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Comment by maxxxxx | Hacker News Reader

Why don't they compete now or why can't you even get a price upfront from them?

EDIT: I am responding to a comment that the AMA is the problem. Maybe the AMA is a problem but it has nothing to do with hospitals not competing over prices.

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Because price negotiations aren’t disclosed and are privy between hospitals and insurance provusers.

The real crux is that point, the patient is removed from pricing and so the whole market becomes distorted. It’s like going to a store without price tags and complaining that your bill is much higher than you expected.

"t’s like going to a store without price tags and complaining that your bill is much higher than you expected."

It's more like only having stores without price tags and then when you overpay people telling you that you should have shopped around for a good price.

You can get a price upfront in my experience. Especially for standard procedures. And definitely for outpatient stuff.

But it isn't reasonable to expect upfront pricing in things as complicated as heart surgery. Or where you are going in for unknown problems. There is no way to know what complications may arise or additional procedures, x-rays or scans may be required.

When I had an HSA I called doctors to get estimates and only rarely got one. The only exception is dentists. They have pretty good price lists.

As someone who used to work in the medical field it can be a pain to even know how much insurances will reimburse for procedures. Especially when it comes to smaller / union insurance providers, health care providers have to call and wait for a fax or snail mail for a reimbursement table. This leads to balance billing or the provider just eating the cost.

On the consumer side I just found out about healthcare blue book and they have prices for just about any procedure.

I was having trouble sleeping for a while; at one point my doctor recommending I go on oxygen for a while until she could figure it out. I called the company that provided the oxygen, and asked how much it would cost. Nobody knew. I called back 3 times, and still nobody could tell me. I called my insurance company; they couldn't tell me either. I ended up electing not to use it (which turned out to be perfectly fine), but it does seem like this was a fairly standard procedure, for outpatient stuff, and nobody involved knew what the prices were.

That matches my experience. Or you get quoted $100 and charged $3000 which after some back and forth turns into $50.

The doctors are the scarce factor. They determine the price.

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