4 ms·

> And don't even get me started on "pre-existing conditions". First, I would delete the sentence after this if I were you, since it could come back to haunt yo

> And don't even get me started on "pre-existing conditions". First, I would delete the sentence after this if I were you, since it could come back to haunt you legally[0]. Second, unless things are different for foreigners in the US (which AFAIK is not the case), this is not how pre-existing conditions actually work (anymore), post-ACA. [0] (I am not a lawyer, I am not your lawyer, and this is not legal advice.) > So you are practically forced to go in completely blind about potential costs. This (price transparency) is actually the real problem more than the sticker prices themselves. If patients had the ability to know expected prices beforehand, market forces would work to bring prices down. As it stands, we have a very awkward situation in which insurers compete to keep premiums down to attract customers, and therefore negotiate lower prices with providers, but patients are completely blind to this entire process and are unable to "vote with their wallets", because the prices that patients pay and the prices that insurers pay are not always directly linked in practice.

crag 12y ago
"If patients had the ability to know expected prices beforehand, market forces would work to bring prices down." If patients knew to ask. Really. If you are covered by insurance (including medicare/tri-care/etc) you won't get an answer. But if you are paying out of pocket (and most hospitals require credit if you are doing something serious - like open heart)you can negotiate the price. Let me say again, the hospital will negotiate. The doctors and labs (not done in the hospital) are another matter. Also, if you see an aspirin on your bill costing $75 you need to call. You'd be surprised how effective this is. Most Americans never question the price of anything. Even cars these days people take at face value. Of course, if you in the ER with chest pain, I'll admit, the last thing on your mind is the bill. And the hospitals know that. So what's the lesson here? In America have insurance. Even if you are 20 years old. A simple care wreck can destroy you financially. You think student loans are bad? Try a drug overdose. Or a heart attack. Or a fractured back ( a car wreck). If you young, insurance is cheap. Dirt cheap.
- maxxxxx 12y ago
  I haven't had much success getting prices when I had a high deductible insurance. Most doctors won't tell you anything or they will quote you one price today and 5 times as much tomorrow. You certainly won't get a binding quote you can plan with.
maxxxxx 12y ago
Price transparency is the one thing I would have liked to see from ObamaCare. They should have mandated to open up all pricing and all quality numbers. It's possible that some people would misinterpret these numbers but right now you are in that crazy situation where you have to make decisions based on no data at all. With open pricing and data a market based health system might work. Maybe.
- danudey 12y ago
  In Canada, a significant amount of medical procedures (possibly all of them?) have pre-set prices. A visit to a doctor's office costs X. A hospital visit costs X. There's no 'how much might you charge for this procedure tomorrow?' Of course, Canadians don't pay out of pocket for the vast majority of insurance things, but it even extends to other non-covered services like RMTs, dentistry, etc. Private insurance may not cover some specific things (like white fillings on molar teeth), but you never have to wonder what the prices are or how much you'll end up paying if you say yes.
  - maxxxxx 12y ago
    As far as I understand the insurance companies also negotiate pr-set prices with hospitals and doctors. But if you pay yourself they just make up prices and you don't know how much the insurance companies are paying so it's hard to negotiate. and even if they give an estimate it's not binding.
glenra 12y ago
> If patients had the ability to know expected prices beforehand, market forces would work to bring prices down. This would only really work if it were legal for hospitals to compete on price and for better/cheaper hospitals to expand and capture extra business thereby driving worse/pricier ones out of business. Which it's not. In any other industry if local providers provide crappy service at ludicrous prices you can open a competing service across the street and steal all their customers. And companies do just that - you get competing gas stations and competing burger joints right across the corner or across the street or just down the street. But hospitals generally need to PROVE their entry to the market WON'T harm the existing players, or they aren't allowed to open or expand facilities. Which means no price competition, no price wars...and no transparent pricing. https://en.wikipedia.org/wiki/Certificate_of_need https://en.wikipedia.org/wiki/Certificate_of_need

crag 12y ago

"If patients had the ability to know expected prices beforehand, market forces would work to bring prices down." If patients knew to ask. Really. If you are covered by insurance (including medicare/tri-care/etc) you won't get an answer. But if you are paying out of pocket (and most hospitals require credit if you are doing something serious - like open heart)you can negotiate the price. Let me say again, the hospital will negotiate. The doctors and labs (not done in the hospital) are another matter. Also, if you see an aspirin on your bill costing $75 you need to call. You'd be surprised how effective this is. Most Americans never question the price of anything. Even cars these days people take at face value. Of course, if you in the ER with chest pain, I'll admit, the last thing on your mind is the bill. And the hospitals know that. So what's the lesson here? In America have insurance. Even if you are 20 years old. A simple care wreck can destroy you financially. You think student loans are bad? Try a drug overdose. Or a heart attack. Or a fractured back ( a car wreck). If you young, insurance is cheap. Dirt cheap.

maxxxxx 12y ago
I haven't had much success getting prices when I had a high deductible insurance. Most doctors won't tell you anything or they will quote you one price today and 5 times as much tomorrow. You certainly won't get a binding quote you can plan with.

maxxxxx 12y ago

Price transparency is the one thing I would have liked to see from ObamaCare. They should have mandated to open up all pricing and all quality numbers. It's possible that some people would misinterpret these numbers but right now you are in that crazy situation where you have to make decisions based on no data at all. With open pricing and data a market based health system might work. Maybe.

danudey 12y ago
In Canada, a significant amount of medical procedures (possibly all of them?) have pre-set prices. A visit to a doctor's office costs X. A hospital visit costs X. There's no 'how much might you charge for this procedure tomorrow?' Of course, Canadians don't pay out of pocket for the vast majority of insurance things, but it even extends to other non-covered services like RMTs, dentistry, etc. Private insurance may not cover some specific things (like white fillings on molar teeth), but you never have to wonder what the prices are or how much you'll end up paying if you say yes.
- maxxxxx 12y ago
  As far as I understand the insurance companies also negotiate pr-set prices with hospitals and doctors. But if you pay yourself they just make up prices and you don't know how much the insurance companies are paying so it's hard to negotiate. and even if they give an estimate it's not binding.

glenra 12y ago

> If patients had the ability to know expected prices beforehand, market forces would work to bring prices down. This would only really work if it were legal for hospitals to compete on price and for better/cheaper hospitals to expand and capture extra business thereby driving worse/pricier ones out of business. Which it's not. In any other industry if local providers provide crappy service at ludicrous prices you can open a competing service across the street and steal all their customers. And companies do just that - you get competing gas stations and competing burger joints right across the corner or across the street or just down the street. But hospitals generally need to PROVE their entry to the market WON'T harm the existing players, or they aren't allowed to open or expand facilities. Which means no price competition, no price wars...and no transparent pricing. https://en.wikipedia.org/wiki/Certificate_of_need https://en.wikipedia.org/wiki/Certificate_of_need