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Tags health care , hospital , prices

View Poll Results: The effect will be....
lower prices 2 9.09%
higher prices 0 0%
something else 6 27.27%
none 8 36.36%
free health care for Planet X 6 27.27%
Voters: 22. You may not vote on this poll

Reply
Old 27th December 2018, 11:29 AM   #1
GnaGnaMan
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US: New law makes hospitals put price lists online

Quote:
Hospitals across the country have geared up to publish online price lists for all the medical services they provide, as a federal law takes effect on January 1.
https://www.newsweek.com/end-hidden-...ts-all-1272328

What will the effect of this be, if any? Higher prices? Lower prices? Something else?
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Old 27th December 2018, 11:54 AM   #2
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It will probably be like hotel room price signs. Room price: $79.00-$189.00 a night.

It will also probably be like nutrition info signs, largely ignored.
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Old 27th December 2018, 12:02 PM   #3
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"Free health care for Planet X" ... interesting

Planet Earth: a planet where every "high and middle-class country" has free or almost free health care (*) with the exception of the USA and a handful of rogue countries.

(*) nobody has to take a 8 year mortgage just to pay for a 30% of a laparoscopic cholecystectomy. It's free, free .... freeeeeee!!!!
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Old 27th December 2018, 12:14 PM   #4
GnaGnaMan
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Originally Posted by aleCcowaN View Post
"Free health care for Planet X" ... interesting

Planet Earth: a planet where every "high and middle-class country" has free or almost free health care (*) with the exception of the USA and a handful of rogue countries.

(*) nobody has to take a 8 year mortgage just to pay for a 30% of a laparoscopic cholecystectomy. It's free, free .... freeeeeee!!!!
Free health care is outlandish and unamerican.
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Old 27th December 2018, 01:46 PM   #5
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What price? There are more than one.

Prices are negotiated between the clinics and the insurance carriers, and another price is dictated by the government for Medicare/Medicaid. And then there's the cash price for the uninsured.

This is just a token gesture towards pretending health care is anything near a free market in America. Private insurance in this country is just a financial black box where premiums go in, medical bills come out, and the insured has no idea what the hell is happening.
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Old 28th December 2018, 05:04 AM   #6
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Originally Posted by SuburbanTurkey View Post
Private insurance in this country is just a financial black box where premiums go in, medical bills come out, and the insured has no idea what the hell is happening.
Financial 'black box'? Yeah right.

But this law is not about insurance,

Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long Term Acute Care Hospital (LTCH) Prospective Payment System Proposed Rule
Quote:
challenges continue to exist for patients due to insufficient price transparency, including patients being surprised by out-of-network bills for physicians, such as anesthesiologists and radiologists, who provide services at in-network hospitals, and patients being surprised by facility fees and physician fees for emergency room visits. We are seeking information from the public regarding barriers preventing providers from informing patients of their out of pocket costs;
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Old 28th December 2018, 06:11 AM   #7
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US hospitals are such divided places.

Worst case scenario, you'll get a bill for:

Triage
room rental
consult 1 (by Dr A)
Consult 2 (by Dr B)
Consumables
Cost of theatre and surgical team
Cost of actual surgeon
Rehab

All of which are separate companies.


So much of how the US is designed to work seems specifically aimed at making life harder in the name of individualism.
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Old 2nd January 2019, 06:22 AM   #8
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Originally Posted by Roger Ramjets View Post
This has everything to do with insurance because most Americans pay for their care via insurance plans. It's a laughable attempt to make medical costs more predictable and thus allow some sort of efficient market to arise via consumer choice. I fail to see how some estimation excel sheet parked on some dark corner of a clinic's webpage is really going to help.

Most Americans pay for medical care via insurance, and insurance companies absolutely negotiate prices with hospitals that will be different from what Medicare or any other "standard" pricing might list. So I ask again, what price?

For any complex service, the average consumer probably doesn't even know what services will be provided. The average consumer is not well versed in medical billing. There's umbrella code for "giving birth", for example. It's a wide variety of billing codes, involving multiple health providers, negotiated rates with insurance companies, deductibles, out of pocket maximums, etc. Sometimes, as 3oint14 says above, you have the pleasure of discovering the doctor that saw you at your "in network" hospital is in fact an "out of network" provider. With the exception of very simple procedures, it is a black box.


A person wanting to estimate how much a medical procedure is going to cost them should start by calling their insurance company, assuming they are insured, and not waste time with some estimation excel sheet. Even then, they should expect a surprise come billing time. It's always a game of billing hot potato, with insurance saying they won't know until they get the bills, and hospitals saying to ask your insurance company what they will or won't cover.
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Old 2nd January 2019, 07:44 AM   #9
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Originally Posted by aleCcowaN View Post
"Free health care for Planet X" ... interesting

Planet Earth: a planet where every "high and middle-class country" has free or almost free health care (*) with the exception of the USA and a handful of rogue countries.

(*) nobody has to take a 8 year mortgage just to pay for a 30% of a laparoscopic cholecystectomy. It's free, free .... freeeeeee!!!!***
This is nonsense of course, its not actually free anywhere.

**nobody does that anywhere though.
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Old 2nd January 2019, 09:58 AM   #10
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On Sunday night I slipped and fell on the pavement outside my home and hit my head, gashing my left brow open. I spent 3 hours at A&E, saw a nurse, saw a doctor, got X-Rays, got a local anaesthetic, 8 stitches and a course of antibiotics. Fortunately as I live in the UK I did not need to check a price list before getting my treatment.

I suppose this provision might make people more aware and increase demands for proper healthcare in the USA, but I wouldn't hold my breath.
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Old 2nd January 2019, 10:32 AM   #11
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Originally Posted by Garrison View Post
I suppose this provision might make people more aware and increase demands for proper healthcare in the USA, but I wouldn't hold my breath.
I'd be in stitches if they did

(ps: Get well!)
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Old 2nd January 2019, 10:38 AM   #12
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Originally Posted by GnaGnaMan View Post
https://www.newsweek.com/end-hidden-...ts-all-1272328

What will the effect of this be, if any? Higher prices? Lower prices? Something else?
I voted "none". As long as everybody involved with a patient's hospital care is an independent contractor who submits their own separate bills to the patient, a hospital can neither control nor predict the ultimate cost to the patient. I'm betting that they certainly won't be held liable if their "estimate" is wrong.

You need a single biller who subcontracts and pays for the necessary services if you want any sort of certainty for the patient and since patient care is the least of the health system's concern, I am not holding my breath.
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Old 2nd January 2019, 10:53 AM   #13
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I think anything that improves transparency is bound to be an improvement. At least put providers through the exercise of figuring out why they even charge what they charge. Half the time they don't know either. Maybe more than half.
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Old 2nd January 2019, 02:33 PM   #14
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Originally Posted by Minoosh View Post
I think anything that improves transparency is bound to be an improvement. At least put providers through the exercise of figuring out why they even charge what they charge. Half the time they don't know either. Maybe more than half.
In my experience the care providers(nurses and doctors) don't have any idea what things cost or what would be charged for services. This could not hurt and might help. As you say, anything that increase transparency would be positive.
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Old 2nd January 2019, 02:51 PM   #15
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Originally Posted by psionl0 View Post
I voted "none". As long as everybody involved with a patient's hospital care is an independent contractor who submits their own separate bills to the patient, a hospital can neither control nor predict the ultimate cost to the patient. I'm betting that they certainly won't be held liable if their "estimate" is wrong.

You need a single biller who subcontracts and pays for the necessary services if you want any sort of certainty for the patient and since patient care is the least of the health system's concern, I am not holding my breath.
Also on the 1/1, Arizona has a new law that Hospitals have to warn you of providers that are not 'in-network' for you, and an estimate of the cost. If they are off by more that $1000, you can take them to state arbitration, and the state will decide if what they got wrong is your responsibility.
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Old 2nd January 2019, 07:38 PM   #16
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No idea how many pay via insurance versus out of pocket but there are a lot of uninsured and even with insurance many procedures, especially elective and cosmetic are usually not covered. I suspect the law is for the benefit of out of pocket payers since Medicare/Medicaid has set prices and insurance generally negotiates a price.

But as mentioned anything adding a little transparency should be a good thing.
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Old 2nd January 2019, 08:01 PM   #17
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They're just going to obfuscate everything so that they can always figure out a bill and then work backwards from there.
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Old 2nd January 2019, 08:06 PM   #18
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Originally Posted by Loss Leader View Post
They're just going to obfuscate everything so that they can always figure out a bill and then work backwards from there.
are you saying they'll be conspiracy theorists?
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Old 2nd January 2019, 09:08 PM   #19
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Originally Posted by 3point14 View Post
US hospitals are such divided places.

Worst case scenario, you'll get a bill for:

Triage
room rental
consult 1 (by Dr A)
Consult 2 (by Dr B)
Consumables
Cost of theatre and surgical team
Cost of actual surgeon
Rehab

All of which are separate companies.


So much of how the US is designed to work seems specifically aimed at making life harder in the name of individualism.
And no one will be able to compare jack **** about the confusing mess of combinations.
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Old 2nd January 2019, 09:35 PM   #20
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Glad to see that almost everyone else is finally as cynically pessimistic as I am about health care in the US.

I don't see this law even being enacted/enforced in any meaningful way.
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Old 2nd January 2019, 09:37 PM   #21
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Originally Posted by 3point14 View Post
US hospitals are such divided places.

Worst case scenario, you'll get a bill for:

Triage
room rental
consult 1 (by Dr A)
Consult 2 (by Dr B)
Consumables
Cost of theatre and surgical team
Cost of actual surgeon
Rehab

All of which are separate companies.


So much of how the US is designed to work seems specifically aimed at making life harder in the name of individualism.
I also got lots of bills from lab companies, radiology companies, and a few other companies.
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Old 3rd January 2019, 04:46 PM   #22
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Originally Posted by aleCcowaN View Post
I'd be in stitches if they did

(ps: Get well!)
That'll cost you... $2,000 apparently.

I can't begin to tell you how glad I am that I live in a civilised country.
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Old 4th January 2019, 12:07 AM   #23
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Originally Posted by welshdean View Post
..........I can't begin to tell you how glad I am that I live in a civilised country.
Wales! Righto....... You've obviously never been out in Swansea on a Friday night.
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Old 4th January 2019, 12:36 AM   #24
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Advertise a cheap base rate and pump the patient for optional extras like anaesthetic.
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Old 4th January 2019, 12:54 AM   #25
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Originally Posted by Sideroxylon View Post
Advertise a cheap base rate and pump the patient for optional extras like anaesthetic.
The "cheap base rate" only gets you into the hospital parking lot (but doesn't pay for your parking). Everything else is an optional extra.
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Old 4th January 2019, 02:31 AM   #26
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Originally Posted by MikeG View Post
Wales! Righto....... You've obviously never been out in Swansea on a Friday night.
Worse than that mate. I've been to Cwmfelinfach. On a hen night!!!!!!
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Old 4th January 2019, 06:05 AM   #27
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Originally Posted by kellyb View Post
I also got lots of bills from lab companies, radiology companies, and a few other companies.

Oh, I'd forgotten about that, yes, one for bloods, one for CT scan, another for MRI. Oh, plus any transport costs, of course.
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Old 4th January 2019, 06:14 AM   #28
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My favorite tale of the efficiency of privatized US medical care.

I was in a minor motorcycle accident that resulted in me being transported to the Emergency room. I was checked out and given minor care, released, and had a couple of follow up appointments. Nothing major, a shoulder X-Ray, head check, and three stitches. All of this was supposed to be covered by the at fault driver's insurance.

Months later, I am informed that a small amount (<$200) of my state tax refund was being intercepted by some clinic that ended up not getting paid. Somehow this bill slipped through the cracks and I ended up liable for it. It was too small an amount to chase down through the insurance networks after it was "settled", so I just ate the loss.

FREE MARKET EFFICIENCY!
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Old 4th January 2019, 07:41 AM   #29
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think they'll have a $1 menu?
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Old 4th January 2019, 11:15 PM   #30
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Originally Posted by welshdean View Post
That'll cost you... $2,000 apparently.

I can't begin to tell you how glad I am that I live in a civilised country.
I share that feeling.

A friend of mine (from a public health care group fighting depression) suffers MS, he can't work, he's 52 and alone but his elderly mother in the last stages of Alzheimer. Each of them have a pension, a surplus because of their diseases, a caretaker paid to help him with his chores and taking care of his mother, and he's getting a medicine patented in the USA to try to stop the disease from going further that is costing the government three thousand pounds a month. All of it in a Third World country in the middle of one of its worst economical crises, with just a 37% of the per capita income the States have, if still that is left.
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Old 5th January 2019, 06:18 PM   #31
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A question for our USA members.
How much could I expect to pay for the following:
Induced coma - 3 weeks
ECMO procedure - 10 days
Kidney and liver functioning at 25% - treatment to rectify
ICU 3weeks
HDU 3 weeks
General ward 1 week
Bucketfuls of some of the best drugs known to man.
I ask because I had all of the above in March/April of '16 and I didn't pay a bean.
Please don't dismiss this question as a wind-up, I'd really like to know.
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