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Again....a liberal (I'm guessing you're a liberal, right?) discounts a very good move because it won't help EVERYONE seeking treatment at a hospital. What about all the expensive elective procedures (and NO, they are not just cosmetic) that would improve a person's mobility or comfort but could be postponed? This could save those people a ton of money.
Bravo, Mr. Trump.
1) Your wrong about the Liberal part, I think freely outside of your Gang War which is hard for some to fathom or deal with.
2) What discounts are you speaking of? Listing a price does not ensure a discount to anyone, in fact you can get list pricing from many hospital now if you request it. In fact I would expect to see more cartel type pricing as most Hospitals are now under large groups with satellite specialty clinics that ensure business is funneled to their facilities. Outside of a discount from the Surgeon or Anesthesia I don't see any discounts coming. Why would HCA or Keiser (Two big Hospital owners) promote competition between its own hospitals? They will just treat it like a McDonalds and make the high prices standardized like they do now.
3) Now if there was huge public outcry and congress or individual state legislators imposed new regulation to curtail pricing then it might change. But that would mean more regulation that has the potential to cause another problem or reduce quality of service so profits remain the same.
New federal regulations finalized Nov. 15 require hospitals to make public all the prices they negotiate with insurers and health plans, starting in 2021. The aim is to untangle the hospital marketplace with a wave of consumer-friendly information that will promote competition that leads to lower costs.
Hospitals are not happy, but advocates of well-informed, patient-centered health care should be cheering.
...Under the new regulations, hospitals, which account for about one-third of all health care costs, also have to divulge the actual rates paid by health plans and insurers for those same codes.
To help consumers make apples-to-apples comparisons, hospitals will be required to go beyond the individual codes and post their negotiated rates for a list of 300 so-called “shoppable” services that consumers might examine before selecting a provider. This requires hospitals to link services that usually accompany each other, such as laboratory and pathology charges along with surgery.
One of the few instances where a regulation frees up the marketplace.
It is a great idea, but it didn't originate with Trump. Thanks Obama!
Per the Obama White House website: "Established new transparency requirements and a “star rating” system for hospitals, nursing homes, Medicare Advantage plans, physicians, and other providers to give consumers information related to quality and cost"
Actually, it already sort of is. I NEVER attempted to negotiate costs with my providers before Obamacare (since my insurance covered things), but now since I have Obamacare-approved insurance, I'm basically on the hook for everything. I've come to negotiate prices with just about every doctor or provider.
Hint: Suggest to the provider that you pay the reimbursement associated with Medicare. For example: an exam with an ophthalmologist pays the doc $180. So that's what I pay my eye doctor. I've found that all doctors who accept Medicare go along with this.
You need to pull yourself up by the bootstraps and find a better job with better benefits, it seems. Historically low unemployment should make that easier than ever.
Our healthcare plan is is $0 employee contribution and $5K/person yearly deductible.
1) Your wrong about the Liberal part, I think freely outside of your Gang War which is hard for some to fathom or deal with.
2) What discounts are you speaking of? Listing a price does not ensure a discount to anyone, in fact you can get list pricing from many hospital now if you request it. In fact I would expect to see more cartel type pricing as most Hospitals are now under large groups with satellite specialty clinics that ensure business is funneled to their facilities. Outside of a discount from the Surgeon or Anesthesia I don't see any discounts coming. Why would HCA or Keiser (Two big Hospital owners) promote competition between its own hospitals? They will just treat it like a McDonalds and make the high prices standardized like they do now.
3) Now if there was huge public outcry and congress or individual state legislators imposed new regulation to curtail pricing then it might change. But that would mean more regulation that has the potential to cause another problem or reduce quality of service so profits remain the same.
1) I really don't think you should be accusing me of a Gang War after the farce we just witnessed on the House Floor. (And you're clearly a Democrat or you wouldn't make that accusation in the first place.)
2) Are you not able to understand that when hospitals must widely publicize their prices that patients with elective or non-urgent procedures will shop around, and this leads to lower prices overall? And do you think hospitals are all contracted with the same insurance company??
3) Of course there's been a big public outcry. As it stands now, we have to go forward with procedures without knowing what we will have to pay. People have been clamoring for transparency for years.
You need to pull yourself up by the bootstraps and find a better job with better benefits, it seems. Historically low unemployment should make that easier than ever.
Our healthcare plan is is $0 employee contribution and $5K/person yearly deductible.
You've made that same snarky remark before. Are you telling the mooches who are getting free taxpayer-funded insurance to get off their duffs and get a job (or a better job)? NO. Liberals like you reserve your hostility toward people like me, who have worked all their adult lives and never took a cent from the government.
And besides, I'm over 60 and semi-retired and age discrimination is rampant. (And you're talking to an entrepreneur - you know, the type liberals hate - who built a modest but successful company from the ground up.) And I HAD great insurance, quite affordable, until Obamacare ruined it.
And your healthcare plan that is $0 means you're either working for the government OR your salary is lowered to provide the free health insurance. You're paying for it indirectly.
BTW, I think if your employer is "giving" you free insurance - worth at least $10,000 a year - that should be considered taxable compensation.
Actually, it already sort of is. I NEVER attempted to negotiate costs with my providers before Obamacare (since my insurance covered things), but now since I have Obamacare-approved insurance, I'm basically on the hook for everything. I've come to negotiate prices with just about every doctor or provider.
Hint: Suggest to the provider that you pay the reimbursement associated with Medicare. For example: an exam with an ophthalmologist pays the doc $180. So that's what I pay my eye doctor. I've found that all doctors who accept Medicare go along with this.
Hint: They don't pay us that much. When you receive an explanation of benefits from the insurance company saying what we billed out, they don't reimburse as much as the paper says. Everything is hidden. Say we bill Humana $275 for a complete eye exam with glaucoma eval. We don't expect to get $275 and they don't pay us that. If they do, we're very happy. You pay a $50 copayment, the little paper comes back to you with the $275 listed, Humana says they paid $180 (but they didn't), then when they send the actual check back to us they only paid $100. So the doctor happily accepts your $180 because you're paying us more than the insurance without us having to file anything. There is no transparency anywhere. But it's good for business, because it requires a ton of insurance people on the payroll just to keep everything clear as mud
You've made that same snarky remark before. Are you telling the mooches who are getting free taxpayer-funded insurance to get off their duffs and get a job (or a better job)? NO. Liberals like you reserve your hostility toward people like me, who have worked all their adult lives and never took a cent from the government.
And besides, I'm over 60 and semi-retired and age discrimination is rampant. (And you're talking to an entrepreneur - you know, the type liberals hate - who built a modest but successful company from the ground up.) And I HAD great insurance, quite affordable, until Obamacare ruined it.
And your healthcare plan that is $0 means you're either working for the government OR your salary is lowered to provide the free health insurance. You're paying for it indirectly.
BTW, I think if your employer is "giving" you free insurance - worth at least $10,000 a year - that should be considered taxable compensation.
Are you telling me that your anecdotal evidence is somehow "better" than mine?
The rule views healthcare as a commodity, where all providers ( hospitals and surgeons) are equal, ranking, experience and outcomes.
A given surgeon may have performed the necessary procedure 5,411 x vs a surgeon who performs similar procedures twice a week, matters.
The incidence of in hospital acquired infection matters.
It does not take into consideration that no MD has surgical and/ or admitting privileges at all hospitals.
The rule seems to ignore patients do not directly book surgical appointments or hospital rooms like a spa or hotel.
The rule does not compel disclosure of your out of pocket costs. Your insurance plan may have negotiated a better rate with the seemingly higher costing hospital, resulting in lower out of pocket cost. It does not take into consideration your plans annual deductible and what remains.
It does not take timing into consideration. By this I mean if surgery/ hospitalization crosses calendar years, your deductible resets. If your surgeon does not have time in the current calendar year to perform non- urgent surgery or the surgeon’s hospital does not have an OR available, the next available date is January 20.
Surgeon fees are independent of hospital billing. Surgeon fees are variable by MD and also take into the patient’s age and medical condition / history into consideration.
The rule does not take into consideration that while many medical procedures are performed on hospital premises, the actual provider is not the hospital. This is common in the ER, Cancer Treatment, MRI, Mammograms, etc.
As expected, lawsuits have been filed against HHS alleging the rule has no legal authority and violates the 1st Amendment rights of hospitals.
Seems to me the purpose of this rule is two- fold, political and disruptive. The political aspect is obvious in that it creates a sound bite for Trump to demonstrate how he has taken on Big Hospital to reduce cost. He can portray the voters as victims against the big bad hospitals.
There is no question the rule will add costs to hospital overhead. Those hospitals a part of massive healthcare systems have a broader base to amortize cost. Small, independent hospitals, especially in rural areas,will likely choke.
I am far more intrigued by the “ disruptive” aspect of the rule.
How exactly would a consumer use this information?
Patients do not directly schedule surgical procedures or book hospital rooms.
Mds do not have operating and/ or admitting privileges at all hospitals.
Let’s assume your Primary Care MD refers you to a surgeon for a hernia. Surgeon determines it must be surgically removed in the hospital outpatient surgical center where most surgeries are performed.
I go to the hospital’s website and locate the procedure and associated stuff and the base price is $ xx,xxx. Then I do some online shopping and find other hospitals have posted different prices, some more and some less.
Neither price has anything to do with how much the procedure is going to cost me out of pocket. The hospital posting $xx,xxx may be substantially less than the hospital charging $yy,yyy because of negotiated rates between my insurance plan and the hospital.
My surgeon does not have operating privileges at the seemingly lower priced hospitals so I will need to schedule an appointment with a different surgeon which results in a bill.
My surgeon does not have privileges at the lower costing hospital. So now I have to find a surgeon who is affiliated with the lower priced hospital and make an appointment and in doing so incur incremental cost.
" Big Win... Hospitals Must Disclose Prices Starting in 2021 "
I'm liking this a lot, also liking that pharmacies can talk to us about other pricing. Let's keep the ball rolling.
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