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Comment by phamilton | Hacker News Reader

We just had a baby and I got a fully itemized bill, down to the total time spent with a head nurse vs the lower down nurses (billed at different rates).

I agree that I would have liked to have known that if my wife buzzed for a refill on her water bottle that we would be billed for the nurses time at $120/hr.

But even if I had known that, the total bill was discounted from 10k to 7k due to an agreement my insurance has with the hospital, and then my 80 | 20 kicked in and our out of pocket expense for a delivery, care and 48 hour stay was $1400 + a $300 copay. So many factors involved would have made estimating my final cost pretty difficult.

And that may be the point. It's not so much about transparency, it's more about how complicated the billing actually is.

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It's absolutely about transparency though. The origin of the complexity is that insurance companies usually get the bills. And insurance, which has all this machinery to deal with the hospital's machinery (see video), sends you a TL;DR and as long as everything seems reasonable - though who really knows what that is - you send your insurance co a check for some fraction of it and everyone moves on.

There are a lot of things broken about US healthcare, but chief among them is that no one is allowed to talk about cost of services. It's untouchable. It's seen as getting between the patient and doctor - again, whatever that means.

10K? Wow. My last child was delivered 4 years ago, standard exit method with no complications, and the tab was $26K (before discounts, of course).

I can't imagine the bill if it was a c-section or if neonatal was involved. It would easily double and go up from there.

The funny thing is that the obstetrician gave us a fixed price for the entire pregnancy. All checkups and the standard delivery was one price. It was the hospital (and the randomly-chosen anesthesiologist) that ran up the price.

This was in Provo, UT, a student town where 50% of students and many of those couples have at least one child while attending school (my wife and I are one of those). The city therefore has a significantly higher than average birthrate but since the student population is transitory the population doesn't really grow that much. The effect of all this is that the hospital has an abnormally large amount of childbirths, and has become pretty darn efficient at it.

That probably contributes to a lower cost.

I'm not sure that 'universal' healthcare is the solution either. I enjoy the luxury (in Canada) of not having to worry about finances when going into an emergency room, clinic, MRI centre, etc but the taxes are a killer.

I recall a few years ago when my mother (US citizen) required knee replacement surgery; same itemized nightmare others have detailed.

Given both options, I'll live with them robbing me bi-weekly.

mark_up 2 hours ago | link [dead]

My wife had a baby a year ago, and it cost us nothing.

I live in the "third" world.

As a fraction of my income, my baby cost us less than 3%. Figure out how much your income went to universal health care. I'm guessing it's higher than 3%.

Figure out how much your income

Duder is hell banned, I was just reposting that dead comment. But from myself...

I'm guessing it's higher than 3%.

Well, of course it would be. You're comparing your baby to every heath service for his family, ever, that is covered by his universal healthcare system. Or are you saying that your baby is the only time your family has or will use heath service.

If you cared to make an honest comparison, you would compare the portion of his, and his employer's income that went towards universal to your lifetime of insurance spending, plus employer spending on coverage for you, plus all of your out of pocket healthcare spending (on items that would be covered by his universal system).

Now, I don't care to do that math, but here in the US we spend (gov't and private total) more per capita on heathcare than any other nation. So his kid was probably cheaper.

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