "co-pays" where you pay a good chunk (20% is common, but it varies, often even within a plan depending on what you're paying for) of just about every bill until you hit some very-high "out-of-pocket max" (usually there's one for individuals, and a higher one for families) and then insurance picks up everything, or you pay 100% until some total-spending value for the year is reached, then it becomes like the prior situation until the out-of-pocket max. Though most insured people don't really have options to shop around. You go to the few places your insurance covers, which is usually 30-60% of providers in a small geographic area. Which is why the "we want to protect your choice!" opposition to healthcare reform is so damn weird. Most people already have very little choice, in practice, and a lot of the "choice" we do have isn't anything desirable ("which of these shitty insurance plans I can barely understand and am not confident I can meaningfully compare, would I like to suffer through?").

manv1 4y ago

A discussion of healthcare pricing would take hours, but here's a TL;DR: Most insurers pay negotiated rates, which have no real relationship to list price (uninsured pricing). The law is supposed to (1) make it easier to compare costs, and (2) shame providers into lowering their list prices. Obviously the industry has been fighting these regulations for years. The annoying thing is al the games they're playing. Everyone already has a list of prices by CPT code, because it's what billing uses. Just list all prices by CPT codes. The industry refuses.

einpoklum 4y ago
And IIRC, the insurers are for-profit, right? What about the hospitals? Are they mostly for-profit or non-profit entities?
- deleted 4y ago
  [deleted]

lotsofpulp 4y ago

>I'm guessing is only important because US hospitals mostly charge individuals rather than health insurance providers / healthcare provider organizations ("sick funds") No, they charge the insurance, but US healthcare providers are still required to show individuals the billing details. This is important because people still pay for amounts up to their deductible and out of pocket maximum, so for non emergency healthcare, a patient still has incentive to compare healthcare prices from different providers.

einpoklum 4y ago
> This is important because people still pay for amounts up to their deductible and out of pocket maximum In many world states, if you have health insurance, and are referred to hospitalization, or come in with a wound or other obviously serious condition, your deductible/out-of-pocket for being in the hospital is exactly 0. Israel is in this category for example. This doesn't cover 100% of hospitals but all the big ones and your "sick fund"'s hospital-grade facilities. In other countries (e.g. the Netherlands), a lot of health care expenses are charged through to you from the get-go, but - your annual out-of-pocket maximum is low, e.g. 500 EUR or 700 EUR or something like that (EUR ~= 1.05 USD right now, was higher when I was in the Netherlands). So, you might be interested in what hospitals charge, but it's not like you would save all that much anyway.

insane_dreamer 4y ago

Hospitals charge insurers negotiated prices. So these prices mostly impact: - what insured persons pay until they reach their deductible (and how high that is depends on the insurance plan they have, cheaper plans have higher deductibles) - uninsured persons

yamtaddle 4y ago

Perhaps confusingly, they charge both. Most insurance requires substantial "co-pays" where you pay a good chunk (20% is common, but it varies, often even within a plan depending on what you're paying for) of just about every bill until you hit some very-high "out-of-pocket max" (usually there's one for individuals, and a higher one for families) and then insurance picks up everything, or you pay 100% until some total-spending value for the year is reached, then it becomes like the prior situation until the out-of-pocket max. Though most insured people don't really have options to shop around. You go to the few places your insurance covers, which is usually 30-60% of providers in a small geographic area. Which is why the "we want to protect your choice!" opposition to healthcare reform is so damn weird. Most people already have very little choice, in practice, and a lot of the "choice" we do have isn't anything desirable ("which of these shitty insurance plans I can barely understand and am not confident I can meaningfully compare, would I like to suffer through?").