Trump signs order that aims to reveal real health care costs

Mr Person said:

If I get my arm torn off I can price shop for the best local hopsital.

Yay!

Click to expand...

Maybe in a couple of years, after the industry approved "rule makers" are told what they really wanted to do.

How is this going to work when it's unknown upfront how much it's going to cost? E.g. until surgeon goes in, they may not know the extent of the work needed and the costs. Until lab work up the result, they don't know the complexity of the analysis involved (as it depends on what they find in the specimen and how hard it becomes to diagnose). Until the tests are run in ER, it's not clear what the treatment is or how much the treatments will cost or what other, follow up tests will require.

dobieg said:

Trump signs order that aims to reveal real health care costs



It's about time someone had the balls to do this and honestly I'm not sure why it wasn't done a long time ago but most of us can guess why.


I also love the argument that insurers are using that posting prices will drive up prices. As if free market competition has ever done anything but drive prices down. Perhaps some of these insurers have some old executives from the former Bell telephone company.

Click to expand...

It's a start, there needs to be much more transparency in our healthcare system. It isn't limited to just the hospitals, though they are part of it. Big Pharma, Big Insurance, etc. all have effects that have led to the insane ballooning of our healthcare costs. We really need transparency in all of it.

I'm not sure how much this will help in and of itself, it's good to get some transparency. But the problem is so large and so complex, it's not going to be solved with something as simple as this disclosure order.

Trump said:

in England your age will tell you if state will spend money on you after heart attack...just saying

Click to expand...

B.S. They have better life expectancy than we do . You know nothing about universal HC.

Checkerboard Strangler said:

If there is follow through on this then I expect that in some situations people will begin to try to shop for their healthcare a little more like they do for other goods and services.

Click to expand...

This model makes a lot more sense for preventative care; something sorely lacking in this country.

Moderate Right said:

There is a reason why voters voted out over 1000 Democrats after Obama took office. Fact is, Americans often vote in divided government because they don't want either party to have full control.

Click to expand...

The stupidity of voters is another topic.

SenorXm/Sirius said:

Yep, that's why the 'free market' and competition will NEVER work in the HC industry. A child has cancer and the child's mother and father are going to run around looking for the cheapest doctor and medicine and treatment? ah NO!! They want the best. Damn the costs..

Click to expand...

So...if I understand you guys correctly, you're ok with being robbed when the hospital has you by the short and curlies?

iguanaman said:

The stupidity of voters is another topic.

Click to expand...

There you guys go yet again, calling voters stupid and then expecting them to vote for you. Great strategy.

Moderate Right said:

There you guys go yet again, calling voters stupid and then expecting them to vote for you. Great strategy.

Click to expand...

Yes voting against your best interests is not too smart. Only those in the 1% benefit from voting GOP.

dobieg said:

I also love the argument that insurers are using that posting prices will drive up prices. As if free market competition has ever done anything but drive prices down. Perhaps some of these insurers have some old executives from the former Bell telephone company.

Click to expand...

It can when it enables tacit collusion.

The Danish government, in an effort to improve competition in the early 1990s, required manufacturers of ready-mix concrete to disclose their negotiated prices with their customers. Prices for the product then rose 15 percent to 20 percent.

The reason, scholars concluded, is that there were few manufacturers competing for business. Once companies knew what their competitors were charging, it was easy for them to all raise their prices in concert. They could collude without the sort of direct communication that would make such behavior illegal. It wasn’t easy for new companies to undercut the existing ones, because the material hardens so fast that you can’t ship it far.

Click to expand...

Research on gasoline markets has likewise found that publicizing prices appears to enable collusion in places where there are only a few competitors. But among more plentiful Israeli supermarkets, a database of prices appears to have lowered them.

Scholars at the Federal Trade Commission put out a paper in 2015 cautioning against the kind of price transparency that the president is embracing. Guess what paper showed up in the footnotes?

Click to expand...

The reality is that it's not really clear what impact making negotiated rates public would have, if any.

The key thing to remember is that consumer prices in the usual sense don't exist in health care. A given service from the same provider will have a different price depending on who the insurer picking up the tab is--that is, after all, why those negotiated rates are treated as secret and proprietary in the first place. One of the things you're buying from your insurer when you choose a plan and pay it a premium is access to the prices it has negotiated for its provider network. Layer on to that mélange of payer-specific prices the reality that the consumer making the choice pays a value determine by the benefit design of his particular plan, which probably is not the actual negotiated price, in any given circumstance and the concept of a consumer "price" gets even muddier.

The market, as it's set up today, isn't really designed for this sort of thing. If we want to go in this direction, we probably need to require providers to offer all-payer rates that are the same regardless of who walks in the door and which insurer they have. Which arguably blows up the concept of managed care competition in insurance markets that's underpinned the concept of multipayer insurer competition for a long time.

roughdraft274 said:

I'll have to see the full details when I have more time, and I fully understand that this will not be a silver bullet, but in general I think this is a good idea.

Click to expand...

There aren't any details, this is just a directive for HHS to work on this and see if they can figure out how to do it. May well be that nothing ever comes of it.

Slavister said:

How is this going to work when it's unknown upfront how much it's going to cost? E.g. until surgeon goes in, they may not know the extent of the work needed and the costs. Until lab work up the result, they don't know the complexity of the analysis involved (as it depends on what they find in the specimen and how hard it becomes to diagnose). Until the tests are run in ER, it's not clear what the treatment is or how much the treatments will cost or what other, follow up tests will require.

Click to expand...

That's a good question. Gets at the same point I was making above, namely that the system isn't really designed for consumer shopping at present. If we wanted to push in that direction, we'd probably need providers to offer and market distinct care bundles that are more or less all-inclusive for a given category of services. Listing a dozen different negotiated rates for a particular CPT code a given person may not know is relevant to them probably isn't very meaningful.

Buzz62 said:

So...if I understand you guys correctly, you're ok with being robbed when the hospital has you by the short and curlies?

Click to expand...

It has very little to do with what people are okay with. It’s just the simple fact that so-called free market principles don’t work in the healthcare industry because there’s no such thing as a consumer price ceiling for goods and services people literally cannot live without. People will pay anything and healthcare industry takes advantage of that.

Greenbeard said:

There aren't any details, this is just a directive for HHS to work on this and see if they can figure out how to do it. May well be that nothing ever comes of it.

Click to expand...

Figures. Par for the course.

Sent from my SAMSUNG-SM-G920A using Tapatalk

Captain Adverse said:

I agree we have a major problem with healthcare costs. Something politicians aren't trying to deal with, thanks to the healthcare lobbies. Instead it seems our politicians keep trying to figure out how to pay more via taxpayer dollars.

Here is an interesting "Real Doctor Reacts to 'Adam Ruins Healthcare.'"



IMO there are lots of things we need to be dealing with regarding the entire Healthcare Industry, from Hospitals through Pharmaceutical companies to Insurance companies.

Just throwing more taxpayer dollars at the problem is not the simple solution.

Click to expand...

IMHO, the same factors that are causing the costs involved in healthcare to rise exponentially are causing education costs to rise exponentially.

Simply finding a way to pay the exorbitantly high costs does not address the cause of the rising costs.

Too much free money chasing the available product for sale is the issue. If nobody asks for a lower rate, nobody is going to get it.

"Getting in" is the only consideration as evidenced by the recent entrance scandals and the movie stars paying the gatekeepers.

Medicine is like education in terms of distribution. if you think it costs a lot now, just wait until it's free!

Napoleon said:

It has very little to do with what people are okay with. It’s just the simple fact that so-called free market principles don’t work in the healthcare industry because there’s no such thing as a consumer price ceiling for goods and services people literally cannot live without. People will pay anything and healthcare industry takes advantage of that.

Click to expand...

America has this hard-on for free market healthcare. As long as that continues, the hospitals and the rest of the industry are gonna screw you. Trump is trying things to help but Libbies just wanna call him names, regardless of his efforts. Instead of doing something, they whine and cry about Obamacare, which was a dumb effort.

Moderate Right said:

Only trouble is much of this doesn't work for a number of reasons. First off, when you're sick or elderly or have an emergency this is just way too much work. Second of all, it's just not realistic to say that I'll take this doctor to do this surgical procedure but I want it done at place x and I want this anesthesiologist but I want meds from this other place. Often times one thing is in network while others may not. Many patients are under a barrel when having healthcare issues and can't make decisions.

Click to expand...

The same can be said of any person that is not educated in the required topic matter when buying a car or a BBQ Grill.

iguanaman said:

Because when we are dying the first thing we think of is "How much will it cost to live" I want to shop around to save a few bucks if I have a heart attack.

Click to expand...

I have had medical procedures to avert death twice in my life. I'm 66. For better or worse, they worked.

I would guess that there has never been a year in my life during which I did not see a doctor. As I age, the visits to medical professionals are more frequent.

So, conservatively, it is safe to calculate at least 132 visits to medical professionals with 2 of them being ER type visits.

That calculates to 1.5% of the time being emergency and 98.5% of the time being planned, elective types of visits. It is the 98.5% of the visits that can be shopped safely.

I would imagine that even a course of treatment like cancer or dialysis is shop-able after the first diagnosis. I hope I will never need to find out.

Trump said:

in England your age will tell you if state will spend money on you after heart attack...just saying

Click to expand...

In the UK the life expectancy is 80.54 years. In the US the life expectancy is 79.68 years.

A better comparison would be between Canada and the US because their cultures and life styles are so similar. In Canada the life expectancy is 81.76 years (and in the US it is still 79.68 years).

However, another metric is "Healthy Average Life Expectancy" and for the US that is a phenomenal 68.5 years while it is a mere 71.9 in the UK and a pitiful 73.2 in Canada.

Obviously the SOCIALIST MEDICAL SYSTEMS in Canada and the US are resulting in hundreds of thousands of people dying when they shouldn't (and when they wouldn't if those Socialist Monarchies were to adopt the vastly superior American model).

code1211 said:

The same can be said of any person that is not educated in the required topic matter when buying a car or a BBQ Grill.

Click to expand...

But you don't usually ever buy a car or a BBQ Grill while you are sick and many of the elderly just can't do this stuff. And when you are buying a car or a BBQ Grill you are just talking about dealing with one thing. In health care you are dealing with several issues all at once. It's just not realistic to say that I'll take this doctor to do this surgical procedure but I want it done at place x and I want this anesthesiologist but I want meds from this other place. Often times one thing is in network while others may not be.

code1211 said:

IMHO, the same factors that are causing the costs involved in healthcare to rise exponentially are causing education costs to rise exponentially.

Simply finding a way to pay the exorbitantly high costs does not address the cause of the rising costs.

Too much free money chasing the available product for sale is the issue. If nobody asks for a lower rate, nobody is going to get it.

"Getting in" is the only consideration as evidenced by the recent entrance scandals and the movie stars paying the gatekeepers.

Medicine is like education in terms of distribution. if you think it costs a lot now, just wait until it's free!

Click to expand...

The US spends around $9,892 per capita annually on health care.

Canada spends around $4,753 per capita annually on health care.

Both the "Life Expectancy at Birth" and the "Healthy Average Life Expectancy" in Canada exceed those for the US and the Canadian health care system is constantly ranked as superior to that of the US.

[NOTE - When considering a health care system, the way that the system works for the WHOLE of the country's population is considered and not just the way that it works for the economically/politically advantaged class in the country.]

AliHajiSheik said:

I would prefer that insurers publish typical covered costs for procedures and align that with what hospitals charge.

Click to expand...

Yes, totally. It will never happen though, and we already know why.

Moderate Right said:

But you don't usually ever buy a car or a BBQ Grill while you are sick and many of the elderly just can't do this stuff. And when you are buying a car or a BBQ Grill you are just talking about dealing with one thing. In health care you are dealing with several issues all at once. It's just not realistic to say that I'll take this doctor to do this surgical procedure but I want it done at place x and I want this anesthesiologist but I want meds from this other place. Often times one thing is in network while others may not be.

Click to expand...

The decisions regarding those types of things would need to be made beforehand using information and knowledge of trusted medical professionals and any other helpful sources.

The Primary Care Physician operating as a part of a network in most cases would need to assume some fiduciary-like responsibility. Mine currently does especially as regards prescription medicines.

In Indianapolis, there is a very robust hospital network involving various providers. I know that very small communities do not afford that kind of choice. However, Indy also has various sources for cars and BBQ Grills.

Being an informed consumer carries with it responsibilities. These can be abdicated. If they they are not available, though, abdication is not an option.

TU Curmudgeon said:

The US spends around $9,892 per capita annually on health care.

Canada spends around $4,753 per capita annually on health care.

Both the "Life Expectancy at Birth" and the "Healthy Average Life Expectancy" in Canada exceed those for the US and the Canadian health care system is constantly ranked as superior to that of the US.

[NOTE - When considering a health care system, the way that the system works for the WHOLE of the country's population is considered and not just the way that it works for the economically/politically advantaged class in the country.]

Click to expand...

Very true! Increased expense does not guarantee enhanced quality.

As long as the insurance companies in the US pay the bills and the customers are "kept in the dark" ordering the procedures without question, the prices will only continue to rise.

When comparative costs are published showing the differences between domestic providers, showing the cost of the same procedures in Canada, EU or Britain or wherever would probably also be helpful.

More information when making a decision is a good thing.

I would prefer "insurers" not exist at all. They're fraudsters profiteering off of human misery. If ever there was an endeavor more soulless, I have not seen it.

code1211 said:

Very true! Increased expense does not guarantee enhanced quality. As long as the insurance companies in the US pay the bills and the customers are "kept in the dark" ordering the procedures without question, the prices will only continue to rise. When comparative costs are published showing the differences between domestic providers, showing the cost of the same procedures in Canada, EU or Britain or wherever would probably also be helpful. More information when making a decision is a good thing.

Click to expand...

You MIGHT be able to get "comparative cost" figures from the UK or the EU, but you won't get them from Canada because the only figure that the Canadian system provides is an "average cost per diem" and that lumps "Bob" who is staying one more day after recovering from the flu so that the lab results can come back and "Betty" who is being rushed in for emergency cardiac surgery in on an equal basis.

TU Curmudgeon said:

You MIGHT be able to get "comparative cost" figures from the UK or the EU, but you won't get them from Canada because the only figure that the Canadian system provides is an "average cost per diem" and that lumps "Bob" who is staying one more day after recovering from the flu so that the lab results can come back and "Betty" who is being rushed in for emergency cardiac surgery in on an equal basis.

Click to expand...

Any information is more helpful than no information as long as it is understood for what it is.