4 ms·

Not long ago there was an article here which reached an opposite conclusion, for hospital costs. It is just unwise not to have health insurance in this country.

by bearmf 14y ago

Not long ago there was an article here which reached an opposite conclusion, for hospital costs. It is just unwise not to have health insurance in this country. Hospitals can charge you arbitrary amounts. If you pay cash and have not agreed on everything in advance it is not a good deal. Paying cash probably makes sense for some routine procedures in case you have a high deductible health plan.

bearmf 14y ago
I also do not buy the whole "shopping around" thing, even if it worked. The idea that patient should know almost nothing about costs is a right one. The current implementation of this idea suffers from various problems, but as more people get health insurance under Obamacare, things will get better. Ideally, under single payer system, patient gets no bills at all, because all of the providers are "in network", as there is only one network.
- JPKab 14y ago
  There is an entire company (Castlight Health) that is centered around trying to allow people to "shop around" for healthcare. Despite cutting edge technology and access to data no one else gets (through member companies insurance statements) the general public can't use it unless their employer signs up for the service. Without this capability, shopping around for healthcare is absolutely impossible. How can you shop around when the prices aren't publically listed and aren't known by the staff/physicians? This article, by the way, is terrible. He gives horrifically bad advice, acting as if the majority of clinics/hospitals actually discount costs for the uninsured. THEY DON'T, as the vastly better researched article "The Bitter Pill" from Time Magazine last week clearly illustrated. I've been a consumer asking for prices as part of a HSA high deductible health plan before. There is no mechanism to support shopping around at all, and the clinics/hospitals still act on a zero price transparency model. See the "chargemasters" discussed in the Time article. They are databases of prices which are not at all publically accessible. The federal gov't should step in, and, at a minimum, force hospitals/clinics to make their chargemaster databases publically accessible. This would be a game changer for consumers in health care.
zeidrich 14y ago
I think the crime is that the costs are so arbitrary. When hospitals can charge 10 times as much for the same procedure depending on how you are going to pay, someone is getting screwed. Even if your insurance covers it, you're paying that insurance, and the reason the cost for your insurance remains so high is because the insurance company has negotiated to pay $2500 for a $250 procedure. I mean, when the insurance company negotiates to pay higher prices, they are lying to overstate their benefit and justify higher prices. Hospitals are complicit in this scheme. But hospitals make more from higher margins, and insurance companies can justify greater prices. It's a broken system when both buyer and seller want to negotiate the highest price they can in secret, away from the person who is funding the buyer.

by bearmf 14y ago

bearmf 14y ago

I also do not buy the whole "shopping around" thing, even if it worked. The idea that patient should know almost nothing about costs is a right one. The current implementation of this idea suffers from various problems, but as more people get health insurance under Obamacare, things will get better. Ideally, under single payer system, patient gets no bills at all, because all of the providers are "in network", as there is only one network.

JPKab 14y ago
There is an entire company (Castlight Health) that is centered around trying to allow people to "shop around" for healthcare. Despite cutting edge technology and access to data no one else gets (through member companies insurance statements) the general public can't use it unless their employer signs up for the service. Without this capability, shopping around for healthcare is absolutely impossible. How can you shop around when the prices aren't publically listed and aren't known by the staff/physicians? This article, by the way, is terrible. He gives horrifically bad advice, acting as if the majority of clinics/hospitals actually discount costs for the uninsured. THEY DON'T, as the vastly better researched article "The Bitter Pill" from Time Magazine last week clearly illustrated. I've been a consumer asking for prices as part of a HSA high deductible health plan before. There is no mechanism to support shopping around at all, and the clinics/hospitals still act on a zero price transparency model. See the "chargemasters" discussed in the Time article. They are databases of prices which are not at all publically accessible. The federal gov't should step in, and, at a minimum, force hospitals/clinics to make their chargemaster databases publically accessible. This would be a game changer for consumers in health care.

zeidrich 14y ago

I think the crime is that the costs are so arbitrary. When hospitals can charge 10 times as much for the same procedure depending on how you are going to pay, someone is getting screwed. Even if your insurance covers it, you're paying that insurance, and the reason the cost for your insurance remains so high is because the insurance company has negotiated to pay $2500 for a $250 procedure. I mean, when the insurance company negotiates to pay higher prices, they are lying to overstate their benefit and justify higher prices. Hospitals are complicit in this scheme. But hospitals make more from higher margins, and insurance companies can justify greater prices. It's a broken system when both buyer and seller want to negotiate the highest price they can in secret, away from the person who is funding the buyer.