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Comment by geerlingguy | Hacker News Reader

Alternatively, I go in for a routine operation and/or surgery with known variables, and have no clue what I will be billed and who will be billing me, and whether the random anesthesiologist who tagged along with the main one is even covered by insurance—until about 6 months later when I get an invoice in the mail.

I could understand more if you're talking about a surprise ER visit, but it's like this for everything.

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I wouldn't say a surgery could be considered routine until it's complete. That's hindsight bias. Most hospitals can provide an estimate for these types of surgeries now, it's built into Epic, the most common electronic medical record system.

Out of network providers are a real issue and certain specialties, frankly, have the hospitals by the balls. The hospitals would love to employ those anesthesiologists. Good luck finding ones who will accept that job offer. We have the 'no surprises act' now that's supposed to address this issue but it's not working very well https://www.hfma.org/topics/hfm/2022/october/no-surprises-ac...

While what you say is true, in many countries the prices for many kinds of surgeries are fixed and known in advance, even if the work of the surgeons can indeed vary from case to case, so they are presumably based on some kind of average work.

> I wouldn't say a surgery could be considered routine until it's complete. That's hindsight bias.

Ehhhh, not if said surgery has a really high success rate and a really low rate of additional complications. There's all sorts of surgeries--say, LASIK eye surgery--that have a 99%+ success rate. And actually, LASIK is a great example of an operation that has lots of price transparency, competition, and where folks have the time to shop around, and it's fairly cheap as a result (~$2-3k per eye).

We can do this with more in the healthcare industry.

There are plenty of surgeries and medical procedures where pricing is upfront, clear, and competitive.

What they all have in common is that these are procedures that are not covered by insurance. Cosmetic surgery and other elective procedures are all easily cross-shopped.

It would appear that insurance is a significant part of the problem

Agreed. Insurance, Medicare in particular, is the root of these issues, from my biased insider's perspective. Doctors don't want to deal with insurance any more than consumers do...

This still isn't that unique to the medical industry. What about software contracts? Sometimes things go over time/budget, but this scenario should be worked out beforehand. You don't tell a client "Sorry we had to bring in an outside consultant, so we'll be charging you 5x our agreed price."

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