5 ms·

Legislate transparent pricing for all medications and procedures first. Paying 40 dollars for lozenges in the ER is insane. Right now the system has an opaque

by shdh 1mo ago

Legislate transparent pricing for all medications and procedures first. Paying 40 dollars for lozenges in the ER is insane. Right now the system has an opaque pricing structure which makes no sense. Force hospitals to expose API's with transparent pricing.

nobodyandproud 1mo ago
Also legislate transparent negotiated pricing for medications and procedures for each insurance plan, as well as rejection rates for medications and procedures. Oh yes, and patient/coverage drop rates
chimeracoder 1mo ago
> Force hospitals to expose API's with transparent pricing. Unless you're uninsured (which is a whole separate clusterfuck), the hospitals aren't the ones who decide how much you pay for any service - the insurance companies are. The sticker price that hospitals charge is almost meaningless and is intentionally high because it's used as the starting point for negotiations, which always bring the price down (never up). There isn't any expectation that any insurer is actually going to pay the billed amount as-is.
- reverius42 1mo ago
  It should be illegal to charge different prices for the same thing to different customers.
  - DesiLurker 1mo ago
    [dead]
  - knollimar 1mo ago
    It's how they negotiate? otherwise you get take it or leave it deals with insurers.
    - reverius42 29d ago
      Hospitals shouldn't have to negotiate with insurers. It should be illegal for an insurer to not pay for a necessary procedure at the hospital's standard rate.
  - Hobadee 29d ago
    That's how virtually all industries work though. The computer you are typing on right now probably costs a different amount depending on which retailer you bought it from, even though it's the same manufacturer.
    - reverius42 29d ago
      The fact that it's already common doesn't mean it shouldn't be illegal. And I'm talking more specifically about a single entity selling to multiple customers. If two different retailers want to charge two different prices of course that's fine.
mhb 1mo ago
Fix the principal/agent problem by decoupling health insurance from employment by not having health insurance be paid for with pre-tax dollars.
- Glyptodon 1mo ago
  I 100% want it decoupled from employment. But it doesn't magically make very sick people capable of comparison shopping either.
  - ziofill 1mo ago
    It should never be shopping in the first place. I live in Canada, my family has needed the hospital and the ER a few times and we never ever had to even reach for our wallet.
  - mhb 29d ago
    Your example is an edge case. Presumably sick people were once healthy. When people are spending their own money, they become a lot more discriminating. Also, if you're looking for treatment after you're sick, that's not health insurance.
    - Glyptodon 26d ago
      I'd tend to think the majority of healthcare is sought after something happens - car wrecks, cancer diagnosis, sports or exercise injury, stuff like ear infections or strep throat... Healthy people without concerns aren't looking for treatment, they're visiting their PCP once a year.
Glyptodon 1mo ago
Won't matter unless service providers are forced to have one single rate for all payers. Which we can't even manage at grocery stores.
sm-silversight 1mo ago
Yeah I'd like to see this before universal healthcare. I think we can do better than universal healthcare if we start with transparency on pricing to kill graft.
twoodfin 1mo ago
For hospitals (where the majority of US healthcare spending occurs), pricing transparency has been the rule for more than 5 years: https://www.cms.gov/priorities/key-initiatives/hospital-price-transparency https://www.cms.gov/priorities/key-initiatives/hospital-pric...
NoMoreNicksLeft 29d ago
>Legislate transparent pricing for all medications and procedures first. This is an impossible ask. Truly impossible. The medical care providers have spent the last 50 years or more honing the art of making costs inscrutable. Not really to make it harder for you or I to know the costs, but for the insurance companies to know the cost. 50 years is a long time, that's not just one set of workers who have done this, it's 4-6 career spans now... the first to learn it taught it to their underlings and coworkers, who invented new sophisticated techniques and bureaucracies and taught that to the third career generation, who did the same and so on. Even if we had universal healthcare, you're not getting rid of that. It's now a culture. A transmissible, everlasting culture. For any political ask you might come up with, absurd and difficult and even intractable as it might be, this is light years beyond that. God himself couldn't make these prices transparent.
HaloZero 29d ago
Just had a kid, navigation all the procedure codes and everything was insane. I just wanted to figure out what they were charging us for. I just gave up b/c we thankfully hit out out of pocket max for this year.

by shdh 1mo ago

nobodyandproud 1mo ago

Also legislate transparent negotiated pricing for medications and procedures for each insurance plan, as well as rejection rates for medications and procedures. Oh yes, and patient/coverage drop rates

chimeracoder 1mo ago

> Force hospitals to expose API's with transparent pricing. Unless you're uninsured (which is a whole separate clusterfuck), the hospitals aren't the ones who decide how much you pay for any service - the insurance companies are. The sticker price that hospitals charge is almost meaningless and is intentionally high because it's used as the starting point for negotiations, which always bring the price down (never up). There isn't any expectation that any insurer is actually going to pay the billed amount as-is.

reverius42 1mo ago
It should be illegal to charge different prices for the same thing to different customers.
- DesiLurker 1mo ago
  [dead]
- knollimar 1mo ago
  It's how they negotiate? otherwise you get take it or leave it deals with insurers.
  - reverius42 29d ago
    Hospitals shouldn't have to negotiate with insurers. It should be illegal for an insurer to not pay for a necessary procedure at the hospital's standard rate.
- Hobadee 29d ago
  That's how virtually all industries work though. The computer you are typing on right now probably costs a different amount depending on which retailer you bought it from, even though it's the same manufacturer.
  - reverius42 29d ago
    The fact that it's already common doesn't mean it shouldn't be illegal. And I'm talking more specifically about a single entity selling to multiple customers. If two different retailers want to charge two different prices of course that's fine.

mhb 1mo ago

Fix the principal/agent problem by decoupling health insurance from employment by not having health insurance be paid for with pre-tax dollars.

Glyptodon 1mo ago
I 100% want it decoupled from employment. But it doesn't magically make very sick people capable of comparison shopping either.
- ziofill 1mo ago
  It should never be shopping in the first place. I live in Canada, my family has needed the hospital and the ER a few times and we never ever had to even reach for our wallet.
- mhb 29d ago
  Your example is an edge case. Presumably sick people were once healthy. When people are spending their own money, they become a lot more discriminating. Also, if you're looking for treatment after you're sick, that's not health insurance.
  - Glyptodon 26d ago
    I'd tend to think the majority of healthcare is sought after something happens - car wrecks, cancer diagnosis, sports or exercise injury, stuff like ear infections or strep throat... Healthy people without concerns aren't looking for treatment, they're visiting their PCP once a year.

Glyptodon 1mo ago

Won't matter unless service providers are forced to have one single rate for all payers. Which we can't even manage at grocery stores.

sm-silversight 1mo ago

Yeah I'd like to see this before universal healthcare. I think we can do better than universal healthcare if we start with transparency on pricing to kill graft.

twoodfin 1mo ago

For hospitals (where the majority of US healthcare spending occurs), pricing transparency has been the rule for more than 5 years: https://www.cms.gov/priorities/key-initiatives/hospital-price-transparency https://www.cms.gov/priorities/key-initiatives/hospital-pric...

NoMoreNicksLeft 29d ago

>Legislate transparent pricing for all medications and procedures first. This is an impossible ask. Truly impossible. The medical care providers have spent the last 50 years or more honing the art of making costs inscrutable. Not really to make it harder for you or I to know the costs, but for the insurance companies to know the cost. 50 years is a long time, that's not just one set of workers who have done this, it's 4-6 career spans now... the first to learn it taught it to their underlings and coworkers, who invented new sophisticated techniques and bureaucracies and taught that to the third career generation, who did the same and so on. Even if we had universal healthcare, you're not getting rid of that. It's now a culture. A transmissible, everlasting culture. For any political ask you might come up with, absurd and difficult and even intractable as it might be, this is light years beyond that. God himself couldn't make these prices transparent.

HaloZero 29d ago

Just had a kid, navigation all the procedure codes and everything was insane. I just wanted to figure out what they were charging us for. I just gave up b/c we thankfully hit out out of pocket max for this year.