14 ms·
A petabyte of health insurance prices per month
- FollowingTheDao 3y agoThey are making it impossible to handle the data so everyone gives up trying so they can go on screwing people over.
- ceejayoz 3y ago/r/MaliciousCompliance, in other words.
- birdman3131 3y agoNot the same article but it has come up on here at least one other time with a lively discussion. Can't find it off hand though.
- jaysinn_420 3y ago!maliciouscompliance@lemmy.world for the post-Reddit fediverse
- searine 3y agoHanlon's razor. Never attribute to malice what can be explained by stupidity. The US healthcare system is a mess, but I don't think it's intentionally malicious. It is just a mash of a thousand different systems, creating one big stupid system.
- deleted 3y ago[deleted]
- RhodesianHunter 3y agoA little of column A, a little of column B.
- burkaman 3y agoNever attribute to malice that which is adequately explained by stupidity. In this case stupidity is not adequate - obviously insurance companies know how to make this data usable, otherwise they couldn't exist. They have just chosen not to make the public format usable.
- bigbillheck 3y agoI think there's plenty of malice in the system, for example https://www.propublica.org/article/cigna-pxdx-medical-health-insurance-rejection-claims https://www.propublica.org/article/cigna-pxdx-medical-health...
- searine 3y agoI agree, but is the design of the system malicious? I don't think so. It's just stupid, and exploited by malicious people.
- rqtwteye 3y agoThere rarely are systems designed in a malicious way. Most malicious systems slowly get shaped actors to their advantage. In some cases (insider trading or corruption) the government steps in and stops the abuse by laws and regulation. In the healthcare system they aren’t doing this and are letting profit oriented players shape the system.
- calibas 3y agoThey made a ridiculously complex and obscure system because it was insanely profitable. It's not really stupidity or maliciousness that's responsible, but simple greed.
- ryandrake 3y agoYea, we need a corollary to Hanlon: Never attribute to malice OR stupidity that which can be explained by greed.
- sdthionsdionoi 3y agoEven a stopped clock is right twice a day. Stupidity can't explain why everything is wrong. The American healthcare system is so totally broken, and broken in ways which so consistently benefit the rich at the expense of everyone else, that I can't see any way it could come about by accident. (Plus we have seen some of the corruption that goes on inside insurance companies.)
- coding123 3y agoI don't think the billing system is malicious. But at the end of the day, each "provider" is given incentives to bill. They get promotions based on this. So the maliciousness is a distributed system that does not get codified at all. It's the exact same thing as cops getting incentives for speeding tickets. Then you start getting more speeding tickets for 5 over instead of 10 over.
- micromacrofoot 3y agoIt's absolutely intentionally malicious, despite the individual employees not having much say... have you ever tried to bounce between calls to get information for an insurer from a hospital billing department? they can make vogons look efficient I've spent hours trying to get an estimate for a inpatient surgery only to find out afterwards that the surgeon used a different billing code than the billing department gave me then the insurance company won't cover it because it's not the billing code they cover, and the hospital won't change the billing code
- FollowingTheDao 3y agoIf it’s stupidity, then I would assume they wouldn’t be making so much freaking money.
- leetcodesucks 3y ago[dead]
- leetcodesucks 3y ago[dead]
- tanseydavid 3y agoThe amount of human labor involved in the US healthcare system, that has nothing at all to do with medical professionals helping patients, is astonishing.
- chris_va 3y agoWhile the pitchfork argument may be appealing, the actual article makes a convincing case that it's just combinatorial expansion: > As a result, the Transparency in Coverage rule requires insurance companies to do the math for patients and, in most cases, publish prices as dollar amounts. That’s helpful for patients, but it requires that a price be pre-calculated for every possible service. ... So, they could publish the rules engine instead of the combinatorial expansion of all possible inputs, but it sounds like the regulation did not specify that.
- deleted 3y ago[deleted]
- ramraj07 3y agoI work with petabytes of data. A petabyte of text is an insane amount of text. You need a billion X multiplication of basic data. That’s not just combinatrionics, it’s deliberate obfuscation.
- beachy 3y ago4 tables, each with 1k rows and one of them with a 1K text column in it, joined together to give a cartesion product, will give you a petabyte of data. So it doesn't sound impossible (just absurd).
- grumple 3y agoThat's a very artificially bloated way of compounding the data in memory with lots of data duplication. From storing the example tables you used, you'd need to store 62.5 million times that to get a petabyte of data. It's an absurd amount of data.
- ramraj07 3y agoeven taking your contrived example, you have to store it in the stupidest way possible to get that level of storage - even assuming your 1K of text is incompressible, you only have 1K unique values. The most basic compression algorithms will make easy work out of compressing the crap out of it, leave alone the advanced compression algorithms used for any big data storage formats.
- caseyh 3y agoThe standard is excessively verbose. Instead of being able to represent a price of a range of procedure codes (as most of the rules engines define it), you have to list every single code individually when often the price is the same. How that standard was set is probably an interesting questions.
- omnicognate 3y agoHanlon's razor maybe applies. I have no way to know if they're trying to do what you say, but the article explains what's going on and it's not hard to see how a flawed schema and implementors going by the letter and not putting any effort into minimising the data volumes could result in this without any malice. Any individual company is presumably producing a fraction of the petabyte total and people are as astonishingly lazy with data sizes now as computers are astonishingly capable of handling them. I'm routinely seeing multi-gigabyte executables these days (don't get me started). Also the article says the schema is published in github and CMS is responsive to feedback on it, so things will hopefully improve. I thought this was a really good article. I wasn't expecting to read all the way through a blog about something that doesn't affect me in the slightest but I did.
- samstave 3y agoI've been a designer for a number of hospitals (tech, and physical, some systems) but never in the billing, however I can attest that billing codes are complete BS (billing codes are basically a number for the procedure/system/resources used such that they can say 'Code 10 == $10,000" to simplify it... Hospitals are usually 'health *groups*' and they work just the same as insurance companies - they have actuaries that do all the calc to determine what they CAN charge for a procedure, not what its summary cost actually is... When youre in a hospital GROUP you have more negotiating power with the insurance companies - so the exact same procedure in one group may be significantly different than what another group charges you.... HOWEVER - and this is important, and they wont ever tell you this - you can "haggle" with hospital billing departments... NEVER pay a hospital bill once you receive it. ALWAYS call and ask for more details about the bill, with a line item receipt for every single action, drug, interaction 'encounter' and you will generally see your bill reduced significantly. - As example, I went to the ER with chest pains. waited 2 hours for an MD to come see me, he didnt even touch me, take a BP, EKG, etc - then 'prescribed' me some motrin (over the counter) and then billed me $1,500 for a 4 minute interaction. I refused to pay this and they tried to drop it to $900 - and I told them, that if they can drop it from $1500 to $900 with just me protesting, then they needed to pay me for the two hours I waited to speak to the MD They dropped the bill entirely. Good Samaratin Hospital, Los Gatos CA.
- talldatethrow 3y agoWhile there are huge problems, I think the majority of the problem is people expect their health insurance plan to be like a prepaid maintenance plan. If you crash your car today without insurance, you understand it won't be covered by getting insurance tomorrow. Why people think they can finally get healthy "insurance" at 45 from company xyz, knowing they need this pill or that pill, and expect the new insurance company to pay for it I will never understand.
- lotsofpulp 3y agoIn the US, federal law requires the insurance company to offer any applicant insurance coverage and pay for necessary healthcare (after accounting for deductible/out of pocket maximums). https://www.healthcare.gov/how-plans-set-your-premiums https://www.healthcare.gov/how-plans-set-your-premiums >Five factors can affect a plan’s monthly premium: location, age, tobacco use, plan category, and whether the plan covers dependents. > FYI Your health, medical history, or gender can’t affect your premium https://www.healthcare.gov/appeal-insurance-company-decision/appeals/ https://www.healthcare.gov/appeal-insurance-company-decision...
- talldatethrow 3y agoI understand the law says so. My point is this makes no sense as an "insurance". It's basically a service plan now.
- lotsofpulp 3y agoYes, health insurance as expected by people has never made sense as "insurance". Once an event goes from unlikely to likely, buying insurance for it turns into simply prepaying an amortized amount for future expenses. Not dissimilar to paying taxes for road maintenance.
- flangola7 3y agoWhy wouldn't they expect it? If they need that medicine/treatment, they need it. If I don't have car insurance my organs won't shut down and I won't die. If I don't have medicine, they do and I will.
- coding123 3y agoLol Cardiac Services ---- 44.8% of billed rate This screams pads and buffers. As in, the administrator adds random line-items to things as long as the name of the service is "similar enough" so that they can justify whatever amount they want in the end. It reminds me of the auto industry. I've been replacing transmission selonoids, serpentine belts, brakes, fluids, etc... last 3 years ( I bought a dodge ram 3500 and if you don't do these things yourself you end up owing the cost of the truck 3 times over during its lifetime). And I have to say, when I replace something it costs me 45 minutes + part cost. The repair shop instead lists it as "Transmission Flush Service" and charges $1500 when in reality it's running the engine for a minute with the pan off, then refilling it with about $200 in new transmission fluid. Again, the repair shop is banking on no one wanting to fix their car. I can say the same thing about healthcare and specific supplements instead of getting superfluous EKGs and other "med junk science" or worse actually dangerous drugs that the doctor is getting paid to prescribe to you. However even I would get a cast put on by a doctor, just as I would have my break calipers replaced and my tires rotated simply because that service is much more highly competitive, and regular. I would also, of course opt for a heart transplant just as I would buy a new cummins engine if mine went out. (The joke about ram is that the engine is the only thing that will hold up, while the rest of the truck falls apart all around it 4 times over)
- crooked-v 3y agoInsurers paying a negotiated X% of the original bill is a common feature of the bizarre US health care market. This has all the knock-on effects you would expect, like the original bill being then massively inflated so that the healthcare provider doesn't go out of business when they're only paid 44.8% of it.
- deleted 3y ago[deleted]
- thomascgalvin 3y agoThere are separate charge codes for everything, and all of those codes need to be reflected in the pricing data. There's a price to slap on a bandaid. There's a price to give someone a Tylenol. Hell, W61.61XA is the medical code for "Bitten by duck, initial encounter." Presumably, this means there's also a code for "Bitten by duck, again." Medical billing is broken, and it's no surprise that the amount of data is overwhelming.
- iambateman 3y ago“Bitten by a duck, initial encounter” needs to be Bon Iver’s next single.
- bradgessler 3y agoHere's the full list of codes for "Bitten by ____, _____ encounter" https://www.icd10data.com/ICD10CM/Codes/V00-Y99/W50-W64/W61- https://www.icd10data.com/ICD10CM/Codes/V00-Y99/W50-W64/W61- The hierarchy looks like this: W61.6 Contact with duck = W61.61 Bitten by duck == W61.61XA …… initial encounter == W61.61XD …… subsequent encounter == W61.61XS …… sequela = W61.62 Struck by duck == W61.62XA …… initial encounter == W61.62XD …… subsequent encounter == W61.62XS …… sequela = W61.69 Other contact with duck == W61.69XA …… initial encounter == W61.69XD …… subsequent encounter == W61.69XS …… sequela There's codings like this for parrots, macaws, chickens, turkey, etc. Hell there's an entire section for alligators and crocodiles at https://www.icd10data.com/ICD10CM/Codes/V00-Y99/W50-W64/W58- https://www.icd10data.com/ICD10CM/Codes/V00-Y99/W50-W64/W58- that includes crushing, bites, etc.
- carabiner 3y agoGotta wonder how other countries with functional healthcare store and calculate pricing. There has to be a better way. This looks like denormalizing a huge number of small tables such that the resulting list of prices is like n^n growth for any possible addition.
- pc86 3y agoThat's exactly what it is, because as another comment pointed out the legislation currently doesn't allow them to just publish a [human,machine]-readable rules engine for calculating price, so they must publish this asinine amount of data every month in perpetuity until someone who's taken a math class in the last 70 years ends up in Congress.
- cool_dude85 3y agoThis does seem to be machine readable, but inefficient. Given the fight the insurers have put up about publishing this, I would expect any allowance of "rules engine" to allow them not to publish anything, or to just play the same game again. For instance, my "rules engine" is to look up the price contained in my db table (proprietary, of course) and multiply by another record in a different table. Or if a court forces us to provide both tables, we find that the structure is similarly unusable as this one. So best case is to get the same garbage. Basically, I'd rather force them to be as explicit as possible, even if it's difficult to sort through, than to allow a loophole that might allow them to not publish prices.
- webstrand 3y agoThe rules engine could even be turning complete, even if it didn't need access to another data source.
- ageitgey 3y agoIn England, the procedure costs for the entire healthcare system fit in one Excel sheet: https://www.england.nhs.uk/costing-in-the-nhs/national-cost-collection/ https://www.england.nhs.uk/costing-in-the-nhs/national-cost-...
- Reptur 3y agoThey're using information overload tactic. This approach leverages a psychological principle that suggests when people are given too many choices or too much information, they can become overwhelmed and struggle to make decisions. The point is to overwhelm, the consumer, the people trying to fix this system etc.
- NoMoreNicksLeft 3y agoA simpler and more rational explanation, is that they're trying to overwhelm the adversary. The insurance company, its claims department. If you can't ever compare two medical treatments because they're never similar, let along identical, then any price at all might be attached to these. The consumer hands over a laminated card and says "I have insurance". No one's overwhelming him. He's not even really a party to the transaction. Not until the insurance company denies the claim, at least.
- lotsofpulp 3y agoAn even more rational explanation is that the human body is one of the most complex machines there is, and we barely have an understanding of it. Those who do have some understanding of it spend decades learning about it, and so a layperson will simply never have the expertise to make informed purchasing decisions. That is why the insurance company (ideally) can serve as an informed agent (employing doctors and pharmacists), who (ideally) will more often than not know what is and is not worth paying for.
- NoMoreNicksLeft 3y agoYes. Your explanation totally makes sense for why there's a billing code for "bitten by duck, initial encounter". I see it now. Disregard my first comment.
- lotsofpulp 3y agoThat is probably explained by the attempt to use an existing system developed for a different purpose to also accomplish the billing task. https://news.ycombinator.com/item?id=36686754 https://news.ycombinator.com/item?id=36686754
- tiffanyg 3y agoBecause our (US) system is at Monty Python levels of absurdity. We waste more money with this "system" than most other countries spend as a total, and with worse outcomes on average [1]. Fundamentally, there are two factors, IMO, that have been conclusively proven (repeatedly, and for decades - much more strongly, recently) to be incompatible with delivering quality healthcare with some level of efficiency: 1) For-profit entities (particularly, publicly-traded / with "fiduciary responsibility" to shareholders) 2) Administrative burden / bureaucracy (partly stemming from all of the competing private entities, partly stemming from essentially impossible efforts to effectively regulate these entities and the created "market") The manner in which the US system evolved, tying insurance to employment through basically existing tax policies, and the move by companies to take advantage of this to attract workers (IIRC), created a massive landscape of entrenched interests that works exactly like such ecosystems work. It is a "teergrube" - an absolute tarpit - where any attempt to fix problems ultimately fails. The administrative situation is out of control, which means fraud (particularly with the turn towards "digital crime" of everyone from traditional organized crime networks to high schoolers) and waste are impossible to effectively control, adding to an already absurd situation where ever-increasing money is spent on marketing, lobbying, administrators / clerks, etc. Meanwhile, we desperately need more doctors, nurses, etc. AND, these professionals are now increasingly being politicized by "exploiters". A great many healthcare professionals are quitting, and those remaining are often trying to move away from areas that often MOST need their services! It's amazing to watch (from the inside, so far) a country that built such "soft-power" might ... such a dominant "marketed / exported 'culture'", have those same tools (used, in any scenario, intentionally or not) turn against itself (/ be turned against it) - sowing the seeds of collapse in all sorts of systems, top-to-bottom. There isn't a face or palm big enough for the facepalm this BS deserves. [1] https://jamanetwork.com/journals/jama/article-abstract/2752664 https://jamanetwork.com/journals/jama/article-abstract/27526... - only providing one of a parade of articles examining the issue in the past decade, especially
- BaseballPhysics 3y ago> We waste more money with this "system" than most other countries spend as a total, and with worse outcomes on average [1] Oh sure, if you don't measure what is obviously the most important outcome: freedom
- Sevii 3y agoThere is so much data because of insurance. Insurers are in the business of declining claims. They have discovered that the best way to decline claims is to create byzantine rules while offloading all the work to comply with those rules to healthcare providers. The only way to fix it at this point is to nationalize the system or to exclude all routine care from the insurance system. Something like a legal ban on deductibles smaller than 20k/year would work.
- lotsofpulp 3y agoPer federal law (ACA), health insurers in the US are required to spend 80% to 85% of revenues on healthcare expenses. Their profit margins are 2% to 6%. Therefore, the higher the revenue, the higher the profit. Where is the incentive to deny legitimate claims?
- ADuckOnQuack 3y agoThe incentive is probably to get their profit margin up to the maximum 15-20% https://www.propublica.org/article/cigna-pxdx-medical-health-insurance-rejection-claims https://www.propublica.org/article/cigna-pxdx-medical-health...
- deleted 3y ago[deleted]
- lotsofpulp 3y agoFor sure, and that is where the government should be handing out heavy penalties. There supposedly is an appeals process, but obviously not enough auditing is being done: https://www.healthcare.gov/appeal-insurance-company-decision/external-review/ https://www.healthcare.gov/appeal-insurance-company-decision... Although, even with those fraudulent denials, Cigna's profit margins are suffering: https://www.macrotrends.net/stocks/charts/CI/cigna-group/net-profit-margin https://www.macrotrends.net/stocks/charts/CI/cigna-group/net... Wonder if they went into too much debt to buy Express Scripts.
- banannaise 3y ago
- FireBeyond 3y agoI used to work for a company that writes claims benefit management software. This: > Notice how every item has a price that requires external information to understand: > Per diem rates are paid for each day a patient is in the hospital. We need to know how long the patient will be in the hospital to know the total amount. > Rates for Cardiac Studies require knowing the price the hospital will bill in the future. The rate is essentially “44.8% of another unknown price,” which isn’t terribly helpful to a patient. > Radiology rates are based on an external price list that has to be looked up in an entirely different database. External rate lists are very common in health insurance but are not helpful unless you have access to the latest price list and can do the math yourself. is where they stood out from their competitors, who typically had huge, and very wide database tables to capture this, but my ex-employer had written a DSL that allowed billing rules to be described with lookups and logic.
- redandblack 3y agoWill LLMs eventually help with this - will be great if it can create structured data out of this to learn/classify
- yetanotherloss 3y agoWhy build LLMs when the problem does not need to exist in the first place. The rest of the civilized world does not need LLMs to solve this because they didn't build this dumpster fire in the first place.
- paulddraper 3y agoI'm curious...who was that company?
- yardie 3y agoMedical billing coder is one of the most bullshitiest of bullshit jobs. Even when I was chatting with a coder a while back and she was explaining to me, a programmer, her job. And in the back of my mind I'm thinking, "I'm sorry, but why does this job exist?" I guess in the government's battle against medical fraud they have created a convoluted system that is even easier to defraud.
- peatmoss 3y agoIt also feels like these codes are also closer to stated preference data than revealed preference data. “Given this permutation of factors, we’d choose to bill X, but insurance companies dictated we actually paid Y.” Would be neat to see both kinds of rates with billing codes and actual billed procedures. Guessing there aren’t petabytes worth of actual procedures either.
- oldgradstudent 3y agoFor reference, here is the Israeli Ministry of Health price list as of July 1st 2023: https://www.gov.il/BlobFolder/dynamiccollectorresultitem/moh-price-list-010723/he/files_databases_moh-price-list_2023_moh-Price-List-010723.xlsx https://www.gov.il/BlobFolder/dynamiccollectorresultitem/moh... Edit: Direct link to an Excel spreadsheet.
- mkmk 3y agoFYI The above is direct link to .xlsx file
- oldgradstudent 3y agoThanks, noted.
- Faaak 3y agoMore or less the same in Switzerland with regulated, mandatory, private healthcare: https://browser.tartools.ch/#/tarmed_kvg/data/L/39.6040 https://browser.tartools.ch/#/tarmed_kvg/data/L/39.6040 Everyone must conform to these prices, rules.
- kasey_junk 3y agoIt’s interesting that so many commentators are blaming the insurers here. The whole article is about how insurers use rules engines and lookups to define these prices and that the data explosion was a result of the legislation requiring price lists instead of an open standard for describing rules and lookups.
- brendanyounger 3y agoHaving worked with this data extensively (tynbil.com) and talked to several payers and providers, I don't think any of this intentional. CMS did their best at guessing what format the payer data could be exported to (with little to no help from the payers themselves). None of the payers have exactly the same schema for defining these rates as they all have home-grown solutions developed over decades. That said, most insurers have gone out of their way to bury us in data. The result is messy and annoying, but not impossible to work with. It's the best we can expect in this imperfect world.
- Buttons840 3y agoCompanies are going to grow around this data. An entire industry might grow around this data, and it will be an industry that I support every time I pay an insanely high insurance premium or medical bill. 15% of our workers are in the medical system [0], and this doesn't even include the surrounding insurance industries or pharma industries (I think). Someone has to pay all these people, and that someone is me when I pay high insurance premiums and high medical bills. I'm picturing a satirical 40s style poster that shows the doctor putting a bandaid on Timmy's knee, and then mom doing her patriotic duty and writing out a $1000 check. The poster then shows that the $1000 supports medical coders who know all the codes for duck attacks, and the pharma advertisers who one-up even Broadway and Hollywood with their 90-second advertisements, and the people who reassemble the poorly organized data this article talks about, and--oh yeah, there's a few bucks left for the doctor too. I used to work at a company that does background checks on doctors. We'd gather data from all 50 states, all of it in different formats, all of it a pain to work with. Hundreds of people were involved in this process, all of us ultimately paid through high hospital bills (hospitals were our customers). With the right regulation, we all could have been replaced with a 50 line Python script. Ultimately, if we're going to build a medical system that takes 15% to 20% of our workers to run, then we're going to have to pay for that. The problem is that "let's make the industry more efficient and put a lot of people out of work" is not politically popular. [0]: https://www.census.gov/library/stories/2021/04/who-are-our-health-care-workers.html https://www.census.gov/library/stories/2021/04/who-are-our-h...
- elcritch 3y agoThere's a similar issue in academia. Tuition costs have risen far faster than inflaction but the number of professors per student is roughly similar. Where does all the extra go? Administrators and bureaucracy!
- lesuorac 3y agoI mean based on all the numbers provided it could have also go into - Construction costs of smaller classrooms - Advanced labs - Land Taxes --- But also if the number of students & teachers has increased at a proportional rate then tuition would be expected to increase to cover the more administrators required to administrate the increased staff.
- hospitalJail 3y agoThe medical cartels need to be destroyed. They are mathematically the most corrupt industry according to open secrets all time lobbying data. Physicians are the richest profession in the US, and limit their supply by weaponizing the ACGME/AMA. Hospitals/clinics make so much money. We own one, and while it was slow to start, the profits are insane. Marketing is the hardest thing, once a patient comes in the door (and they don't have medicaid) its pure profit. Don't let anyone in healthcare let you think margins are slim. Pharma... we all know pharma.. (And pharmacists in 2023? Heck ML/AI will always be better than trusting that a pharmacist is on their game 100% of the time) Insurance, I have no idea how they waste so much money and have slim margins. Anyway they are weirdly allies most of the time because they will adjust a $400 bill down to $125. But they also suck with how expensive premiums are... again. what the heck is going on with their slim margins? Maybe its their ultra fancy buildings.
- izzydata 3y agoAren't there laws that require insurance companies and utility companies to have specific margins? They could in theory just print infinite money so they need to be reigned in by governments.
- thedougd 3y agoYes. https://www.healthcare.gov/health-care-law-protections/rate-review/#:~:text=The%2080%2F20%20Rule%20generally,Medical%20Loss%20Ratio%2C%20or%20MLR https://www.healthcare.gov/health-care-law-protections/rate-....
- jmole 3y agoSo the only way to grow profits is by increasing the base cost of service.
- lotsofpulp 3y agoAn insurance company can also increase the number of customers.
- kadoban 3y agoHow much of this is just to bury everyone in useless data, similar to how in discovery for lawsuits, one tactic is to just send hundreds of boxes of paper in the hopes that nobody will find the actually bad stuff?
- 6510 3y agoI always find it amusing what excuses people come/came up with when they hate on new ideas or inventions. Usually a few decades into the project/revolution the real issues appear. No one would have argued against computers back in the day because it will cause petabytes worth of important nonsense. It would have sounded unbelievable.
- DoreenMichele 3y agoThis write up reminds me of the origin story of GIS. Canada wrote some law or other and someone invented GIS to be able to actually comply with it. I wish them well. Health care in the US has problems, opaque pricing being only one of them.
- jimnotgym 3y agoThese kind of tales make me very happy to live in the UK with the NHS. Not perfect...but surely better than this?
- yardie 3y agoI've been under the care of both. As an American I can say our system isn't that bad. You see the trick is to always be healthy, don't ever get sick. /s
- karaterobot 3y agoI read the article, and I understand that the cause of that size is an absurd amount of redundancy. However, I still can't conceive how it could be that big. A petabyte is a million gigabytes. Wikipedia, uncompressed, is about 42 gigabytes. So, every month there is the equivalent of about 24,000 Wikipedias generated just from pricing data? And it's all just text. Wow.
- cobertos 3y agoI dove a bit into the data, and the dashboard with an account works much better than the front page search. Are there any good use cases for this data? It looks like this company (turquoise.health) is already targeting price comparisons ("rate sense"), contract negotiations for people/companies who purchase health care ("clear contracts") and other parts of the value chain. Are there any other parts of the value chain left? I can't think of anything...
- kurosawa 3y agoThis is interesting: could we see it as the most exhaustive set of plausible/probable human events of a harmful nature ? Sure it is for insurance purposes, but I’m wondering what we could use it to label human experience in general—and what applications that could help. “Hey Chat-gpt, I’m thinking of taking a walk near that pond, what should I expect…”
- smsm42 3y ago> The data is further ballooned because it includes rates for many medical services that can never occur. For example, an insurance company may have a contract that says they pay $180,000 for a heart transplant. The payer follows the rules and publishes that price for the list of “all doctors in this hospital.” This looks like intentional sabotage by malicious compliance. "Yes, we published our prices, good luck making any sense out of it".