Comment by rqtwteye | Hacker News Reader

Comment by rqtwteye | Hacker News Reader

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A good start would be if the medical industry in the US were run like normal businesses with transparent and consistent pricing. Right now nobody can predict how much something cost because insurances, hospitals, drug companies and a lot of middlemen play all kinds of games. I think we should mandate that all prices are open so people know what's actually going on. Hospitals should also charge the same price for the same procedure to everybody independently of insurance or day of the week or whatever factor makes a procedure cost $5000 sometimes and $50000 another time.

All the excuses like "we need to charge more to insured people because of uninsured people" or "we need to charge 10x as much in the US for drugs than in other countries because of R&D" should be viewed as self serving BS until all the numbers are transparent. If there is an imbalance we should do direct subsidies based on the actual numbers instead of the current mess.

Health care is not regular business in the sense that you don't have to buy a product if it's too expensive and where it's easy to compare competing products. How would I know which hospital is better than another?

Absolutely! The truth is that nobody really knows what medications actually cost. They are often sold in bundles similar to cable tv channels.

For those who are running into coverage / affordability problems for drugs in the US… contact the manufacturer. They often have payment assistance programs or discounts to reduce out of pocket costs. They may be able to help you get costs covered by your insurer.

You should not ever be paying the full “list price” out of pocket. Pharma companies want market share and they would rather sell to you at a discount than lose you as a customer.

Not only that, but insurance companies get to negotiate special rates, but as an individual you have zero opportunity to do so, zero leverage. That is, to your point, the price of the service is 100% flexible. The ambiguity and confusion benefits those who are best positioned to benefit from it, that's not the individual.

It's a system optimized to be self-serving. It's the Healthcare Industrial Complex, that doesn't actually care much about health. Profits over people.

>>A good start would be if the medical industry in the US were run like normal businesses with transparent and consistent pricing.

People keep saying this, but I don't see how that helps in the slightest if you have had an accident and need help now.

Or for non-urgent care - something is wrong, you don't know what, you go to two doctors, one recommends a set of tests for $5000, the other a different set for $10,000, how does price transparency help you here in any way shape or form?

Edit: to be clear, this isn't meant to be a comment against price transparency. My point is that I don't think that's what the issue is. When I go to an NHS doctor here in UK I have absolutely 0 idea how much any of the tests or procedures cost, and yet the system isn't putting people in poverty(it has a lot of other problems, but bankrupting people isn't one of them).

It would provide some incentive to equalize across hospitals and rein in any sort of egregious outliers. Right now no one has any idea what is an outlier.

There was already list pricing published and some hospitals charge wildly different prices for the same tests, never mind with different insurers.

It wouldn’t solve everything but the base of knowledge we have is effectively zero, so something would be better than nothing.

Consumers in the US are also perfectly capable of shopping around for non-urgent care. They already do this for elective dentistry, for example.

Absolutely true for urgent care, but most care isn't urgent. If you need a new hip or cataract surgery, that's very much plannable and if you could save a few thousand by going to a different hospital, definitely something to consider.

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