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Comment by rb808 | Hacker News Reader

$2k for major surgery, nice! Last time I went to ER it was $2k for the doctor's assistant to ask a few questions and put a band aid on.

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My wife fainted at a Shake Shack in NYC on the UWS. The 5 hour hospital stay with medicine, a regular check in from a nurse, and fluids cost less than $500. The < 5 MINUTE ambulance ride cost over $2500 to go from W77 to E77 (straight across the park, about a mile).

The ambulance game is the real racket.

Should have taken Uber/Lyft. A lot of folks are now using them to go to Emergency.

https://www.buzzfeednews.com/article/carolineodonovan/taking...

Did you even read what you linked? This is terrible!

Well, you need to just appear to not be sick and they'll accept you as a ride: don't barf allover the place as you get in, wait until the trip has started. After that, they have every incentive to deliver you to the hospital.

Sure, ideally we'd have reasonable ambulance pricing, but since that's not going to happen, taxis and ubers/lyft are the best thing.

In Washington state that trip would have cost about $700 (I used to work in private EMS, now in Fire).

In Washington, the ambulance companies are separate.

In NY state, and particularly in the City, most ambulance companies are owned by the hospitals themselves. It's cost shifting.

Yup, they're real basterd. I'd give them a middle finger every time I see one, but it's not the driver/nurses who deserves the blame.

This is where regulation can play a good role. We really need to stop these predatory Hospitals.

Hah. $2k. Cheap.

Me = goto ER for absurdly high BP and heart palpitations, which I've never had before. Quick hook up to ekg, watch BP, learn about PVCs, get kicked out after an hour or so as BP lowers somewhat. All in the hallway, no real admission. Admittedly not necessary looking back but you do what you have to.

Cost? $10k for the ER. $1500 for the doctor. Next cost? $4k for the ER if I'm poor Next cost? $350 of co-pay once I dug out my insurance card, God knows what Blue Cross pays. Broken system? I think so.

Actually it wasn't a critically urgent problem but needed doctors attention. If someone wants an idea for an app or website - a way to lookup local ERs by price would be great.

>If someone wants an idea for an app or website - a way to lookup local ERs by price would be great.

>lookup local ERs by price

Incredible. It's absurd that an idea like this is a reasonable suggestion.

It's beyond absurd.

Last year my system cut her finger quite deeply while dealing with a can opener, at ~9.30pm. It wasn't an ambulance-worthy emergency but still, it didn't look good. So we called our emergency number and they sent out an "ambulance lite", basically a paramedic and a doctor who's just finished university.

The cut wasn't serious despite the great loss of blood, but it was in a tricky spot and the young doctor didn't want to deal with it without a second opinion. So they took her to the ER, and we followed by car.

At the ER, within 45 minutes, she had seen the doctor on call that night and got the stitches put on from the cosmetic surgeon on duty that night.

Not only it didn't cost us 1 cent but we even got a free cup of coffee out of it, offered by one the ambulance drivers who was on call that night.

I envy a lot of things about the US, but not their medical care.

Why? It’s the free market approach. After all, healthcare is just a service.

Like someone in this thread said: "Medical care really is one of those things that no person should have to beg or borrow for, in a civil society."

There's nothing I can do for you if you think that access to health care should be contingent on your bank account.

My fear is that if hospitals start to make their prices publicly available, it will drive prices upward not downward.

Why? Because hospitals have no incentive to compete on price. The majority of people get ambulance'd to the nearest hospital, not necessarily the cheapest one.

So any hospital that notices it's charging less than its competitors will raise its price, because, why not? It's a very inelastic demand.

this is the kind of bogus reasoning lobbyists use to get congress pass BS anticompetetive laws.

you do know that most people who get into ambulance are not unconscious, right?

Er, and, most folks arrive by car. I'm pretty sure ambulance arrivals are a tiny percentage of their overall business.

Opinion based on a. Being alive and b. Paying accident claims for 5+ years.

Even with accidents, most claims did not involve an ambulance bill. In one memorable claim, a gunshot victim drove himself to the ER with multiple bullet wounds while bleeding profusely.

> The majority of people get ambulance'd to the nearest hospital, not necessarily the cheapest one.

But is ambulanced-in patients the majority of hospital business?

I suppose it depends on the operation. You might find price competition in non-emergency operations, but price fixing in emergency operations.

No, not remotely. Scheduled surgeries are the lion's share of revenue at any hospital.

Also people compare quality on price. If you want important live-saving treatment would you choose the cheapest or most expensive?

> If someone wants an idea for an app or website - a way to lookup local ERs by price would be great.

Predicting current local ER wait times for a given set of symptoms would probably be more useful.

Every single ER will charge every insurance company/plan differently, so that list would be pretty unreliable.

that is the whole point of publishing prices. with it implicitly you have to adjust your billing to be able to charge predictably for a service such as MRI etc. and if you dont you dont survive in long run as people gravitate towards the providers that give them clarity.

why should be hospitals be the only ones allowed to do this highly anticompetitive practice?

If clarity was a compelling concern for healthcare purchasers, everyone would buy HMO plans, which provide certainty for most things even where the provider doesn't.

The vast majority of patients don't care about price because their insurance is covering it.

That's shifting though with the rise in popularity of high deductible plans.

My plan is 5k deductible, 5k OOP Max, so I'm acutely aware of how much everything costs.

They do this in Maryland[1], I wish it were standard across the US

[1] https://healthcarequality.mhcc.maryland.gov/Article/View/f84...

And an app to verify that all doctors, nurses and equipment used in a procedure are all part of your in-network. Going out of network is so devastating, you could loose your entire life savings.

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