Hospitals Suing Trump To Keep Prices Secret

[BehindBlueI's]

I've only used the hospital system of one other country, Qatar. They have a dual system with a government ran hospital that's free but private hospitals are allowed as well. I had no trouble getting a price on a procedure and it was significantly cheaper then it would have been in the US. There's plenty of differences in the cost of medical school, the ability to sue for malpractice, etc. and the gov't competition drives down prices, I'm sure. I don't know that I'd want a kidney transplant done there, but for routine hospital stuff it was great. It was like having a procedure done while staying at an upscale hotel.

I don't know the same system would be workable here. Much larger population spread over a much larger area, etc. It worked very well there, though.

 

[Ingomike]

Some interesting market based proposals...

https://www.healthcareforyou.com/policy-guide/


https://www.jobcreatorsnetwork.com/...s-unveil-healthcare-for-you-reform-framework/

 

[DoggyDaddy]

Try calling your insurance and ask them to look up the prices in their database. They should know the negotiated price for the hospital or clinic. If you can get the procedure code the insurance should be able to give you a firm price and explain your options.

I recently had an MRI on my knee and my insurance company actually called me in advance to offer me other options. BUT, it was to save them money, not me. I asked what my out of pocket would be and they basically told me it would be the same for me no matter what. Since they didn't call me until the day before my appointment, I politely declined and stuck with my original appointment.

 

[jedi]

As others have stated.
Hospitals is just the tip of the iceberg.
A surgery is typically 3 to 4 different Bill's to the end user: hospital, surgeon, lab work, anesthesia team. Trying to figure out those charges is close to impossible. Heck the surgeon does not even know how much he cost when you ask him.

 

[DoggyDaddy]

As others have stated.
Hospitals is just the tip of the iceberg.
A surgery is typically 3 to 4 different Bill's to the end user: hospital, surgeon, lab work, anesthesia team. Trying to figure out those charges is close to impossible. Heck the surgeon does not even know how much he cost when you ask him.

See, I think that's BS. If you hire a home builder to build you a house, they're going to hire various subcontractors (electricians, plumbers, roofers, etc.) and they can tell you exactly how much your house is going to cost. I see absolutely no reason why healthcare procedures couldn't work the same way.

 

[jedi]

The only "yeah ok" explanation I got when my dad had surgeon was they (hospital) could not give you a firm price because of the unknown. For example say surgery cost $100 but in doing the surgery dad goes into cardiac arrest and they have to revive him with xyz equipment and supplies. That stuff is not part of surgery stuff but now used to keep dad alive. So how do they bill you for something you may or may not use.

Still dont buy that BS!

 

[DoggyDaddy]

The only "yeah ok" explanation I got when my dad had surgeon was they (hospital) could not give you a firm price because of the unknown. For example say surgery cost $100 but in doing the surgery dad goes into cardiac arrest and they have to revive him with xyz equipment and supplies. That stuff is not part of surgery stuff but now used to keep dad alive. So how do they bill you for something you may or may not use.

Still dont buy that BS!

Well sure, there are going to be contingencies that can't be predicted, but those should be the exception rather than the rule. At the very least, they should be able to give a "standard" price assuming everything goes as planned. Maybe a home remodel would have been a better analogy. You hire a contractor for a kitchen remodel, but then the plumber or electrician discovers problems that weren't apparent at the time of the original estimate.

 

[ATOMonkey]

Government is the reason medical billing is messed up. I doubt that more government will make it better.

Look at vision and dental. Still requires doctors, and they have up front, and even SALE prices on procedures.

What is the difference? Less regulation.

I haven't researched it, but I imagine there are probably laws regarding how medical billing has to work.

 

[BugI02]

Nearly two years ago I had pretty straight forward arthroscopic surgery. I elected to have it done at a surgery center rather than a hospital operating room (less sick people around). When they called me a few days befor the procedure, I was appalled to find that not only did they know all the particulars of my particular insurance including max out of pocket; they knew how much expenditures I already had rung up towards that max out of pocket!

They gave me a range of expected costs to me as part of this process, but unsurprisingly what they charged rubbed right up against the max I would have to pay. Prior to surgery they could not narrow down what I would have to pay because of the unexpected complication canard, and when I sought an itemized bill I could not get one because the surgical theatre was all inclusive with charges being made by time increments for usage not for expendables consumed. It was billed as 'X' dollars per 'Y' minute increment of use

I was quite satisfied with the results, but I suspected and could not prove that the charges for the operating theatre were set to maximize what I would have to pay without going over and requiring the insurance company to pay more than they wanted to (thus possibly ****ing them off)

 

[ATOMonkey]

Nearly two years ago I had pretty straight forward arthroscopic surgery. I elected to have it done at a surgery center rather than a hospital operating room (less sick people around). When they called me a few days befor the procedure, I was appalled to find that not only did they know all the particulars of my particular insurance including max out of pocket; they knew how much expenditures I already had rung up towards that max out of pocket!

They gave me a range of expected costs to me as part of this process, but unsurprisingly what they charged rubbed right up against the max I would have to pay. Prior to surgery they could not narrow down what I would have to pay because of the unexpected complication canard, and when I sought an itemized bill I could not get one because the surgical theatre was all inclusive with charges being made by time increments for usage not for expendables consumed. It was billed as 'X' dollars per 'Y' minute increment of use

I was quite satisfied with the results, but I suspected and could not prove that the charges for the operating theatre were set to maximize what I would have to pay without going over and requiring the insurance company to pay more than they wanted to (thus possibly ****ing them off)

Yes, I have run into the same thing. It's a striking coincidence that the amount it will cost for the procedure is the exact same as the amount insurance will allow.

How much is this going to cost?

How much do you have?

How to bill insurance requires an associates degree I believe...

 

[BugI02]

I was really jagged at my insurance. The only way the surgical theatre could have known my unmet OOP balance was if the insurance company told them. Seemed like collusion to me

 

[ATOMonkey]

I was really jagged at my insurance. The only way the surgical theatre could have known my unmet OOP balance was if the insurance company told them. Seemed like collusion to me

One hand washes the other. Prices are so high that I need insurance! Since I have insurance, it doesn't matter what the prices are.

College is so expensive that I need loans! I have loans so it doesn't matter how much college costs.

Cars are wicked expensive! If only I could take out a loan for 6 years instead of 3.... ad infinitum.

Here's a fun experiment if you ever feel so inclined. The next time you see your medical provider, tell them that you want to pay cash (Amish style). See what happens to the bill. Then tell them that you forgot that you actually DO have insurance. I wonder what the difference would be.

 

[jedi]

It may be collusion but no way to prove it I think.
Your college example is VERY CORRECT!

 

[ATOMonkey]

It may be collusion but no way to prove it I think.
Your college example is VERY CORRECT!

My parents never had health insurance until I was in HS I think. My in-laws didn't either.

How did people ever manage back then?

When you lower the cost of money, prices will invariably rise.

IMO, this is one reason why new vehicles depreciate so sharply. The cost of money for used vehicle is much higher than the cost of money for a new vehicle. What do I mean? Manufacturer financial arms will give you 0% interest for 6 years. Your local bank will give you 6% for 3 years.

Second hand car buyers are also looking for the highest VALUE for their purchase. So, there is much more discernment in the purchase.

The emotional factor needs to be considered as well. People are super happy to buy new, they buy used because they have to.

Having said all of that... Why would auto makers give people a free loan? They know they can charge a much higher price.

 

[jedi]

Sssshhh
That was sssssooo last century.

 

[HoughMade]

All the above but also the doctors are being told what they can and can't do for their patient by the insurance companies. I wish the insurance companies would keep their noses out of that.

Doctors are never told what they can and cannot do for a patient.

They are only ever told what an insurance company will pay for. It is always between the doctor and patient (and hospital if applicable) whether a given treatment will be rendered. Always.

 

[ATOMonkey]

Doctors are never told what they can and cannot do for a patient.

They are only ever told what an insurance company will pay for. It is always between the doctor and patient (and hospital if applicable) whether a given treatment will be rendered. Always.

Yep 100%. In my experience a doctor will not recommend a procedure, because they don't think the patient can afford it when insurance won't cover it. I have never had an issue getting a physician to perform a procedure or a test that I have specifically requested. They look at me like I have two heads when I say I'll just pay it out of pocket, but I'm used to it by now.

 

[finnegan]

I work in an operating room in a anesthesis tech role, which includes ordering supplies. Some high use objects are pretty cheap for us, while other supposedly more rare objects can be absurdly expensive. You are also billed differently for same thing depending on location. For instance, if you have to an arterial line placed, itll change the bill if it's done in pre op or in the OR. Itd be nice if we could just have a flat "pay X for Y" type of pricing, but its unfortunately convoluted. Surgeon a little late but you are already in the OR? You'll still be paying for the anesthesiologist every 15 minutes, etc.

 

[jedi]

so you are the reason we have high un known cost for surgery!

But we will give you a pass being a gun owner.

 

[finnegan]

I do what I can to reduce waste, but still end up throwing away a few thousand dollars worth of open but unused supplies a month. I have no idea what the drawn up but unused drugs i toss cost. Probably dont want to know.
On a related note, I've been donating to ripmedicaldebt.org . Pretty good charity for medical debt relief.