3 ms·

Perhaps this is a place the government could help? -- to make estimates contractually binding.

franktankbank 1y ago
I was under the impression there were already laws in place around this signed in first Trump term?? Anyone know what I'm talking about? Now I would not be surprised that the industry flaunts it completely.
- yepitwas 1y ago
  They have to provide prices for various billing codes, but you can't really make them commit to which billing codes will apply. This is for both legitimate reasons (stuff might go wrong, they might find something is different than what they thought it was just because that unavoidably happens pretty often in medicine, et c.) and for illegitimate reasons that the legitimate reasons give them cover for (medical billing departments are the organizational embodiment of smarmy, lying assholes who are constantly trying to screw everyone)
  - franktankbank 1y ago
    I think its the last part. For most cases you are planning ahead to come get some particular thing done, yet still get fucked around.
- maerF0x0 1y ago
  kind of reminds me of the california law about salaries. Gov't: "you must post salary range" , Company: "The range is minimum wage to $1M per year"
danaris 1y ago
AIUI, this is very difficult to do: the estimate is going to be based on a superficial (in the literal, physical sense) examination of the problem, and once they are actually in there doing what they need to do, they may very well find that there is more that needs doing than they expected. They can't exactly pause the surgery and get you to consent to an extra few thousand dollars' worth of work. This is another example of why healthcare really, genuinely is best left as a single-payer government-funded service. People can get the care they need to be healthy, without ever needing to worry about the uncertainty inherent in the price of such a service.
- maerF0x0 1y ago
  You're focused on the sparse exceptions, i agree there should be carveouts. I'm talking in the wide, vast, main.
  - danaris 1y ago
    In the wide, vast, main, we're still better off with single-payer healthcare.
    - maerF0x0 1y ago
      As someone who has lived in single payer single provider. I couldn't disagree more. Nearly every Canadian I know grumbles about the healthcare system. The patients, the workers...
      - danaris 1y ago
        Something can be well worth grumbling about, and still be better than other systems elsewhere. There's plenty of actual data on this. Relying on what "nearly every Canadian you know grumbles about" when the topic is "are single-payer systems, on average, better than the clusterfuck the US has", isn't sound reasoning.
        maerF0x0 1y ago
        It also has a values based bent to it. Things like: 1. We value the average outcome more than the outcome the (tax)payer receives 2. We value equality of outcomes, a rich person cannot pay more to get more 3. We fix the amount we'll spend and then prioritize the sickest person. You may not get any help until you're the sickest person. Personally, those 3 violate my values.
dv_dt 1y ago
that would just increase prices to cover wider range of possible outcomes that can't necessarily be predicted going in
- maerF0x0 1y ago
  and price competition would squeeze the range towards better estimates or even taking a loss on some slice of procedures. Just as insurance does right now.
  - dv_dt 1y ago
    The indirection for variability of costs basically places a accounting hole that the motivation for "fixed" estimates was attempting to plug. Then it basically becomes a regulatory accounting chasing game that costs even more to administer. Instead of verify, time and materials expended are whats billed, now to verify fair prices, you need a sample size of all the outcomes of all the procedures that started with this code and their relative weighting of occurrence, and verify all the time and materials expended for each. It all costs more for dubious benefit of a privatized multi payer model

I was under the impression there were already laws in place around this signed in first Trump term?? Anyone know what I'm talking about? Now I would not be surprised that the industry flaunts it completely.

yepitwas 1y ago
They have to provide prices for various billing codes, but you can't really make them commit to which billing codes will apply. This is for both legitimate reasons (stuff might go wrong, they might find something is different than what they thought it was just because that unavoidably happens pretty often in medicine, et c.) and for illegitimate reasons that the legitimate reasons give them cover for (medical billing departments are the organizational embodiment of smarmy, lying assholes who are constantly trying to screw everyone)
- franktankbank 1y ago
  I think its the last part. For most cases you are planning ahead to come get some particular thing done, yet still get fucked around.
maerF0x0 1y ago
kind of reminds me of the california law about salaries. Gov't: "you must post salary range" , Company: "The range is minimum wage to $1M per year"

danaris 1y ago

AIUI, this is very difficult to do: the estimate is going to be based on a superficial (in the literal, physical sense) examination of the problem, and once they are actually in there doing what they need to do, they may very well find that there is more that needs doing than they expected. They can't exactly pause the surgery and get you to consent to an extra few thousand dollars' worth of work. This is another example of why healthcare really, genuinely is best left as a single-payer government-funded service. People can get the care they need to be healthy, without ever needing to worry about the uncertainty inherent in the price of such a service.

maerF0x0 1y ago
You're focused on the sparse exceptions, i agree there should be carveouts. I'm talking in the wide, vast, main.
- danaris 1y ago
  In the wide, vast, main, we're still better off with single-payer healthcare.
  - maerF0x0 1y ago
    As someone who has lived in single payer single provider. I couldn't disagree more. Nearly every Canadian I know grumbles about the healthcare system. The patients, the workers...
    - danaris 1y ago
      Something can be well worth grumbling about, and still be better than other systems elsewhere. There's plenty of actual data on this. Relying on what "nearly every Canadian you know grumbles about" when the topic is "are single-payer systems, on average, better than the clusterfuck the US has", isn't sound reasoning.
      - maerF0x0 1y ago
        It also has a values based bent to it. Things like: 1. We value the average outcome more than the outcome the (tax)payer receives 2. We value equality of outcomes, a rich person cannot pay more to get more 3. We fix the amount we'll spend and then prioritize the sickest person. You may not get any help until you're the sickest person. Personally, those 3 violate my values.

dv_dt 1y ago

that would just increase prices to cover wider range of possible outcomes that can't necessarily be predicted going in

maerF0x0 1y ago
and price competition would squeeze the range towards better estimates or even taking a loss on some slice of procedures. Just as insurance does right now.
- dv_dt 1y ago
  The indirection for variability of costs basically places a accounting hole that the motivation for "fixed" estimates was attempting to plug. Then it basically becomes a regulatory accounting chasing game that costs even more to administer. Instead of verify, time and materials expended are whats billed, now to verify fair prices, you need a sample size of all the outcomes of all the procedures that started with this code and their relative weighting of occurrence, and verify all the time and materials expended for each. It all costs more for dubious benefit of a privatized multi payer model