White House Unveils Rules Requiring Online Disclosure of Hospital Prices 119
schwit1 shares a report from The Hill: The Trump administration on Friday unveiled new rules to require increased disclosure of health care prices, in a move officials said would drive down costs by increasing competition. One regulation would require hospitals to provide a consumer-friendly online page where prices are listed for 300 common procedures like X-rays and lab tests. A second regulation would require insurers to provide an online tool where people could compare their out-of-pocket costs at different medical providers before receiving treatment. The rule announced Friday affecting hospitals is a final rule, set to take effect Jan. 1, 2021. The rule for insurers is still a proposal that is not yet finalized. "Hospitals and insurers will fight this. The last thing they want is consumers price shopping," adds schwit1.
Excellent. (Score:5, Insightful)
There are lots of things this administration has done that I don't like but this is actually a great improvement. I look forward to the release of applications that will utilize this data.
Re:Excellent. (Score:5, Informative)
There are lots of things this administration has done that I don't like but this is actually a great improvement. I look forward to the release of applications that will utilize this data.
Problem is that the "List" price that hospitals charge isn't what they actually get paid. What they actually get payed is negotiated. If you have ever been to an open air market in Mexico you likely got an education in haggling.
They ask $20 for an item for which they hope to get $3. I have a great story about being had if anyone wants to hear it.
Anyway, hospitals publishing list price isn't very representative of actual cost.
What would be ideal would be a listing of the average price an insurance company actually paid for a service.
They only get away with that because secret (Score:4, Informative)
Problem is that the "List" price that hospitals charge isn't what they actually get paid. What they actually get payed is negotiated.
That's true today, but the reason everyone gets away with it is because you cannot compare prices to start.
Now suddenly, if you can see inflated pre-negotiation prices from several sources, would you really start with the most expensive even knowing you can probably negotiate it down?
Seeing prices from everyone before purchase is the first step to list prices coming down much closer to real prices, because people will be able to compare to select beforehand and call out prices that are dramatically different.
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Problem is that the "List" price that hospitals charge isn't what they actually get paid. What they actually get payed is negotiated.
That's true today, but the reason everyone gets away with it is because you cannot compare prices to start.
Now suddenly, if you can see inflated pre-negotiation prices from several sources, would you really start with the most expensive even knowing you can probably negotiate it down?
Seeing prices from everyone before purchase is the first step to list prices coming down much closer to real prices, because people will be able to compare to select beforehand and call out prices that are dramatically different.
At first i thought to myself nothing this guy is saying makes any sense at all. Then I realized that you were referring to the free market principle that competition would drive down prices.
But i do not think that will apply to this situation. Insurance companies will continue to pay $3K for a procedure listed at $20K, and the average Joe uninsured will continue to be bankrupted over medical bills.
Because why not take as much as you possibly can right? Why leave money on the table?
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Fair? It's about saving lives, and rapid improvements in drugs and treatments are what saves lives, not a financial analysis that presumes a static level of science.
By driving profits out of drugs, you get slower development, just as you would for phones or video games. For lifesaving techniques, which are not fluff, this is mass murderous.
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Fair? It's about saving lives, and rapid improvements in drugs and treatments are what saves lives, not a financial analysis that presumes a static level of science.
By driving profits out of drugs, you get slower development, just as you would for phones or video games. For lifesaving techniques, which are not fluff, this is mass murderous.
Yes of course
Now tell me about the wonders of trickle down economics
Re: They only get away with that because secret (Score:2)
It's called "inelastic demand", and those kind of things often need regulation, unfortunately.
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Hospitals set their "suggested retail prices" way high, as do drug companies, so they can negotiate down with insurance companies.
It isn't much of a negotiation for insurance if they pay the same as someone off the street -- where's the savings to brag about to their customers?
This should lower prices by making those out of whack "official", pre-negotiation prices open. Those are the prices people without insurance pay, as collateral in this silly negotiation game.
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Except that most hospitals are technically non-profits, so your tax write-off argument doesn't really hold up.
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that, and the "not paid" is a net zero when written off under both cash and accrual accounting (although under accrual, there might be revenue the year of services and the matching loss the year of writedown).
hawk
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Problem is that the "List" price that hospitals charge isn't what they actually get paid. What they actually get payed is negotiated. If you have ever been to an open air market in Mexico you likely got an education in haggling.
Perhaps I'm misunderstanding your point, but isn't that what the second regulation would handle? Insurers (who negotiate the rates with the providers) would be required to show the negotiated rates as well. Both "list" prices (from the hospitals) and "discounted" prices (from the insurers) would be available to the consumer, right?
Or are you saying that the rates the insurers pay are different than the rates the insured pay? For most plans, I don't think that's the case. Typically, before the deductible
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Perhaps you should try reading the summary again.
Insurers would only have to disclose the out of pocket costs to the insurance subscriber, not the actual negotiated prices. Or are you under the misapprehension that the typical 10% copay is actually 10% of what the insurer pays?
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Or are you under the misapprehension that the typical 10% copay is actually 10% of what the insurer pays?
It depends on the plan and the service, but yes, under a high-deductible health plan (HDHP), I see both the rate the provider billed at as well as the (drastically less) negotiated rate. I pay 100% of the negotiated rate for my plan (before deductible is met), a percentage of the negotiated rate (after the deductible is met, but before the out-of-pocket is met), and 0% after the out-of-pocket is met.
What I can't see, at least not until this regulation goes into effect, is the negotiated rate for a particul
Re: Excellent. (Score:2)
This is the part of the scam that is medical insurance that requires the most scrutiny.
A quick solution is to ban deductibles, but I worry about unintentional consequences
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You should be paying the negotiated rate even during your deductible period. Of course the insurance company pays after you've met your deductible. If you experience something where you meet your max not through a single event but through a series of events (like maternity care), clearly everybody is being paid since they are different people submitting the bills. Nobody would say "Oh wow you paid the hospital a lot, so ok I'll take 10%."
I have seen two different approaches though -- sometimes they will inc
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>"Problem is that the "List" price that hospitals charge isn't what they actually get paid. What they actually get payed is negotiated. If you have ever been to an open air market in Mexico you likely got an education in haggling."
This is very true. And the reason? Insurance. It does this in every industry, it is not just a "hospital" thing. What you pay for car repairs is not the same. What you pay for dental services is not the same. Doctor offices, home repairs, medications, not the same as what
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The guy from the maid service estimating your house is more looking at you and what you can afford than tying rates to your square footage.
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So what? When I shop at Amazon, I see the prices I would pay if I want the item. I don't see what the price would ve if someone else would pay. If I'm a Prime member, maybe I'd pay a different price as well. Same goes for many stores - perhaps some customers might get a layalty disco
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When NPR was talking about this yesterday, they said it would include the list price, the "cash" price (for uninsured), and the negotiated price. It sounded really good, even they couldn't find something to rag on Trump.
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Agreed. Although I'd disagree maybe with the word great. I do think this is a step in the right direction, but I don't think it's going to have THAT great an impact...
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Set to take effect in 2021. It'll be repealed by Warren on her first day in office.
Even if it is Warren who wins the 2020 election, this would be in place for 20 days before she takes office, assuming the fight from the health care industry bigwigs doesn't draw it out to 2025 or such.
Re: Excellent. (Score:4, Insightful)
Re: Excellent. (Score:2)
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Lots of medical care is not of the emergency variety. For instance, when you are looking for maternity care, you have plenty of time to do research typically.
Even some emergency care can be considered with forethought. If you are at risk for a heart attack, like maybe you've already had one, then you can do some research about where to go for your next one. If your kids are involved in extreme activities, you can check out prices for broken arms.
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So, yes, this is a huge improvement. Now, we need to take care of those last 2 million folks, but let's not the perfect be the enemy of the good.
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but this is actually a great improvement
Maybe. But its putting a bandaid on a severed limb. But then Americans think regulation is a dirty word.
will they say in or out of network and all in pric (Score:2)
will they say in or out of network and all in price?? Not just well the x-ray tech will sent his own bill.
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That's a good point -- This regulation will help expose the "out-of-network" bad actor problem, but not fix it.
In my experience, it's the anesthesiologists that are the biggest offender here. You don't get to choose your anesthesiologist for a procedure, and you might randomly get one assigned on the day-of-your-procedure that is covered by your plan or (much more often) one that is not, potentially leaving you on the hook for thousands for their full-price.
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Finally (Score:4, Insightful)
This was the problem with Obamacare: it never attempted to solve the problem of COST. The insurers and medical providers always try to hide the cost, and it is dishonest.
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Re:Finally (Score:5, Interesting)
The real stupidity is the jacked up initial prices, which they know insurance companies will 'negotiate' down to about a third.
Or more. When my wife was diagnosed with a brain tumor in November 2005, the list price for her chemotherapy medicine Temodar [wikipedia.org] was $11,000 for a one-month supply of pills (several months would be required). Under my BC/BS PPO, the co-pay was $1,100 (10%) and under her Optima HMO the co-pay was $40 -- yes, forty. Clearly, the pharmaceutical company can accept much less than the list price they posted, so WTF?
Sue died seven weeks later in January 2006 before finishing even her first round of meds. Remember Sue... [tumblr.com]
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"Clearly, the pharmaceutical company can accept much less than the list price they posted"
Not clearly, since you did not show the price that was accepted from the insurance companies, i.e. the thing you actually claimed.
Re:Finally (Score:4, Insightful)
Your remembrance brought me to tears.
I am sorry for your loss.
Re:Finally (Score:4, Informative)
My condolences for your wife - glioblastoma kills people rapidly, and even today survival rates and times are worse than for many other brain tumors. Immunotherapy has made a big difference in some other brain tumors, but the large variety of mutated cells in a glioblastoma has made this approach less successful. Immunotherapies and chemotherapies are all expensive drugs. Even though they're expensive, most patients will quickly hit the stop-loss threshold after which insurance will pay 100% with no-copays - picking an insurance plan with a stop-loss limit that you can afford is important for this reason.
The co-pay is only what the patient pays, you need to find the negotiated insurance price. The hospital gets the sum of the negotiated insurance payment and the co-pay from the patient - that what you need to compare to the list or chargemaster price. For expensive drugs, many drug manufacturers have programs to rebate or pay all or most of the co-pay, or insurance companies will waive all or most of the co-pay if you buy the drug through a specified mail-order pharmacies. All these programs make figuring out the actual prices complicated.
Hospital "Chargemaster" list prices are rarely what anyone pays. If you have no insurance, hospitals will discount those prices when paid in cash (usually 50%-66%) even when the patient doesn't qualify for needs-based assistance, and insurance companies commonly negotiate pricing that's more like 80-90% off. Needs-based assistance will just write-off all or nearly all the cost. Keeping Chargemaster prices jacked up make it imperative that you have insurance coverage, because insurers can negotiate much better pricing than you can get as an individual nearly all the time.
For drugs, entities such as GoodRX.com seem able to negotiate near insurance-company level pricing for cash patients with no insurance - their program provides codes that look like insurer codes to pharmacies, but provide no funding to the pharmacies. Family members have used this to get better prices for drugs that our insurers won't cover for us, such as when a drug is outside their formulary list, or "step treatment": when the insurer requires that you try half a dozen cheaper drug and demonstrate that they're not working for you. In a sense, they're similar to "high deductible" insurance plans, where, until you're spending a bundle on medical care, pay absolutely nothing on your behalf, but do give access to discounted prices.
So, even if hospitals and other medical care providers have to provide these Chargemaster prices, it won't do much at all in the way of enhancing competition or price shopping, because actual pricing varies by so many factors. Even different insurance companies get different pricing from hospitals, and negotiate rules about how procedures are billed, such as whether they're allowed to bill for certain line items, or certain personnel.
Medicare has been running several programs that pay a straight "capitated rate" for certain procedures, a single price per patient no matter whether the patient's case is easy or complicated, whether post-operative infections set in, requiring extended hospital stays or further treatment - these programs give hospitals a big incentive to find the cheapest way to get the job done. Some of these programs pay bonuses based upon average outcomes - for example, paying extra if they can keep infections or other complications low.
Without being able to investigate the precise rules that the White House is writing, it's damn hard to figure out whether these rules are going to help anyone.
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You misspelled "tenth or less".
Exactly right... (Score:2)
The insurers and medical providers always try to hide the cost, and it is dishonest.
As I saw a comment on Twitter say, you can't have a market (as in the generic concept of the free market) without prices!
Re:Finally (Score:4, Insightful)
I definitely agree. As someone who would describe themselves as "generally on the Left" I was always lukewarm on Obamacare. Sure, I certainly love having more people with insurance but it completely fails to address a major core problem with our medical system which is cost.
In fact, it might have actually made the core problem worse through government subsidization with zero review of costs paid.
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That was one problem. The other problem is that it writes the insurance companies into the law. We need to get rid of them, not keep them on the gravy train forever. Remember how everyone was worried about "death panels"? We had them already, and they were run by the insurance companies. And they still are.
Re: Finally (Score:1)
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That was one problem. The other problem is that it writes the insurance companies into the law. We need to get rid of them, not keep them on the gravy train forever.
There is no need to get rid of private insurance companies, but just eliminate their monopoly on being the negotiating element in healthcare. Allow Medicare and other governmental programs to negotiate in the same way, and to buy meds in bulk. Allow private buyers' clubs for long-term conditions (diabetes, etc.) to do the same. Each added element of competition will reduce prices.
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Re:Finally (Score:4, Informative)
In general I think it's pretty fair to say that if the insurance companies were on board with it, it wasn't going to be good for consumers. But it was funny to see Republicans spend all of their time arguing against what they labeled as Obamacare when the plan was essentially a repackaged adaptation of a Republican plan that Mitt Romney had instituted in Massachusetts previously.
Making costs available to the consumer will go a long way towards increasing competition and driving down prices. Price signals serve as the basis for some schools of thought on free market economics so it seems like a lack of that information naturally leads to inefficiencies. I think the other thing that needs to happen is opening up more markets to other providers. Until there's an incentive to compete, the insurance company has no real incentive to offer lower prices, particularly when the system incentivizes them spending out as much money as possible. Letting Americans purchase drugs from other countries would help a lot as well.
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Exactly. The insurance companies WROTE the law. That is how you know it was written for Americans. They just used Obama to try and sell it, because he was generally liked and people felt like he could be trusted.
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First, there wasn't a "Republican plan" in Massachusetts similar to the ACA that Mitt Romney instituted. He did go partially along with it, but their health care law was passed overriding his vetos [masslive.com] by a Democratic legislature.
Second, the ACA didn't cap profits by requiring a minimum amount of spending on patient care. All that did was incentivize insurance companies to increase health spending/costs because now they just ended up with a flat percentage on top of what got spent rather than the difference bet
Re:Finally (Score:4, Insightful)
Pricing transparency MIGHT provide inventives to lower prices. Several problems;
(1) in medical care as others, sometimes price is a signal of quality, luxury, or prestige - so patients might seek out higher priced care because they think it's better.
(2) Hospitals have a capture region - ambulances in a certain region will go to that hospital because it's closer, and patients may really want to go to a local hospital - so hospitals may not compete on price because it customers won't use a farther-away hospital even if it's cheaper.
(3) Doctors & Hospitals have combined together into enormous entities in order to get the upper hand in pricing from insurance companies - Sutter Health just settled an antitrust lawsuit that California was about to reach a trial - as far as I know, details of that settlement aren't even available. Sutter Health controls 24 hospitals, 36 surgery centers, and 5500 physicians (as of 2018) - people may have to travel REALLY far to get non-Sutter-care.
(4) Insurance companies are selling EPO plans, Exclusive Provider "Option" plans, where the ONLY "option" is to get care from who they tell you are covered in their plans - the only option is between their way or no way.
(5) Patients tend to respond to price signals by avoiding medical care altogether. While some medical issues resolve with the passage of time and no treatment, (Back-ache, for example, resolves about as rapidly with no treatment as compared with a variety of non surgical treatments. Surgery to repair knee meniscus damage may have the same average outcome as leaving it alone.) - some medical problems can be treated inexpensively if caught promptly, but become much more expensive if left untreated - (such as common staph infections, where antibiotics are effective early on, but if it progresses to below the skin to "flesh eating," becomes very damaging and expensive to treat. These kinds of issues are behind the requirement that ACA-compliant insurance plans cover a free general health exam once a year. (This is a tricky thing to obtain, by the way, because asking certain questions during that free exam can start procedures that will cost you money.)
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>because now they just ended up with a flat percentage on top of what
>got spent rather than the difference between premiums and what was spent
Which was also idiotic.
The result was that high deductible policies, which have the same basic overhead (every claim must still be filed and process) and *necessarily* have a higher ratio of administrative costs to claims paid (the very point of the policy!) suddenly had to start cutting rebate checks.
After two years of rebate checks from thins ill-conceived law
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It did, right until Obama realised he would need to water down his plans to get it through the republican senate. At that point it stopped being any kind of a sane plan for a healthcare system in the 1st world.
Re:Finally (Score:5, Informative)
Re:Finally (Score:4, Interesting)
Wrong. There was a bill, that was much more meager and had some uncomfortable provisions, The PPACA (Patient Protection and Affordable Care Act) that passed the Senate, but wasn't in condition to pass the House. The replacement of Kennedy with Republican Scott Brown on January 19, 2010 gave Republicans the ability to block bills by filibuster in the Senate, meant that Obamacare could only be passed by taking the PPACA bill, and modifying it with another "reconciliation" bill.
It meant that an existing bill (The PPACA bill) that had passed the Senate earlier, by carefully getting a 60-vote majority, but didn't include much of what Democrats in the House wanted, was the only one that the House could pass to get an act to the White House for signing, and all remaining changes (The Health Care and Education Reconciliation Act) had to be of a budgetary nature. Reconciliation bills aren't permitted by Senate rules to be filibustered, so HCERA only needed 51 votes in the Senate. Republicans couldn't block it. But all they're allowed to do is make budgetary changes.
HCERA changed the subsidy levels, the taxes needed to pay for those subsidies - and a key point: killed the special deal for Nebraska Medicaid that was put into the PPACA to get the 60th vote in the Senate. HCERA killed the Nebraska Medicaid deal by depriving that part of the PPACA bill of the necessary funding. It was a clever/evil trick - Nebraska Democrat Ben Nelson wouldn't vote for the PPACA except for the added "Cornhusker Provision" that gave Nebraska extra money for Medicaid expansion over any other state. Because it was a monetary provision, the reconciliation bill could zero it out. In 2018, Nebraska passed their Medicaid expansion authorization, even though they never got the extra money.
The other late change to the PPACA was to kill the "public option" that was in the bill, in order to get Independent Joe Leiberman to vote for it, although a state-based public option for Vermont stayed in the bill. Democrats couldn't snake Leiberman, though, by getting the public option back in the reconciliation bill. Obamacare would have been a different system with a public option - many people think it could have lead to employers moving away from providing medical insurance, and people getting something very much like "Medicaid for All" as in the stump speeches of several Democratic Presidential candidates this time around. You have Joe Leiberman to thank or blame, depending on your point of view, for the public option getting ripped out of Obamacare in 2010.
So, to recap, Obamacare never really got 60 votes for the whole program, as expressed in the two bills. They got 60 votes for the PPACA bill, and only got 56 votes for the HCERA bill, which substantially modified the budgetary components of the PPACA bill.
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Educate yourself [wikipedia.org]. Please check the timeline:
Introduced in the House as the "Service Members Home Ownership Tax Act of 2009" (H.R. 3590) by Charles Rangel (D–NY) on September 17, 2009
Committee consideration by Ways and Means
Passed the House on November 7, 2009 (220–215)
Passed the Senate as the "Patient Protection and Affordable Care Act" on December 24, 2009 (60–39) with amendment
House agreed to Senate amendment on March 21, 2010 (219–212)
The Senate was DONE WITH THE BILL on December 24th, 2009. DONE. Never touched it again. BEFORE Scott Brown joined the Senate. Quit trying to revise history, because that's lying. You got what Obama promised - and it was a pile of steaming, fetid dung.
And as Nancy Pelosi said, you didn't know what you were getting until it was passed.
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The article you point to does not refute anything that craighansen said. To wit: "most House Democrats agreed to pass the Senate bill on condition that it be amended by a subsequent bill.[183] They drafted the Health Care and Education Reconciliation Act, which could be passed by the reconciliation process.[184][187][188]"
Amending your incomplete timeline:
Senate passed the "Patient Protection and Affordable Care Act" with amendments on December 24, 2009 (60–39)
House passed the Senate amendment to "Pat
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craighansen did not claim otherwise
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The PPACA (Patient Protection and Affordable Care Act) that passed the Senate, but wasn't in condition to pass the House. The replacement of Kennedy with Republican Scott Brown on January 19, 2010 gave Republicans the ability to block bills by filibuster in the Senate, meant that Obamacare could only be passed by taking the PPACA bill, and modifying it with another "reconciliation" bill.
That's from craighansen. PPACA was already passed by the Senate when Scott Brown was seated. The House may have had issues, but that's because the DEMOCRAT MAJORITY wanted to change it; Nancy Pelosi was in charge, and there is NO filibuster in the House, meaning any changes/delays are because the majority (Democrats) wanted it.
Trying to blame PPACA on the Republicans or their ability to block action in the Senate is a bald-faced lie. Flat out. Democrats made it, wrote it, passed it - they own it 100% wi
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The only fucking question is, are you aware of it? Are you also a fucking liar?
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&%^@ Yes! (Score:4, Informative)
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Medical providers are required to provide
- emergency services(with out any regard for compensation),
- medicad and medicare services(an approved provider)(where the government pays what ever it pays with no regard for the cost of the services provided)
- General government regulations and mandates all have a cost that is usually buried to keep the true cost of government from being disclosed.
I wonder if all these costs are a
Re:&%^@ Yes! (Score:5, Insightful)
Given that the cost of Government run healthcare (i.e. nearly all of Europe) is far lower for the same outcome, I don't think it's the US Government that's keeping costs high in your healthcare.
Re:&%^@ Yes! (Score:4, Informative)
Given that the cost of Government run healthcare (i.e. nearly all of Europe) is far lower for the same outcome, I don't think it's the US Government that's keeping costs high in your healthcare.
Same outcome? You have to be fucking joking
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Same outcome? You have to be fucking joking
You're right, most of Europe actually gets better health outcomes.
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Gotta love getting modded as Troll when you speak what the gathered evidence says..
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GP is. Outcomes are generally better in most European countries than in the USA.
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You are absolutely correct. If we really want to provide a "provide a consumer-friendly" option, single-payer Medicare for All is the solution.
Here is a good podcast overview of Medicare for All: Medicare For All, An Overview [podbean.com].
And this podcast episode explains why our current health care system is not sustainable: The Economics of Health Care, Part 1: The Problem - Our Current Health Care System Is Unaffordable [podbean.com]
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Umm.... do you realize that healthcare costs in European countries went way up right after the governments each took it over? That the US government already spends more per person (across the total population) than most European countries, while only covering people under Medicare/caid and the VA? That the reason we're in the current health care cost situation is that the government creates additional demand while limiting supply? That health insurance companies are super-regulated, to the point where they
Re:&%^@ Yes! (Score:4, Insightful)
That the US government already spends more per person (across the total population) than most European countries, while only covering people under Medicare/caid and the VA?
You do realize those groups are the most expensive people to take care of, right? Old people, poor people, and veterans generally have much more significant health issues than young, middle/upper class people. Private insurance only works at all because we've pulled the most expensive people to care for out of the system and have a huge pool of people who need little to no care paying into the system.
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It sounds like you missed the point.
Not counting any private spending, the US Federal government already spends more on health care / 327.2 Million people in the country than the per capita spending in most European countries whose governments cover their entire populations, not just a subset like here.
If we only counted Federal government spending per Medicare/caid/VA recipient, then yes, you'd obviously get an even higher number by dividing by a much smaller denominator.
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And you fail to see the point - yes, those groups have more expensive healthcare needs, everyone agrees that.
However, those costs in other countries are covered for less.
The point is, what you are spending on those groups is *more* per total head of population in the US, not just those groups, than most western socialised healthcare systems to cover the entire population and most just those groups, often with similar outcomes.
To sum up - you spend more on less of your population than other countries manage
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I don't think it's the US Government that's keeping costs high in your healthcare.
Yes it is, by allowing pharma and hospitals to write their own legislation to lock out competition and maintain a medieval guild system.
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I don't think it's the US Government that's keeping costs high in your healthcare
You're right, sort of. On a per-patient basis, the US spends way more than Canadian or European single-payer health care systems for more or less the same outcomes.
But a great deal of positive patient outcome comes from the pharmaceutical industry, which is heavily subsidized by the high prices paid by those in the US. While France can negotiate a per-pill cost of $10 for SuperDrug, the morass of Medicare/Medicaid/private in
Nightmare (Score:4, Informative)
If you work on Wall Street, the easiest way to make money is when the buyer/seller doesn't know the true cost/value of a bond, CDS, CLO etc. Keeping actual transaction prices private is key to keeping the gravy train running.
Medical transaction prices are finally coming out of the shadows!
Doctor sign strict non-disclosure agreements with insurers. Disclose true prices, and you are immediately removed from the plan. Insurers defend those secret prices as if their lives depend on it.
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If you're on wallstreet that's fine. Trading stocks today isn't a life or death situation. If you asked consumers which hospital they want to go to the answer is invariably none. This is putting a bandaid on a severed limb. It may make a marginal improvement in costs, but it isn't going to really make a dent in the MIC built up in America.
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Even with this, you still won't know the actual transaction prices. All you will know is the rack-rate that no one actually pays.
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Doctor sign strict non-disclosure agreements with insurers. Disclose true prices, and you are immediately removed from the plan. Insurers defend those secret prices as if their lives depend on it.
This may sound like a naive question/statement, but the hospital bills I've gotten all list the line item charges, the amount paid by my insurance, and the remainder for me to pay.
The only case that didn't happen was one particular incident where the bills exceeded my yearly deductible and the insurance was paying 100%, in which case I just wasn't sent a bill.
Are you saying both the total charge and amount paid by insurance are made up numbers?
Clearly the amount due must be correct since they need to keep t
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About damn time (Score:5, Informative)
About 15 years ago I had a problem with my shoulder. The most likely explanation was bursitis, which can normally be fixed with a cortisone shot. But I didn't have any insurance at the time, and was tight on money, so I ignored it as long as I could. Finally, I could not ignore it any longer. I could hardly move my right (dominant) arm which meant I couldn't work. Hell, I couldn't really drive because I had a stick shift. So and went to a local medical facility. I asked how much it would cost. They flat out would not tell me, no matter how much I pressed them. I couldn't even get a ballpark figure. It turned out to be bursitis and I got the shot, which fixed me right up. Then the shock of the bill arrived a week later.
If I take my car to the shop because one tire has a very slow leak they'll tell me it's "x dollars if it's a simple patch". If it's something more, e.g. the wheel itself is damaged and requires replacement, I know the initial estimate will not be valid.
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Most of the meds I need are free
Kidney stone removal free
Mind you, we have a real democracy where its "by the people for the people", our electoral boundaries are set independently, none of this gerrymandering, voter deregistration garbage.
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Has nothing to do with democracy. Germany got its first statutory health insurance system in the late 19th century when it still was a monarchy.
Explaining everything to patients? (Score:3)
Are you going to be handed an itemized list of all procedures, supplies, etc, before you get something done to you?
Most people, even if explained in detail, dumbed-down so a child could understand it, are still not going to understand a fair portion of things they're being charged for, regardless of them being necessary.
Worse, do you really think doctors or nurses have the time to sit with someone for an hour (or more) going over that itemized list with every single patient? For, say, someone who needs cancer treatment, or heart surgery, or something else similarly dire and complicated, there might not be enough time to explain it all.
What about things the patient can't be around to consent to pay for? For instance: something unexpected comes up during surgery.
None of the above even touches on emergency room services. If you're unconscious, bleeding to death, etc, there is LITERALLY NO TIME for any of that. They're going to do whatever is necessary to save your life, regardless of cost.
Now, as a sidebar to this subject: what I'd really like to see, is healthcare mandated to be not-for-profit. That would not only cut down on excessive costs, but it would remove the motivation to price-gouge people. I understand that it used to be this way, some decades ago..
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Over in the UK, we have itemised costs on the patient pathway.
Once diagnosis is made, and it's being treated, yes, you can very easily provide an itemised list with specific costs for everything, down to each blood sample require to track.
If a patient doesn't want to see that list, that's fine. I bet an insurer would insist on it.
As conditions evolve, it's nice and easy to move the path, have that auto-calculate based on medical protocol and the procedures that will be required, and inform the patient of t
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>Worse, do you really think doctors or nurses have the time to sit with someone for an hour (or more) going over that itemized list with every single patient?
If they can charge it, they can bloody well print out an itemization. It's not hard. Select "print list of stuff we might do for X and the price" on the computer and insert a new overpriced inkjet cartridge into the HIPPA approved printer.
This won't help (Score:3)
This won't help with your plan's Preferred Facilities such as hospitals.
This won't help because "all things" aren't equal.
This won't help with special needs patients. (Think Children's Hospitals all over the country as well as nursing homes.)
Great Idea that will most likely be poorly implemented. (Like compelling the patient prove that a hospital that charges more than the cheapest is Necessary! Etc. Etc.)
What a big nose you have, Mr. Camel!
Common fallacy: 100% is required (Score:2)
This is repeating a common fallacy: that for anything to be good it needs to be 100% perfect.
In fact, that's a common tactic to ensure that the idea never happens at all.
Realistically speaking, more and more information will be published.
At some point Congress would force all healthcare providers to list, by CPT code, every charge.
The only people who really care about not doing this are people in the healthcare industry. In real life very few people understand how the healthcare industry (payers, providers)
Consumers can't price shop (Score:4, Informative)
Healthcare is not like buying Twinkies or even PCs. It's too complex and too high risk for someone not trained in the field to make good purchasing choices. You don't have enough information, what information you do have you don't have the training to understand.
I'm tired of Wallet Biopsies. I want to live in a world where I don't go to the doctor knowing that somewhere in the back of his mind he's asking himself "am I gonna get stiffed by this guy's insurance?". Sooner or later my doctor will skip ordering a test because he doesn't already know the result (insurance companies won't pay for tests that come back negative, why should they, the doctor must have ordered an unnecessary test) and I'll be screwed. And yes, I know folks who this has happened to, but good luck proving it in court.
TL;DR, Medicare for All now.
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I find it amazing that there are so many people defending a system that is clearly out there to make the most profit out of bad fortune of others. It's like all of you are brainwashed into rejecting anything that might be good for everyone involved.
From a European viewpoint, you oppose all that is good for you. You oppose affordable healthcare, price transparency, government break-up of monopolies (internet/tv anyone), wealth taxes and even progressive tax systems.
Then there's the blaming "the other polit
What's the angle? (Score:1)
As I said elsewhere on the thread I don't think this will matter. As a consumer I don't have enough information to safely and reliably compare prices. And that's before we talk about the venture capitalists buying up hos
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You know who has taken literally millions of dollars from insurance companies, and millions more from lawyers? Elizabeth Warren [opensecrets.org].
You know who else has taken millions from insurance companies and hospitals? Bernie Sanders [opensecrets.org].
Makes you wonder just why they're giving millions and millions to the Presidential candidates that want to completely change the medical industry. Maybe those insurance companies and lawyers and hospitals want to buy the best law they can, much like with Obamacare?
Um... no, you're lying (Score:3)
Open secrets lists donations from people by industry. Sanders gets a lot of those because he's been endorsed by nurses [thehill.com]
Warren? Yeah, let's face it, she's basically a 1980s moderate Republican. But that makes her a lefty by today's Overton Window shifted world's point of view. The billionaire class are, at least, concerned. [wsj.com]
And your whataboutism doesn't change a damn thing. There is exactly one presidential candidate who has stood for Universal healthc
Again, you're lying (Score:2)
Taking money from Hospital _companies_ is bad.
Taking money from somebody who happens to work for an insurance company or hospital is _not_ bad.
You know this, and thus are lying by omission.
And Medicare for All works in every civilized country. JFK supported it, look the videos of him talking about it up (it wasn't branded "Medicare for All" back then, but it's the same system).
Finally you right wing trolls have been saying the country will go
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Sure both Warren and Sanders have more donations from the healthcare field than either Buttigieg [opensecrets.org] or Harris [opensecrets.org], but that's just
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Price per cpt code (Score:3)
Prices should be listed by cpt code, period.
or ... (Score:2)
Half the story (Score:2)
I want to know the cost/failure ratio. I'm not very keen on my health care being done by the cheapest possible option if half their patients die or have to be re-admitted due to complications other providers don't cause.
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