Hacker News Reader

Comment by cosmodisk | Hacker News Reader

As someone who lived only countries with free public health service,these numbers are appalling.Not the numbers per se but rather lack of competition between healthcare providers.

View on HN

That's the problem. As a healthcare consumer, there is no way to discern between costs of providers. Just that some are "in-network" (meaning your insurance works with them and they agree to your insurance's rates) and "out-of-network".

It is extremely difficult to determine how much things will cost in the US system ahead of time and there is no reasonable way you can "shop" around for better prices when it comes to healthcare.

It's like you go out for dinner, but the restaurant won't tell you how much things cost, just that you should definitely order X,Y, and Z. And all the restaurants in town have the same policy. You order it, and then they mail you the bill 2 weeks later. Only for you to find out the exorbitant costs. Plus, they decided to charge you for the extra ketchup you requested.

Might be of interest to you: https://fmma.org/shophealth/

Good luck trying to figure out what inpatient services are gonna cost ahead of time though. I work in a hospital, and a doctor asked me for data two weeks ago about what a sample set of ten of his patients were getting charged, as well as what his clinic was getting reimbursed. Took an email chain eight people long before we found someone who could actually pull the right info. Ridiculous.

Publicly available pricing won't solve it all,as it can't be always easy to define how much a treatment would cost without actually doing it,however it would benefit a lot to ensure better prices.There must be a very strong lobbying programme going on against it if they are considering changing the law.

>it can't be always easy to define how much a treatment would cost without actually doing it.

Actually, it can be very easy. Quote a price prior to treatment and you are not allowed to charge more. Providers will lose money on some treatments, but on a large scale that can be predicted and rolled into the average price.

If there is a small provider, or particular treatment with high financial downside risk to the provider that the uncertainty is potentially crippling for the provider, then the provider can take out insurance to cover their loss if the treatment turned out to be far more expensive than originally anticipated.

In my state, movers are regulated like this. The result? Everything has a 30% error margin.

That approach is why the $10 test costs $400. Medicaid mandates $10.01 payment, and selling it to someone for less than that is a crime (fraud). Everyone else gets a percent off of list.

Everything already has an error margin. The difference is that the entire error margin is paid by the unlikely few who turned to cost more than expected. The point is to reduce risk by spreading the cost between those unlucky enough to have incurred extra with the rest of the patients.

If the actual cost of covering the unexpected costs is less than the margin they are tacking on, then that is simply over charging, and is not meaningfully different from the overcharging they can do anyway.

Show me an example of a price ceiling that doesn’t raise prices.

Interesting complaint. The common downside of price ceilings is that they prevent raising prices, leading to shortages.

Regardless, I am not proposing a price ceiling, I am proposing determining the price prior to rendering services.

They do that too, but given a ceiling of $1, the vendors who sold the widget for $0.95 will raise the price.

Reply on news.ycombinator.com